Fertility

ACUPUNCTURE REGULATES HORMONES DURING IVF PREPARATION
American researchers have investigated the effects of acupuncture on serum cortisol and prolactin in IVF patients undergoing drug-induced ovarian hyperstimulation. Sixty-seven women were randomised to receive either IVF alone or IVF plus acupuncture, according to protocols derived from randomised controlled trials. Serum levels of cortisol and prolactin were measured and synchronised with medication stimulation days of the IVF cycle. Cortisol levels in the acupuncture group were significantly higher on IVF medication days 7, 8, 9, 11, 12, and 13 compared with controls. Prolactin levels in the acupuncture group were significantly higher on IVF medication days 5, 6, 7, and 8 compared with controls. The authors conclude that there appears to be beneficial regulation of cortisol and prolactin in the acupuncture group during the medication phase of the IVF treatment, with a trend toward more normal fertile cycle dynamics. (Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization-embryo transfer treatment. Fertil Steril. 2008 Dec 30. [Epub ahead of print]).

ACUPUNCTURE INCREASES IVF SUCCESS
The beneficial effect of acupuncture on fertility treatment has once again been highlighted by the results of a major scientific study. The research found that women undergoing IVF treatment were much more likely to have a successful pregnancy if they also had acupuncture treatment on the day of embryo transfer. Acupuncture carried out on the day of embryo transfer was found to increase the chances of having live birth from one in five to one in three. The systematic review and meta-analysis, published as part of the Cochrane Database of Systematic Reviews, and carried out by a team from the University of Southampton, identified a total of 16 trials involving acupuncture and assisted conception, of which 13 were considered high enough quality to be included in the study. These involved a total of more than 2000 IVF patients. Analysis of the pooled results led the authors to conclude that acupuncture around the time of embryo transfer achieved a higher live birth rate of 35% compared with 22% without active acupuncture. They found no evidence of benefit when acupuncture was performed in the days after embryo transfer, nor at the time of egg retrieval. (Acupuncture and assisted conception. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD006920).

ACUPUNCTURE IMPROVES IVF SUCCESS RATE
A meta-analysis of seven clinical trials in which acupuncture was used to support embryo transfer during IVF has concluded that it improves rates of pregnancy and live birth. Dutch and American researchers analysed results from seven clinical trials (selected as eligible from a total of 108), all published since 2002 and carried out in four Western countries. They included data on 1366 women and compared acupuncture given within one day of embryo transfer, with sham acupuncture or no additional treatment. All except one used a similar acupuncture protocol (based on Paulus et al). The analysis showed that combining real acupuncture with embryo transfer was associated with significant and clinically relevant improvements in clinical pregnancy rate. Women who underwent acupuncture were 65% more likely to have a successful embryo transfer procedure and 91% more likely to have a live birth. On the basis of ‘number needed to treat’, this means that ten women undergoing IVF would need to be treated with acupuncture to bring about one additional pregnancy. (Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ. 2008 Mar 8;336(7643):545-9).

ACUPUNCTURE IMPROVES SPERM QUALITY
A study of the effect of acupuncture on sperm quality in men suffering infertility of unknown cause, found that after twice weekly treatment for five weeks, there were fewer structural sperm defects (acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibres of sperm organelles) and an increase in the number of normal sperm ejaculated. Other sperm abnormalities such as immature or dead sperm were not affected. Acupuncture was given at Guanyuan REN-4, Shenshu BL-23, Ciliao BL-32 and Taixi KID-3 with Zusanli ST-36, Xuehai SP-10, Sanyinjiao SP-6, Guilai ST-29 and Baihui DU-20 as secondary points. Deqi was obtained at all needling sites and aimed to be transmitted from Shenshu BL-23 and Ciliao BL-32 to the sacral or perineal area and the anterior hypogastric region. (Fertility and Sterility, Volume 84, Issue 1 , July 2005, Pages 141-147). Meanwhile there is evidence that infertility may now be affecting more men than women. Intra-cytoplasmic sperm injection (ICSI), in which a single sperm is injected straight into an egg and is normally used in cases where the sperm is of too poor quality to permit conventional fertilisation has become the most commonly used technique in Europe and now outnumbers conventional IVF. (European Society of Human Reproduction and Embryology annual conference, Copenhagen, 2005).