In vitro fertilization and acupuncture: Clinical efficacy and mechanistic basis

Pacific College of Oriental Medicine, New York, USA.
Alternative therapies in health and medicine (Impact Factor: 1.24). 05/2007; 13(3):38-48.
Source: PubMed


To provide an overview of the use of acupuncture as an adjunct therapy for in vitro fertilization (IVF), including an evidence-based evaluation of its efficacy and safety and an examination of possible mechanisms of action.
Literature review using PubMed, the Science Citation Index, The Cochrane Library (Database of Systematic Reviews and Central Register of Controlled Trials), the New England School of Acupuncture library databases, and a cross-referencing of published data, personal libraries, and Chinese medicine textbooks.
Limited but supportive evidence from clinical trials and case series suggests that acupuncture may improve the success rate of IVF and the quality of life of patients undergoing IVF and that it is a safe adjunct therapy. However, this conclusion should be interpreted with caution because most studies reviewed had design limitations, and the acupuncture interventions employed often were not consistent with traditional Chinese medical principles. The reviewed literature suggests 4 possible mechanisms by which acupuncture could improve the outcome of IVF: modulating neuroendocrinological factors; increasing blood flow to the uterus and ovaries; modulating cytokines; and reducing stress, anxiety, and depression.
More high-quality randomized, controlled trials incorporating placebo acupuncture controls, authentic acupuncture interventions, and a range of outcome measures representative of both clinical outcomes and putative mechanistic processes are required to better assess the efficacy of acupuncture as an adjunct for IVF.

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Available from: Danny Schust, Oct 08, 2015
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    • "The first point is that acupuncture may mediate the release of neurotransmitters, which may influence the menstrual cycle, ovulation, and fertility by stimulating the secretion of gonadotrophin-releasing hormone. Acupuncture was well known for its effect of releasing β-endorphin and enkephalin in the central nervous system, and β-endorphin levels could influence the secretion of steroid hormones, regulate the menstrual cycle and ovulation [48, 49], and reduce anxiety of infertile couples [50, 51]. Both acupuncture and EA have been proved that could increase the levels of several neurotransmitters such as β-endorphin inhibiting the perception of pain and playing a positive effect on the outcomes of IVF [48, 52]. "
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    ABSTRACT: About 10-15% of couples have difficulty conceiving at some point in their reproductive lives and thus have to seek specialist fertility care. One of the most commonly used treatment options is in vitro fertilization (IVF) and its related expansions. Despite many recent technological advances, the average IVF live birth rate per single initiated cycle is still only 30%. Consequently, there is a need to find new therapies to promote the efficiency of the procedure. Many patients have turned to complementary and alternative medical (CAM) treatments as an adjuvant therapy to improve their chances of success when they undergo IVF treatment. At present, several CAM methods have been used in infertile couples with IVF, which has achieved obvious effects. However, biologically plausible mechanisms of the action of CAM for IVF have not been systematically reviewed. This review briefly summarizes the current progress of the impact of CAM on the outcomes of IVF and introduces the mechanisms.
    Evidence-based Complementary and Alternative Medicine 01/2014; 2014:419425. DOI:10.1155/2014/419425 · 1.88 Impact Factor
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    • "A previous study from our team demonstrated that acupuncture can increase the implantation rate up to four times compared to rats with embryo implantation failure [17]. Anderson et al. also suggested that acupuncture improves the success rate of IVF and may be a safe adjuvant therapy for IVF patients [18]. As mentioned above, CCL2, CXCL8, and uNK cells play important roles in embryo implantation and placentation during pregnancy, so whether acupuncture can modulate the expression of these chemokines and the subset of uNK cells has been rarely studied. "
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    ABSTRACT: The present study was designed to investigate the efficacy and mechanism of acupuncture treatment on embryo implantation failure in rats. The pregnant rats were randomized into normal group (N), implantation failure group (M), acupuncture treatment group (A), and progestin treatment group (W). The embryo implantation failure model was established by mifepristone. Efficacy of acupuncture treatment was evaluated by the number of implanted embryos. The expression of CCL2 and CXCL8 and the subset of uterine natural killer cells in the endometrium were detected. We demonstrated that the number of implanted embryos was dramatically reduced after mifepristone (M group) treatment, while the acupuncture (A group) and progestin (W group) treatments significantly rescued impaired embryo implantation. The protein and mRNA expressions of CCL2 and CXCL8 were significantly reduced by mifepristone treatment, but the attenuated expression of CCL2 and CXCL8 was markedly reversed by acupuncture or progestin treatment. More importantly, acupuncture and progestin could markedly increase the subset of uNK cells in rats with embryo implantation failure. These evidences suggest that acupuncture is able to modulate the endometrial immune microenvironment and thus improve embryo implantation in pregnant rats, which provides solid experimental evidence for the curative effect of acupuncture treatment on infertility.
    Evidence-based Complementary and Alternative Medicine 12/2013; 2013(1):678390. DOI:10.1155/2013/678390 · 1.88 Impact Factor
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    • "There is debate in the acupuncture community whether the acupuncture performed in these randomised controlled trials reflects the practice of real world acupuncture [6]. Often no diagnostic framework is applied, and there is a lack of individualisation to address specific TCM imbalances and symptoms, and the dose of acupuncture used is described as low [6]. "
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    ABSTRACT: Assisted reproductive technologies (ART) are increasingly utilised for resolving difficulties conceiving. These technologies are expensive to both the public purse and the individual consumers. Acupuncture is widely used as an adjunct to ART with indications that it may assist reducing the time to conception and increasing live birth rates. Heterogeneity is high between treatment protocols. The aim of this study was to examine what fertility acupuncturists consider key components of best practice acupuncture during an ART cycle, and to establish an acupuncture protocol by consensus. Fifteen international acupuncturists with extensive experience treating women during ART interventions participated in 3 rounds of Delphi questionnaires. The first round focused on identifying the parameters of acupuncture treatment as adjunct to ART, the second round evaluated statements derived from the earlier round, and the third evaluated specific parameters for a proposed trial protocol. Consensus was defined as greater than 80% agreement. Significant agreement was achieved on the parameters of best practice acupuncture, including an acupuncture protocol suitable for future research. Study participants confirmed the importance of needling aspects relating to the dose of acupuncture, the therapeutic relationship, tailoring treatment to the individual, and the role of co-interventions. From two rounds of the Delphi a consensus was achieved on seven treatment parameters for the design of the acupuncture treatment to be used in a clinical trial of acupuncture as an adjunct to ART. The treatment protocol includes the use of the traditional Chinese medicine acupuncture, use of manual acupuncture, a first treatment administered between day 6-8 of the stimulated ART cycle which is individualised to the participant, two treatments will be administered on the day of embryo transfer, and will include points SP8, SP10, LR3, ST29, CV4, and post transfer include: GV20, KD3, ST36, SP6, and PC6. Auricular points Shenmen and Zigong will be used. Practitioner intent or yi will be addressed in the treatment protocol. Despite a lack of homogeneity in the research and clinical literature on ART and acupuncture, a consensus amongst experts on key components of a best practice treatment protocol was possible. Such consensus offers guidance for further research.
    BMC Complementary and Alternative Medicine 07/2012; 12(1):88. DOI:10.1186/1472-6882-12-88 · 2.02 Impact Factor
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