Study shows acupuncture facilitates IVF conception

Study shows acupuncture facilitates IVF conception

A controversial new study measuring the degree to which getting acupuncture during IVF treatment increases a woman's chance of a successful pregnancy, has found this to be the case to a significant degree.

Acupuncture administered for 25 minutes both before and after an embryo is transferred to the uterus improves the likelihood of a live birth, a review presented at a medical conference in Brisbane has shown.

"On the basis of the current level of evidence we have, if nine women have acupuncture around the time of embryo transfer with IVF there will be one extra live born baby," said Professor Neil Johnson, lead researcher of the New Zealand study, and medical director of Fertility Plus in Auckland.

"That figure looks pretty good, especially to women wanting to do all they can to have a baby."

But Johnson's Australian counterparts have applied caution and skepicism to the findings, labelling the statistic as stretching "the current scientific data too far".

However, Professor Johnson has reviewed the latest major studies on the benefits of this ancient Chinese therapy regarding reproductive technology, and fertility in general, to a definitive degree.

"In a nutshell there is evidence that acupuncture administered around the time of embryo transfer really does help," he said.

"But doing acupuncture at other times in IVF treatment doesn't appear to be helpful, and there's no really robust evidence about the effectiveness of acupuncture for couples trying to get pregnant naturally."

Johnson explained that acupuncture has traditionally been believed to be effective because it improves energy flow through pathways in the body. However the conventional medicine take is that it inhibits the nervous system, which improves pelvic blood flow or makes the uterus "quieter".

"It might just be that relaxing and having some TLC at this stressful time is where the benefit comes in, but it would seem there's something more at work," Professor Johnson said.

Whatever the reason, the therapy has been widely embraced by IVF patients in Auckland, often those with the poorest pregnancy outlook deriving the most benefit.

It still may be a while however, before doctors and medical professionals embrace the method.

IVF Australia's Professor Michael Chapman said acupuncture had the strongest evidence of any alternative therapy for use in fertility, but the studies were small and "relatively inconclusive".

"The evidence to date would suggest it's not harmful but I certainly wouldn't recommend every IVF patient rush out and get it," Prof Chapman said.

THE MENSTRUAL CYCLE

A healthy menstrual cycle is an important aspect in women's physiology as it reflects the proper functioning of the reproductive organs. There are 4 phases in the menstrual cycle. Each phase relates to a dynamic change within the female body.

1. Menstruation
2. Post Period
3. Ovulation
4. Pre -Menstruation

With each phase different hormones are triggered and this causes the body to respond in different ways. Modern physiologists describe the menstrual cycle in terms of hormones made by the ovaries (estrogen & progesterone) and their actions on the follicles, the tubes, the endometrium (lining) and the uterus. In Chinese Medicine we talk about the involvement of Qi & Blood with the influence of Yin/Yang.

The average menstrual cycle is 28 but can range from 24-35 days.

Day 1-5: Menstruation
Day 1 is the considered the first day of the 28 day cycle. If an egg has not been fertilized it disintegrates. Low levels of both estrogen & progesterone during this phase cause the endometrium (lining of the uterus) to break down and shed in the form of menstrual blood. Bleeding last an average of 5 days.
Note: if your period begins in the evening ie 5pm or during the night 3am then Day 1 is taken from the next day.
The nature of the menstrual flow and its accompanying symptoms are all significant in pinpointing any glitches in the movement of qi and blood. Any obstructions to the menstrual flow can have implications for infertility. The timely arrival and departure of the period is therefore crucial to the transition, growth and decline between yin & yang and the interplay of qi and blood.

Days 1-13: Follicular Phase
Early in the menstrual cycle the pituitary gland in the brain produces rising amounts of follicle stimulating hormone (FSH) which acts on the ovaries to promote the development of several follicles, each one containing an egg. Only one follicle will reach maturity. Toward the end of this phase, the ovaries secrete increasing levels of estrogen which causes the uterine lining to begin thickening in preparation for a potential fertilized egg.

Days 10-18: Ovulatory Phase
The pituitary gland and hypothalamus release a surge of lutenizing hormone (LH) about midway through the cycle. This causes the mature follicle to bulge out from the surface of the ovary and burst, releasing the egg. Ovulation usually occurs around day 14 of the cycle. The egg then begins to travel down the fallopian tube into the uterus. This is the time woman are most likely to fall pregnant.

Day 15-28: Luteal Phase
After releasing the egg, the ruptured follicle develops into a structure called the corpus luteum (an endocrine body), which secretes increasing amounts of progesterone. The corpus luteum is the only structure which produces the hormone progesterone in large quantities. The progesterone causes the endometrium to thicken further and prepare to support embryonic development. If the egg is fertilized, the corpus luteum begins to produce chrionic gonadotropin (HCG) pregnancy hormone which maintains the corpus luteum and its progesterone secretion. The egg moves to the uterus and attaches itself to the endometrium about six or seven days after ovulation, where it begins to develop into a fetus.

If the egg is not fertilized, the corpus luteum degenerates after about 14 days and levels of progesterone and estrogen drop. This causes the endometrium to break down and shed, and a new menstrual cycle begins.

The advantages of Acupuncture during IVF treatment and natural fertility

Acupuncture works in the following ways:

1. Acupuncture can increase blood flow to the reproductive organs, which dramatically improves a woman’s response to hormonal therapy.

2. Acupuncture has been shown to regulate hormone levels by moderating the release of beta endorphins levels in the brain, which improves the release of gonadotrophin releasing hormone by the hypothalamus, follicle stimulating hormone from the pituitary gland and oestrogen and progesterone levels from the ovary.

3. Acupuncture reduces stress and a hyperactive sympathetic nervous system response.

4. Acupuncture has been speculated to moderate cyclooxygenase and prostaglandin levels in the uterus, reducing uterine motility to improve implantation rates.

5. Herbs nourish the blood, whilst acupuncture moves qi, which facilitates the movement of blood. It has been claimed that some herbal formulas produce high clinical pregnancy rates as well as improve the general wellbeing of patients.

The following descriptions below will describe how acupuncture can integrate with Western Medicine. Each point is directly linked to the points above.

1. There needs to be adequate blood flow to the developing ovarian follicle. This is essential to the initiation and maintenance of normal human pregnancy. Doppler ultrasound evaluation of uterine and ovarian blood flow has demonstrated that improved blood flow in either vascular system is associated with improved fertility outcomes. Women who respond poorly to ovarian stimulation for IVF have compromised blood flow to their ovarian follicles.

2. There are 4 phases in the menstrual cycle. During each phases various hormones are released. The most common cause of infertility is hormonal imbalance.

3. From a Western Medicine perspective, people who are under stress release the hormone cortisol in the brain. Cortisol alters the brain’s neurochemical balance thus changing hormone levels and disrupting the pituitary balance, which is the key to the reproductive cycle. Because of this delicate balance between the hypothalamus, pituitary and reproductive glands, stress is capable of preventing a woman from ovulating entirely.

4. For IVF transfers and implantations the endometrium needs to be of particular
density and thickness for successful implantations and fertilization. The uterus therefore needs to be in a relaxed state.

5. The menses is based on the condition of blood.