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Laser Acupuncture Before and After Embryo Transfer Improves ART Delivery Rates study

admin — Thu, 14 Jan 2010 00:13:59 +0000

Laser Acupuncture Before and After Embryo Transfer Improves ART Delivery Rates: Results of a Prospective Randomized Double-Blinded Placebo Controlled Five-armed Trial involving 1000 Patients.

J.L. Fratterelli, M.R. Leondires, K.Fong, A Theall, S. Locatelli, R.T. Scott, Reproductive Medicine Associates of new Jersey, Morristown, NJ

OBJECTIVE: Acupuncture has been advocated for the treatment of infertility, including immediately prior to and after transfer. Unfortunately, data are conflicting and adequate studies with appropriate controls are lacking. This study evaluates 2 forms of acupuncture on outcomes in ART patients.

DESIGN: Prospect randomized double blind and placebo controlled.

MATERIALS AND METHODS: On the day of transfer, participants were randomly assigned to a study group; needle acupuncture (AC), laser acupuncture (LZ AC), sham laser acupuncture (LA sham), relaxation (RX), or not treatment (NT). The AC and LZ AV puncture groups were considered treatment groups, the RX controls for the additional rest before and after transfer, and NT is the non-intervention groups. Most significantly, the LZ sham group provided an important control group. The laser acupuncture device was randomly preprogrammed per case to either fire (and provide LZ AC) or to not fire and thus provide a true double blind control group (LZ sham). It was not possible for the patient of acupuncturist to know if the laser fired. No contact occurs with the patient in laser acupuncture so there is no acupressure effect of contact with the wrong meridians. All treatments were administered for 25 minutes before and after embryo transfer. Out comes were compared by Chi-square and multiple logistic regression analysis to control for the potential confounders including female age, embryo quality, and day of transfer (Table 1).

RESULTS: All treatments were well tolerated. No differences in terms of patient demographics, cycle type, stimulation outcomes, embryo number and quality, day of embryo transfer, transferring physician, or acupuncturist were found between the 5 study groups. Implantation rates were significantly improved with laser acupuncture. Traditional needle acupuncture had outcomes equivalent to the 3 control groups. Subanalyses of patient age and embryo transfer day produced similar findings with laser acupuncture enhancing outcome rates.

CONCLUSIONS: This large prospective randomized and well controlled study consistently demonstrated benefit to LZ AC. Treatment was well tolerated and significantly improved implantation rates.

Table 1. Clinical outcomes (%)

Rates	AC(n=200)	LZ AC(n=202)	LZ Sham(n=198)	RX(n=203)	NT(n=197)	PValues
Implantation	28.9	33.7	26.8	24.9	30.2	<0.05
Chemical Pregnancy	61.5	60.9	53.0	53.7	60.4	0.22
Clinical Pregnancy	51.5	54.5	43.9	45.3	50.3	.019
Ongoing Pregnancy/Delivery	39.0	42.1	34.4	37.4	39.6	0.71

Supported by: EMD Serono
Reproduced from: Fertility and Sterility

Changes in serum cortisol and prolactin associated with acupuncture during IVF

admin — Tue, 12 Jan 2010 12:57:55 +0000

Conclusion: The researchers found that the women who had acupuncture showed beneficial changes in serum levels of stress hormones compared to the control group of women who did not have acupuncture. This may have implications for both egg quality and implantation. In addition the pregnancy and live birth rate was significantly higher in the acupuncture group.

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A number of women going through IVF were given acupuncture to increase blood flow through the uterine arteries in the immediate weeks before egg collection. The researchers found that the women who had acupuncture showed beneficial changes in serum levels of stress hormones compared to the control group of women who did not have acupuncture. The acupuncture treatments appear to normalize levels of cortisol and prolactin which have been artificially depressed by the IVF drugs. This may have implications for both egg quality and implantation. In addition the pregnancy and live birth rate was significantly higher in the acupuncture group.

Magarelli, PC, D Cridennda, M Cohen. Fertil Steril 2009 in press Fertility and Sterility

Abstract

Objective: To determine whether changes in serum cortisol (CORT) and PRL are affected by acupuncture (Ac) in Ac-treated IVF patients.
Design: Prospective cohort clinical study.
Setting: Private practice reproductive endocrinology and infertility clinic and private practice acupuncture consortium.
Patient(s): Sixty-seven reproductive-age infertile women undergoing IVF.
Intervention(s): Blood samples were obtained from all consenting new infertility patients and serum CORT and serum PRL were obtained prospectively. Patients were grouped as controls (IVF with no Ac) and treated (IVF with Ac) according to acupuncture protocols derived from randomized controlled trials.
Main Outcome Measure(s): Serum levels of CORT and PRL were measured and synchronized with medication stimulation days of the IVF cycle (e.g., day 2 of stimulation, day 3, etc.). Reproductive outcomes were collected according to Society for Assisted Reproductive Technology protocols, and results were compared between controls and those patients treated with Ac.
Result(s): CORT levels in Ac group were significantly higher on IVF medication days 7, 8, 9, 11, 12, and 13 compared with controls. PRL levels in the Ac group were significantly higher on IVF medication days 5, 6, 7, and 8 compared with controls.
Conclusion(s): In this study, there appears to be a beneficial regulation of CORT and PRL in the Ac group during the medication phase of the IVF treatment with a trend toward more normal fertile cycle dynamics. (Fertil Steril 2008;-:-–-. 2008 by American Society for Reproductive Medicine.)
Key Words: IVF, acupuncture, cortisol, prolactin, pregnancy, traditional Chinese medicine, TCM

Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy

admin — Sun, 10 Jan 2010 06:27:35 +0000

Conclusion: Acupuncture seems to be a useful tool for improving pregnancy rate after ART. Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.

Paulus W et al, Fertil Steril 2002 Vol 77, pg 721-724 Fertility and Sterility

OBJECTIVE: To evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy (ART) by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no acupuncture.

DESIGN: Prospective randomized study.

SETTING: Fertility center.

PATIENT(S): After giving informed consent, 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through random selection: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80).

INTERVENTION(S): Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy.

MAIN OUTCOME MEASURE(S): Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer.

RESULT(S): Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.

Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture

admin — Sat, 09 Jan 2010 02:50:56 +0000

Conclusion: This study reported in Human Reproduction (the official journal of the European Society of Human Reproduction and Embryology) shows that after 8 acupuncture treatments blood flow to the uterus was markedly increased.

Stener-Victorin E, et al Hum Reprod 1996; 11:1314-1317. Human Reproduction

Abstract:
In order to assess whether electro-acupuncture (EA) can reduce a high uterine artery blood flow inpedance, 10 infertile but otherwise healthy women with a pulsatility index (PI) ≥3.0 in the uterine arteries were treated with EA in a prospective, non-randomized study. Before inclusion in the study and throughout the entire study period, the women were down-regulated with a gonadotrophin-releasing hormone analogue (GnRHa) in order to exclude any fluctuating endogenous hormone effects on the PI. The baseline PI was measured when the serum oestradiol was ≤0.1 nmol/l, and thereafter the women were given EA eight times, twice a week for 4 weeks. The PI was measured again closely after the eighth EA treatment, and once more 10-14 days after the EA period. Skin temperature on the forehead (STFH) and in the lumbosacral area (STLS) was measured during the flrst, fifth and eighth EA treatments. Compared to the mean baseline PI, the mean PI was significantly reduced both shortly after the eighth EA treatment (P < 0.0001) and 10-14 days after the EA period (P < 0.0001). STFH increased significantly during the EA treatments. It is suggested that both ot these effects are due to a central inhibition of the sympathetic activity.