Enhancing IVF Success Rates with acupuncture

baby2ART (Assisted Reproduction Technology-IUI, IVF, ICSI, FET etc) has advanced at extraordinary speed in the last two decades and offers many infertile couples their only chance for achieving a family. Due to the relatively low success rate of IVF per cycle, as well as high emotional and financial costs associated with IVF, many patients have turned to complementary and alternative medicine (CAM) to enhance the success of IVF treatment. Among CAMs acupuncture is a frequently used, safe, low cost adjuvant treatment.

There have been several studies investigating the use of acupuncture to improve the outcome of IVF. In May 2006, the journal Fertility and Sterility published two studies showing significantly increased pregnancy rates for women receiving acupuncture treatments in conjunction with the embryo transfer stage of in vitro fertilization.

A reviewing study by Manheimer et al (BMJ, 2008), in which seven trials with 1366 women undergoing in vitro fertilisation were included in the meta-analyse, concluded that evidence suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing IVF.

The potential mechanisms for its effects on fertility might be:

Mediating the release of neurotransmitters, which may in turn stimulate secretion of gonadotrophin releasing hormone (GnRH), thereby influencing the menstrual cycle ovulation, and fertility.

Stimulate blood flow to the uterus by inhibiting uterine central sympathetic nerve activity.

Stimulate the production of endogenous opioids, which may inhibit the central nervous system and the biological stress response.

For successful implantation we need a good quality of gamete, as well as receptive and nourishing endomentrium. By improving the quality of eggs and sperm, improving the reproductive system’s (ovaries and uterus) blood flow and balancing hormone levels, counteracting the stress that often accompanies infertility acupuncture gives you the best chance of achieving and maintaining a healthy pregnancy.

It also has been demonstrated that acupuncture reduces uterine contractility, so relaxing the uterus to set up a better environment for implantation.

When should I start treatment?

Clinical reality means that we should look at combining what Western and Chinese medicine can offer either in preparing women for IVF cycles, or helping then recover from IVF cycles. Protocols for IVF are complex, involving multiple phases with specific physiological aims. Correspondingly, acupuncture treatments before, during, and after IVF need to be carefully considered in relation to the biomedical aspects that are being manipulated.

When to start to support IVF depends on lots of factors. Your age, any reason for infertility, any previous successful/failed IVF cycles, any gynaecology disorders, any autoimmune disorders, high FSH, low AMH, poor response, or over stimulation, poor uterine blood flow, or implantation failure, etc, are all needed to be considered.

Can Chinese medicine help with premature Ovarian Failure?

If a woman has high FSH before 40, it is diagnosed as Premature Ovarian Failure or premature menopause, which means there is a low ovarian reserve and low fertility. There is no treatment from conventional medicine. The contraceptive pill or HRT may sometimes help a little, but they can't help to improve ovarian function. Because of the poor response to IVF drug, these women are often turned away by the IVF clinic and advised to use donor eggs.
Acupuncture with Chinese herbs, sometimes combined with HRT, can be very effective in treating high FSH. The treatment focuses on regulating menstruation. When the FSH has come down (some doctors think that's impossible), the chances of conceiving is high, providing there are no other factors affecting fertility. If patients want to try IVF again, the treatment will help to produce better quality eggs and improve the condition of the lining of the uterus, which will increase the probability of success.

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Publications

There is growing evidence that acupuncture can greatly increase a woman's chance of becoming pregnant - Guardian Newspaper

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