Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. The impact of acupuncture on in vitro fertilization outcome. Electro-acupuncture as a peroperative analgesic method and its effects on implantation rate and neuropeptide Y concentrations in follicular fluid. Randomized controlled trial: effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization. Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. [Effects of acupuncture combined Chinese materia medica for tonifying shen and soothing gan on the anxiety and depression of patients with in vitro fertilization and embryo transplantation and on the treatment outcomes]. Effects of Acupuncture on the Outcome of in Vitro Fertilisation and Intracytoplasmic Sperm Injection in Women with Polycystic Ovarian Syndrome The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Effect of Acupuncture on Assisted Reproduction Treatment Outcomes Acupuncture and amitriptyline for pain due to HIV-related peripheral neuropathy: a randomized controlled trial. Terry Beirn Community Programs for Clinical Research on AIDS. [Effect of electroacupuncture on oocyte quality and pregnancy for patients with PCOS undergoing in vitro fertilization and embryo transfervitro fertilization and embryo transfer]. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. Acupuncture for frozen-thawed embryo transfer cycles: a double-blind randomized controlled trial. Auricular electro-acupuncture as an additional perioperative analgesic method during oocyte aspiration in IVF treatment. Acupuncture performed before and after embryo transfer: a randomized controlled trial. A randomized double blind comparison of real and placebo acupuncture in IVF treatment. The Role of Acupuncture in Assisted Reproductive Technology Influence of Acupuncture on the Outcomes of in Vitro Fertilisation When Embryo Implantation Has Failed: A Prospective Randomised Controlled Clinical Trial Pain relief during oocyte retrieval with a new short duration electro-acupuncture technique--an alternative to conventional analgesic methods. Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Electroacupuncture reduces uterine artery blood flow impedance in infertile women. Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization-embryo transfer treatment. Electro-acupuncture versus conventional analgesia: a comparison of pain levels during oocyte aspiration and patients' experiences of well-being after surgery. Acupuncture on the day of embryo transfer: a randomized controlled trial of 635 patients. Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer. Prediction of extracellular water and total body water by multifrequency bio-electrical impedance in a Southeast Asian population. Increase of success rate for women undergoing embryo transfer by transcutaneous electrical acupoint stimulation: a prospective randomized placebo-controlled study. Electroacupuncture and postoperative pain. A prospective randomized study of electro-acupuncture versus alfentanil as anaesthesia during oocyte aspiration in in-vitro fertilization. Effects of acupuncture on smoking cessation or reduction for motivated smokers. [Effects of electroacupuncture on in vitro fertilization-embryo transfer (IVF-ET) of patients with poor ovarian response].
OBJECTIVE 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 . DESIGN Prospect i ve r and omized study . SETTING Fertility center . PATIENT(S ) After giving informed consent , 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through r and om selection : embryo transfer with acupuncture ( n = 80 ) and embryo transfer without acupuncture ( n = 80 ) . INTERVENTION(S ) Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer . In the control group , embryos were transferred without any supportive therapy . MAIN OUTCOME MEASURE(S ) Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer . RESULT ( S ) Clinical pregnancies were documented in 34 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 . CONCLUSION ( S ) Acupuncture seems to be a useful tool for improving pregnancy rate after ART OBJECTIVE To replicate previous research on the efficacy of acupuncture in increasing pregnancy rates ( PR ) in patients undergoing IVF and to determine whether such an increase was due to a placebo effect . DESIGN Prospect i ve , r and omized , controlled , single blind trial . SETTING Private , academically affiliated , infertility clinic . PATIENT(S ) One hundred fifty patients scheduled to undergo embryo transfer . INTERVENTION(S ) Subjects were r and omized to either the acupuncture or control group . Acupuncture patients received the protocol , as first described by Paulus and his colleagues , for 25 minutes before and after embryo transfer . Control subjects laid quietly . All subjects then completed question naires on anxiety and optimism . The IVF staff remained blind to subject assignment . MAIN OUTCOME MEASURE(S ) Clinical PRs , anxiety , optimism . RESULT ( S ) Before r and omization both groups had similar demographic characteristics including age and psychological variables . There were no significant differences in PRs between the two groups . Acupuncture patients reported significantly less anxiety post-transfer and reported feeling more optimistic about their cycle and enjoyed their sessions more than the control subjects . CONCLUSION ( S ) The use of acupuncture in patients undergoing IVF was not associated with an increase in PRs but they were more relaxed and more optimistic BACKGROUND In a previous study on the effect of electro-acupuncture ( EA ) in combination with a paracervical block ( PCB ) as an analgesic method during oocyte aspiration in IVF treatment , EA appeared to increase the pregnancy rate . This study was design ed to test the hypothesis that EA as an analgesic during oocyte aspiration would result in : ( i ) a better IVF pregnancy rate than with alfentanil ; ( ii ) peroperative analgesia that was as good as that produced by alfentanil ; ( iii ) less postoperative abdominal pain , nausea and stress ; and ( iv ) a reduction in the use of additional analgesics . Neuropeptide Y ( NPY ) concentrations in follicular fluid ( FF ) were analysed when possible . METHODS AND RESULTS In this prospect i ve , r and omized , multicentre clinical trial , 286 women undergoing oocyte aspiration were r and omly allocated to the EA group ( EA plus a PCB ) or to the alfentanil group ( alfentanil plus a PCB ) . No significant differences were found between the EA and alfentanil groups in any of the IVF variables . NPY concentrations in FF were significantly higher in the EA group compared with the alfentanil group . No correlation between pregnancy rate and NPY concentrations was found in either analgesic group . Both EA plus a PCB and alfentanil plus a PCB induced adequate peroperative analgesia during oocyte aspiration evaluated using the visual analogue scale . After 2 h , the EA group reported significantly less abdominal pain , other pain , nausea and stress than the alfentanil group . In addition , the EA group received significantly lower amounts of additional alfentanil than the alfentanil group . CONCLUSION EA does not improve pregnancy rate in the present clinical situation . The observation that NPY concentrations in FF were higher in the EA group may be important for human ovarian steroidogenesis . The analgesic effects produced by EA are as good as those produced by conventional analgesics , and the use of opiate analgesics with EA is lower than when conventional analgesics alone are used OBJECTIVE To evaluate the influence of " true " versus " sham " acupuncture on pregnancy rates ( PRs ) in women undergoing IVF . DESIGN R and omized controlled trial , double-blinded with independent observer . SETTING Academic infertility clinic . PATIENT(S ) One hundred sixty patients < 38 years old undergoing IVF with or without intracytoplasmic sperm injection . INTERVENTION(S ) Subjects were r and omly allocated to the true or sham group and underwent acupuncture 25 minutes before and after ET . Subjects completed a McGill Pain Question naire regarding their clinical symptoms during ET . MAIN OUTCOME MEASURE(S ) Clinical PR and clinical symptoms during ET . RESULT ( S ) While the overall clinical PR was 51.25 % , there was no significant difference between the arms of the study ( true = 45.3 % vs. sham = 52.7 % ) ; 33.1 % of the patients had ultrasound-documented singleton pregnancy , and 15 % of patients had twin gestations , while one patient in the true arm had a triplet gestation . There were significant differences in the subjective , affective , and total pain experience between both arms . The subjects in the true arm described their acupuncture session as being more " tiring " and " fearful " and experienced more " achiness " compared with their sham counterparts . CONCLUSION ( S ) There was no statistically significant difference in the clinical or chemical PRs between both groups . Patients undergoing true acupuncture had differing sensory experiences compared with patients in the sham arm . There were no significant adverse effects observed during the study , suggesting that acupuncture is safe for women undergoing ET OBJECTIVE To determine the effect of luteal-phase acupuncture on the outcome of  IVF/intracytoplasmic sperm injection ( ICSI ) . DESIGN R and omized , prospect i ve , controlled clinical study . SETTING University IVF center . PATIENT(S ) Two hundred twenty-five infertile patients undergoing IVF/ICSI . INTERVENTION(S ) In group I , 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine . In group II , 109 patients received placebo acupuncture . MAIN OUTCOME MEASURE(S ) Clinical and ongoing pregnancy rates . RESULT ( S ) In group I , the clinical pregnancy rate and ongoing pregnancy rate ( 33.6 % and 28.4 % , respectively ) were significantly higher than in group II ( 15.6 % and 13.8 % ) . CONCLUSION ( S ) Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI OBJECTIVE To assess the effects of acupuncture combined Chinese materia medica for tonifying shen and soothing gan ( CMMTSSG ) on the anxiety and depression of patients with in vitro fertilization and embryo transplantation ( IVF-ET ) , and to observe the treatment outcomes . METHODS Totally 97 IVF-ET patients were r and omly assigned to two groups , the acupuncture combined CMMTSSG ( group A , 51 cases ) and the Western medicine treatment group ( group B , 46 cases ) . The long protocol of IVF-ET in a mid luteal phase was performed in all patients . Patients in group A received acupuncture and CMMTSSG ( erzhi tiangui granule and xiaoyao granule ) during the process of ovarian hyperstimulation , while those in group B only received the routines of IVF-ET . The improvement of Shen deficiency Gan depression syndrome ( SDGDS ) between after and before treatment were observed in the two groups . The changes of self-rating anxiety scale ( SAS ) and Beck depression inventory ( BDI ) score were observed . The endometrial thickness , typing , and endometrial blood flow resistance index ( RI ) on the day of injecting HCG , the number of retrieved oocytes , the rate of high quality oocytes , the fertilization rate , the rate of high quality embryos , and the clinical pregnancy rate were respectively compared between the two groups . RESULTS The scores of SDGDS , SAS , and BDI were improved more obviously in group A than in group B , showing statistical difference ( P < 0.01 ) . There was no statistical difference in the endometrial thickness on the day of injecting HCG between the two groups ( P > 0.05 ) . The proportion of type A endometrium was 74.5 % ( 38/51 cases ) in group A and 45.7 % ( 21/46 cases ) in group B , showing statistical difference between the two groups ( P < 0.01 ) . The RI was significantly lower in group A ( 0.48 + /- 0.03 ) than in group B on the day of injecting HCG ( 0.52 + /- 0.06 , P < 0.01 ) . There was no statistical difference in the number of retrieved oocytes and the fertilization rate between the two groups ( P > 0.05 ) . The rate of high quality oocyte , the rate of high quality embryos , and the clinical pregnancy rate were all improved more significantly in group A than in group B , showing statistical difference between the two groups ( P < 0.05 ) . CONCLUSIONS Acupuncture combined CM-MTSSG could obviously alleviate unfavorable emotions as anxiety and depression in patients with IVF-ET , effectively improve the treatment outcomes . Its effects might be correlated with lowering the excitability of the sympathetic nervous system , elevating the quality of oocytes , and improving the endometrial receptivity Background Different mechanisms have been described for the effects of acupuncture on fertility . Acupuncture may mediate neurotransmitter release , which results in the stimulation of gonadotrophin-releasing hormone secretion . The production of neurotransmitters such as endogenous opioids may also inhibit central nervous system outflow and biological stress response . Acupuncture may also stimulate blood flow to the uterus by inhibiting uterine central sympathetic nerve activity . Despite some evidence suggesting beneficial effects of acupuncture on in vitro fertilisation ( IVF ) success rates , recent clinical trials could not duplicate these effects , especially in patients who are infertile with polycystic ovarian syndrome ( PCOS ) who are undergoing IVF . Methods A total of 62 women with PCOS undergoing IVF/intracytoplasmic sperm injection ( ICSI ) at Shayamehr IVF Clinic in Tehran ( Iran ) participated in a r and omised , controlled trial . Participants were r and omly allocated to one of two groups : there were 31 women each in the acupuncture ( group I ) and control groups ( group II ) . Acupuncture based on traditional Chinese medicine was performed in group I versus no adjunctive treatment in group II . All acupuncture procedures were performed in five sessions : start of downregulation , start of stimulation , 2 days before ovum pick-up , and immediately before and after embryo transfer . We measured the rate of oocytes in metaphase II , the fertilisation rate and the quality of embryos . Results Our results showed a statistically higher mean of good quality embryos in group I compared with group II ( p=0.044 ) . However , the mean number of metaphase II oocytes retrieved and fertilisation rate were similar between the two groups . We also could not find any significant differences among clinical , biochemical or ongoing pregnancy rates . Conclusions Acupuncture at an early stage of oocyte recruitment may have a beneficial effect on embryo quality . However , it seems to have no significant effect on other IVF/ICSI outcomes of women with PCOS . Trial Registration Number ( I RCT ID : 201011275181N4 Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background Acupuncture has recently been used as a complementary technique in the management of infertility . It has physiological and psychological effects and may be considered an alternative for stress reduction in women undergoing infertility treatments . Objective To examine the hypothesis that acupuncture treatment may increase the pregnancy rate in patients undergoing intracytoplasmic sperm injection cycles . Methods Patients enrolled in the study were stratified according to age and r and omised to either a control group ( n=208 ) or acupuncture group , ( n=208 ) . The pregnancy , implantation and abortion rates of the two groups were compared . Results No influence of acupuncture treatment on clinical outcomes was seen ; however , when cycles in which the causes of infertility were exclusively tubal-uterine or idiopathic were evaluated separately , a positive influence of acupuncture on pregnancy ( OR=5.15 , 95 % CI 1.03 to 34.5 ; p=0.048 ) was noted . Moreover , trends toward an increase in implantation were seen when acupuncture was performed ( regression coefficient : 0.645 ; p=0.092 ) . Conclusion The results suggest that acupuncture treatment had no influence when performed immediately before and immediately after embryo transfer , on clinical outcomes overall . In a subgroup analysis , when the embryo was not affected by an ovarian or seminal influence , a benefit was noted CONTEXT Peripheral neuropathy is common in persons infected with the human immunodeficiency virus ( HIV ) but few data on symptomatic treatment are available . OBJECTIVE To evaluate the efficacy of a st and ardized acupuncture regimen ( SAR ) and amitriptyline hydrochloride for the relief of pain due to HIV-related peripheral neuropathy in HIV-infected patients . DESIGN R and omized , placebo-controlled , multicenter clinical trial . Each site enrolled patients into 1 of the following 3 options : ( 1 ) a modified double-blind 2 x 2 factorial design of SAR , amitriptyline , or the combination compared with placebo , ( 2 ) a modified double-blind design of an SAR vs control points , or ( 3 ) a double-blind design of amitriptyline vs placebo . SETTING Terry Beirn Community Programs for Clinical Research on AIDS ( HIV primary care providers ) in 10 US cities . PATIENTS Patients with HIV-associated , symptomatic , lower-extremity peripheral neuropathy . Of 250 patients enrolled , 239 were in the acupuncture comparison ( 125 in the factorial option and 114 in the SAR option vs control points option ) , and 136 patients were in the amitriptyline comparison ( 125 in the factorial option and 11 in amitriptyline option vs placebo option ) . INTERVENTIONS St and ardized acupuncture regimen vs control points , amitriptyline ( 75 mg/d ) vs placebo , or both for 14 weeks . MAIN OUTCOME MEASURE Changes in mean pain scores at 6 and 14 weeks , using a pain scale ranging from 0.0 ( no pain ) to 1.75 ( extremely intense ) , recorded daily . RESULTS Patients in all 4 groups showed reduction in mean pain scores at 6 and 14 weeks compared with baseline values . For both the acupuncture and amitriptyline comparisons , changes in pain score were not significantly different between the 2 groups . At 6 weeks , the estimated difference in pain reduction for patients in the SAR group compared with those in the control points group ( a negative value indicates a greater reduction for the " active " treatment ) was 0.01 ( 95 % confidence interval [ CI ] , -0.11 to 0.12 ; P=.88 ) and for patients in the amitriptyline group vs those in the placebo group was -0.07 ( 95 % CI , -0.22 to 0.08 ; P=.38 ) . At 14 weeks , the difference for those in the SAR group compared with those in the control points group was -0.08 ( 95 % CI , -0.21 to 0.06 ; P=.26 ) and for amitriptyline compared with placebo was 0.00 ( 95 % CI , -0.18 to 0.19 ; P=.99 ) . CONCLUSIONS In this study , neither acupuncture nor amitriptyline was more effective than placebo in relieving pain caused by HIV-related peripheral neuropathy OBJECTIVE To observe the impacts of electroacupuncture ( EA ) on oocyte quality and pregnant outcome for the patients with polycystic ovary syndrome ( PCOS ) undergoing in vitro fertilization and embryo transfer ( IVF-ET ) and explore its potential mechanism . METHODS Sixty-six patients with PCOS and undergoing IVF-ET were divided into two groups r and omly , including an observation group ( 34 cases ) and a control group ( 32 cases ) . Ethinylestradiol and cyproterone acetate tablets and gonadotropin-releasing hormone agonist were administered for long-program superovulation in either group . In observation group , the intervention of EA was applied to Guanyuan ( CV 4 ) , Zhongji ( CV 3 ) , Sanyinjiao ( SP 6 ) , Zigong ( EX-CA 1 ) and Taixi ( KI 3 ) additionally . The pregnant outcome and the levels of stem cell factor ( SCF ) in the serum and follicular fluid on the day of egg collection were compared between two groups . RESULTS The score of kidney deficiency symptoms reduced remarkably after treatment in either group and the improvement in observation group was superior to that in control group ( P < 0.01 ) . The fertilization rate [ ( 76.25 + /- 20.33)% vs ( 66.34 + /- 15.44)% ] , cleavage rate [ ( 98.66 + /- 3.70)% vs ( 94.47 + /- 9.45)% ] and the rate of high- quality embryos [ ( 60.20 + /- 22.20)% vs ( 50.55 + /- 16.15)% ] in observation group were all superior to those in control group separately ( all P < 0.05 ) . Clinical pregnancy rate ( 46.67 % , 14/30 ) in observation group was higher than that ( 37.93 % , 11/29 ) in control group , but without statistical difference ( P > 0.05 ) . SCF levels in the serum and follicular fluid on the day of ovary collection were higher obviously than those in control group ( all P < 0.05 ) . CONCLUSION Electroacupuncture plays an active role in the pregnant outcomes of PCOS patients undergoing IVF-ET and it can relieve the symptoms of kidney deficiency in terms of TCM and improve clinical pregnant rate . The results are relevant with the overall adjustment of organic endocrinal system and the local micro-environment of ovary and the improvement of oocyte quality through the up-regulation of SCF level in mechanism CONTEXT A prior national survey documented the high prevalence and costs of  alternative medicine use in the United States in 1990 . OBJECTIVE To document trends in alternative medicine use in the United States between 1990 and 1997 . DESIGN Nationally representative r and om household telephone surveys using comparable key questions were conducted in 1991 and 1997 measuring utilization in 1990 and 1997 , respectively . PARTICIPANTS A total of 1539 adults in 1991 and 2055 in 1997 . MAIN OUTCOMES MEASURES Prevalence , estimated costs , and disclosure of alternative therapies to physicians . RESULTS Use of at least 1 of 16 alternative therapies during the previous year increased from 33.8 % in 1990 to 42.1 % in 1997 ( P < or = .001 ) . The therapies increasing the most included herbal medicine , massage , megavitamins , self-help groups , folk remedies , energy healing , and homeopathy . The probability of users visiting an alternative medicine practitioner increased from 36.3 % to 46.3 % ( P = .002 ) . In both surveys alternative therapies were used most frequently for chronic conditions , including back problems , anxiety , depression , and headaches . There was no significant change in disclosure rates between the 2 survey years ; 39.8 % of alternative therapies were disclosed to physicians in 1990 vs 38.5 % in 1997 . The percentage of users paying entirely out-of-pocket for services provided by alternative medicine practitioners did not change significantly between 1990 ( 64.0 % ) and 1997 ( 58.3 % ) ( P=.36 ) . Extrapolations to the US population suggest a 47.3 % increase in total visits to alternative medicine practitioners , from 427 million in 1990 to 629 million in 1997 , thereby exceeding total visits to all US primary care physicians . An estimated 15 million adults in 1997 took prescription medications concurrently with herbal remedies and /or high-dose vitamins ( 18.4 % of all prescription users ) . Estimated expenditures for alternative medicine professional services increased 45.2 % between 1990 and 1997 and were conservatively estimated at $ 21.2 billion in 1997 , with at least $ 12.2 billion paid out-of-pocket . This exceeds the 1997 out-of-pocket expenditures for all US hospitalizations . Total 1997 out-of-pocket expenditures relating to alternative therapies were conservatively estimated at $ 27.0 billion , which is comparable with the projected 1997 out-of-pocket expenditures for all US physician services . CONCLUSIONS  Alternative medicine use and expenditures increased substantially between 1990 and 1997 , attributable primarily to an increase in the proportion of the population seeking alternative therapies , rather than increased visits per patient The role of acupuncture on the pregnancy rate has not been evaluated in frozen-thawed embryo transfer ( FET ) cycles . This r and omized double-blind study aim ed to determine whether acupuncture performed on the day of FET improves clinical outcomes . On the day of FET , 226 patients were r and omly allocated to either real or placebo acupuncture according to a computer-generated r and omization list in sealed opaque envelopes . They received a session of real or placebo acupuncture for 25 min on site immediately after FET . The anxiety level and serum cortisol concentration were evaluated before and after real and placebo acupuncture . There were no significant differences in rates of overall pregnancy , clinical pregnancy , ongoing pregnancy , live birth and implantation in the placebo acupuncture group , when compared with the real acupuncture group . The anxiety level and serum cortisol concentration were similar for both groups . Only the placebo acupuncture group had significantly higher ongoing pregnancy ( P=0.022 ) and implantation rates ( P=0.038 ) than those who declined to join the study and received no acupuncture . In conclusion , comparable pregnancy and live birth rates of FET treatment were found in patients who had one session of real or placebo acupuncture after FET BACKGROUND The aim of this study was to compare the pain-relieving effect and the subjective well-being between auricular electro-acupuncture ( EA ) analgesia , auricular acupuncture ( A ) and conventional analgesia with remifentanil ( CO ) . METHODS A total of 94 women undergoing IVF were r and omized to auricular acupuncture with ( EA , n = 32 ) or without ( A , n = 32 ) continuous 1 Hz auricular stimulation ( using a battery-powered miniaturized stimulator , P-Stim ) or with adhesive tapes instead of needles and no electrical stimulation ( control group , CO , n = 30 ) at the auricular acupuncture points 29 , 55 and 57 . All patients received patient-controlled analgesia ( PCA ) with remifentanil .  Pain intensity and psychological well-being were assessed by means of visual analogue scales ( VAS ) ; tiredness , nausea and vomiting and analgesic drug consumption were documented . RESULTS Pain relief and subjective well-being were significantly greater in group EA during and after the procedure as compared with groups A and CO ( P < 0.001 ) . The patients were significantly more tired in group CO than in groups A and EA ( P < 0.001 ) . Consumption of the opioid remifentanil was significantly lower in group EA , comparable nausea ( P < 0.001 ) . CONCLUSION Auricular EA significantly reduces pain intensity and analgesic consumption of the opioid remifentanil during oocyte aspiration in IVF treatment OBJECTIVE To compare the clinical pregnancy rates in women who underwent fresh embryo transfer ( ET ) with and without one acupuncture session before and after the transfer using a modified Paulus protocol . STUDY DESIGN The prospect i ve , physician-blinded study r and omized 113 women to either no intervention ( n = 56 ) or acupuncture performed off-site ( n = 57 ) . Secondary outcomes were positive pregnancy test and live birth rates . Intent-to-treat analysis and per protocol analysis were performed . RESULTS No difference in age and in vitro fertilization-embryo transfer ( IVF-ET ) parameters were detected . Compared to the control group , the treatment group had a lower pregnancy rate ( 43.6 % vs. 64.8 % , p = 0.045 ) . More women in the control group had live births than did those in the acupuncture group ( 56.0 % vs. 36.0 % , respectively , p = 0.033 ) . Generalized mixed models revealed that patients who received acupuncture had lower odds of clinical pregnancy than those who did not undergo acupuncture treatment ( OR = 0.42 , 95 % CI 0.19 - 0.93 ) . CONCLUSION Our study found that acupuncture performed off-site on the day of ET was detrimental to the success of the transfer . More research is needed with a greater number of subjects to eluci date the role of acupuncture before and after ET , ideal treatment frequency , and to further explore the role of individualized acupuncture treatment on IVF-ET pregnancy rates BACKGROUND Acupuncture has been used during IVF treatment as it may improve outcome , however , there are concerns about the true efficacy of this approach . This r and omized double blind study aim ed to compare real acupuncture with placebo acupuncture in patients undergoing IVF treatment . METHODS On the day of embryo transfer ( ET ) , 370 patients were r and omly allocated to either real or placebo acupuncture according to a computer-generated r and omization list in sealed opaque envelopes . They received 25 min of real or placebo acupuncture before and after ET . The endometrial and subendometrial vascularity , serum cortisol concentration and the anxiety level were evaluated before and after real and placebo acupuncture . RESULTS The overall pregnancy rate was significantly higher in the placebo acupuncture group than that in the real acupuncture group ( 55.1 versus 43.8 % , respectively , P = 0.038 ; Common odds ratio 1.578 95 % confidence interval 1.047 - 2.378 ) . No significant differences were found in rates of ongoing pregnancy and live birth between the two groups . Reduction of endometrial and subendometrial vascularity , serum cortisol concentration and the anxiety level were observed following both real and placebo acupuncture , although there were no significant differences in the changes in all these indices between the two groups . CONCLUSIONS Placebo acupuncture was associated with a significantly higher overall pregnancy rate when compared with real acupuncture . Placebo acupuncture may not be inert . Trial registered with HK Clinical Trials.com : number HKCTR-236 The aim of this paper was to provide reliable evidence by performing a systematic review and meta- analysis for evaluating the role of acupuncture in assisted reproductive technology . All r and omized controlled trials that evaluated the effects of acupuncture , including manual , electrical , and laser acupuncture ( LA ) techniques , on the clinical pregnancy rate ( CPR ) and live birth rate ( LBR ) of in vitro fertilization ( IVF ) or artificial insemination were included . The controlled groups consisted of no acupuncture and sham acupuncture groups . The sham acupuncture included sham acupuncture at acupoints , sham acupuncture at non- or inappropriate points , sham LA , and adhesive tapes .  Twenty-three trials ( a total of 5598 participants ) were included in this paper . The pooled CPR from all acupuncture groups was significantly higher than that from all controlled groups , whereas the LBR was not significantly different between the two groups . However , the results were quite distinct when the type of control and /or different acupuncture times were examined in a sensitivity analysis . The results mainly indicate that acupuncture , especially around the time of the controlled ovarian hyperstimulation , improves pregnancy outcomes in women undergoing IVF . More positive effects from acupuncture in IVF can be expected if a more individualized acupuncture programs are used Objective To evaluate the effectiveness of acupuncture and moxibustion as an adjuvant treatment in women undergoing in vitro fertilisation ( IVF ) when embryo implantation has failed . Methods A prospect i ve , r and omised controlled clinical trial was conducted with 84 infertile patients who had had at least two unsuccessful attempts of IVF . The patients were r and omised in three groups : control ( n=28 ) , sham ( n=28 ) and acupuncture ( n=28 ) . The sample size was calculated by assuming a pregnancy rate of 10 % when embryo implantation had failed . The pregnancy rates of the current IVF cycle were evaluated by measurement of blood β human chorionic gonadotrophin ( βhCG ) and subsequent transvaginal ultrasound .  Acupuncture was performed on the first and seventh day of ovulation induction , on the day before ovarian puncture and on the day after embryo transfer . In the acupuncture group , patients were treated with moxibustion at nine acupuncture points ( BL18 , BL22 , BL23 , BL52 , CV3 , CV4 , CV5 , CV7 , GV4 ) and needling at 12 points . In the sham group needles were inserted in eight areas that did not correspond to known acupuncture points . Results The clinical pregnancy rate in the acupuncture group was significantly higher than that in the control and sham groups ( 35.7 % vs 7.1 % vs 10.7 % ; p=0.0169 ) . Conclusions In this study , acupuncture and moxibustion  increased pregnancy rates when used as an adjuvant treatment in women undergoing IVF , when embryo implantation had failed BACKGROUND Acupuncture previously has proved its pain-relieving effect for ovum pick-up ( OPU ) . The analgesic effect of electro-acupuncture ( EA ) was evaluated when EA was applied for only a few minutes prior to OPU in an attempt to make EA more attractive for clinical use . METHODS Two hundred patients undergoing OPU were r and omized prospect ively using sealed , unlabelled envelopes , to receive pain relief with either EA in combination with a paracervical block ( PCB ) ( n = 100 ) or conventional medical analgesia ( CMA ) in combination with a PCB ( n = 100 ) . A visual analogue scale ( VAS ) was used to evaluate pain and anxiety before , during and after OPU . The primary outcome measure was pain relief ; secondary end-points were costs , time to discharge and clinical outcome parameters . RESULTS There were no differences in any VAS ratings before the procedure . Directly after OPU , the EA group reported significantly higher mean and maximum pain , and ' pain now ' than the CMA group . At 30 min after OPU and thereafter , no significant differences were found between the groups regarding abdominal pain . Time to discharge and costs were significantly lower in the EA group compared with the CMA group . No differences in clinical outcome parameters were seen . CONCLUSION A significant difference was found between the EA and the CMA groups regarding pain during the OPU , probably due to the fact that the CMA group was pre-medicated as part of the study design . Despite a per-operative difference in pain rating , EA , given a few minutes prior to OPU , is a good alternative to CMA . The procedure is well tolerated by the patients , with a shorter hospitalization time and lower costs OBJECTIVE To evaluate the effect of acupuncture on reproductive outcome in patients treated with IVF/intracytoplasmic sperm injection ( ICSI ) . One group of patients received acupuncture on the day of ET , another group on ET day and again 2 days later ( i.e. , closer to implantation day ) , and both groups were compared with a control group that did not receive acupuncture . DESIGN Prospect i ve , r and omized trial . SETTING Private fertility center . PATIENT(S ) During the study period all patients receiving IVF or ICSI treatment were offered participation in the study . On the day of oocyte retrieval , patients were r and omly allocated ( with sealed envelopes ) to receive acupuncture on the day of ET ( ACU 1 group , n = 95 ) , on that day and again 2 days later ( ACU 2 group , n = 91 ) , or no acupuncture ( control group , n = 87 ) . INTERVENTION(S ) Acupuncture was performed immediately before and after ET ( ACU 1 and 2 groups ) , with each session lasting 25 minutes ; and one 25-minute session was performed 2 days later in the ACU 2 group . MAIN OUTCOME MEASURE(S ) Clinical pregnancy and ongoing pregnancy rates in the three groups . RESULT ( S ) Clinical and ongoing pregnancy rates were significantly higher in the ACU 1 group as compared with controls ( 37 of 95 [ 39 % ] vs. 21 of 87 [ 26 % ] and 34 of 95 [ 36 % ] vs. 19 of 87 [ 22 % ] ) . The clinical and ongoing pregnancy rates in the ACU 2 group ( 36 % and 26 % ) were higher than in controls , but the difference did not reach statistical difference . CONCLUSION ( S ) Acupuncture on the day of ET significantly improves the reproductive outcome of IVF/ICSI , compared with no acupuncture . Repeating acupuncture on ET day + 2 provided no additional beneficial effect OBJECTIVE To evaluate the effects of electroacupuncture ( EA ) on pregnancy rate and uterine artery blood flow impedance in patients undergoing in vitro fertilization ( IVF ) . MATERIAL S AND METHODS This prospect i ve , r and omized trial was carried out in the IVF center of China Medical University Hospital in Taiwan , from February 1 , 2004 to January 30 , 2005 . A total of 44 patients were enrolled in the study . Of these , 30 were allocated to acupuncture , and 14 were allocated to no acupuncture . EA was performed four times , twice a week for 2 weeks , from day 2 of the study to the day before oocyte retrieval . After patients felt the needle reaction , the needles were attached to an electrical stimulator for 30 minutes . Clinical pregnancy and pulsatility index ( PI ) of right and left uterine arteries before and after EA were measured . RESULTS There was no significant difference in pregnancy rate between the two groups ( acupuncture group , 30 % ; non-acupuncture group , 28.6 % ) . The mean PI of both uterine arteries was significantly reduced after EA ( left uterine artery , 2.3 to 2.0 ; right uterine artery , 2.4 to 2.2 ) . There was no significant change in PI in the group with no acupuncture ( left uterine artery , 2.5 to 2.3 ; right uterine artery , 2.4 to 2.3 ) . CONCLUSION EA could be useful for reducing uterine artery blood flow impedance , but did not increase the pregnancy rate in patients undergoing IVF OBJECTIVE To determine whether changes in serum cortisol ( CORT ) and PRL are affected by acupuncture ( Ac ) in Ac-treated IVF patients . DESIGN Prospect i ve cohort clinical study . SETTING Private practice reproductive endocrinology and infertility clinic and private practice acupuncture consortium . PATIENT(S ) Sixty-seven reproductive-age infertile women undergoing IVF .  INTERVENTION(S ) Blood sample s were obtained from all consenting new infertility patients and serum CORT and serum PRL were obtained prospect ively . Patients were grouped as controls ( IVF with no Ac ) and treated ( IVF with Ac ) according to acupuncture protocol s derived from r and omized controlled trials . MAIN OUTCOME MEASURE(S ) Serum levels of CORT and PRL were measured and synchronized with medication stimulation days of the IVF cycle ( e.g. , day 2 of stimulation , day 3 , etc . ) . Reproductive outcomes were collected according to Society for Assisted Reproductive Technology protocol s , and results were compared between controls and those patients treated with Ac . RESULT ( S ) CORT levels in Ac group were significantly higher on IVF medication days 7 , 8 , 9 , 11 , 12 , and 13 compared with controls . PRL levels in the Ac group were significantly higher on IVF medication days 5 , 6 , 7 , and 8 compared with controls . CONCLUSION ( S ) In this study , there appears to be a beneficial regulation of CORT and PRL in the Ac group during the medication phase of the IVF treatment with a trend toward more normal fertile cycle dynamics BACKGROUND The primary aims were to compare the pain-relieving effect and post-operative well-being between electro-acupuncture analgesia ( EA ) and conventional analgesia ( CA ) comprising opiates . Further aims were to compare time for mobilization , and costs for time and drug consumption . METHODS In all , 160 women undergoing IVF were r and omized , according to a computer-generated list , to EA or CA . Well-being was evaluated with the State Trait Anxiety Inventory ( STAI ) . Pain and subjective expectations and experiences were recorded on a visual analogue scale ( VAS ) . Time and drug consumption were recorded . RESULTS Although VAS pain ratings were significantly higher at oocyte aspiration ( P < 0.0001 ) and after retrieval ( P < 0.01 ) in the EA than in the CA group , they were similar 60 min after surgery . Both groups had similar STAI well-being scores . The EA group was significantly less tired and confused than the CA group after oocyte aspiration . No significant differences in time and costs for drug consumption were noted . CONCLUSION EA can not generally be recommended as a pain-relieving method at oocyte aspiration but might be an alternative for women desiring a non-pharmacological method . An advantage of EA is less post-operative tiredness and confusion compared with CA This prospect i ve , r and omized , controlled and double-blinded trial studied whether acupuncture in relation to embryo transfer could increase the ongoing pregnancy rates and live birth rates in women undergoing assisted reproductive therapy . A total of 635 patients undergoing IVF or intracytoplasmic sperm injection ( ICSI ) were included . In 314 patients , embryo transfer was accompanied by acupuncture according to the principles of traditional Chinese medicine . In the control group , 321 patients received placebo acupuncture using a vali date d placebo needle . In the acupuncture group and the placebo group , the ongoing pregnancy rates were 27 % ( 95 % CI 22 - 32 ) and 32 % ( 95 % CI 27 - 37 ) , respectively . Live birth rates were 25 % ( 95 % CI 20 - 30 ) in the acupuncture group and 30 % ( 95 % CI 25 - 30 ) in the placebo group . The differences were not statistically significant . These results suggest that acupuncture administered in relation to embryo transfer has no effect on the outcome of IVF and ICSI OBJECTIVE To evaluate the effects of acupuncture on clinical pregnancy rates for women undergoing ET . DESIGN Single-blind , r and omized controlled trial using a noninvasive sham acupuncture control . SETTING Repromed , The Reproductive Medicine Unit of The University of Adelaide . PATIENT(S ) Women undergoing IVF . INTERVENTION(S ) Women were r and omly allocated to acupuncture or noninvasive sham acupuncture with the placebo needle . All women received three sessions , the first undertaken on day 9 of stimulating injections , the second before ET , and the third immediately after ET . MAIN OUTCOME MEASURE(S ) The primary outcome was pregnancy . Secondary outcomes were implantation , ongoing pregnancy rate at 18 weeks , adverse events , and health status . RESULT ( S ) Two hundred twenty-eight subjects were r and omized . The pregnancy rate was 31 % in the acupuncture group and 23 % in the control group . For those subjects receiving acupuncture , the odds of achieving a pregnancy were 1.5 higher than for the control group , but the difference did not reach statistical significance . The ongoing pregnancy rate at 18 weeks was higher in the treatment group ( 28 % vs. 18 % ) , but the difference was not statistically significant . CONCLUSION ( S ) There was no significant difference in the pregnancy rate between groups ; however , a smaller treatment effect can not be excluded . Our results suggest that acupuncture was safe for women undergoing ET Three different adult Indonesian population groups living on Sumatra ( Palembang ) , Java ( Depok ) and Sulawesi ( Makale ) participated in a study on body composition . Body weight , body height and multifrequency bioelectrical impedance ( 1 , 5 , 50 and 100 kHz ) were measured and in addition total  body water ( TBW ) and  extracellular water ( ECW ) were determined by dilution techniques , using deuterium oxide and sodium bromide , respectively , as tracers . In total 318 subjects , 159 males and 159 females , participated in the study . Predicting ECW and TBW from  bio-electrical impedance  , using existing prediction formulas from the literature , did not result in valid estimates of these parameters . Therefore new prediction equations for ECW and TBW were developed in this group and the prediction equations were vali date d in several subgroups . Extracellular water ( kg ) could be predicted with the formula 0.262 height2/Z1 + 2.7 ( SEE = 0.9 kg ) and TBW with the formula 0.516 height2/Z100 + 3.5 ( SEE = 1.6 kg ) , where Z1 and Z100 are impedances at frequency 1 and 100 kHz , and SEE is the st and ard error of estimate . The prediction formulas showed good validity in the three geographical subgroups , in males and females separately and in two r and omly selected subgroups . The absolute prediction error ( kg ) of the newly developed prediction equations is lower compared with values normally reported in the literature , but when expressed as coefficient of variation the errors are comparable with values from the literature . Addition of weight age and sex ( for TBW only ) improves the prediction equation . The prediction equations were compared with prediction equations developed in Dutch subjects . In the Indonesian subjects the slopes of the regression equations were not different from the Dutch equations but the intercepts were lower . This means that for the same body water compartment and for the same height Indonesians have lower impedance values . This could be explained by a slightly higher ECW/TBW ratio and a more slender body build among Indonesians . A higher environmental temperature and skin temperature of the subjects in this study could have added to the effect . The formulas should preferably be vali date d before applying them to other Asian population OBJECTIVE To evaluate the effect of transcutaneous electrical acupoint stimulation ( TEAS ) on pregnancy rates ( PR ) in women undergoing ET . DESIGN Prospect i ve , r and omized , single-blinded placebo-controlled clinical trial . SETTING Research and laboratory facilities . PATIENT(S ) A total of 309 patients , less than 45 years old , undergoing cryopreservation embryos transplant or fresh cycle IVF with or without intracytoplasmic sperm injection ( ICSI ) .  INTERVENTION(S ) The subjects were r and omly allocated to three groups : mock TEAS treatment : 30 minutes after ET ( group I , n = 99 ) ; single TEAS treatment : 30 minutes after ET ( group II , n = 110 ) ; and double TEAS treatments : 24 hours before ET and 30 minutes after ET ( group III , n = 100 ) . MAIN OUTCOME MEASURE(S ) Clinical PR , embryos implantation rate , live birth rate . RESULT ( S ) The clinical PR , embryos implantation rate , and live birth rate of group I ( 29.3 % , 15.0 % , and 21.2 % , respectively ) were significantly lower than those in group II ( 42.7 % , 25.7 % , and 37.3 % , respectively ) and group III ( 50.0 % , 25.9 % , and 42.0 % , respectively ) . CONCLUSION ( S ) Transcutaneous electrical acupoint stimulation , especially double TEAS , significantly improved the clinical outcome of ET We studied 20 otherwise healthy women undergoing lower abdominal surgery . Immediately after wound closure , while still anaesthetized , they received either electroacupuncture ( EA ) or no further treatment . They were allowed pethidine for postoperative analgesia by patient-controlled infusion pump . Signs of postoperative distress ( pain , nausea , drowsiness ) were evaluated after 2 and 6 h by visual analogue scale scores . The group receiving EA consumed half the quantity of pethidine as that used used by the no treatment group . Two patients in the EA group had no postoperative analgesia in the first 2 h. There was no difference in the assessment s of postoperative distress between groups . No patient was aware of having received EA or not The aim of the present study was to evaluate the anaesthetic effect during oocyte aspiration of a paracervical block ( PCB ) in combination with either electro-acupuncture ( EA ) or intravenous alfentanil . In all , 150 women undergoing in-vitro fertilization ( IVF ) and embryo transfer were r and omized to receive either EA plus PCB or alfentanil plus PCB .  Visual analogue scales ( VAS ) were used to evaluate subjective experiences during oocyte aspiration , and IVF outcome parameters were recorded . No differences in pain directly related to oocyte aspiration , adequacy of anaesthesia during oocyte aspiration , abdominal pain , or degree of nausea were found between the two groups in the VAS ratings . Before oocyte aspiration , the level of stress was significantly higher in the EA group than in the alfentanil group ( P < 0.05 ) , and the EA group experienced discomfort for a significantly longer period during oocyte aspiration ( P < 0 . 01 ) . Compared with the alfentanil group , the EA group had a significantly higher implantation rate ( P < 0.05 ) , pregnancy rate ( P < 0.05 ) , and take home baby rate ( P < 0.05 ) per embryo transfer . In conclusion , EA has been shown to be as good an anaesthetic method as alfentanil during oocyte aspiration , and we suggest that EA may be a good alternative to conventional anaesthesia during oocyte aspiration BACKGROUND This study was undertaken to examine the effects of acupuncture on smoking reduction and possibly also cessation and to examine whether some acupoints are more effective than others for smoking cessation . METHODS A total of 46 healthy men and women , 39 + /- 9 years of age ( mean + /- SD ) , who smoked 20 + /- 6 cigarettes per day and had smoked for 23 + /- 8 years , and who wanted to quit smoking , volunteered to participate . The subjects were r and omly assigned to two groups . One group was given acupuncture treatment at points previously used for anti-smoking ( test group , TG ) . The other group was given acupuncture treatment at points assumed to have no effect for smoking cessation ( control group , CG ) . Before each treatment and after the last treatment each subject answered question naires about his or her smoking habits and attitudes . In addition the concentrations of serum cotinine , serum thiocyanate , serum peroxides , and plasma fibrinogen were measured before the first and after the last acupuncture treatment . RESULTS The daily cigarette consumption fell during the treatment period in both groups , but the reduction was larger for TG than for CG ( P < 0.002 ) . Altogether 31 % of subjects in TG had quit smoking completely at the end of the treatment , compared with none in CG . For TG the concentrations of cotinine and thiocyanate were reduced significantly after the treatment period ( P < 0.001 ) , but no significant reductions were observed for CG . For both groups the taste of tobacco worsened during the treatment period , but the effect was more pronounced for TG than for CG ( P < 0.05 ) . The desire to smoke fell significantly in both groups after treatment , and the reduction was larger for TG than for CG ( P < 0.001 ) . No significant changes in serum peroxides and plasma fibrinogen concentrations were observed during the treatment period for either group . CONCLUSIONS This study suggests that acupuncture may help motivated smokers to reduce their smoking or even quit smoking completely . Different acupoints appear to have different effects for smoking cessation and reduction OBJECTIVE To observe the effect of electroacupuncture therapy on oocyte quality and pregnancy outcome of patients with poor ovarian response or decreased reserve in the course of in vitro fertilization ( IVF ) . METHODS Sixty cases accepting IVF-ET were r and omly divided into an observation group and a control group , 30 cases in each group . The two groups were both treated with antagonist scheme for ovulation induction , and the electroacupuncture intervention was also added in the observation group , Guanyuan ( CV 4 ) , Taixi ( KI 3 ) , Sanyinjiao ( SP 6 ) etc . were selected . The therapeutic effects in the two groups were compared after treatment . RESULTS There was no significant difference between the two groups before treatment . The symptoms of kidney difficiency in the observation group were significantly improved after treatment , and the levels of serum estradiol ( E2 ) , fertilization rate , oocyte maturation rate , good quality embryos rate , and implantation rate in the observation group were superior to those in the control group on human Chorionic Gonadotropin ( hCG ) injection day ( all P<0.05 ) ; the levels of stem cell factor ( SCF ) in follicular fluid and serum in the observation group were significantly higher than those in the control group ( both P<0.05 ) . The pregnancy rate in the observation group was higher than that in the control group , and the abortion rate in the observation group was lower than that in the control group , but there was no significant difference between the two groups ( both P>0.05 ) . CONCLUSION Electroacupuncture therapy has a good clinical effect for IVF patients with poor ovarian reserve , and can improve oocyte quality and pregnancy outcome
Purpose Controversial results have been reported concerning the effect of acupuncture on  in vitro fertilization ( IVF ) outcomes .
The current review was conducted to systematic ally review published studies of the effects of acupuncture on IVF outcomes .