Acupuncture and In Vitro Fertilization:
Does the Number of Treatments Impact Reproductive Outcomes?
D.K.
Cridennda L.Ac.(1), P.C. Magarelli MD, Ph.D. (2) , and M. Cohen, MBA
(2).
.(1), East Winds Acupuncture Colorado Springs, CO; (2) Reproductive
Medicine & Fertility Center, Colorado Springs, CO
Objective: The purpose of this study was to determine the optimal
number of acupuncture treatments that provide the patient with the best
IVF outcomes, i.e., pregnancy.
Materials and
Methods: Retrospective clinical study in private practice Acupuncture
and IVF center. Data were compiled in a group of infertile patients (n =
216) who received acupuncture during their IVF treatment cycle between
2001 and 2005. Data were analyzed to determine the optimal number of
Electrical Stimulation (e-Stim) acupuncture treatments (Stener-Victorin
protocol) that would |
result in a clinical pregnancy. Two hundred
sixteen patients over a 4 year period were included in this study. Based
on our previous studies, we determined a significant improvement in IVF
outcomes when patients were treated with Acupuncture (Ac). We utilized
two protocols: Stener-Victorin et al 1996 (reported on uterine blood
flow) and Paulus et al. 2002 protocol (reported on acupuncture given
just before and just after embryo transfer). Patients received a
combination of both protocols. This population was stratified into
pregnant and non pregnant groups and then evaluated by Student T=test
and Chi-Square analysis for age, FSH levels, weight, BMI and E-2 levels.
The pregnant and non-pregnant groups were further subdivided into those
that received or did not receive acupuncture and were analyzed by
Chi-square analysis. Since all patients received acupuncture consisting
of e-Stim, their distribution was analyzed utilizing Kaplan- Meier
survival analysis for pregnancy and no pregnancy to determine the number
of e-stimulation that would provide the greatest chance for pregnancy.
Results: Patients age, day 3 FSH levels, weight, BMI (body mass
index) and E2 (estrogen level at embryo transfer) were not statistically
significantly different between the Non Acupuncture (No Ac) and the
Acupuncture (Ac) groups. There was a statistically significant
improvement (p < 0.01) in pregnancy rates in the group that received Ac
(49 patients of 106 (37.4%) in the No Ac became pregnant vs. 77 patients
of 111 (61.1%) of the Ac group became pregnant). This is over 23%
increase in pregnancy rates in the Ac group. When the data were compared
between e-Stim treatments in the Ac only group, an average of 6.5
treatments were found in the non-pregnant Ac group and 5.9 treatments in
pregnant Ac group (not statistically significantly different). When the
data were plotted comparing pregnant vs. non pregnant Ac patients, there
was a trend towards numerically more e-Stim treatments in those who
achieved a pregnancy. In order to confirm or refute differences in these
two groups, Kaplan Meier’s survival analyses were done. Based on these
analyses, the average accumulated affect in the non pregnant Ac group
was 5.1 e-Stim treatments and 8.4 e-Stim treatments in the pregnant Ac
group. This was statistically significantly different at the p < 0.05.
Conclusion: In traditional Chinese medicine the basic theory is
that only when the body is balanced will it function at its optimal
level. Acupuncture helps restore balance which results in a higher
chance of achieving pregnancy. In our study, we found that patients who
received more than 8 e-Stim treatments appeared to have the maximum
benefit for IVF outcomes: pregnancy (p < 0.05). In our study, we also
reviewed the independent effects of the Paulus protocol, however due to
small numbers; we could not perform the analyses. In the IVF center
included in this study, patients receive Valium (diazepam) to reduce
smooth muscle contractility. This treatment may provide all that is
needed to reduce uterine contractility and therefore the additional
impact of Ac at the pre and post transfer (Paulus protocol) may well be
masked by the medication. More study of these and other treatments must
be done. We are currently investigating the role of Ac in stress hormone
circulating levels.
Source:
"Acupuncture and In Vitro Fertilization:
Does the Number of Treatments Impact Reproductive Outcomes?" East
Winds Acupuncture. 15 Oct. 2008 <http://www.eastwindsacupuncture.com/medicalarticles/diane+and+dr.+magarelli's+articles/2.html>.
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