1
|
Zhang HR, Zhang C, Ma PH, Sun CY, Sun CY, Liu XY, Pu ZQ, Lin YH, Liu BY, Liu CZ, Yan SY. Pregnancy Benefit of Acupuncture on in vitro Fertilization: A Systematic Review and Meta-Analysis. Chin J Integr Med 2023; 29:1021-1032. [PMID: 37815728 DOI: 10.1007/s11655-023-3748-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Currently, more and more infertility couples are opting for combined acupuncture to improve success rate of in vitro fertilization (IVF). However, evidence from acupuncture for improving IVF pregnancy outcomes remains a matter of debate. OBJECTIVE To quantitatively summarized the evidence of the efficacy of acupuncture among women undergoing IVF by means of systematic review and meta-analysis. METHODS Four English (PubMed, Web of Science, EMBASE, and Cochrane Register of Controlled Clinical Trials) and Four Chinese databases (Wanfang Databases, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and SinoMed) were searched from database inception until July 2, 2023. Randomized controlled trials (RCTs) that evaluated the acupuncture's effects for women undergoing IVF were included. The subgroup analysis was conducted with respect to the age of participants, different acupuncture types, type of control, acupuncture timing, geographical origin of the study, whether or not repeated IVF failure, and acupuncture sessions. Sensitivity analyses were predefifined to explore the robustness of results. The primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR), and the secondary outcomes were ongoing pregnancy rate and miscarriage rate. Random effects model with I2 statistics were used to quantify heterogeneity. Publication bias was estimated by funnel plots and Egger's tests. RESULTS A total of 58 eligible RCTs representing 10,968 women undergoing IVF for pregnant success were identifified. Pooled CPR and LBR showed a signifificant difference between acupuncture and control groups [69 comparisons, relative risk (RR) 1.19, 95% confifidence intervals (CI) 1.12 to 1.25, I2=0], extremely low evidence; 23 comparisons, RR 1.11, 95%CI 1.02 to 1.21, I2=14.6, low evidence, respectively). Only transcutaneous electrical acupoint stimulation showed a positive effect on both CPR (16 comparisons, RR 1.17, 95%CI 1.06 to 1.29; I2=0, moderate evidence) and LBR (9 comparisons, RR 1.20, 95%CI 1.04 to 1.37; I2=8.5, extremely low evidence). Heterogeneity across studies was found and no studies were graded as high-quality evidence. CONCLUSION Results showed that the convincing evidence levels on the associations between acupuncture and IVF pregnant outcomes were relatively low, and the varied methodological design and heterogeneity might inflfluence the fifindings. (Registration No. PROSPERO CRD42021232430).
Collapse
Affiliation(s)
- Hao-Ran Zhang
- College of Preschool Education, Beijing Youth Politics College, Beijing, 100102, China
| | - Cheng Zhang
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Pei-Hong Ma
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Cheng-Yi Sun
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Chong-Yang Sun
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Xiao-Yu Liu
- School of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Zhen-Qing Pu
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yu-Han Lin
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Bao-Yan Liu
- China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Cun-Zhi Liu
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Shi-Yan Yan
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China.
| |
Collapse
|
2
|
Feng X, Zhu N, Yang S, Wang L, Sun W, Li R, Gong F, Han S, Zhang R, Han J. Transcutaneous electrical acupoint stimulation improves endometrial receptivity resulting in improved IVF-ET pregnancy outcomes in older women: a multicenter, randomized, controlled clinical trial. Reprod Biol Endocrinol 2022; 20:127. [PMID: 35996188 PMCID: PMC9396882 DOI: 10.1186/s12958-022-00997-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To examine the effects and mechanisms of transcutaneous electrical acupoint stimulation (TEAS) on pregnancy outcomes in women undergoing in vitro fertilization (IVF)-embryo transfer (ET). DESIGN, SETTING, AND PARTICIPANTS This efficacy study was a multicenter, randomized, controlled clinical trial (RCT) in women receiving IVF-ET. The mechanistic study was a single-center RCT. INTERVENTIONS The participants received TEAS vs. no TEAS treatment. MAIN OUTCOME MEASURES In the efficacy study, the primary outcomes were the rates of clinical pregnancy, embryo implantation, and live birth. In the mechanistic study, sex hormones and endometrial protein expression were examined. RESULTS Ultimately, 739 participants were enrolled (367 and 372 in the TEAS and control groups, respectively). The clinical pregnancy rate was higher in the TEAS group than in the controls (55.1% vs. 46.7%, P = 0.03). There were no significant differences in embryo implantation, biochemical pregnancy, and live birth rates between the two groups (all P > 0.05) in the study population. In women > 35 years, the clinical pregnancy rates, embryo implantation rates and live birth rates in the TEAS and control groups were 48.9% vs. 23.7% (P = 0.004),30.8 vs. 13.9% (P = 0.001) and 34.0% vs. 19.7% (P = 0.06) respectively. In the mechanistic study with 120 participants, on the theoretical embryo implantation day, better developed endometrial pinopodes, elevated endometrial integrin α1β1/αVβ3, leukemia inhibitory factor, and elevated serum progesterone levels were found in the TEAS group compared with controls. CONCLUSION TEAS significantly improved the clinical pregnancy rate in women undergoing IVF-ET, especially in women of older age. It might be due to improved endometrial receptivity. TRIAL REGISTRATION ChiCTR-TRC-13003950.
Collapse
Affiliation(s)
- Xiaojun Feng
- Center of Reproductive Medicine, The Second Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, 250001, China
| | - Na Zhu
- Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, 410000, China
| | - Shuo Yang
- Center of Reproductive Medicine, Department of Obstetrics and GynecologyKey Laboratory of Assisted Reproduction, Ministry of EducationBeijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, 100191, China
| | - Li Wang
- Center of Reproductive Medicine, The Second Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, 250001, China
| | - Wei Sun
- Center of Reproductive Medicine, The Second Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, 250001, China
| | - Rong Li
- Center of Reproductive Medicine, Department of Obstetrics and GynecologyKey Laboratory of Assisted Reproduction, Ministry of EducationBeijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, 100191, China
| | - Fei Gong
- Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, 410000, China
| | - Songping Han
- Wuxi Shengpingxintai Medical Technology Co., Ltd, Wuxi, 214091, China
| | - Rong Zhang
- Department of Neurobiology, School of Basic Medical Sciences, Key Lab for Neuroscience, Neuroscience Research Institute, Peking UniversityPeking University Health Science CenterThe Ministry of EducationThe Ministry of Health, Beijing, 100191, China.
- Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences, Peking University, Beijing, 100191, China.
| | - Jisheng Han
- Department of Neurobiology, School of Basic Medical Sciences, Key Lab for Neuroscience, Neuroscience Research Institute, Peking UniversityPeking University Health Science CenterThe Ministry of EducationThe Ministry of Health, Beijing, 100191, China.
| |
Collapse
|
3
|
Acupuncture for Female Infertility: Discussion on Action Mechanism and Application. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3854117. [PMID: 35832528 PMCID: PMC9273356 DOI: 10.1155/2022/3854117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/11/2022] [Indexed: 11/18/2022]
Abstract
A higher incidence of female infertility has been reported with an unexpectedly early appearance in recent years. The female infertility treatment and application of assisted reproductive technology have recently gained immense interest from scientists. Many studies have discussed the beneficial effects of acupuncture on female infertility. With advancements in science and medical technology, acupuncture-related research has increased in investigating its effectiveness in treating female infertility. This review focuses on a compilation of research in recent years on acupuncture for female infertility treatment and the exploration of the underlying mechanism. For this purpose, literature was searched using various search engines like PubMed, Web of Science, and Google Scholar. The search was refined by only focusing on recent studies on acupuncture effectiveness and mechanism in female infertility and evaluating pregnancy outcomes.
Collapse
|
4
|
Acupuncture as Treatment for Female Infertility: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3595033. [PMID: 35222669 PMCID: PMC8865966 DOI: 10.1155/2022/3595033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/08/2022] [Indexed: 01/04/2023]
Abstract
Background The effects of acupuncture on female infertility remain controversial. Also, the variation in the participant, interventions, outcomes studied, and trial design may relate to the efficacy of adjuvant acupuncture. The aim of the study is to systematically evaluate the efficacy and safety of acupuncture for female with infertility and hopefully provide reliable guidance for clinicians and patients. Methods We searched digital databases for relevant studies, including EMBASE, PubMed, Cochrane Library, and Web of Science, and the Cochrane Library up to April 2021, for randomized controlled trials (RCTs) evaluating the effects of acupuncture on women undergoing IVF and other treatment. We included studies with intervention groups using acupuncture and control groups consisting of no acupuncture or sham (placebo) acupuncture. Primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Meta-regression and subgroup analysis were conducted on the basis of ten prespecified covariates to investigate the variances of the effects of adjuvant acupuncture on pregnancy rates and the sources of heterogeneity. Results: Twenty-seven studies with 7676 participants were included. The results showed that the intervention group contributes more in outcomes including live birth rate (RR = 1.34; 95% CI (1.07, 1.67); P < 0.05), clinical pregnancy rate (RR = 1.43; 95% CI (1.21, 1.69); P < 0.05), biochemical pregnancy rate (RR = 1.42; 95% CI (1.05, 1.91); P < 0.05), ongoing pregnancy rate (RR = 1.25; 95% CI (0.88, 1.79); P < 0.05), adverse events (RR = 1.65; 95% CI (1.15, 2.36); P < 0.05), and implantation rate (MD = 1.19; 95% CI (1.07, 1.33); P < 0.05) when compared with the control group, and the difference is statistically significant. In terms of the number of oocytes retrieved, good-quality embryo rate, miscarriages, and ectopic pregnancy rate, the difference between the acupuncture group and the control group was not statistically significant. Conclusions: Our analysis finds a benefit of acupuncture for outcomes in women with infertility, and the number of acupuncture treatments is a potential influential factor. Given the poor reporting and methodological flaws of existing studies, studies with larger scales and better methodologies are needed to verify these findings. More double-blind RCTs equipped with high quality and large samples are expected for the improvement of the level of evidence.
Collapse
|
5
|
Zhou X, Li X, Ding H, Lu Y. Acupuncture effects on in-vitro fertilization pregnancy outcomes: A meta-analysis. Complement Ther Clin Pract 2021; 46:101525. [PMID: 34979465 DOI: 10.1016/j.ctcp.2021.101525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/22/2021] [Accepted: 12/26/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The effects of acupuncture on in-vitro fertilization outcomes remain controversial. This study aimed to perform a meta-analysis to assess the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls on improving pregnancy outcomes in women undergoing in-vitro fertilization. METHODS A systematic literature search up to January 2021 was performed and 29 studies included 6623 individuals undergoing in-vitro fertilization at the baseline of the study; 3091 of them were using acupuncture as an adjuvant therapy to embryo transfer, 1559 of them were using sham-controls, and 1441 of them were using no adjuvant therapy controls. They reported a comparison between the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls on improving pregnancy outcomes in women undergoing in-vitro fertilization. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated assessing the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls using the dichotomous method with a random or fixed-effect model. RESULTS Significantly higher outcomes with acupuncture were observed in biochemical pregnancy (OR, 1.98; 95% CI, 1.55-2.53, p < 0.001); clinical pregnancy (OR, 1.70; 95% CI, 1.46-1.98, p < 0.001); ongoing pregnancy (OR, 1.78; 95% CI, 1.41-2.26, p < 0.001); and live birth (OR, 1.58; 95% CI, 1.15-2.18, p = 0.005) compared to no adjuvant therapy controls. However, no significant difference were found between acupuncture and no adjuvant therapy controls in miscarriage (OR, 0.96; 95% CI, 0.48-1.92, p = 0.91). No significant difference was observed with acupuncture in biochemical pregnancy (OR, 1.16; 95% CI, 0.65-2.08, p = 0.62); clinical pregnancy (OR, 1.13; 95% CI, 0.83-1.54, p = 0.43); ongoing pregnancy (OR, 1.04; 95% CI, 0.66-1.62, p = 0.87); live birth (OR, 1.02; 95% CI, 0.73-1.42, p = 0.90), and miscarriage (OR, 1.16; 95% CI, 0.86-1.55, p = 0.34) compared to sham-controls. CONCLUSIONS Using acupuncture as an adjuvant therapy to embryo transfer may improve the biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth outcomes compared to no adjuvant therapy controls. However, no significant difference was found between acupuncture as an adjuvant therapy to embryo transfer and sham-controls in any of the measured outcomes. This relationship forces us to recommend the use of acupuncture as adjuvant therapy in women undergoing in-vitro fertilization and inquire further studies comparing acupuncture and sham-controls to reach the best procedure.
Collapse
Affiliation(s)
- Xue Zhou
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China
| | - Xiuling Li
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China
| | - Hui Ding
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China
| | - Ying Lu
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China.
| |
Collapse
|
6
|
The Effects of Acupuncture on Pregnancy Outcomes of Recurrent Implantation Failure: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6661235. [PMID: 33613685 PMCID: PMC7878089 DOI: 10.1155/2021/6661235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/16/2021] [Accepted: 01/21/2021] [Indexed: 01/12/2023]
Abstract
Objective To systematically evaluate the efficacy and safety of acupuncture for patients with recurrent implantation failure (RIF) undergoing in vitro fertilization-embryo transfer (IVF-ET) and hopefully provide reliable guidance for clinicians and patients. Methods Through searching domestic and foreign medical journals, the literature of randomized controlled trials (RCTs) of acupuncture for RIF undergoing IVF-ET was collected. RevMan 5.3 software was used for meta-analysis and Cochrane's risk of bias assessment tool was used to evaluate the quality of the included studies. Results Seven documents meeting the criteria were finally included. The results showed that the intervention group contributes more in outcomes including clinical pregnancy rate (RR = 1.90, 95% CI (1.51, 2.40), P < 0.05), biochemical pregnancy rate (RR = 1.59, 95% CI (1.27, 1.99), P < 0.05), embryo implantation rate (RR = 1.89, 95% CI (1.47, 2.45), P < 0.05), and endometrial thickness (MD = 1.11, 95% CI (0.59, 1.63), P < 0.05) when compared with the control group, and the difference is statistically significant. In terms of the number of embryo transfers and the type of endometrium, the difference between the acupuncture group and the control group was not statistically significant. Conclusion Acupuncture therapy on patients with RIF can improve the pregnancy outcome of patients. It is a relatively effective treatment with satisfactory safety and suitable for clinical application. However, as the quality of the included studies is not good enough, the conclusion of this meta-analysis should be treated with caution. More double-blind RCTs equipped with high quality and large samples are expected for the improvement of the level of evidence.
Collapse
|
7
|
Effectiveness of acupuncture on pregnancy success rates for women undergoing in vitro fertilization: A randomized controlled trial. Taiwan J Obstet Gynecol 2020; 59:282-286. [DOI: 10.1016/j.tjog.2020.01.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2019] [Indexed: 11/18/2022] Open
|
8
|
Integrated miRNA-seq analysis reveals the molecular mechanism underlying the effect of acupuncture on endometrial receptivity in patients undergoing fertilization: embryo transplantation. 3 Biotech 2020; 10:6. [PMID: 31824817 DOI: 10.1007/s13205-019-1990-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/12/2019] [Indexed: 12/16/2022] Open
Abstract
Endometrial receptivity (ER) is the main factor affecting in vitro fertilization (IVF) and embryo transplantation. Previous studies have shown that acupuncture might be useful for increasing ER. However, the underlying microRNA (miRNA) molecular mechanisms deserve to be further elucidated. In this study, we performed small RNA sequencing of endometrial samples from infertile women who either underwent acupuncture therapy or did not. Differentially expressed microRNAs (DEmiRNAs) were identified and used to predict target genes. Then, the functional and pathway were analyzed for the target genes. Moreover, quantitative reverse transcription PCR (qRT-PCR) was performed to validate the RNA-seq results. Finally, the miRNA-gene network was conducted by Cytoscape. A total of 39 DEmiRNAs were identified between the acupuncture group and the control group. The functional enrichment analysis suggested that the target genes of the DEmiRNAs were significantly enriched in GO biological process (BP) terms associated with transcription, such as regulation of DNA-templated transcription and positive regulation of DNA-templated transcription. The pathway analysis showed that DEmiRNAs might be involved in acupuncture therapy via Endocytosis, Axon guidance, Oxytocin signaling, the Hippo pathway, and Estrogen signaling pathways. Significant downregulation of hsa-miR-449a and hsa-miR-449b-3p, and significant upregulation of hsa-miR-3135b and hsa-miR-345-3p in the RNA-seq results were validated by qRT-PCR. Besides, these four DEmiRNAs and their 34 target genes conducted a miRNA-gene network. Our results predict that hsa-miR-449a, hsa-miR-3135b and hsa-miR-345-3p may underly mechanisms by which acupuncture therapy help increase ER and promote endometrium receptivity in preparation for in vitro fertilization and embryo transplantation.
Collapse
|
9
|
Kusuma AC, Oktari N, Mihardja H, Srilestari A, Simadibrata CL, Hestiantoro A, Wiweko B, Muna N. Electroacupuncture Enhances Number of Mature Oocytes and Fertility Rates for In Vitro Fertilization. Med Acupunct 2019; 31:289-297. [PMID: 31624528 DOI: 10.1089/acu.2019.1368] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective: The increasing prevalence of infertility every year is in line with the increasing need for in vitro fertilization (IVF) programs. Failure of oocyte maturation is an obstacle that often causes low success in IVF. According to several studies, controlled ovarian stimulation (COS) has been reported to increase the risk of granulosa-cell apoptosis associated with inhibition of oocyte maturation. This study was conducted to determine the effect of electroacupuncture (EA) on oocyte maturation; rate of fertilization; granulosa-cell apoptosis; and levels of growth-differentiation factor 9 (GDF9) and bone-morphogenetic protein 15 (BMP15) an IVF program. Materials and Methods: A randomized controlled trial was conducted with 24 subjects who were in the IVF program. Subjects were randomly allocated into verum-EA (n = 12) and sham-EA groups (n = 12). Microscopic assessment of oocyte maturation and rate of fertilization was performed by embryologists, and examinations of granulosa-cell apoptosis index (Bax/Bcl-2 ratio), GDF9, and BMP15 were performed, using real-time quantitative polymerase chain reaction and messenger-RNA techniques. Results: There were significant differences in oocyte maturation (P = 0.02) and fertilization rates (P = 0.03) between the verum-EA and sham-EA groups. There were differences in granulosa-cell apoptosis index between the verum-EA and sham-EA groups (P < 0.001). There were significant differences in Bax-protein expression (P = 0.04) and Bcl-2 (P = 0.03) granulosa cells between the verum-EA and sham-EA groups. There was no significant difference in GDF9 levels (P = 0.34) and BMP15 (p = 0.47) between the verum-EA and sham-EA groups. Conclusions: EA can enhance oocyte maturation and fertilization rate, and reduce the granulosa-cell apoptosis index in an IVF program.
Collapse
Affiliation(s)
- Ayu Cintani Kusuma
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nadia Oktari
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Hasan Mihardja
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Adiningsih Srilestari
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Christina L Simadibrata
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Andon Hestiantoro
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Budi Wiweko
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Naylah Muna
- Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute, Universitas Indonesia, Jakarta, Indonesia
| |
Collapse
|
10
|
Gu YE, Zhang X, Zhang Q, Dai MC, Wu Y, Zhou Y, Qu F. The effects of acupuncture on pregnancy outcomes of in vitro fertilization with embryo transfer: An interdisciplinary systematic review. J Gynecol Obstet Hum Reprod 2019; 48:677-684. [PMID: 31276842 DOI: 10.1016/j.jogoh.2019.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/25/2019] [Accepted: 07/01/2019] [Indexed: 12/14/2022]
Abstract
The present systematic review is designed to summarize the evidence concerning the effect of acupuncture on pregnancy outcomes in vitro fertilization with embryo transfer (IVF-ET). We searched MEDLINE, the Wanfang Database, the China Academic Journal Electronic Full-text Database in the China National Knowledge Infrastructure, and the Index to Chinese Periodical Literature. Randomized controlled trials with intervention groups using acupuncture and control groups consisting of no acupuncture or sham (placebo) acupuncture in IVF-ET treatment were selected. Study characteristics were examined from these studies and an intention-to-treat approach was used to extract outcome data from each study. In total, 31 articles including 4450 women passed our selection criteria. The legitimacy, characteristics, and IVF outcomes of the included trials were summarized. Additional Traditional Chinese Medicine (TCM) theory-based, standardized, large-size, randomized, and multicenter trials are necessary prior to any conclusions being drawn on whether TCM can improve IVF outcomes.
Collapse
Affiliation(s)
- Ying-Er Gu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xian Zhang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qing Zhang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Min-Chen Dai
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yan Wu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yong Zhou
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fan Qu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| |
Collapse
|
11
|
Acupuncture Enhances Chances of Pregnancy in Unexplained Infertile Patients Who Undergo A Blastocyst Transfer in A Fresh-Cycle. Chin J Integr Med 2019; 25:298-302. [PMID: 31236890 DOI: 10.1007/s11655-018-2918-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2017] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To analyze the effects of acupuncture on in vitro fertilization patients with unexplained infertility. METHODS We retrospectively analyzed the charts of a total of 302 cycles performed in 273 patients attending Assisted Reproductive Technology (ART) Centre from August 2013 to August 2016. During the study period, embryo transfer with acupuncture (Acupuncture group, 46 cases) and without acupuncture (Control group, 42 cases) were applied. Prior to embryo transfer, the following points were used in the acupuncture group: Neiguan (CX 6), Diji (SP 8), Taichong (Liv 3), Baihui (Gv 20), and Guilai (S 29). These sessions were carried out two times before and after embryo transfer in a single day. In addition, auricular acupuncture was also performed at ear points, including ear point 55 (Shenmen), ear point 58 (Zhigong), ear point 22 (Neifenmi) and ear point 34 (Naodian). The biochemical pregnancy rate and clinical pregnancy rate after transplantation were compared between two groups. RESULTS The clinical pregnancy rate in the acupuncture group was higher than that in the control group [60.9% (28/46) vs. 33.3% (14/42), respectively, P<0.05]. Likewise, the live birth rate in the acupuncture group was also higher than that in the control group [71.7% (33/46) vs. 31.0% (12/42), P<0.01). CONCLUSION Administration of acupuncture on the day of embryo transfer dramatically improved fertility results in women who underwent in vitro fertilization/intra-cytoplasm sperm injection for reproduction.
Collapse
|
12
|
Xie ZY, Peng ZH, Yao B, Chen L, Mu YY, Cheng J, Li Q, Luo X, Yang PY, Xia YB. The effects of acupuncture on pregnancy outcomes of in vitro fertilization: a systematic review and meta-analysis. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:131. [PMID: 31200701 PMCID: PMC6570865 DOI: 10.1186/s12906-019-2523-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 05/15/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND The effects of acupuncture on in vitro fertilization (IVF) outcomes remain controversial. And the variation in participant, interventions, outcomes studied, and trial design may relate to the efficacy of adjuvant acupuncture. METHODS We searched digital databases for relevant studies, including Embase, PubMed, Cochrane Library and some Chinese databases up to December 2018, for randomized controlled trials (RCTs) evaluating the effects of acupuncture on women undergoing IVF. We included studies with intervention groups using needling, and control groups consisting of no acupuncture or sham (placebo) acupuncture. Primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Meta-regression and subgroup analysis were conducted on the basis of eight pre-specified covariates to investigate the variances of the effects of adjuvant acupuncture on pregnancy rates and the sources of heterogeneity. RESULTS Twenty-seven studies with 6116 participants were included. The pooled clinical pregnancy rate (CPR) from all of acupuncture groups was significantly greater than that of control groups (RR 1.21, 95% CI: 1.07-1.38), whereas the pooled live birth rate (LBR) was not. Meta-regression subgroup analysis showed a more significant benefit of acupuncture for repeated IVF cycle proportion (number of women with a history of prior unsuccessful IVF attempt divided by number of women included in each trial) ≥ 50% group (CPR: RR 1.60, 95% CI: 1.28-2.00; LBR: RR 1.42, 95% CI: 1.05-1.92), and this covariate explained most of the heterogeneity (CPR and LBR: adjusted R2 = 100 and 87.90%). Similar results were found between CPR and number of acupuncture treatments (CPR: p = 0.002, adjusted R2 = 51.90%), but not LBR. CONCLUSIONS Our analysis finds a benefit of acupuncture for IVF outcomes in women with a history of unsuccessful IVF attempt, and number of acupuncture treatments is a potential influential factor. Given the poor reporting and methodological flaws of existing studies, studies with larger scales and better methodologies are needed to verify these findings.
Collapse
Affiliation(s)
- Zheng-yun Xie
- Nanjing Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhi-hang Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Bing Yao
- Center of Reproductive Medicine, Nanjing Jinling Hospital, Nanjing University School of Medical, Nanjing, China
| | - Li Chen
- Center of Reproductive Medicine, Nanjing Jinling Hospital, Nanjing University School of Medical, Nanjing, China
| | - Yan-yun Mu
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Cheng
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qian Li
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xi Luo
- Changzheng Hospital of the Second Military Medical University, Nanjing branch, Nanjing, China
| | - Peng-yan Yang
- Nanjing Jiangning Hospital of Traditional Chinese Medicine, Nanjing, China
| | | |
Collapse
|
13
|
Shuai Z, Li X, Tang X, Lian F, Sun Z. Transcutaneous electrical acupuncture point stimulation improves pregnancy outcomes in patients with recurrent implantation failure undergoing in vitro fertilisation and embryo transfer: a prospective, randomised trial. Acupunct Med 2019; 37:33-39. [PMID: 30864824 DOI: 10.1136/acupmed-2017-011483] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective: To evaluate the effect of transcutaneous electrical acupuncture stimulation (TEAS) on pregnancy outcomes in patients with recurrent implantation failure (RIF) undergoing in vitro fertilisation (IVF). Methods: A total of 122 women with RIF undergoing fresh embryo transfer cycle IVF were randomly allocated to a TEAS or mock TEAS (MTEAS) group. Gonadotrophin therapy using a long protocol was provided in both groups. TEAS consisted of 30 min of stimulation (9–25 mA, 2 Hz) at SP6, CV3, CV4 and Zigong from day 5 of the ovarian stimulation cycle once every other day until the day of embryo transfer. The patients in the control group received MTEAS. Implantation, clinical pregnancy and live birth rates were compared. Results: In the TEAS group, the implantation rate, clinical pregnancy rate and live birth rate (24.3%, 32.8% and 27.9%, respectively) were significantly higher than in the MTEAS group (12.1%, 16.4% and 13.1%, respectively). Conclusions: TEAS significantly improves the clinical outcomes of subsequent IVF cycles among women who have experienced RIF. Trial registration number: ChiCTR-TRC-14004730.
Collapse
Affiliation(s)
- Zhenhong Shuai
- Center for Reproductive Medicine, The Affiliated Shenzhen City Maternity and Child Healthcare Hospital of Southern Medical University, Shenzhen, China
| | - Xuemei Li
- Center for Reproductive Medicine, The Affiliated Shenzhen City Maternity and Child Healthcare Hospital of Southern Medical University, Shenzhen, China
| | - Xuelian Tang
- Center for Reproductive Medicine, The Affiliated Shenzhen City Maternity and Child Healthcare Hospital of Southern Medical University, Shenzhen, China
| | - Fang Lian
- The Fourth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen, China
| | - Zhengao Sun
- The Fourth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen, China
| |
Collapse
|
14
|
Smith CA, Armour M, Shewamene Z, Tan HY, Norman RJ, Johnson NP. Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis. Reprod Biomed Online 2019; 38:364-379. [PMID: 30658892 DOI: 10.1016/j.rbmo.2018.12.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 09/05/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
Abstract
This was a systematic review and meta-analysis to examine the efficacy, effectiveness and safety of acupuncture as an adjunct to embryo transfer compared with controls to improve reproductive outcomes. The primary outcome was clinical pregnancy. Twenty trials and 5130 women were included in the review. The meta-analysis found increased pregnancies (risk ratio [RR] 1.32, 95% confidence interval [CI] 1.07-1.62, 12 trials, 2230 women), live births (RR 1.30, 95% CI 1.00-1.68, 9 trials, 1980 women) and reduced miscarriage (RR 1.43, 95% CI 1.03-1.98, 10 trials, 2042 women) when acupuncture was compared with no adjunctive control. There was significant heterogeneity, but no significant differences between acupuncture and sham controls. Acupuncture may have a significant effect on clinical pregnancy rates, independent of comparator group, when used in women who have had multiple previous IVF cycles, or where there was a low baseline pregnancy rate. The findings suggest acupuncture may be effective when compared with no adjunctive treatment with increased clinical pregnancies, but is not an efficacious treatment when compared with sham controls, although non-specific effects may be active in both acupuncture and sham controls. Future research examining the effects of acupuncture for women with poorer IVF outcomes is warranted.
Collapse
Affiliation(s)
- Caroline A Smith
- NICM Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia.
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia
| | - Zewdneh Shewamene
- NICM Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia
| | - Hsiewe Ying Tan
- School of Science and Health, Western Sydney University, Penrith NSW 2751, Australia
| | - Robert J Norman
- Robinson Research Institute, University of Adelaide and Fertility SA, Adelaide SA 5000, Australia
| | - Neil P Johnson
- Robinson Research Institute, University of Adelaide and Fertility SA, Adelaide SA 5000, Australia; Repromed Auckland, 105 Remuera Road, Auckland 1050, New Zealand
| |
Collapse
|
15
|
Zhang X, Lee MS, Smith CA, Robinson N, Zhou Y, Wu Y, Mao YY, Qu F. Effects of acupuncture during in vitro fertilization or intracytoplasmic sperm injection: An updated systematic review and meta-analysis. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
16
|
Gay C, Cros A, Berbis J, Bretelle F, Perrin J, Courbiere B. Evaluation of "Energy Resonance by Cutaneous Stimulation" Among Women Treated by In Vitro Fertilization. J Altern Complement Med 2018; 24:578-583. [PMID: 29641245 DOI: 10.1089/acm.2017.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Pregnancy rate in in vitro fertilization (IVF) depends on many factors, such as the characteristics of the couple and the clinicobiological parameters. Interest in alternative and complementary medicine (ACM) for IVF is discussed because of the lack of scientific evidence. Energy resonance by cutaneous stimulation (ERCS), an acupuncture-like technique, consists of skin stimulation to transmit vibratory messages. The aim of this study was to evaluate the effect of ERCS on live birth rates (LBRs) in IVF. DESIGN A prospective observation study was performed in the Unit of Assisted Reproductive Technologies of a University Teaching Hospital. Every woman who agreed to participate in this study and received a fresh embryo transfer (ET) after IVF or Intracytoplasmic Sperm Injection (ICSI) was included. Patients randomly underwent an ERCS session on the day of ET according to the schedule of the midwife performing this technique. The control group consisted of women undergoing ET under usual conditions. The main outcome measure was the LBR per transfer. RESULTS Three-hundred-eighteen women were included, 120 in the ERCS + ET group and 198 in the ET without ERCS group. None of the women dropped out. The clinical characteristics in both groups were comparable. There was a significant difference in the clinical pregnancy rates, 31.7% in the ERCS group versus 21.7% in the No ERCS group (p = 0.037). The LBR in the ERCS group was nearly significantly higher, 29.2% versus 20.7% in the No ERCS group (p = 0,059). CONCLUSIONS Women undergoing ERCS on the day of ET had a significantly higher IVF pregnancy rate. However, this methodology made not possible to draw conclusions about the mechanisms that induced the increase of IVF LBRs: placebo effect, "cocooning," or ERCS self-effect? Further well-conducted studies are strongly needed to assess ERCS efficacy.
Collapse
Affiliation(s)
- Camille Gay
- 1 Department of Gynecology-Obstetric and Reproductive Medicine , AP-HM, Hôpital La Conception-Hôpital Nord, Marseille, France
| | - Anne Cros
- 1 Department of Gynecology-Obstetric and Reproductive Medicine , AP-HM, Hôpital La Conception-Hôpital Nord, Marseille, France
| | - Julie Berbis
- 2 EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix Marseille University , Marseille, France
| | - Florence Bretelle
- 1 Department of Gynecology-Obstetric and Reproductive Medicine , AP-HM, Hôpital La Conception-Hôpital Nord, Marseille, France .,3 Aix Marseille University, CNRS UMR 7278, Inserm U1095 , Marseille, France
| | - Jeanne Perrin
- 1 Department of Gynecology-Obstetric and Reproductive Medicine , AP-HM, Hôpital La Conception-Hôpital Nord, Marseille, France .,4 Aix Marseille University, CNRS, IRD, Avignon University , IMBE UMR 7263, Marseille, France
| | - Blandine Courbiere
- 1 Department of Gynecology-Obstetric and Reproductive Medicine , AP-HM, Hôpital La Conception-Hôpital Nord, Marseille, France .,4 Aix Marseille University, CNRS, IRD, Avignon University , IMBE UMR 7263, Marseille, France
| |
Collapse
|
17
|
Saffari M, Khashavi Z, Valiani M. The Effect of Auriculotherapy on the Stress and the Outcomes of Assistant Reproductive Technologies in Infertile Women. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:8-13. [PMID: 29344039 PMCID: PMC5769191 DOI: 10.4103/ijnmr.ijnmr_105_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background: Infertility means failure to achieve pregnancy after one year of regular unprotected sexual intercourse. Infertile women may experience severe stress and depression. Numerous studies have indicated that auriculotherapy could reduce stress. Thus, the aim of the present study was to determine the effect of auriculotherapy on the stress and the outcome assisted reproductive technology in infertile women. Materials and Methods: The present study was a clinical trial that was conducted on 56 infertile women aged 20–45, who were assigned into two groups of intervention and control, from November 2014 to November 2015. The control group only received the routine treatments, while the intervention group, in addition to their routine treatment, received auriculotherapy for 8–10 sessions during menstrual cycle. Both groups completed Newton's Fertility Problem Inventory in three stages. The datasets collected for the study were analyzed using independent t-test, repeated-measures analysis of variance, and Chi-square test. Results: The mean score of stress in the intervention group decreased significantly, compared to the control group prior to the embryo transfer and pregnancy test stages. Although insignificant, the rate of pregnancy in the intervention group was higher than the control group. There was a significant increase in the rate of clinical pregnancy in the intervention group, compared to the control. Conclusions: The results indicated that auriculotherapy might be effective in reducing stress and improving the outcome of assisted reproductive treatment.
Collapse
Affiliation(s)
- Mozhgan Saffari
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Khashavi
- Om-e-Leila fertility and infertility center, Bandar Abbas, Iran
| | - Mahboubeh Valiani
- Department of Midwifery, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
18
|
Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis. Arch Gynecol Obstet 2016; 295:543-558. [PMID: 27995371 DOI: 10.1007/s00404-016-4255-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 11/25/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Controversial results have been reported concerning the effect of acupuncture on in vitro fertilization (IVF) outcomes. The current review was conducted to systematically review published studies of the effects of acupuncture on IVF outcomes. METHODS Women undergoing IVF in randomized controlled trials (RCTs) were evaluated for the effects of acupuncture on IVF outcomes. The treatment groups involved traditional, electrical, laser, auricular, and other acupuncture techniques. The control groups consisted of no, sham, and placebo acupuncture. The PubMed, Embase, and Web of Science databases were searched. The pregnancy outcomes data are expressed as odds ratios (ORs) with 95% confidence intervals (CIs) based on a fixed model or random model depending on the heterogeneity determined by the Q test and I2 statistic. The major outcomes were biochemical pregnancy rate (BPR), clinical pregnancy rate (CPR), live birth rate (LBR), and ongoing pregnancy rate (OPR). Heterogeneity of the therapeutic effect was evaluated by a forest plot analysis, and publication bias was assessed by a funnel plot analysis. RESULTS Thirty trials (a total of 6344 participants) were included in this review. CPR data showed a significant difference between the acupuncture and control groups (OR 1.26, 95% CI 1.06-1.50, p = 0.01), but there was significant statistical heterogeneity among the studies (p = 0.0002). When the studies were restricted to Asian or non-Asian area trials with a sensitivity analysis, the results significantly benefited the CPR in Asian group (OR 1.51, 95% CI 1.04-2.20, p = 0.03). Based on the area subgroup analysis, we found that in the Asian group, the IVF outcomes from the EA groups were all significantly higher than those from the control groups (CPR: OR 1.81, 95% CI 1.20-2.72, p = 0.005; BPR: OR 1.84, 95% CI 1.12-3.02, p = 0.02; LBR: OR 2.36, 95% CI 1.44-3.88, p = 0.0007; OPR: OR 1.94, 95% CI 1.03-3.64, p = 0.04). Meanwhile, compared with other acupuncture time, the IVF outcome results were significantly superior in the acupuncture group when acupuncture was conducted during controlled ovarian hyperstimulation (COH) (CPR: OR 1.71, 95% CI 1.27-2.29, p = 0.0004; LBR: OR 2.41, 95% CI 1.54-3.78, p = 0.0001; BPR: OR 1.50, 95% CI 1.02-2.20, p = 0.04; OPR: OR 1.88, 95% CI 1.06-3.34, p = 0.03). However, when acupuncture was conducted at the time of embryo transfer, the BPR and OPR from the acupuncture groups were significantly lower than those of the controls in the Asian group (BPR: OR 0.67, 95% CI 0.48-0.92, p = 0.01; OPR: OR 0.68, 95% CI 0.49-0.96, p = 0.03). CONCLUSIONS Based on an analysis of the studies, acupuncture improves the CPR among women undergoing IVF. When the studies were restricted to Asian or non-Asian area patients, compared with traditional acupuncture and other methods, electrical acupuncture yielded better IVF outcomes. Optimal positive effects could be expected using acupuncture in IVF during COH, especially in Asian area. However, as a limitation of this review, most of the included studies did not mention the number of embryos transferred.
Collapse
|
19
|
Wang L, Han L, Liu P, Yang J, Cui Y, Bai H, Liu J, Huang Y, Huang J, Huang C, Zhao B. Moxa smoke: Is it a beneficial or hazardous factor for infertility? A preclinical study on sperm parameters and sex hormones in male rats. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2015.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
Anesthesia Related Toxic Effects on In Vitro Fertilization Outcome: Burden of Proof. BIOMED RESEARCH INTERNATIONAL 2015; 2015:475362. [PMID: 26161404 PMCID: PMC4486487 DOI: 10.1155/2015/475362] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 06/04/2015] [Accepted: 06/08/2015] [Indexed: 11/17/2022]
Abstract
Management of pain and anxiety during oocyte retrieval makes anesthesia an important part of the in vitro fertilization (IVF) procedures. There are many studies investigating the influence of anesthesia on IVF success. This review article provides an overview of published data regarding the potential toxic effects of different anesthetic techniques (Loco-regional, general anesthesia (GA), and monitored anesthesia care (MAC)), different anesthetic agents, and alternative medicine approach (principally acupuncture) on the IVF outcome. From our analysis, evidence of serious toxicity in humans is not well established. Trials regarding different anesthetic techniques ended up without clear conclusions. Studies about GA came up with conflicting results. A few trials relate GA with lower pregnancy rates, although some others failed to prove this conclusion. Furthermore, detectable amounts of some anesthetic agents are measurable in the follicular fluid but these findings are not strongly associated with toxicity. MAC and Loco-regional anesthesia appear as safe alternative choices and there is evidence of improved outcome. Whereas acupuncture may provide assistance increasing IVF success according to some trials, some others could not obtain these effects. Questions about the appropriate time of application and the underlying mechanism of action are not answered yet, so further investigation should be done.
Collapse
|
21
|
Shuai Z, Lian F, Li P, Yang W. Effect of transcutaneous electrical acupuncture point stimulation on endometrial receptivity in women undergoing frozen-thawed embryo transfer: a single-blind prospective randomised controlled trial. Acupunct Med 2014; 33:9-15. [PMID: 25303950 DOI: 10.1136/acupmed-2014-010572] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the effect of transcutaneous electrical acupuncture point stimulation (TEAS) on endometrial HOXA10 protein expression and three-dimensional (3D) power Doppler ultrasound parameters as markers of endometrial receptivity in women undergoing frozen-thawed embryo transfer (FET). METHODS A total of 68 women undergoing FET were randomised to receive TEAS or mock TEAS at acupuncture points CV3, CV4 and SP6 and Zigong bilaterally. Both groups had six sessions per cycle for three menstrual cycles prior to the scheduled FET. Each session lasted 30 min and was repeated every other day. 3D power Doppler ultrasound parameters, HOXA10 protein expression and rates of embryo implantation, clinical pregnancy and live birth were compared. RESULTS There were no significant differences between the two groups in endometrial thickness or endometrial volume. The ultrasonographic endometrial triple-line pattern was present more often in the TEAS group (p=0.002). The TEAS group had a greater endometrial and subendometrial vascularisation index (VI) than the mock TEAS group (p=0.001 and p<0.001, respectively) on 3D ultrasound and increased endometrial HOXA10 expression (p=0.001) immediately prior to FET. Subsequently, the rates of embryo implantation, clinical pregnancy and live birth rates were all higher in the TEAS group than in the mock TEAS group (p=0.024, p=0.038 and p=0.033, respectively). CONCLUSIONS In patients undergoing FET, TEAS may have beneficial effects on endometrial HOXA10 expression and ultrasound markers of endometrial receptivity. These findings may explain the improvement in clinical outcome of FET associated with the use of TEAS. TRIAL REGISTRATION NUMBER ChiCTR-TRC-14004448.
Collapse
Affiliation(s)
- Zhenhong Shuai
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Fang Lian
- Integrative Medicine Research Centre of Reproduction and Heredity, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Pengfei Li
- Department of Urology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wenxiu Yang
- Integrative Medicine Research Centre of Reproduction and Heredity, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| |
Collapse
|
22
|
Shen C, Wu M, Shu D, Zhao X, Gao Y. The Role of Acupuncture in in vitro Fertilization: A Systematic Review and Meta-Analysis. Gynecol Obstet Invest 2014; 79:1-12. [DOI: 10.1159/000362231] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 03/14/2014] [Indexed: 11/19/2022]
|
23
|
Zhang Y, Fu Y, Han F, Kuang H, Hu M, Wu X. The effect of complementary and alternative medicine on subfertile women with in vitro fertilization. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2014; 2014:419425. [PMID: 24527047 PMCID: PMC3914344 DOI: 10.1155/2014/419425] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 12/13/2013] [Accepted: 12/15/2013] [Indexed: 02/06/2023]
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.
Collapse
Affiliation(s)
- Yuehui Zhang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China
- Center for Post-Doctoral Studies, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Yiman Fu
- Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Fengjuan Han
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Hongying Kuang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Min Hu
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Xiaoke Wu
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| |
Collapse
|
24
|
e Silva PMR, Carvalho VF, Cordeiro RSB, Martins MA. Down-regulation of allergic responses in conditions of experimental diabetes: a role for glucocorticoids? Neuroimmunomodulation 2009; 16:13-8. [PMID: 19077441 DOI: 10.1159/000179662] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Accepted: 06/26/2008] [Indexed: 11/19/2022] Open
Abstract
The prevalence of atopic diseases and diabetes is increasing worldwide, though the co-occurrence of both diseases in the same individual is less frequent than predicted. Previously published studies suggest that the Th1/Th2 concept could explain the inverse relationship between allergic diseases and type 1 diabetes. However, down-regulation of the IgE-mast cell system can also markedly contribute to the lack of responsiveness to local and systemic allergen challenges in diabetic conditions. Moreover, dysregulation of the hypothalamic-pituitary-adrenocortical axis and elevated endogenous glucocorticoid levels play a pertinent role in some of the pathological-related processes associated with poorly controlled or uncontrolled diabetes.
Collapse
Affiliation(s)
- Patrícia M R e Silva
- Laboratório de Inflamação, Departamento de Fisiologia e Farmacodinâmica, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brasil.
| | | | | | | |
Collapse
|