About 1 in 6 couples have difficulty conceiving and seek specialist fertility treatment. There are various treatments available depending on the causes of the infertility. In vitro fertilisation (IVF) is one of the most successful treatments for couples with infertility. Since IVF technique was developed 30 years ago, it helped many couples to achieve pregnancy. In 2003 over 120000 IVF treatment cycles were carried out in clinics in the USA. According to the European Society of Human Reproduction and Embryology, over 300000 treatment cycles of IVF and intracytoplasmic sperm injection (ICSI) were performed each year in Europe. In 2000, about 200000 babies worldwide were conceived through IVF. However, the success rate of IVF is still not satisfactory. IVF also is expensive, lengthy and stressful. It also affects physical and mental health. To improve IVF success rate, reduce stress, anxiety and depression, acupuncture became a popular IVF assistant technique for women undergoing IVF. A survey to study the state of acupuncture treatments in assisted reproductive technology in fertility centers in Swiss, German and Austrian fertility centers has shown 40% fertility centers offer acupuncture treatments. In these centers acupuncture points selected were standardized and acupuncture was performed by physician-acupuncturist.
The main causes of infertility in the UK are unexplained infertility (no identified male or female cause) (25%), ovulatory disorders (25%), tubal damage (20%), factors in the male causing infertility (30%), uterine or peritoneal disorders (10%). In about 40% of cases disorders are found in both the man and the woman.
In 2011, 48,147 women had a total of 61,726 cycles of IVF or intracytoplasmic sperm injection (ICSI) and 2,087 women had a total of 4,091 cycles of donor insemination. A total of 89,648 embryos were transferred during the course of fertility treatment which started in 2011. A total of 13,703 pregnancies were reported as a result of IVF treatment which started in 2011. In the UK, 201,811 babies have been born after IVF treatment between 1991 and 2010. Of the women who received fertility treatment during 2011, they were, on average, 35-years-old and had been trying to conceive for around 4 years (4.6 for IVF, 4 for donor insemination). Four in ten (40.3%) IVF treatment cycles were funded by the NHS in 2011. Acupuncture for infertility treatment is increased from 2.5% in 2002 to 13% in 2009.
Acupuncture helps IVF step by step.
Before egg collection, acupuncture helps follicles (egg) development improving egg quality and uterine lining. Research has shown that IVF egg maturation rate, fertilization rate and good quality embryo rate and implantation rate and the pregnancy rate was increased with acupuncture treatment.
After egg collection, acupuncture continues to help uterine lining development to get ready for embryo implantation. Research has shown that IVF implantation rate and pregnancy rate was higher with acupuncture treatment.
The first report that acupuncture increased IVF success rate was from Stener-Victorin et al in 1999. They applied acupuncture before occytes collection. They found that women in acupuncture group had significantly higher implantation rate, pregnancy rate and live birth rate in IVF embryo transfer. Eric Manheimer et al did first systematic review published in BMJ to investigate the effects of acupuncture on pregnancy rates and live birth rates among women with infertility undergoing IVF. They analysed seven trials involved in 1366 women undergoing IVF. All trials were conducted in four different Western countries and published in English since 2002. In all trials, women received acupuncture immediately before or immediately after the embryo transfer. The acupuncture points selected in all trials are fixed and the acupuncture sessions lasted 25-30 minutes. Clinical pregnancy, ongoing pregnancy and live birth rates were improved. There was no side effect found. Recently a new review found that there were 5 studies involved 463 women who were undergoing IVF. They were given acupuncture twice a week for 2 weeks during the controlled ovarian hyperstimulation period for IVF. The pregnant rate was higher in acupuncture group than that in control group for women undergoing IVF.
Acupuncture helps reducing stress and anxiety in women undergoing IVF.
Research studied the effect of acupuncture on symptoms of anxiety in women undergoing IVF. 43 patients participated in the study. After 4 week treatment the anxiety score for acupuncture group was significantly lower than for the control group. There is perceived stress on the day of embryo transfer (ET). There was a study on the effect of acupuncture on perceived stress and pregnancy rate on the day of ET. In this study, 57 patients with infertility and undergoing IVF or IVF/ISI were involved. Women who received acupuncture treatment achieved 64.7% pregnancy rate while those who didn’t receive acupuncture treatment had 42.5% pregnancy rate. Women with acupuncture had lower stress score both pre-ET and post-ET compared to those without acupuncture. Women with lower stress score had higher pregnancy rate.
Acupuncture helps succeed in first round IVF
A 39 year old woman has been trying to conceive for a year and half. Her husband’s sperm was good. She was very stressed from this. Also she worked very hard and work stress was enormous too. Her fertility test was absolutely normal. Her period was 28-29 days. However she did ovulate a bit early in about day 11 checked by ovulation kit test. Her period was light lasting for 3 days. She also had chronic diarrhea about two to three times a day. She decided to try acupuncture to help with conceiving. She had acupuncture treatment on weekly basis. With the treatment progress, her ovulation was changed to day 12 and then day 13. Her diarrhea was disappeared. Her bowel movement was once a day and no longer loose. Her period last 5 days. Her stress level was decreased and she felt more relaxed. After three month acupuncture treatment, she felt a lot better, but she was still not pregnant. She decided to go ahead for IVF, because age was not on her side and she did not want to wait to get pregnant naturally. She was continuing another two month acupuncture treatment while planning IVF. During the IVF procedure, everything was going smoothly. She had 12 eggs retrieved and 11 of them were fertilised. One of the embryo was transferred and pregnancy test was positive after two weeks waiting.
Acupuncture can help next IVF success after failed IVF.
Recently a research paper has shown that acupuncture increased pregnancy rate in women with previous failed IVF cycles. In this study, there were 84 patients participated the study. These patients had at least two unsuccessful attempts of IVF cycles. The predicted success rate for these patients was 10% for this group of patients. Acupuncture was performed on the first and seventh day of ovulation induction, on the day before egg collection and on the day after embryo transfer. The result has shown that the clinical pregnancy rate in the acupuncture group was significantly higher than that in the control and sham groups (35.7%, 7.1% and 10.7% respectively).
Acupuncture helps decrease ovarian hyperstimulation syndrome during IVF
Ovarian hyperstimulation syndrome (OHSS) is a serious side effect during the procedure of IVF treatment. It occurs in women who are very sensitive to the fertility drugs. Too many eggs develop in the ovaries, which become very large and painful. Abdominal pain, nausea and diarrhoea are common symptoms. Can acupuncture help reduce the chance of OHSS? Recently a research studied the effect of acupuncture on clinical outcomes and the occurrence of OHSS in IVF. 109 patients were divided into two groups: control and acupuncture group. Patients in the control group received controlled ovarian hyperstimulation (COH) referring to GnRH-a long protocol. On the basis of COH, those in the EA group received EA from the day of Gn injection to the day of embryo transfer. Blood tests were monitored on the day of hCG injection, the day of egg collection and the day of embryo transfer. The oocyte retrieval rate, good quality embryo rate, clinical pregnancy rate, the abortion rate, and the occurrence of OHSS were compared between the two groups. Compared with the control group, serum oestrogen E2 levels on the day of egg collection and the day of ET were significantly lower in the EA group. vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) significantly decreased compared with control group on the day of hCG injection, on the day of egg collection and embryo transfer. The occurrence of OHSS and the canceling rate of transplant cycle were significantly lower in the EA group than in the control group. The research suggested that acupuncture as an adjunctive therapy, could reduce the occurrence of OHSS in IVF.
References
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