Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis.

Fertil Steril. 2012 Mar;97(3):599-611. Epub 2012 Jan 11.

Zheng CH, Huang GY, Zhang MM, Wang W.

Source

Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China.

Abstract

OBJECTIVE:

To evaluate the effect of acupuncture on in vitro fertilization (IVF) outcomes.

DESIGN:

Systematic review and meta-analysis.

PATIENT(S):

Women undergoing IVF in randomized controlled trials (RCTs) who were evaluated for the effects ofacupuncture on IVF outcomes.

SETTING:

Not applicable.

INTERVENTION(S):

The intervention groups used manual, electrical, and laser acupuncture techniques. The control groups consisted of no, sham, and placebo acupuncture.

MAIN OUTCOME MEASURE(S):

The major outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Heterogeneity of the therapeutic effect was evaluated with a forest plot analysis. Publication bias was assessed by a funnel plot analysis.

RESULT(S):

Twenty-four trials (a total of 5,807 participants) were included in this review. There were no significant publication biases for most of the comparisons among these studies. The pooled CPR (23 studies) from all of the acupuncture groups was significantly greater than that from all of the control groups, whereas the LBR (6 studies) was not significantly different between the two groups. The results were different when the type of control was examined in a sensitivity analysis. The CPR and LBR differences between the acupuncture and control groups were more obvious when the studies using the Streitberger control were ignored. Similarly, if the underlying effects of the Streitberger control were excluded, the LBR results tended to be significant when the acupuncture was performed around the time of oocyte aspiration or controlled ovarian hyperstimulation.

CONCLUSION(S):

Acupuncture improves CPR and LBR among women undergoing IVF based on the results of studies that do not include the Streitberger control. The Streitberger control may not be an inactive control. More positive effects from using acupuncture in IVF can be expected if an appropriate control and more reasonable acupuncture programs are used.

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Management of female infertility with Chinese Herbal Medicine can improve pregnancy rates 2-fold within a 4 month period compared with Western Medical fertility drug therapy or IVF.

Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: A systematic review.

Ried K, Stuart K. Complement Ther Med. 2011 Dec;19(6):319-31. Epub 2011 Oct 5.

Original information from http://www.pubmed.gov

Source

Discipline of General Practice, School of Population Health & Clinical Practice, The University of Adelaide, South Australia 5005, Australia.

Abstract

OBJECTIVES:

To assess the effect of Traditional Chinese Herbal Medicine (CHM) in the management of femaleinfertility and on pregnancy rates compared with Western Medical (WM) treatment.

METHODS:

We searched the Medline and Cochrane databases and Google Scholar until February 2010 for abstracts in English of studies investigating infertility, menstrual health and Traditional Chinese Medicine (TCM). We undertook meta-analyses of (non-)randomised controlled trials (RCTs) or cohort studies, and compared clinical pregnancy rates achieved with CHM versus WM drug treatment or in vitro fertilisation (IVF). In addition, we collated common TCM pattern diagnosis in infertility in relation to the quality of the menstrual cycle and associated symptoms.

RESULTS:

Eight RCTs, 13 cohort studies, 3 case series and 6 case studies involving 1851 women with infertility were included in the systematic review. Meta-analysis of RCTs suggested a 3.5 greater likelihood of achieving a pregnancy with CHM therapy over a 4-month period compared with WM drug therapy alone (odds ratio=3.5, 95% CI: 2.3, 5.2, p<0.0001, n=1005). Mean (SD) pregnancy rates were 60±12.5% for CHM compared with 32±10% using WM drug therapy. Meta-analysis of selected cohort studies (n=616 women) suggested a mean clinical pregnancy rate of 50% using CHM compared with IVF (30%) (p<0.0001).

CONCLUSIONS:

Our review suggests that management of female infertility with Chinese Herbal Medicine can improve pregnancy rates 2-fold within a 4 month period compared with Western Medical fertility drug therapy or IVF. Assessment of the quality of the menstrual cycle, integral to TCM diagnosis, appears to be fundamental to successful treatment of female infertility.

read more:

www.ChineseMedicineDoctor.us

www.vitcm.org

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Acupuncture Baby-Ivy P.A.,posted by Dr.Arthur Fan in Washington DC, Northern Virgina 03/31/2011

This afternoon, the gentleman of mail delivering danced entered my office, gave a postcard from a mother, my former patient J.A. He said the baby on the card is very cute!

This is another “acupuncture baby”. Acupuncture plus IVF.

The mother was 41 years old, had a son 4 and half years old(through IVF?). She wanted to have another child. But the quality of her husband’s sperm and her eggs are poor. Before she came to see me, she had 8 times IUIs, 2 times IVFs.

She got acupuncture and herbal tea treatments before she schedule to try another IVF.  It did helpful. She gets her baby in last month! 5 LB 14 ozs,18Inches.

Here is baby mom’s letter.

“Dr.Fan-

Thank you for all that you did to make my dream of having another child come true. You were very kind and helpful during an awful time in my life and I am grateful for all your advice and assistance.

Best regards,

J.A.

www.ChineseMedicineDoctor.US

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Pulse diagnosis and Gender prediction: A reply to an e-mail, By Arthur Fan

Asking

From: A…. C
Subject: gender prediction
To: ArthurFan@ChineseMedicineDoctor.us
Date: Wednesday, September 22, 2010, 12:53 PM

Hi –

I just read your post on the internet regarding determining pregnancy thru pulse reading. My Acupuncturist recently told me the gender of my baby thru pulse reading (only 6 days after and IVF transfer). Is there any merit to this, and if so, how early can it be done? He mentioned about the left side stronger, and not detecting the babies female hormone in my body, therefore it must be a boy. There’s not much about it on the internet, but what I could find says that it can be about 80% accurate.

Thank you.

A….C.

A reply from Dr. Arthur Fan

Hi, A….,

The pulse diagnosis should be one of testing methods, which gives a trend of something (just a potential) and need other tests to confirm it.

My main concern is in “modern days”, there are too much interfering stuff which could affect the pulse and make the pulse diagnosis inaccurate some time (I mean the “sham pulse”). For example, using too much of progesterone may cause the pulse bigger and slippery, some providers may think the woman may get pregnant.

For your case, the pulse could be affected by the hormone or drugs you used during IVF.

At this moment, only 6 days after the embryo transferred, it is a bit too soon to tell –is boy or girl.

Let say, 10 women got pregnant only for 6 days, if the provider says 10 all boys. At last, if at half (5 are boys, 5 are girls), or as you said 80% chance, say 8 are boys, 2 girls, then some women will treat the provider “magic”(if at last they get boys), and other will treat him “nonsense”(if get the girls).

I mean, we use the pulse diagnosis as one of testing methods, which give us some trends, not the last diagnosis. We must combine some other methods to make last diagnosis. I strongly against the way–only use pulse diagnosis to tell something.

I did see some patients had bad experience from our “colleagues”.

Arthur Yin Fan, PhD,CMD,LAc
McLean Center for Complementary and Alternative Medicine, PLC
8214 Old Courthouse Road, Tysons Square Office Park,
Vienna, VA 22182.
Phone:(703)499-4428; Fax:(703)547-8197
Web: http://www.ChineseMedicineDoctor.US
Blogs: www.arthuryinfan.wordpress.com

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Acupuncture, Fertility Research Delivers Healthy Results

Acupuncture, Fertility Research Delivers Healthy Results
By: Jennifer Dubowsky, L.Ac. M.S.O.M., Dipl.Ac(Article From www.Acufinder.com)

Traditional Chinese Medicine (TCM) has been practiced for thousands of years. Amazingly, the first written gynecological records date back to the Shang dynasty (1500 BC- 1000 BC), but here in the U.S. and other Western countries, people are just beginning to understand and appreciate the effectiveness of Traditional Chinese Medicine.

It isn’t easy to compare Traditional Chinese Medicine and Western medicine because there are profound differences that underlie the basic notions of your health, body and treatment. Western medicine often takes a more mechanistic view of people – your body may be treated as if it is a collection of machine parts rather than one whole, integrated system. Alternatively, Traditional Chinese Medicine sees individuals as personal ecosystems, with each part depending on, and influencing, all the other parts. This “whole body” approach means that treatment addresses the complete systems of your body rather than just attending to your symptoms. As a result of such a treatment strategy, most patients experience an improvement in their specific condition and also a better overall sense of health and well being.
                
TCM and Fertility: The Research

Let’s define infertility. The American Fertility Society defines infertility as occurring when “a couple has 1 year of regular intercourse without contraception and has been unable to conceive.”

There are many factors that may make your conception difficult to achieve and, even after conception, you may face problems bringing your pregnancy to term, which causes frustration, upset and increased stress. However, research using acupuncture to enhance fertility is providing reason for new optimism in the struggle with this old problem.

Traditional Chinese Medicine (TCM) can be used alone or in conjunction with Western medicine. A 2002 German study that received a lot of attention found significantly higher conception rates (42.5% vs. 26.3%) when acupuncture was used with IVF.  More recently, two studies published in May 2006, showed that acupuncture can improve IVF success rates. First, in Germany, 225 women undergoing in vitro fertilization participated in a study. Of these, 116 patients received luteal phase (the phase after ovulation) acupuncture according to the principles of TCM and 109 people received a standard protocol of acupuncture. The treatment group using TCM principles had a significantly higher clinical pregnancy rate than the placebo group (33.6% vs. 15.6% respectively).  Second, a Denmark study published at the same time examined the effect of acupuncture received on the day of embryo transfer vs. no acupuncture, and they also found a significant increase in pregnancy rates (39% vs. 26%). The researchers concluded that acupuncture on the day of embryo transfer improved the outcome of IVF.  A third study published at the same time found the results too small to be considered clinically significant but these researchers also concluded that acupuncture was safe for women undergoing IVF.
 
Other research is showing acupuncture’s effectiveness with men. A study published in 2005 demonstrated that sperm motility and quality improved after the men received treatment with acupuncture.  

As further proof that TCM has gained acceptance and success, in September, 2005, the University of Maryland received $400,000 from The National Center for Complementary & Alternative Medicine, a division of the National Institute of Health, to research the benefits of Acupuncture combined with IVF.

In Vancouver on May 18, 2007, Dr. Paul Magarelli, an infertility physician at the Reproductive Medicine & Fertility Center, and Diane Cridennda, an acupuncturist at East Winds, both centers in Colorado Springs, Colorado, presented their research results which were published in Infertility and Sterility in April, 2007. This is one of several studies the two have completed. In the protocol, they used a minimum of 9 acupuncture treatments within 2 months before the embryo transfer. Since this was a research study, each patient received the same treatment. No modification in points was allowed. From a clinical TCM/acupuncture perspective, the treatment protocols were very limited compared to individulized treatment of each patient.

What were their results? Lorne Brown, Doctor of TCM, founder and clinical director of Acubalance Wellness Centre, the first TCM clinic in British Columbia dedicated to reproductive wellness, analyzed the data Dr. Magarelli presented and has posted the following conclusions on his website:

1. Acupuncture does not cause harm to fertility or negatively interfere with an IVF outcome.
2. Acupuncture can statistically improve the live birth rate from IVF to between 10-15%.
3. Acupuncture reduces the number of ectopic pregnancies in an IVF setting.
4. The acupuncture protocol (minimum of 9 treatments using set points) did not affect egg quality BUT it did improve the host. Therefore, it seemed to improve factors affecting implanation rather the egg quality itself.
5. The mechanism by which acupuncture improves implantation and live birth rates results from acupuncture’s ability to regulate the body’s hormone levels (particularly prolactin and cortisol) to mimic these hormone levels in a natural cycle.

Why Does TCM Work?

Why? “Acupuncture provides better circulation and better blood flow to the womb,” said Dr. Raymond Chang, director of New York’s Meridian Medical Group, who has been incorporating acupuncture into fertility treatments for the past decade. “It will give a better chance for the eggs to be nourished and therefore carried.” Acupuncture seems to help some women because it improves circulation to your ovaries and to your uterus. It aids ovarian stimulation, improves the thickness of uterine lining, and therefore can help with implantation. Acupuncture is relaxing, which helps to lower your cortisol levels and increase progesterone output, important factors in decreasing your chance of having a miscarriage.

Western medicine works with an eye on the numbers. The main goal is to increase the quantity of eggs or sperm, thereby increasing your chances of a viable pregnancy. In contrast, Traditional Chinese Medicine is holistic and cumulative. It will likely include suggestions about diet and lifestyle as well as acupuncture. TCM is very personalized. Your practitioner will needle specific points and may suggest specific herbs, all depending on your body and your situation. When your body is healthy and balanced, you increase your chances of getting pregnant and producing a healthy child. The goal of acupuncture is to return your body to a state of health. The effects take time; the results get better over time. Even if your Western doctor does not understand the benefits of acupuncture, most physicians now agree that it does not cause harm.

            
“Nourish the Soil before Planting the Seed”

Plan ahead. The ideal time to begin preparing your body for a baby is three months before conception or an IVF cycle. This is the time to begin acupuncture treatments, but many couples wait until they are actively trying to conceive. In my practice, I recommend twice weekly treatments until we get a positive pregnancy test and once a week for the first trimester to reduce the risk of miscarriage.
    
Of course, making good nutritional choices is always important for both mother and child. Specific suggestions can be found in one of my previous articles, “The ABCs of Fertility: Acupuncture, Babies, Chinese Medicine” which can be read on Acufinder.com and on tcm007.com

You can also help your body’s readiness by attending to the following suggestions:

• Caffeine: Reduce or cut out coffee from your diet. A joint US/Swedish study of 562 women found that 1-3 cups of coffee increased miscarriage rate by 30% and more than 5 cups increased it by 40%.  Also, in another study conducted during the first trimester of pregnancy, women who had a high caffeine intake showed an increased risk of repeated miscarriage.  

• Stress: Stress has been linked to irregularieties in  ovulation and abnormal sperm development. When you can lower your levels of physiological stress, you have increased your chances of conception.

• Sleep: Treatment in Chinese medicine always aims to improve your sleeping pattern. Lack of sleep has long been recognized as influencing fertility. It  leads to physiological disruptions including the inhibition of growth hormones.

• Alcohol: Women who drink alcohol may delay conception because it is poorly metabolised and can lead to a disturbance of the oestrogen/ progesterone balance. During IVF, men and women are both advised to avoid alcohol because, in women, it can lead to reduced egg production and, in men, it may reduce the number of healthy sperm.

• Weight: Being too thin or too heavy can have an impact on how quickly you conceive. Excessive thinness is known to interfere with menstrual periods. Now, it is also believed that if both partners are overweight or obese, conception will take longer.

• Smoking: Smokers have an increased rate of repeated miscarriage.  Women smokers have been shown to have lower levels of oestrogen which may delay conception. Smoking is also thought to influence tubal factor infertility, and can cause early menopause. In men, smoking may damage sperm. When men stop smoking, their sperm count increases quickly. 

By following the Chinese medicine approach to balancing your body, mind and spirit, you will not only boost your fertility but you will feel more energized, sleep better and experience a greater sense of wellbeing.  
                                                               
Summary
       
In summary, Acupuncture and Chinese herbs have a long history of benefiting fertility in many ways. Benefits of TCM include:

1. Improvements in your uterine lining
2. Increased blood flow to your uterus
3. Regulation of your hormones
4. Reduction of your stress associated with fertility problems
5. Improved function of your ovaries
6. Increased conception with or without ART
7. Increased live birth rates
8. Lower rates of ectopic pregnancies                              

And for men…

• Improved semen quality and quantity
• Reduce stress and improve well being 

                      
About the Author
Jennifer earned her Master of Science degree in Oriental Medicine from Southwest Acupuncture College, an accredited 4 year Master’s program in Boulder, Colorado. She received her Diplomate from the NCCAOM, the National Certification Commission for Acupuncture and Oriental Medicine and completed an internship at the Sino-Japanese Friendship Hospital in Beijing, China. Jennifer has been in practice since 2001. She has a passion for her work and has researched and written articles on Chinese medicine. She holds a Bachelor of Science Degree in Kinesiology from the University of Illinois. She can be reached at 312-399-5098 or through e-mail at TCM007@aol.com.

References

1. Paulus, W., et al. Fertility and Sterility. April, Vol. 77 (4):721-724, 2002.
2. Dieterle,S., Ying, G., Hatzmann, W., Neuer, A. Fertility and Sterility, May, Vol. 85 (5):1347-135, 2006.
3. Westergaard, L., Mao, Q., et al. Fertility and Sterility, May, Vol. 85 (5): 1341-1346, 2006.
4. Smith, C., Coyle, M., et al. Fertility and Sterility, May, Vol. 85 (5) 1352-1358, 2006.
5. Pei, J., Strehler, E., Noss, U. et al. Fertility and Sterility, July, Vol. 84 (1), pgs. 141-7, 2005.
6. Cnattingius, S. et al, New England Journal of Medicine Vol.343(25):1839-1845, Dec., 2000.
7. George, L., et al. Paediatric and Perinatal Epidemiology, Vol. 20 (2): 119-126, March, 2006.
8. Ibid.

Additional references
The Infertility Cure: The Ancient Chinese Wellness Program for Getting Pregnant and Having Healthy Babies by Dr. Randine Lewis.
 Human Reproduction Journal, Volume 11, Number 6, 1996.
Fertility and Sterility, Volume 78, Number 6, December 2002 Raised cortisol predicts spontaneous abortion Source: Proceedings of the National Academy of Sciences 2006. Early online publication

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Acupuncture Does Help Fertility. There are more than30 recommendations for Dr Arthur Fan,from DC UrbanMom.com Washington DC

Dr. Arthur Fan has been highly recommended by patients and their friends in Acupuncture/Chinese Medicine treating infertility.

Recently, one of his infertility patients told him that she comes to see him “only” because there are so many recommendations online, especially on one of most popular websites in fertility discussions called DCUrbanMom.com.

There are more than 30 recommendations in that website for Dr. Arthur Fan(sometime the name was misspelled as “Arthur Fann”, or” drthur fan”).  Some of them also described the detail information.

Read more at:

Arthur Fan-AcupunctureFertility 04022010

http://www.dcurbanmom.com/jforum/jforum.page?module=search&action=search&search_keywords=arthur+fan&match_type=all&search_forum=&sort_by=relevance

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Why You Are Still Hesitate to Use Organic Medicine? Such As Acupunture, Or Chinese Herbology? by Dr.Arthur Fan 03/10/2010

Nowadays, many people prefer to use organic foods, because they are afraid of chemicals, such as chemicals for killing the insects, fertilizers, etc., which may be harmful to our body, esp. when we get such chemicals in a certain amount in a short-term, or a very small amount in a long-term. We do have concerns.

However, when people are sick, most of them still prefer to use chemical medications. The reasons are complicated, but the main reason probably is the healthcare system has been controlled by pharmaceutical companies, which use a lot of money each year to protect their interests by lobbing the congress, supporting medical schools, their style scientific studies, etc. MDs actually intentionally or unintentionally become drug sale representatives, in some extent. Due to the health insurance system, patients have to go to MDs to get examinations, advises, prescriptions (using chemicals). Actually, Patients have no choice. And very high percentage of patients may not be aware that using chemical drugs could cause potential problems.

Another reason that patients prefer the use of chemical drugs is that they feel chemical drug-style medicine is scientific, best in testing, and based on their education. Also they may think they will get results faster.

An example is for fertility treatments. In conventional medicine, MDs prefer In vitro fertilization (IVF), by using different chemical drugs to help patient to get pregnant quickly (20-30% success rate). After such a process, I really don’t know if the quality of such a child is still the best.

We are often afraid of something may be wrong for maintaining our health– when we eat animal foods, which grow so fast under chemicals stimulation. However, when we think of having our babies, we also use such a chemical procedure. It seems have some potential worry in there.

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