IVF is the best-known treatment for infertility due to tubal dysfunction. Its technology also makes it useful in treating other causes of infertility, for example poor sperm quality and unexplained infertility. There is research out there telling us that by integrating acupuncture with IVF, the patient will feel better as well as have a higher chance of improved clinical pregnancy rates.
IVF involves the retrieval of a woman’s eggs, fertilizing them in a laboratory and then transferring back into her uterus. Most women who undergo fertility treatments already possess high levels of anxiety. Each additional IVF cycle often adds to the existing levels of stress.
A 2009 study by Balk et al explored whether acupuncture could affect the perceived level of stress at the time of embryo transfer, and whether these perceived stress levels play a role in the outcome of an IVF cycle. Women who received acupuncture in this study had both higher rates of pregnancy and lower reported levels of stress.
Although a 2010 study of Buck et al involved neither IVF nor acupuncture, it did look at the relationship between stress and fertility. It found that a positive stress response, as measured by salivary alpha-amylase levels, significantly reduced the probability of conception. This reflects another way how acupuncture, which reduces stress hormones, may improve fertility.
Good blood flow to the uterus ensures a healthy endometrial lining. The Pulsitility Index (PI), as measured by transvaginal Doppler ultrasound is used to measure uterine blood flow. A high PI indicates diminished blood flow, which entails reduced endometrial receptivity. Steer et al demonstrated that a high PI in the uterine arteries could predict clinical pregnancy failures.
Research shows that poor blood flow of the uterine arteries is associated with reduced rates of clinical pregnancy following an IVF embryo transfer. In a 1996 study by Stener-Victorin et al, reported in “Human Reproduction” (the official journal of the European Society of Human Reproduction and Embryology), blood impedance to the uterus was significantly reduced after 8 acupuncture treatments over the span of 1 month. This effect of reduce blood impedance was present up to two weeks after completion of the 8 treatments. The acupuncture protocol employed by Stener-Victorin was replicated in 2004 by a group of IVF clinics in California, USA. It turns out that acupuncture as adjunct therapy significantly improved pregnancy rates.
Stener-Victorin et al demonstrated again in 2003 that acupuncture can significantly increase blood flow to the ovaries. Although this study was done on rats, we can imagine a similar mechanism playing out in women too.
Whatever the mechanism of action, three out of four randomised controlled trials revealed significantly higher pregnancy rates in the acupuncture groups compared with the control groups. Take for example the 2002 study by Paulus et al on 160 patients, half of whom used acupuncture for implantation assistance – the results showed an improvement in clinical pregnancy rates from 42.5% in the acupuncture group versus 26.3% in the control group, a very significant result for a couple of needles put into the body before and after embryo transfer.
Women in Singapore are embracing this tool to help them during a trying time, and so are many IVF centres hoping to raise their clinical pregnancy rates. It appears that acupuncture has a positive effect in IVF support and has not shown adverse effects on pregnancy outcome.