Effect of acupuncture vs sham acupuncture on live births among women undergoing in vitro fertilization: a randomized clinical trial

Caroline Smith et al, JAMA, 2018 DOI: 10.1001/jama.2018.5336

Journal of the American Medical Association.

 

848 women at 16 different IVF centres in Australia and New Zealand were given acupuncture (with real or sham needles)  by 80 different acupuncturists. A standardised protocol was delivered on Day 6 of the stimulation phase and another at some point before and after the embryo transfer. The data indicated that at this dose of acupuncture, and using these protocol points, there was no significant difference in live births between those who received the real or the sham needles.

The authors admit that ” the lack of frequent treatments was a limitation of our trial” since in real clinical practice acupuncture treatment is individualised with variation in dosing, including more frequent treatment prior to and during the IVF cycle.

They also noted that while a very short course of acupuncture may statistically be no better than sham at improving live birth and pregnancy outcomes, a psycho-social benefit from acupuncture was reported by women undergoing IVF.

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Electroacupuncture for reproductive hormone levels in patients with diminished ovarian reserve: a prospective observational study

Yang Wang et al, 2016, BMJ Acup Med, Vol 34, Issue 5

BMJ Acupuncture in Medicine

 

This study from Beijing examined the effect of electro-acupuncture on women who were diagnosed with poor ovarian reserve, indicated by their baseline FSH level being elevated on Day 2 or 3 of their menstrual cycle, ie between and 11 and 40 mIU/ml.

After 12 weeks of treatment mean FSH levels dropped by nearly a half, a highly significant result.

 

 

 

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Effects of transcutaneous electrical acupoint stimulation on ovarian reserve of patients with diminished ovarian reserve in in vitro fertilization and embryo transfer cycles.

Zheng Y et al, J Obstet Gynaecol Res. 2015 Dec;41(12):1905-11

The Journal of Obstetric and Gynecological Research

 

240 women with poor ovarian reserve who were undergoing IVF treatment, were divided into either a group that received electrostimulation to acupuncture points or into a control group. The study showed that the 56 women who received the electrostimulation to acupuncture points had a significantly higher clinical pregnancy rate than the other groups. This is an encouraging finding for these patients since it is often thought that not much can be done to improve the chances of IVF patients with low ovarian reserve.

 

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Prior to Conception: The Role of an Acupuncture Protocol in Improving Women’s Reproductive Functioning

Cochrane S et al,  Evid Based Comp and Alt Med, 2016, Article ID 3587569, 11 pages

Evidence-Based Complementary and Alternative Medicine

 

Acupuncture as a modality to improve fertility in women who had been trying to conceive for a year or more without success, was assessed in this review. It shows that women receiving acupuncture tend to conceive more rapidly than those in a control group. Read More

Effects of traditional Korean medicine on anti-Mullerian hormone inpatients with diminished ovarian reserve: A retrospective study

Acupuncture-Pregnancy-307Junyoung Jo et al, Comp  Ther  Med  24 (2016) 118–122

Complementary Therapies in Medicine, Elsevier

 

This Pilot study examined the effect of taking traditional herbal formulas for fertility in 22 women who had very low ovarian reserve (measured as AMH <1.1ng/ml). They found that 2 months of taking the herbal formulas increased the AMH significantly (double)  in women below 38 years of age, but not over this age. This study now needs to be repeated with a larger number of women.

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Effect of Zishen Yutai Pill on Embryo Implantation Rate in Patients Undergoing Embryo Transfer

Acupuncture-Pregnancy-369

ZHU Wen-jie et al, C JIM (Chin) 2002;22(10) ‘ 729

Chinese Journal of Integrative Medicine

 

70 IVF patients were given Zi Shen Yu Tai pills (a famous traditional remedy for miscarriages) after their embryo transfer and success rates were compared with 70 women who were given usual care only. The Chinese herb formula was seen to significantly improve the implantation and pregnancy rate.

 

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Traditional Chinese Medicine, the Zishen Yutai Pill, Ameliorates Precocious Endometrial Maturation

Acupuncture-Pregnancy-401Qi Gao et al, EB Comp and Alt Med, 2015, Article ID 317586, 10 pages

Evidence-Based Complementary and Alternative Medicine

 

Following on from earlier research which showed that Zi Shen Yu Tai pill ( a famous remedy for recurrent miscarriage) could improve implantation rates in IVF patients, these researchers decided to investigate the mechanism. They found that this formula increased the expression of HOXA10, an important marker of uterine receptivity.

 

 

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Transcutaneous electrical acupoint stimulation improves outcomes of in vitro fertilization by increasing neuropeptide Y levels: A RCT

1-s2.0-S1876382015X00023-cov150hFan Qu et al, EuJIM, 2015 Vol 7, Suppl 1, p 18

European Journal of Integrative Medicine,

 

Electrical stimulation of acupuncture points has proved to help success rates of frozen embryo transfer cycles in previous clinical trials, with evidence of improvement in the structure of the uterine lining. In this trial the levels of a certain neuropeptide was increased in the follicles of IVF patients who received electro-stimulation 2/100Hz and in the same women, the pregnancy rate was significantly improved.

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Effect of transcutaneous electrical acupuncture point stimulation on endometrial receptivity in women undergoing frozen-thawed embryo transfer: a single-blind prospective randomised controlled trial

Acupuncture-Pregnancy-447  Shuai Z, et al. Acupunct Med 2014;0:1–7. doi:10.1136

 Acupuncture in Medicine, BMJ

 

Mild electrical stimulation of acupuncture points on the abdomen and legs, in the three cycles leading up to a  frozen embryo transfer, significantly improved rates of implantation, clinical pregnancy and live births compared  to control groups. Ultrasound showed that the treatment improved the structure and quality of the uterine lining. Read More

Oocyte quality improvement using a herbal medicine comprising 7 crude drugs

Inoue T et al, OJOG, Vol. 3, No. 1A (2013)
Open Journal of Obstetrics and Gynecology

 

This pilot study recruited women with very poor fertility outlooks. They had suffered repeated IVF failures and were in their late 30s. However when they took Chinese herbs during a subsequent IVF cycle, some of these women became pregnant.

 

 

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Acupuncture and Chinese herbal treatment for women undergoing intrauterine insemination

Sela K et al, Eur Jn Int Med, Vol 3, 2, 2011, Pgs e77–e81
European Journal of Integrative Medicine

 

Many couples prefer to try less invasive methods before doing IVF. IUI is one such method, that involves insemination of washed sperm to the uterus at precisely the time of ovulation. In this study women who were being treated with acupuncture and Chinese herbs, had a 50% higher pregnancy rate than those who weren’t. 

 

 

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Acupuncture and in vitro fertilization: a retrospective chart review.

Hullender R et al J Altern Complement Med. 2013 Jul;19(7):637-43.
Jnl Alternative and Complementary Medicine

 

In this interesting observational study, women receiving embryos from donor eggs, were given acupuncture on the day of transfer, and live birth rates were compared with a similar control group. 87% of the women who received donor egg embryos and had acupuncture had a baby compared with 66% in the donor group that did not have acupuncture.

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