Acupuncture
AND IVF Poor Responders: A Cure?
Acupuncture, Infertility, & IVF Research - Medical Articles
P.C. Magarelli, D.K. Cridennda. Reproductive Medicine
& Fertility Center, Colorado Springs, CO.
FERTILITY AND STERILITY®, Proceeding from the 2004
Pacific Coast Reproductive Society annual meeting in
Palm Springs
Background and Significance: The utility of
acupuncture in the treatment of infertility has been
demonstrated in two controlled studies. The first study
determined the effect of reducing the Pulsatility Index
(PI) of the uterine artery on reproductive outcomes; the
second study described a Pre/Post embryo transfer
protocol that enhanced overall pregnancy rates (PR).
There are no studies that have utilized both techniques.
Objective: The purpose of the study was to
determine the influence of these two acupuncture
protocols on IVF outcomes and secondly to identify the
appropriate patient groups that would most benefit from
this adjunctive therapy.
Materials and Methods: In this retrospective
study, data was extracted from medical records of
patients RE&I clinic & acupuncture clinics between
January 2001 and November 2003. All patients completing
an IVF cycle with transfer were included. One RE&I
provided the IVF care and a consortium of acupuncturists
overseen by the author provided the strict acupuncture
protocols. PR per transfer were the endpoints measured.
Data was analyzed by student's t test and
Multiregression with Wilcox ranking (MRW).
Results: 147 patients were included in the study
and of those 53 had Acupuncture (Ac) and 94 did not
(Non-Ac group). Demographic data between these Ac and
Non-Ac groups respectively indicated remarkable equity
(Table 1). Fertility Factors also demonstrated equity
and there were no differences in Diagnoses, IVF
Protocols and type of Gonadatrophin protocols used.
Factors that demonstrated significance were:
Length of time infertile, Peak FSH, PI for total group
without MRW; PI for MRW groups reversed this (Table 2)
and finally average: Sperm Morphology, Peak E2, Peak P4
prior to HcG: and endometrial thickness. PR before
Wilcox ranking were the same: 40% v 38%. MRW analysis
revealed FSH, Length of time trying to get pregnant,
Sperm Morphology and E2 levels as significant: 6.5, 4.1,
4.0 and 1.6 respectively. When the Ac group was modified
(15 Ac patient dropped), PI was elevated from 1.76 to
1.94 resulting in a significant elevation compared to
the Non-Ac group, p < 0.01. Also PR changed from 40%
before to 53% after and this value was significantly
greater than the Non-Ac group (38%), p < 0.01.
Conclusions: Significant increases in pregnancy
outcomes were con- firmed by this study and the data
uniquely supported the advantage of acupuncture in
patients with normal PI (prior studies were done on
patient with PI > 3). We also demonstrated that both
acupuncture treatment protocols could be used together
with a synergistic effect. Finally, this study is the
first to demonstrate that the use of acupuncture in
patients with poor prognoses (elevated Peak FSH, longer
history of infertility, poor sperm morphology) can
achieve similar pregnancy rates to normal prognosis
patients.
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