Acupuncture and its effect on Cortisol in an IVF cycle
In a natural cycle, a significant rise in intrafollicular cortisol (a stress hormone) occurs immediately prior to ovulation, which is thought to help with oocyte maturation and embryo implantation.
Keay et al in 2002 found that elevation in the enzymes that convert cortisol to cortisone in IVF follicular fluid was associated with poor outcome in IVF. Therefore, if cortisol remained normal or elevated a more positive outcome would be expected.
Dr Magarelli and Diane Cridennda in the United States, noted a significant elevation of cortisol in the acupuncture group of their trials, just prior to hCG or non-physiological but pharmacological ovulation.
Diane Cridennda and Dr Magarelli, USA
Acupuncture and its effect on Prolactin in an IVF cycle
Prolactin is known to play a significant role in regulating ovarian function: folliculogenesis, steroidogenesis, ovulation and corpus luteum function. Midcyle increase in serum prolactin in granulosa cells in humans is normal and abnormal follicular development is observed in females deficient in prolactin.
In 1997, in JCEM, Jinno et al. hypothesized that significantly more available prolactin was associated with IVF patients who successfully got pregnant. Dr Magarelli and Diane Cridennda in the United States, observed during their trials that there was significantly more prolactin in patients treated with acupuncture than in the control group.
Acupuncture at embryo transfer can improve pregnancy rate
A trial was carried out in Germany to evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy (ART) by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no acupuncture.
160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through random selection: embryo transfer with acupuncture (80 patients), and embryo transfer without acupuncture (80 patients). Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy. Clinical pregnancy was defined as the presence of a foetal sac during an ultrasound examination 6 weeks after embryo transfer.
Clinical pregnancies were documented in 34 out of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.
The trial concluded that acupuncture seems to be a useful tool for improving pregnancy rate after ART.
Wolfgang E Paulus, MD, Mingmin Zhang, MD, Erwin Strehler, MD, Imam El-Danasouri, PhD and Karl Sterzik MD; ‘Fertility and Sterility’, Vol.77, no.4, April 2002.
Further trials on acupuncture at embryo transfer reconfirm the efficacy of acupuncture at improving pregnancy rates
A further study to the German report mentioned above has been carried out at the Reproductive Medicine and Fertility Centre in Colorado Springs, USA. It compared pregnancy rates of 114 women, half of whom received acupuncture before and after embryo transfer, whilst the other half did not (control group). The acupuncture group obtained a 51% pregnancy rate and 8% miscarriage rate compared to 36% and 20% respectively in the control group. In addition, acupuncture was found to reduce the risk of tubal pregnancy.
Oct 2004, American Society of Reproductive Medicine