Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. The impact of acupuncture on in vitro fertilization outcome. Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial. Electro-acupuncture as a peroperative analgesic method and its effects on implantation rate and neuropeptide Y concentrations in follicular fluid. An evidence based approach to individualising treatment 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. Effect of Acupuncture on Symptoms of Anxiety in Women Undergoing in Vitro Fertilisation: A Prospective Randomised Controlled Study Effects of Acupuncture on the Outcome of in Vitro Fertilisation and Intracytoplasmic Sperm Injection in Women with Polycystic Ovarian Syndrome Safety of Acupuncture: Results of a Prospective Observational Study with 229,230 Patients and Introduction of a Medical Information and Consent Form The effect of acupuncture on psychosocial outcomes for women experiencing infertility: a pilot randomized controlled trial. Effect of Acupuncture on Assisted Reproduction Treatment Outcomes Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Acupuncture for frozen-thawed embryo transfer cycles: a double-blind randomized controlled trial. Sham device v inert pill: randomised controlled trial of two placebo treatments 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 Is Placebo Acupuncture What It Is Intended to Be? 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. Acupuncture on the day of embryo transfer: a randomized controlled trial of 635 patients. The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: a pilot study. Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer. Assisted hatching: trends and pregnancy outcomes, United States, 2000-2010. Mood state as a predictor of treatment outcome after in vitro fertilization/embryo transfer technology (IVF/ET). Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro Fertilization: A Randomized Clinical Trial A prospective randomized study of electro-acupuncture versus alfentanil as anaesthesia during oocyte aspiration in in-vitro fertilization.
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 Acupuncture has been demonstrated to improve menstrual frequency and to decrease circulating testosterone in women with polycystic ovary syndrome ( PCOS ) . Our aim was to investigate whether acupuncture affects ovulation frequency and to underst and the underlying mechanisms of any such effect by analyzing LH and sex steroid secretion in women with PCOS . This prospect i ve , r and omized , controlled clinical trial was conducted between June 2009 and September 2010 . Thirty-two women with PCOS were r and omized to receive either acupuncture with manual and low-frequency electrical stimulation or to meetings with a physical therapist twice a week for 10 - 13 wk . Main outcome measures were changes in LH secretion patterns from baseline to after 10 - 13 wk of treatment and ovulation frequency during the treatment period . Secondary outcomes were changes in the secretion of sex steroids , anti-Müllerian hormone , inhibin B , and serum cortisol . Ovulation frequency during treatment was higher in the acupuncture group than in the control group . After 10 - 13 wk of intervention , circulating levels of estrone , estrone sulfate , estradiol , dehydroepi and rosterone , dehydroepi and rosterone sulfate , and rostenedione , testosterone , free testosterone , dihydrotestosterone , and rosterone glucuronide , and rostane-3α,17β-diol-3-glucuronide , and and rostane-3α,17β-diol-17-glucuronide decreased within the acupuncture group and were significantly lower than in the control group for all of these except and rostenedione . We conclude that repeated acupuncture treatments result ed in higher ovulation frequency in lean/overweight women with PCOS and were more effective than just meeting with the therapist . Ovarian and adrenal sex steroid serum levels were reduced with no effect on LH secretion 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 To which groups of patients can the results of clinical trials be applied ? This question is often inappropriately answered by reference to the trial entry criteria . Instead , the benefit and harm ( adverse events , discomfort of treatment , etc ) of treatment could be assessed separately for individual patients . Patients at greatest risk of a disease will have the greatest net benefit as benefit to patients usually increases with risk while harm remains comparatively fixed . To assess net benefit , the relative risks should come from ( a meta- analysis of ) r and omised trials ; the risk in individual patients should come from multivariate risk equations derived from cohort studies . However , before making firm conclusions , the assumptions of fixed adverse effects and constant reduction in relative risk need to be checked 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 Purpose To determine if acupuncture improves symptoms of anxiety in infertile women undergoing in vitro fertilisation ( IVF ) treatment . Methods A r and omised clinical trial was performed in 43 patients undergoing IVF . The patients were r and omised into two groups : test group ( n=22 ) and control group ( n=21 ) . The anxiety level of each patient was analysed before and after treatment using the Hamilton Anxiety Rating Scale ( HAS ) . Treatment sessions consisted of four weekly sessions . In the test group , needles were inserted at points HT7 , PC6 , CV17 , GV20 and Yintang . In the control group , needles were inserted in areas near but not corresponding to acupuncture points . Results The mean HAS score after the 4-week experimental period was significantly lower in the test group than in the control group ( 19.4±3.2 vs 24.4±4.2 ; p=0.0008 ) . Conclusions The results indicate that acupuncture can reduce anxiety symptoms observed by the reduction of psychological parameters of women undergoing IVF . Further evidence should be sought as to whether acupuncture might be a complementary option for patients undergoing IVF 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 Background : To evaluate the safety of acupuncture in a large number of patients receiving conventional health care and , based on these results , to develop a new medical consent form for acupuncture . Methods : The prospect i ve observational study included patients who received acupuncture treatment for chronic osteoarthritis pain of the knee or hip , low back pain , neck pain or headache , allergic rhinitis , asthma , or dysmenorrhoea . After treatment , all patients documented adverse events associated with acupuncture ( defined as adverse effects ) . Patients who reported a need for treatment due to an adverse effect completed an additional st and ardised question naire on the most important adverse effect . Based on this data and considering ethical and legal aspects a new consent form was developed . Results : A total of 229,230 patients received on average 10.2 ± 3.0 acupuncture treatments . Altogether , 19,726 patients ( 8.6 % ) reported experiencing at least one adverse effect and 4,963 ( 2.2 % ) reported one which required treatment . Common adverse effects were bleedings or haematoma ( 6.1 % of patients , 58 % of all adverse effects ) , pain ( 1.7 % ) and vegetative symptoms ( 0.7 % ) . Two patients experienced a pneumothorax ( one needed hospital treatment , the other observation only ) . The longest duration of a side effect was 180 days ( nerve lesion of the lower limb ) . The result ing medical consent form consists of five modules : Introduction to acupuncture and moxibustion , Risks of acupuncture treatment , Conditions which can increase the risk , Doctor ’s statement , and Consent . Conclusion : Acupuncture provided by physicians is a relatively safe treatment and the proposed consent form could support both patients and professionals in the process of obtaining informed consent OBJECTIVES The study objectives were to examine the effectiveness of acupuncture for reducing  infertility-related stress .  DESIGN The study design was a r and omized controlled trial of acupuncture compared with a wait-list control . SETTING The study was conducted at The University of Western Sydney . SUBJECTS Thirty-two ( 32 ) women aged 20 - 45 years , with a diagnosis of infertility , or a history of unsuccessfully trying to conceive for 12 months or more , were the subjects of the study . INTERVENTIONS Women received six sessions of acupuncture over 8 weeks . OUTCOME MEASURES The primary outcomes were infertility self-efficacy , anxiety , and infertility-related stress . The women 's experience of infertility and acupuncture is also reported . RESULTS At the end of the 8-week intervention , women in the acupuncture group reported significant changes on two domains on the Fertility Problem Inventory with less social concern ( mean difference [ MD ] -3.75 , 95 % confidence interval [ CI ] -7.58 to 0.84 , p=0.05 ) , and less relationship concern ( MD -3.66 , 95 % CI -6.80 to -0.052 , p=0.02 ) . There were also trends toward a reduction of infertility stress on other domains , and a trend toward improved self-efficacy ( MD 11.9 , 95 % CI -2.20 to 26.0 , p=0.09 ) and less anxiety ( MD -2.54 , 95 % CI -5.95 to 0.86 , p=0.08 ) in the acupuncture group compared with the wait-list control . Women described the experience and impact of acupuncture as positive relating to a sense of relaxation and time out , the engagement with the practitioner , and an intervention that had very few negative side-effects . Changes were also perceived after treatment with women describing a physical and psychologic sense of relaxation and calmness , and a changed perspective in relation to coping . CONCLUSIONS Acupuncture may be a useful intervention to assist with the reduction of infertility-related stress . Further research is justified 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 In order to assess whether electro-acupuncture ( EA ) can reduce a high uterine artery blood flow impedance , 10 infertile but otherwise healthy women with a pulsatility index ( PI ) > = 3.0 in the uterine arteries were treated with EA in a prospect i ve , non-r and omized study . Before inclusion in the study and throughout the entire study period , the women were down-regulated with a gonadotrophin-releasing hormone analogue ( GnRHa ) in order to exclude any fluctuating endogenous hormone effects on the PI . The baseline PI was measured when the serum oestradiol was < = 0.1 nmol/l , and thereafter the women were given EA eight times , twice a week for 4 weeks . The PI was measured again closely after the eighth EA treatment , and once more 10 - 14 days after the EA period . Skin temperature on the forehead ( STFH ) and in the lumbrosacral area ( STLS ) was measured during the first , fifth and eighth EA treatments . Compared to the mean baseline PI , the mean PI was significantly reduced both shortly after the eighth EA treatment ( P < 0.0001 ) and 10 - 14 days after the EA period ( P < 0.0001 ) . STFH increased significantly during the EA treatments . It is suggested that both of these effects are due to a central inhibition of the sympathetic activity 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 Abstract Objective To investigate whether a sham device ( a vali date d sham acupuncture needle ) has a greater placebo effect than an inert pill in patients with persistent arm pain . Design A single blind r and omised controlled trial created from the two week placebo run-in periods for two nested trials that compared acupuncture and amitriptyline with their respective placebo controls . Comparison of participants who remained on placebo continued beyond the run-in period to the end of the study . Setting Academic medical centre . Participants 270 adults with arm pain due to repetitive use that had lasted at least three months despite treatment and who scored ≥3 on a 10 point pain scale . Interventions Acupuncture with sham device twice a week for six weeks or placebo pill once a day for eight weeks . Main outcome measures Arm pain measured on a 10 point pain scale . Secondary outcomes were symptoms measured by the Levine symptom severity scale , function measured by Pransky 's upper extremity function scale , and grip strength . Results Pain decreased during the two week placebo run-in period in both the sham device and placebo pill groups , but changes were not different between the groups ( −0.14 , 95 % confidence interval −0.52 to 0.25 , P = 0.49 ) . Changes in severity scores for arm symptoms and grip strength were similar between groups , but arm function improved more in the placebo pill group ( 2.0 , 0.06 to 3.92 , P = 0.04 ) . Longitudinal regression analyses that followed participants throughout the treatment period showed significantly greater downward slopes per week on the 10 point arm pain scale in the sham device group than in the placebo pill group ( −0.33 ( −0.40 to −0.26 ) v −0.15 ( −0.21 to −0.09 ) , P = 0.0001 ) and on the symptom severity scale ( −0.07 ( −0.09 to −0.05 ) v −0.05 ( −0.06 to −0.03 ) , P = 0.02 ) . Differences were not significant , however , on the function scale or for grip strength . Reported adverse effects were different in the two groups . Conclusions The sham device had greater effects than the placebo pill on self reported pain and severity of symptoms over the entire course of treatment but not during the two week placebo run in . Placebo effects seem to be malleable and depend on the behaviours embedded in medical rituals 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 R and omized , placebo-controlled clinical trials are recommended for evaluation of a treatment 's efficacy with the goal of separating the specific effects ( verum ) from the non-specific ones ( placebo ) . In order to be able to carry out placebo-controlled acupuncture trials , minimal/sham acupuncture procedures and a sham acupuncture needle has been used with the intention of being inert . However , clinical and experimental results suggest that sham/minimal acupuncture is not inert since it is reported that both verum acupuncture and sham/minimal acupuncture induce a significant alleviation of pain . This alleviation is as pronounced as the alleviation obtained with st and ard treatment and more obvious than the one obtained with placebo medication or by the use of waiting list controls . These results also suggest that sham acupuncture needles evoke a physiological response . In healthy individuals  sham acupuncture results in activation of limbic structures , whereas a deactivation is seen in patients with pain , i.e. results from healthy individuals do not reflect what is seen in clinical conditions . Also , depending on the etiology of pain ( or any under clinical condition under investigation ) , the response to sham acupuncture is varying . The acupuncture ritual may also be seen as an emotional focused therapy allowing for psychological re-orientation . Sham needling in such context may be as powerful as verum acupuncture . We recommend that the evaluated effects of acupuncture could be compared with those of st and ard treatment , also taking the individual response into consideration , before its use or non-use is established 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 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 UNLABELLED The aim of this paper was to determine the effect of acupuncture on perceived stress levels in women on the day of embryo transfer ( ET ) , and to determine if perceived stress levels at embryo transfer correlated with pregnancy rates . The study was an observational , prospect i ve , cohort study based at the University IVF center . PATIENT(S ) 57 infertile patients undergoing IVF or IVF/ICSI . INTERVENTIONS ( S ) Patients were undergoing Embryo Transfer with or without acupuncture  as part of their st and ard clinical care . MAIN OUTCOME MEASURE(S ) Perceive Stress Scale scores , pregnancy rates . RESULT ( S ) women who received this acupuncture regimen achieved pregnancy 64.7 % , whereas those without acupuncture achieved pregnancy 42.5 % . When stratified by donor recipient status , only non-donor recipients potentially had an improvement with acupuncture ( 35.5 % without acupuncture vs. 55.6 % with acupuncture ) . Those who received this acupuncture regimen had lower stress scores both pre-ET and post-ET compared to those who did not . Those with decreased their perceived stress scores compared to baseline had higher pregnancy rates than those who did not demonstrate this decrease , regardless of acupuncture status . CONCLUSIONS ( S ) The acupuncture regimen was associated with less stress both before and after embryo transfer , and it possibly improved pregnancy rates . Lower perceived stress at the time of embryo transfer may play a role in an improved pregnancy rate 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 OBJECTIVE To assess trends and outcomes of assisted hatching among assisted reproductive technology ( ART ) cycles . DESIGN Retrospective cohort analysis using National ART Surveillance System ( NASS ) data . SETTING U.S. fertility centers reporting to NASS . PATIENT(S ) Fresh autologous noncanceled ART cycles conducted from 2000 - 2010 . INTERVENTION(S ) None . MAIN OUTCOME MEASURE(S ) Implantation , clinical pregnancy , live-birth , miscarriage , multiple gestation . RESULT ( S ) Assisted hatching use statistically significantly increased in absolute number ( from 25,724 to 35,518 cycles ) , percentages of day-3 ( from 50.7 % to 56.3 % ) and day-5 transfers ( from 15.9 % to 22.8 % ) , and percentage of transfers among women ≥38 years ( from 17.8 % to 21.8 % ) or women with ≥2 prior ART cycles and no live birth(s ) ( from 4.3 % to 7.4 % ) . Both day-3 and day-5 cycles involving assisted hatching were associated with lower odds of implantation ( adjusted odds ratios [ aOR ] 0.7 and 0.6 , respectively ) , clinical pregnancy ( aOR 0.8 and 0.7 , respectively ) , live birth ( aOR 0.8 and 0.7 , respectively ) , and increased odds of miscarriage ( aOR 1.4 and 1.4 , respectively ) , as compared with cycles without assisted hatching . Assisted hatching was associated with lower odds of multiple gestation in day-5 cycles ( aOR 0.8 ) . In cycles for women with a " poor prognosis , " the association of assisted hatching with pregnancy outcomes was not statistically significant . CONCLUSION ( S ) Assisted hatching use had an increasing trend but was not associated with improved pregnancy outcomes , even in poor-prognosis patients . Prospect i ve studies are needed to identify the patients who may benefit from assisted hatching The association between mood state and treatment outcome after In Vitro Fertilization/Embryo Transfer ( IVF/ET )  was assessed in a prospect i ve sample of 330 women , of whom 113 were first time participants ( inductees ) and 217 were repeat cycle women ( veterans ) . Initial evaluation of mood state indicated a significantly higher level of depression amongst veterans than inductees and a significantly greater proportion of veterans ( 25 % ) with clinical ly elevated depression scores compared with inductees ( 15 % ) and community norms ( approx . 12 % ) . Up to 12 months after initial assessment and after controlling for the number of treatment cycles , a significant difference was observed in the course of pregnancy over time between depressed and non-depressed women . Depressed women exhibited a lower pregnancy rate for the first treatment cycles than non-depressed women . The results and their implication s are discussed Importance Acupuncture is widely used by women undergoing in vitro fertilization ( IVF ) , although the evidence for efficacy is conflicting . Objective To determine the efficacy of acupuncture compared with a sham acupuncture control performed during IVF on live births . Design , Setting , and Participants A single-blind , parallel-group r and omized clinical trial including 848 women undergoing a fresh IVF cycle was conducted at 16 IVF centers in Australia and New Zeal and between June 29 , 2011 , and October 23 , 2015 , with 10 months of pregnancy follow-up until August 2016 . Interventions Women received either acupuncture ( n = 424 ) or a sham acupuncture control ( n = 424 ) . The first treatment was administered between days 6 to 8 of follicle stimulation , and 2 treatments were administered prior to and following embryo transfer . The sham control used a noninvasive needle placed away from the true acupuncture points . Main Outcomes and Measures The primary outcome was live birth , defined as the delivery of 1 or more living infants at greater than 20 weeks ’ gestation or birth weight of at least 400 g. Results Among 848 r and omized women , 24 withdrew consent , 824 were included in the study ( mean [ SD ] age , 35.4 [ 4.3 ] years ) ; 371 [ 45.0 % ] had undergone more than 2 previous IVF cycles ) , 607 proceeded to an embryo transfer , and 809 ( 98.2 % ) had data available on live birth outcomes . Live births occurred among 74 of 405 women ( 18.3 % ) receiving acupuncture compared with 72 of 404 women ( 17.8 % ) receiving sham control ( risk difference , 0.5 % [ 95 % CI , −4.9 % to 5.8 % ] ; relative risk , 1.02 [ 95 % CI , 0.76 to 1.38 ] ) . Conclusions and Relevance Among women undergoing IVF , administration of acupuncture vs sham acupuncture at the time of ovarian stimulation and embryo transfer result ed in no significant difference in live birth rates . These findings do not support the use of acupuncture to improve the rate of live births among women undergoing IVF . Trial Registration anzctr.org.au Identifier : 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 The effects of acupuncture on in vitro fertilization ( IVF ) outcomes remain controversial .
And the variation in participant , interventions , outcomes studied , and trial design may relate to the efficacy of adjuvant acupuncture .