Acupuncture and IVF

Acupuncture and IVF – How might it work?

There are several by which acupuncture could influence the results of In vitro Fertilization - IVF. Acupuncture has
been shown in some studies to affect the levels of pituitary and ovarian hormones. Electro-acupuncture may help
improve blood flow in the uterine arteries of infertile women.

The most immediate possible effect is that acupuncture served to "relax" the uterus around the time of the transfer.
Several studies have shown that the uterus has contractions and that these contractions could cause expulsion of the
transferred IVF embryos. If the contractions were reduced by acupuncture then that could be a mechanism for an
improvement in IVF pregnancy rate.

However, researchers performing a study on 164 IVF patients found that acupuncture did not reduce uterine
contractions. Furthermore, implantation of the embryos into the uterine lining does not occur for two to five days after
embryo transfer depending upon when the embryos were transferred. It is unknown whether the effect of acupuncture
performed on the day embryo transfer would last until the day of embryo implantation or longer.

Many patients have been told that they should use acupuncture for IVF because they will respond better to
medication, get more eggs, get healthier eggs, or get higher pregnancy rates. Many women with specific problems
such as high FSH levels or miscarriages have been promised that acupuncture will cure all these problems. To date,
however, there is no objective data that backs up these claims.

As of early 2008, there have been a few studies looking at whether acupuncture influences the outcome of IVF
cycles. I have reviewed most of these studies below. A new IVF and acupuncture study , published in February 2008,
combined the results of many of these smaller studies. they concluded that it would take 10 IVF embryo transfers to
obtain one additional live birth

Acupuncture and IVF - Study Number 1

The first published study, which received a great deal of attention, was conducted by Paulus and colleagues.
Although this study was well designed, it looked at a very specific group of patients. The results may not be
applicable to other patient groups.

Acupuncture IVF Patient Groups- Study Number 1

The study looked at 160 women aged 21 to 43. Over half the couples were being treated for IVF because of male
factor. One fourth had blocked tubes. This is an important consideration since three fourths of the patients would not
be expected to have any hormonal abnormalities or uterine issues.

Another requirement for entry into the study was that only couples "with good embryo quality" were eligible. This is an
extremely important point. Based on the results of this study, we do not have any idea whether acupuncture would
work for couples who do not have good embryo quality.

Acupuncture and IVF Treatment - Study Number 1

In this study, IVF patients received acupuncture 25 minutes before and 25 minutes after the embryo transfer. No
patients received acupuncture before or during treatment with fertility medications. Thus, we do not know if
acupuncture would have had any effect on improving the number of eggs or any influence in the preparation of the
uterine lining.

The acupuncture points chosen for the study were supposed to result in:

 Better blood perfusion and "energy" in the uterus

 Sedation of the patient
 "Stabilization" of the endocrine system
Acupuncture and IVF Pregnancy Rates and Results - Study Number 1

In this study, IVF patients who had acupuncture had a 42% pregnancy rate. IVF patients who did not have
acupuncture had a 26% rate.

There was no difference between the two groups in the thickness of the uterine lining or indexes of blood flow through
the uterine arteries either before or after the embryo transfer. Hormone levels were not measured during this study.

One of the criticisms of this study is that the results could be due to the placebo effect. To counter these criticisms,
one year after publishing the original study, the authors presented a placebo-controlled study at the annual meeting
of the European Society for Human Reproduction and Embryology. Two hundred patients with good embryo quality
were randomized to receive either real or sham acupuncture for 25 minutes before and after ET. There were clinical
pregnancies in 43% of the real and 37% of the sham acupuncture patients. Statistical analysis of the results
determined there was no significant difference between the groups. In other words, in this study, conducted by the
same investigators and performed in the same way as the original study, acupuncture was not found to improve
pregnancy rates.

Conclusions from Study Number 1

When the first and second parts of this study conducted by these investigators are taken into account, it would
appear that performing acupuncture immediately before and after the embryos transfer may not result in a higher
chance for pregnancy.

Acupuncture and IVF - Study Number 2

Prior to beginning their study, the doctors who conducted acupuncture study number 2 performed a “power analysis”.
This means they used some of the data from the Paulus study above as well as the pregnancy rate results from their
own clinic to calculate, ahead of time, the number of patients they would need to study in order to prove that
acupuncture either works or doesn’t work. They determined that to find a difference in the clinical pregnancy rate of
11% between no acupuncture (the control group) and acupuncture (the treatment group) they would require
approximately 100 patients in a control group and 200 patients in the acupuncture groups.

Acupuncture and IVF Treatment Protocol- Study Number 2

The study was conducted over a period of 16 months. During that time, about 1000 couples underwent in vitro
fertilization at their center. Of these, 300 couples agreed to participate in the study and were randomized to one of
three groups on the day of egg retrieval. After randomization, 27 patients were excluded for various reasons. Of the
remaining 273 patients, 87 were allocated to no acupuncture (control group), 95 to acupuncture on the day of embryo
transfer, and 91 to receive acupuncture on the day of ET and again 2 days later.

Acupuncture IVF Pregnancy Rates and Results - Study Number 2

There was no difference between the three groups in the number of eggs retrieved or the number of embryos
available to transfer to the uterus.

The ongoing pregnancy rate was higher in both of the acupuncture groups compared to the control group. The
ongoing pregnancy rate in the group which received acupuncture once was 36%, in the group that received
acupuncture twice, the rate was 33% and in the group that did not receive acupuncture at all it was 22%. Statistical
analysis was performed to determine whether these results might have been due to random chance. The analysis
determined that the improvement in pregnancy rates in the single acupuncture group was unlikely to be due to
chance but that the improvement in the double acupuncture group may have been due to chance.
 Interestingly, the miscarriage rate in the group that received acupuncture twice was 33%. This is higher than the
miscarriage rate in the group that had acupuncture once 21% or the control group -- 15%. Statistical analysis showed
that these results might have occurred by random chance however.

The results of this study are somewhat confusing. If acupuncture was beneficial in increasing pregnancy rates, then
why weren’t two acupuncture sessions better than one? What was the reason for the seemingly higher miscarriage
rate in the group that received acupuncture twice?

Acupuncture and IVF - Study Number 3

In this third acupuncture study, a total of 225 infertile patients were included: 116 women were randomized into group
I (the study group), and 109 women were randomized into group II (the control group). The physician who performed
the embryo transfer was not aware of which couples were in which group. On the day of embryo transfer, the patients
in the study group received acupuncture according to the principles of traditional Chinese medicine. At the same time,
a special Chinese medical drug (the seed of Caryophyllaceae) was placed on the patient’s ear. The seeds remained
in place for 2 days and were pressed twice daily for 10 minutes. Three days after the embryo transfer, the patients
received a second acupuncture treatment. In addition, the same ear points were pressed at the opposite ear twice
daily. The seeds were removed after 2 days.

The control group received placebo or phony acupuncture. As in the treatment group, patients received phony
acupuncture treatment for 30 minutes. The phony acupuncture treatment was repeated three days after the embryo
transfer. Equal numbers of needles were applied to the study and control groups. The placebo acupuncture treatment
was designed not to influence fertility.

Acupuncture and IVF Pregnancy Rates and Results - Study Number 3

Both groups were similar in terms of age, weight, duration of infertility, cause of infertility, and number of previous IVF
attempts. No differences were found in the specifics of the ovarian stimulation, the number of eggs retrieved, the
fertilization rate, or the number of embryos transferred.

The success rates were looked at in a few ways. The implantation rate is the number of pregnancies produced
divided by the number of embryos transferred. The real acupuncture group had an implantation rate of 14.2%
whereas the phony acupuncture group’s implantation rate was only 5.9%. The ongoing pregnancy rate was 28.4% in
the real acupuncture group compared to 13.8% in the phone group.

Acupuncture and IVF - Conclusions from Study Number 3

This study introduced a number of variables that make it difficult to interpret the results. First, a Chinese medicine
was administered in addition to the acupuncture. There is no way to determine, therefore, whether the results were
the result of the acupuncture or the medicine.

The “control group” had acupuncture performed at sites that were not thought to improve fertility. It is possible
however, that these sites actually had a negative effect. The way the study was designed, there is no way to
determine which is correct.

Acupuncture and IVF - Study Number 4

This next acupuncture and in vitro fertilization study subjected the patients to three acupuncture treatment sessions.
The first took place before the egg retrieval on the 9th day of ovarian stimulation with fertility drugs, and the second
and third acupuncture treatments were performed immediately before and after the embryo transfer. Women were
randomly allocated to receive treatment with acupuncture or with noninvasive “sham” (placebo or phony)
acupuncture.
Acupuncture IVF Patient Groups- Study Number 4

Subjects were randomly allocated to a study group by selection of sealed envelopes. Women were allocated to
receive treatment with acupuncture or with noninvasive sham acupuncture.

Acupuncture and IVF Treatment Pregnancy Rates - Study Number 4

Of the 228 subjects randomized, 15% were unable to complete the treatment protocol because their IVF cycle was
cancelled prior to the embryo transfer. No difference in the grading of embryos was found between groups. The
pregnancy rate, defined as fetal heart rate on ultrasound scan, was 31% in the acupuncture group and 23% in the
control group. Statistical analysis demonstrated that the difference seen was likely the result of chance and not the
acupuncture itself.

The pregnancy rate was also not found to differ between groups if the women studies were under age 35.

No difference was found between groups for other study endpoints: number of eggs retrieved, fertilization rate or
number of embryos transferred.

To examine whether the attempts to conceal from the patients the treatments they were receiving was successful,
subjects were asked which group they thought they had been allocated to. Twenty-six subjects (11%) correctly
guessed which group they were in. 16 subjects were in the treatment group and 10 were in the control group.

Acupuncture and IVF -- Conclusions from Study Number 4

This study, which appeared to have a valid control group, could not demonstrate a benefit in terms of better
pregnancy rates when acupuncture was used.

Acupuncture in infertility

We have several acupuncturists that work with our patients. If you are interested in having acupuncture performed as
part of your IVF treatment then contact the office for a list of names.
Last Updated ( Monday, 17 March 2008 )
 

Study: Acupuncture Improves Fertility in Men, Too

By Editorial Staff

In many cultures, women are unfairly blamed for the inability of a sexually active couple to conceive.
In reality, men suffer from infertility issues just as frequently as women. According to statistics from
the National Infertility Association (an organization also known as RESOLVE), between 35 percent and
40 percent of infertility problems among couples are actually caused by male conditions.

Several factors may be responsible for male infertility, including low sperm count, abnormal sperm
shape and size, and reduced motility. Lifestyle, genetics, and physiological changes can also raise or
lower male fertility levels, and can significantly affect a man's ability to produce offspring.
Previous research has shown that acupuncture can improve fertility levels in women. Fewer studies on
male infertility have been conducted, although evidence suggests that acupuncture can have an effect
on sperm production and quality, without causing any changes in behavior or sexual desire. A recent
trial published in Fertility and Sterility has shown just how effective acupuncture can be in the
treatment of this condition, leading to significant increases in the number of normal sperm and equally
significant reductions in structural defects.

In the study, 28 men who were diagnosed with idiopathic infertility received acupuncture twice a week
over a period of 5 weeks. The following acupuncture points were used as main points: Guan yuan (Ren
4), shen shu (UB 23, bilateral), ci liao (UB 32, bilateral), tai cong (Liv 3, bilateral), and tai xi (KI 3,
bilateral). Secondary points included zhu san li (ST 36, bilateral), xue hai (SP 10, bilateral), san yin
jiao (SP 6, bilateral), gui lai (ST 29, bilateral), and bai hui (Du 20). Needles were inserted to a depth
of between 15 and 25 millimeters, depending on the region of the body being treated. Needles were
manipulated for 10 minutes to achieve de qi, then left in place for another 25 minutes before being
removed.

Semen samples were collected from each of the men after a 3-day period of sexual abstinence. Two
samples were collected from each patient: one obtained the day before treatment began, the other
after the last acupuncture treatment. Samples from the treatment group were then randomized with
semen samples from 12 untreated control patients and analyzed.

Compared to the control group, motility levels increased significantly in semen samples in the men
receiving acupuncture. While median motility levels increased from 32% to 37% in the control group,
they increased from 44.5% to 50% in the acupuncture group.

The number and percentage of healthy sperm also increased dramatically in the acupuncture patients.
At baseline, only 0.06% the sperm among men in the acupuncture group was considered "healthy,"
while the median number of healthy sperm calculated in ejaculate was 0.04 x 10 6 (40,000). After 10
sessions of treatments, the median percentage of healthy sperm had increased more than four-fold, to
0.26%, while the median number of healthy sperm per sample had reached 0.2 x 10 6 (200,000).

In addition, significant changes in sperm structure and quality were seen in the samples from the
acupuncture group. Before treatment, only 22.5% of the sperm samples in the acupuncture patients
contained normal-shaped acrosomes, a cap-like structure that develops over the anterior portion of a
sperm cell's nucleus. After treatment, the median percentage of normal acrosome shapes showed a
"statistically significant improvement" to 38.5%.

Similarly, the percentage of sperm with a normal axoneme pattern increased significantly among men
receiving acupuncture. (The axoneme is a microscopic structure that contains a series of tubules
arranged in a distinct pattern, and is believed to aid in sperm motility.) Prior to the start of the study,
the correct axoneme pattern was present in 52% of sperm in the control group, but only 46.1% in the
acupuncture group. After 5 weeks of therapy, the median percentage increased to 52.2% in
acupuncture patients, but actually decreased to 38.2% in the control group.

While acupuncture appeared able to improve the overall quality and structural integrity of sperm, it
was ineffective against some common sperm pathologies. Apoptosis levels (programmed cell death) in
sperm samples were reduced slightly, but not to a statistically significant degree. Median percentages
of necrosis (unprogrammed cell death) and sperm immaturity also decreased slightly in the
acupuncture group, but not to a level considered statistically significant.

The authors concluded that despite the inability of acupuncture to significantly reduce some sperm
abnormalities, the treatment could be used to improve overall sperm quality, leading to the possibility
of increased fertility.
"In conjunction with ART or even for reaching natural fertility potential, acupuncture treatment is a
simple, noninvasive method that can improve sperm quality," the authors concluded. "Further
research is needed to demonstrate what stages and times in spermatogenesis are affected by
acupuncture, and how acupuncture causes the physiologic changes in spermatogenesis."

References

1. Hopps CV, Goldstein M. Male infertility: the basics. Available online.

2. Levine D. Boxers or briefs: myths and facts about men's infertility. Available online.
3. Pei J, Strehler E, Noss U, et al. Quantitative evaluation of spermatozoa ultrastructure after
acupuncture treatment for idiopathic male infertility. Fertility and Sterility July 2005;84(1):141-
7.

Question: How Does Acupuncture Help Fertility?

Acupuncture is one of the most popular forms of alternative medicine used to improve fertility and
possibly treat infertility. But how exactly is sticking little needles into the body supposed to help you
get pregnant? How does it work?

Answer:

There are two ways to ways to answer this question. We can answer this question from the so-called
Eastern perspective. In other words, with what traditional Chinese medicine (TCM) say about
acupuncture and fertility. We can also answer the question from the Western point of view: What does
the medical research suggest about acupuncture? How can acupuncture help those with infertility?

How Acupuncture May Work, According to Traditional Chinese Medicine

I asked Jill Blakeway -- licensed acupuncturist, certified herbalist, Clinic Director of The
YinOva Center in New York City, and co-author of the book Making Babies: A Proven Three
Month Program for Maximum Fertility (Little Brown, 2009) -- to explain how acupuncture
works.

According to classical Chinese philosophy, Blakeway says, we have channels of "energy" called
meridians that run through our bodies. "They are often compared to rivers running through the body,
in order to nourish the tissues," she explains. "Stagnation in the flow of these energy rivers is like a
dam that is backed up."

According to traditional Chinese medicine, disruption of the flow can lead to physical and emotional
illnesses, including infertility. These meridians can be affected by needling specific points, also known
as acupuncture points. By needling the acupuncture points, the flow of the energy gets "unstuck" and
is allowed to flow in a free and balanced way.
 How Acupuncture May Work, According to the Current Research

Of course, the Western, scientific explanation is quite different. The truth of the matter is that no one
is sure how acupuncture works. But there are theories.

One theory is that by needling points on the body, chemicals and hormones are triggered and
released. "These chemicals either change the experience of pain, or they trigger a cascade of
chemicals and hormones which influence the body's own internal regulating system," Blakeway says.
"The improved energy flow and biochemical balance produced by acupuncture stimulates the body's
natural healing abilities, and enhances physical and emotional well-being."

Research has shown specifically that acupuncture increases the amount of beta-endorphins flowing
through the body. Beta-endorphins are feel-good hormones that help lessen pain. Exercise is also
known to boost the amount of beta-endorphins in the body. If you've ever experienced a "runner's
high," you've enjoyed a boost of beta-endorphins.

But some interesting research on acupuncture points may imply that it's more than just beta-
endorphins and hormones at play. In a research study at UC Irvine, researchers used MRIs to look at
the brain while patients received acupuncture treatment.

"Traditionally, acupuncturists have used a point on the little toe to address eye pain," says Blakeway.
"The point is chosen because it is on the same meridian as the eye." What's amazing is that in this
study, when the point on the foot for eye pain was stimulated, the part of the brain that regulates
vision lit up.

Acupuncture and Infertility

The research on acupuncture and infertility is ongoing, and the topic is controversial. Some studies
have been too small to prove a definitive connection to improved pregnancy rates, and some studies
contradict each other in their results.

With that said, here are a few of possible benefits of acupuncture, according to the preliminary
research:

 Improved pregnancy rates during IVF treatment cycles, when acupuncture takes place on the
day of embryo transfer
 Increased blood flow to the uterus, leading to an improved endometrial lining
 Reduced stress and anxiety levels
 Possible improvement in ovulation for women with PCOS
 Possible improvement in sperm count and quality in men with infertility
 Possible regulation of gonadotropin-releasing hormone, which in turn could help regulate
ovulation

To read more about the controversy and current research, check out this article on acupuncture and
infertility:
 In Support of Acupuncture

Researchers at the Center for Integrative Medicine, at the University of Maryland's School of Medicine,
conducted a meta-analysis of several research studies on the effects of acupuncture on IVF outcomes.
(A meta-analysis is a research study that gathers information from several studies and evaluates them
together.) The meta-analysis considered seven trials, which all together included 1,366 women.

The researchers found that when acupuncture took place on the day of embryo transfer, statistically
significant improvements were found in the rates of clinical pregnancies, ongoing pregnancy, and live
births. They also found that 10 woman would need to be treated with IVF and acupuncture to see one
additional pregnancy.

In another study, often referred to as the "German study," a German fertility clinic offered 160 IVF
patients who had good-quality embryos an opportunity to participate in a study on acupuncture and
IVF outcomes. Half of the patients received acupuncture treatment, 25 minutes before and after
embryo transfer. The control group did not receive any supportive therapy.

In the acupuncture group, 34 of the 80 patients got pregnant. In the control group, 21 out of 80 got
pregnant.

There have been a number of other, smaller sized research studies on acupuncture and fertility.
Because of their small size, the results of these studies are controversial. Just a few of the possible
connections between acupuncture and fertility found in the smaller studies:

 Acupuncture may improve sperm quality and counts in infertile men.

 Acupuncture may improve the lining of the endometrium, including increased the blood flow to
the uterus.
 Acupuncture may help regulate hormone levels, specifically gonadotropin-releasing hormone,
which in turn may improve ovulation rates.
 Acupuncture may help women with PCOS and anovulatory cycles.
 Acupuncture may help those with thyroid problems. (And problems with the thyroid can lead
to problems with fertility.)
 Acupuncture may increase the number of follicles produced during an IVF treatment.

Controversy and Ambiguity

While the supportive research looks great, critics claim that the studies are less than sufficient to show
a true connection between acupuncture and improved pregnancy rates. None of the studies have used
the so-called Gold Standard for research - randomized, double-blind placebo trials.

Also, many of these studies were too small to be considered definitive. For example, all the research
studies on male infertility and acupuncture involved anywhere from 10 to 20 patients. Not nearly
enough to judge the effectiveness of the results.

Perhaps most importantly, other research studies have failed to achieve similar results. A research
study led by Alice Domar, a big proponent of the mind-body fertility connection, looked at the effect of
acupuncture on IVF outcomes. In this study, 150 IVF patients awaiting embryo transfer were included.
Subjects were randomly assigned into the control group or acupuncture group, and the IVF staff was
"blind" to who was receiving the acupuncture treatments.

The acupuncture group received treatment 25 minutes before and after embryo transfer. They also
filled out forms asking about their anxiety and feelings of optimism. The acupuncture group reported
feeling less anxious and more optimistic than the control group. However, unlike the "German Study,"
this study did not find any improvement of pregnancy rates.

Another study, this one conducted by Dr. LaTasha B. Craig while she was with University of
Washington, found that acupuncture treatment on the day of embryo transfer actually decreased the
rate of pregnancy. In this study, high embryo quality was not required for inclusion in the study.

The acupuncture method was the same one used during the German Study, with treatment 25
minutes before and after embryo transfer. However, unlike the German Study, acupuncture treatment
took place somewhere besides the fertility clinic. This is more realistic, considering that few fertility
clinics offer acupuncture treatment onsite.

In this study, those who received acupuncture treatment had a 46% clinical pregnancy rate, compared
to 76% rate for those who did not receive treatment. The live birth rate for the acupuncture treated
patients was 39%, compared to a 65% live birth rate those not treated with acupuncture. Dr. Craig
theorizes that driving to and from the acupuncturist may have increased the levels of stress, leading
to the lower pregnancy rates.

Where It Stands

There does seem to be evidence that acupuncture performed on the day of embryo transfer may
improve your chances of success. Maybe, if you don't get stressed driving to and from the
acupuncturist.

However, acupuncture performed at other times during treatment, and acupuncture performed
without IVF treatment, may or may not make a difference. The research is conflicting and unclear.

But that doesn't mean acupuncture is without merit. Further research is needed, and no one is saying
that acupuncture absolutely makes a difference, or definitely doesn't. Not yet, anyway.

Plus, the relaxation response to acupuncture treatment is undisputed. Even in studies where
acupuncture didn't improve pregnancy rates, researchers noted that the patients were more relaxed
and more optimistic after treatments. Given the high levels of stress couples go through during
fertility treatments, a little relaxation and lowered stress brought on by acupuncture treatment
probably won't hurt, and it may even help.
Study: Acupuncture may boost pregnancy
Posted 2/7/2008 8:30 PM |  Comments 27  |  Recommend 15

Gannett News Service file

 Enlarge
photo

Needles were inserted in a patient's ears as part of

her treatment at the Iowa Acupuncture Clinic in
Des Moines.
Share
Yahoo! Buzz
 Add to Mixx
 Facebook
 Twitter

 More
o  Fark
o  Digg
o  Reddit
o  MySpace
o  StumbleUpon
o  Propeller
o  LinkedIn

Subscribe
 myYahoo
 iGoogle

 More
o  Netvibes
o  myAOL

The Associated Press

It sounds far-fetched — sticking needles in women to help them become pregnant — but a scientific review suggests that acupuncture m
done right before or after embryos are placed in the womb.

The surprising finding is far from proven, and there are only theories for how and why acupuncture might work. However, some fertility sp
relatively inexpensive and simple treatment might ultimately prove to be a useful add-on to traditional methods.

"It is being taken more seriously across our specialty," and more doctors are training in it, said Dr. William Gibbons, who runs a fertility cl
president of the Society for Assisted Reproductive Technology. "I have not seen proof ... but we wouldn't mind at all" if it turned out to wo
The analysis was led by Eric Manheimer, a researcher at the University of Maryland School of Medicine, and paid for by a federal agenc
Complementary and Alternative Medicine. Results were published Friday in the British medical journal, BMJ.

Acupuncture involves placing very thin needles at specific points on the body to try to control pain and reduce stress. In fertility treatmen
the uterus, relax the cervix and inhibit "fight or flight" stress hormones that can make it tougher for an embryo to implant, Manheimer said

The analysis pools results from seven studies on 1,366 women in the United States, Germany, Australia and Denmark who are having in
mixing sperm and eggs in a lab dish to create embryos that are placed in the womb.

Women were randomly assigned to receive IVF alone, IVF with acupuncture within a day of embryo transfer, or IVF plus sham acupunct
shallowly or in spots not thought to matter.

Individually, only three of the studies found acupuncture beneficial, three found a trend toward benefit and one found no benefit. When re
pooled, researchers found that the odds of conceiving went up about 65% for women given acupuncture.

Experts warn against focusing on that number, because this type of analysis with pooled results is not proof that acupuncture helps at al
pregnancy about 35% of the time. Adding acupuncture might boost that to around 45%, the researchers said.

The authors include doctors from the Netherlands and Georgetown University in Washington, D.C. One is an acupuncturist but had no ro

The American Society for Reproductive Medicine has no policy on acupuncture. "There's been a lot of conflicting research" on its usefuln

"It looks like, from the body of evidence out there, that some patients benefit," said Dr. James Grifo, head of the infertility program at New

However, Dr. Zev Rosenwaks, director of infertility treatment at New York-Presbyterian Hospital/Weill Cornell Medical Center, said other
meetings and not included in the published analysis, did not find it helped.

"The jury is still out," he said, but added, "It's unlikely that acupuncture does any harm."

Dr. Ann Trevino, a 37-year-old family physician who recently moved to Houston, is pregnant, and a believer. She had three unsuccessfu
insemination before trying acupuncture with IVF at a fertility clinic in San Antonio where she used to live.

"I had been reading about acupuncture, probably like every other patient on the Internet. I was just willing to do anything possible to impr
acupuncture, "I just felt very warm and relaxed" when the embryos were placed.

Dr. Francisco Arredondo, who runs Reproductive Medicine Associates of Texas where Trevino was treated, said he started offering acup
requested it and because some studies suggested it helped.

Acupuncturist Kirsten Karchmer said she places about a dozen needles in the ears, hands, feet, lower legs, abdomen and sometimes th
treatments twice a week, and patients typically go for three months, she said.

IVF costs around $12,000 per attempt, so a treatment that improves its effectiveness might save money in the long run, Manheimer said

Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Acupuncture and Fertility Studies and
Treatments
Acupuncture and fertility are linked together almost as much as
oysters and the libido. The idea of using acupuncture to treat those
with fertility problems may sound strange but cultures have been
using it for centuries to combat infertility.

If you feel that western science is not doing enough to ensure that
you get pregnant, you may want to give the Chinese medicine of
acupuncture a chance.

Although researchers can't explain why, women who use

acupuncture in combination with infertility treatments such as in-
vitro fertilization, are more likely to become pregnant than women
who have not had acupuncture. This has been confirmed, so far, in
two different studies.

Acupuncture and Infertility Studies

One study in the U.S. where 51% of the women who received
acupuncture treatments with their in-vitro fertilization treatments
became pregnant, while only 36% of those without acupuncture
treatments became pregnant. In the German in-vitro fertilization
study (consisting of 160 women) - half were given acupuncture
and half were not. Of the ones that received acupuncture, 30
became pregnant. Of the women who did not receive acupuncture,
only 21 became pregnant.

There have been instances where conception occurred from using

only a combination of acupuncture and herbal medicines and
without traditional medical interventions such as in-vitro
fertilizations. However, since these events are isolated and
happened outside of a test environment, no one can say that if the
conception was due to acupuncture and herbs or whether the
conception was simply a matter of luck.

Accupuncture and Fertility Theories

Acupuncture works by inserting ultra thin needles into specific
points on the body that are linked to the reproductive organs. This
causes certain parts of the body to be stimulated, increasing the
flow of energy to those areas and, hopefully addressing the
patient's fertility problems.

Acupuncture is also thought to sometimes help by correcting

problems such as hypothyroidism. This is a hormone imbalance,
where there's not enough of the thyroid hormone in the blood
stream. This can affect pregnancy by making the uterus
environment inhospitable to the egg. A woman with
hypothyroidism is also at greater risk for miscarriage because the
hormone imbalance prevents the body from functioning in a
normal manner.

Many believe that the primary benefit of acupuncture to women

attempting to get pregnant is that it helps her to relax. Although
this may be true in some cases, it's not yet been proven. And since
almost half of fertility problems due to men, relaxing the women in
those cases would not have much of an effect.

There are various theories as to how acupuncture works to

increase the odds of conception. From stimulating egg production
in women to simply relaxing women so that conception takes place
more easily. But not everybody always agrees on the reasoning
behind why acupuncture should work.

How To Proceed With Your Acupuncture

and Fertility Treatments
The most successful outcomes for combining acupunture and
fertility have the woman beginning her acupuncture treatments
about 3-4 months prior to her beginning the in-vitro fertilization
treatments.

Regardless of whether you use acupuncture in conjunction with

herbs or not, it's a good idea to have your doctor give you a basic
fertility workup to establish your fertility baseline. A fertility
workup is important because, in most cases, it can determine the
reason why you are having trouble conceiving.
 Acupuncture Treatment for Infertility: Landmark Study
Identifies Mechanism for Improved Pregnancy Outcomes on
In Vitro Fertilization (IVF)
Dr Paul Magarelli, a reproductive endocrinologist who is presenting at the
Vancouver 2010 Canadian Fertility and Andrology Society Meeting (CFAS),
has co-authored a groundbreaking study, published in the journal Fertility and
Sterility, that identifies how acupuncture regulates the stress hormones that
impact ovulation. This coincides with another recent study showing that
elevated markers for stress are associated with decreased pregnancy rates.
 ShareThis Email PDF Print

Dr Paul Magarelli

We've suspected that stress affects fertility for a long time

Vancouver, Canada (PRWEB) September 30, 2010

In Canada, more than 350,000 couples struggle with infertility. While in vitro fertilization (IVF) has been in the
spotlight, with Quebec and now Manitoba pledging to fund this high tech treatment, an ancient remedy is becoming
the newest therapy. A growing number of scientific studies show that there is a powerful connection between
acupuncture and improved pregnancy rates with IVF.

Dr Paul Magarelli's groundbreaking study, published in the journal Fertility and Sterility, identifies how acupuncture
regulates the stress hormones that impact ovulation.

"We've suspected that stress affects fertility for a long time," says Dr Magarelli. "What's new about our study is that it
indicates that acupuncture may positively adjust the levels of the stress hormones Cortisol and Prolactin during the
stimulation phase of IVF. In other words, acupuncture "corrects" for the negative changes and brings a woman's body
into balance, optimizing the chances of conception."
While Kristine Guichon didn't know the science behind acupuncture's effect on fertility, she firmly believes that this
2000 year old treatment gave her body the added boost she needed to conceive. Devastated after the failure of her
first round of IVF, she turned to fertility acupuncture on the advice of her reproductive specialist at Genesis Fertility
Centre. After a few months of acupuncture treatment at Acubalance Wellness Centre, combined with lifestyle and diet
changes, she went back for her second IVF at Genesis. This time things were completely different. Both the quality
and quantity of her eggs were excellent and her IVF was a success. She recently gave birth to a baby boy.

What a difference a few years makes, marvels Lorne Brown, Dr of Chinese Medicine and clinical director of
Acubalance Wellness Centre. "Just a few years ago women were afraid to tell their fertility specialist they were using
acupuncture. Today we have a very open relationship with Genesis and provide acupuncture on site at their clinic
before and after IVF." Brown will be co-presenting a talk with Magarelli on acupuncture and IVF at the CFAS meeting.

And now medical students will be learning about acupuncture at the same time as they study the latest high tech
interventions as a new medical textbook, Infertility and Assisted Reproduction (Cambridge University Press), includes
a chapter co-authored by Magarelli entitled How Chinese Medicine Impacts Outcomes in Fertility Care.

According to Dr Jason Hitkari, a reproductive endocrinologist and co-director at Genesis, it is important to choose an
acupuncturist with experience in fertility treatment and a good knowledge of Western medical treatment and
protocols. "Couples should do their homework and make sure that their Chinese Medicine practitioner has
specialized training in fertility and experience working with IVF and western medical doctors. One way to assure this
is to look for practitioners that are certified by the American Board of Oriental Reproductive Medicine (ABORM)."

Dr Magarelli sits on the advisory board of the ABORM. Consumers can go to the ABORM website (aborm.org) to find
a board-certified practitioner in their area.

To learn more about acupuncture and IVF, people hear Dr Paul Magarelli MD, PhD as he discusses his
groundbreaking research on acupuncture and fertility at a free public talk Monday, October 4th, 7:00 pm to 9:00 pm,
at Genesis Fertility Centre, Suite 300 - 1367 W Broadway, Vancouver, BC.

Space is limited; reservations required. For details or to reserve a seat, call 604 678-8600 or go to
www.acubalance.ca

###

The Ancient Art of Infertility Treatment

When it comes to getting pregnant, old world techniques may be just what today's high-
tech doctors will order.

By Colette Bouchez
WebMD Feature

Reviewed by Brunilda Nazario, MD

If headlines are any indication of what's hot and what's not, it's easy to believe that infertility treatment is
strictly a modern day science, made possible solely through the courtesy of high-tech medicine.
But as good as modern science is, many couples trying to get pregnant find themselves turning to an age-
old treatment for help -- one so steeped in tradition it's about as far from life in the 21 st century as one can
get.
That treatment is acupuncture, and today, even high-tech reproductive specialists are looking to the
somewhat mysterious world of Chinese medicine to help those fertility patients for whom western science
alone is not quite enough.
"Most of our patients are referred to us by reproductive medicine specialists -- they are usually women
who have failed one or usually more than one attempt at IVF (in vitro fertilization), and their doctor is
looking for something to help implement the success of their treatment, over and above what the
protocols alone can accomplish," says Raymond Chang, MD, the medical director of Meridian Medical
and a classically trained acupuncturist as well as western-trained medical doctor.
Acupuncture is an ancient Chinese medicine treatment that relies on the painless but strategic placement
of tiny needles into a "grid-like" pattern that spans the body, from head to toe. The needles are used to
stimulate certain key "energy points" believed to regulate spiritual, mental, emotional, and physical
balance. And, for many women, it's often just what the doctor ordered.
"It can allow you to cross the line from infertile to fertile by helping your body function more efficiently,
which in turn allows other, more modern reproductive treatments, like IVF, to also work more efficiently,"
says James Dillard, MD, assistant clinical professor, Columbia University College of Physicians and
Surgeons, and clinical adviser to Columbia's Rosenthal Center for Complementary and Alternative
Medicine.
Indeed, in a study of 160 women, published April 2002 in the reproductive journal Fertility and Sterility, a
group of German researchers found that adding acupuncture to the traditional IVF treatment protocols
substantially increased pregnancy success.
In this study one group of 80 patients received two, 25-minute acupuncture treatments -- one prior to
having fertilized embryos transferred into their uterus, and one directly afterwards. The second group of
80, who also underwent embryo transfer, received no acupuncture treatments.
The result: While women in both groups got pregnant, the rate was significantly higher in the acupuncture
group -- 34 pregnancies, compared with 21 in the women who received IVF alone.
But increasing the odds of IVF is not the only way acupuncture can help. Chang says it can also work to
stimulate egg production in women who can't -- or don't want to -- use fertility medications to help them
get pregnant.
"When you compare the pregnancy rates for an egg producing drug such as Clomid to acupuncture
alone, the rates are equal -- a 50% chance of pregnancy in three months for general patients -- to those
not undergoing IVF," says Chang.
Unfortunately, however, Chang says that because acupuncture generally stimulates the growth and
release of just one egg, it can't be substituted for fertility drugs used in IVF, since they work to produce
the multiple eggs necessary to achieve success with this treatment

The Ancient Art of Infertility Treatment

When it comes to getting pregnant, old world techniques may be just what today's high-
tech doctors will order.
(continued)
How Acupuncture Works

Although acupuncture is fast becoming an accepted fertility protocol, not everyone agrees on how -- or
why -- it works.
According to the traditional Chinese medicine explanation, acupuncture stimulates and moves Qi
(pronounced "Chee") a form of life energy that ancient wisdom says must flow through the body
unhampered from head to toe, 24/7. When it doesn't, illness or malfunctions such as infertility arise.
"Acupuncture works to restore the flow of Qi -- your essence, your body energy -- so with regards to
infertility, treatment has a calming, restorative effect that increases a sense of well- being and ultimately
helps the body to accept the creation of life," says acupuncturist Ifeoma Okoronkwo, MD, a professor of
medicine at New York University School of Medicine.
By placing the needles at key energy meridians linked to the reproductive organs, Okoronkwo tells
WebMD acupuncture increases, and more importantly, moves the flow of Qi from areas where it may be
too abundant, to areas that are deficient, all in a direction that encourages fertility.
To get your fertility Qi up to snuff, most experts say you will need about two, 30 minute treatments a
week, sometimes for several months, before the effects can be seen.
However, a slightly more Western way of looking at the effects points less to the mystical Qi and more
towards the solid science of brain chemistry.
In studies published in the journal Fertility and Sterility in 2002, Chang, along with noted Cornell
University reproductive endocrinologist Zev Rosenwaks, MD, found a clear link between treatment and
the brain hormones involved in conception.
More specifically their research noted that acupuncture increases production of endorphins, the body's
natural "feel good" brain chemical that also plays a role in regulating the menstrual cycle.
Chang says acupuncture also appears to have a neuroendocrine effect, impacting a three-way axis
between the two areas of the brain involved with hormone production (the hypothalamus and the pituitary
glands) and the ovaries, a constellation that ultimately impacts egg production and possibly ovulation.
In still another research paper published in the journal Medical Acupuncture in 2000, Sandra Emmons,
MD, assistant professor of obstetrics and gynecology at Oregon Health Sciences University, reports that
acupuncture may directly impact the number of egg follicles available for fertilization in women
undergoing IVF.
"My guess is that acupuncture is changing the blood supply to the ovaries, possibly dilating the arteries
and increasing blood flow, so that ultimately, the ovaries are receiving greater amounts of hormonal
stimulation," says Emmons, who also uses acupuncture in her traditional medical practice.
Chang says acupuncture may also help when the lining of the uterus is too weak to sustain a pregnancy
-- a problem that is also known to increase the risk of chronic miscarriage.
By increasing blood flow to this area, the lining may be better able to absorb the nutrients and hormones
necessary to help it grow strong enough to hold onto an implanted embryo, says Chang.

The Ancient Art of Infertility Treatment

When it comes to getting pregnant, old world techniques may be just what today's high-
tech doctors will order.
(continued)
Can Acupuncture Help You? How to Tell

As good as it sounds, acupuncture is clearly not the panacea for all fertility problems. As Dillard tells
WebMD, in instances where a structural defect exists -- such as a blocked fallopian tube or a fibroid tumor
-- acupuncture won't help you get pregnant.
Likewise, once past a certain age, no amount of tickling your Qi is going to increase necessary hormones
that have long gone out of production.
For this reason, many doctors recommend that you have at least a basic fertility workup before attempting
acupuncture treatment, particularly if you are approaching, or you are over, the age of 40.