| Results from a recent study in Germany indicate
that adding acupuncture to the treatment protocol of IVF patients
greatly enhances their chances of becoming pregnant. While the
physiologic mechanisms by which acupuncture may affect the uterus and
reproductive system have not been identified, the researchers found that
as a practical matter, at least among their small study population, the
technique worked. In a study of 160 patients undergoing in vitro fertilization,
researchers utilized acupuncture, an important element in the 4,000-year-old
tradition of Chinese medicine, before and after the embryo transfers of half
their patients. The patients, who were all required to have embryos
of good quality, were evenly and randomly divided into two groups similar in
age and diagnosis.
The group receiving acupuncture treatments had one treatment before transfer and another after embryos had been transferred to their
uteruses. Sterile needles were inserted into the patients'
bodies at very specific points. According to the principles of traditional
Chinese medicine, energy flows through the body along defined pathways, or
meridians. Acupuncture is a means of influencing this energy
to induce a desired physiological effect. Points were chosen for these patients
along the spleen and stomach/colon meridians in an effort to
positively influence blood flow and energy to the uterus and to provide a
sedative effect. Additional needles were inserted in the patients' ears
to influence the uterus and stabilize the endocrine system.
Needles were left in place for 25 minutes while the patients rested. The
control group also rested, lying still for 25 minutes after embryo transfer, as
part of the IVF protocol.
The difference between pregnancy rates for the two groups was notable. Patients were examined using ultrasound six weeks
after their IVF procedures. In the control group, 21 out of 80 patients
became pregnant. Of the patients who had received acupuncture treatments,
34 of 80 became pregnant. The researchers plan to conduct further
studies to try to rule out possible psychological or psychosomatic effects.
Sandra Carson, MD, President-Elect of ASRM, commented, "If these
findings are confirmed, they may help us improve the odds for our IVF patients'
achieving pregnancy."
(Paulus, et al., Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy, Fertility and
Sterility, Vol.77, No.4, April 2002)
Patient Age Influences Egg Quality and Embryo Development, But Once Blastocysts Are Transferred, Pregnancy Rates are Similar for Older
and Younger Women
Researchers at the Las Vegas Fertility Center and the University of
Nevada School of Medicine have come up with some rather encouraging findings. While it is well known that female fertility
declines significantly with age, this seems to be based on the reduced number
of eggs that women produce as they age and the poorer quality of those
eggs. Looking back at the records of 300 patients between the ages of 18
and 45 who underwent in vitro fertilization, the researchers determined
that, when embryos are cultured to the blastocyst stage before being
transferred to the uterus, older women have as good a chance of becoming
pregnant as younger women. The difference is that fewer of the older
women's embryos will develop to the blastocyst stage, and therefore fewer older
women will undergo transfer and become pregnant.
The researchers examined the records of all IVF patients treated at
the clinic during a period when all embryos were being grown to
blastocyst stage before transfer. Most of their findings confirmed the
recognized trend of decreasing fertility associated with increasing age.
Older patients were more likely to have their retrievals cancelled and
fewer eggs were retrieved from them. While women in their early to
mid-twenties produced approximately 20 eggs per cycle, those in their early to
mid-forties produced only about 10. Fertilization rates were
similar for the eggs of older and younger women, but embryo development was much
poorer for the older patients. Less than 70% of the patients
in their forties with fertilized eggs had them develop to transferable
blastocysts, while more than 90% of those in their twenties did.
The news is that, once a healthy blastocyst has developed, a
patient's age has little or no effect on the embryo's potential to implant and
result in a pregnancy. Even though pregnancy rates per stimulation cycle
declined dramatically from over 40% for the youngest patients to around 25%
for patients in their forties, implantation and pregnancy rates per
embryo transfer were steady- over 45% for all patients, including those in
their early forties.
"These results are very interesting and will contribute to our
ability to counsel our older patients and develop new protocols. It may
be advantageous for women in their forties to have embryos transferred
before they reach blastocyst stage," remarked William Keye, Jr., MD,
President of ASRM.
(Shapiro, et. al., Influence of patient age on the growth and
transfer of blastocyst-stage embryos, Fertility and Sterility, Vol.77, No.4,
April 2002)
The American Society for Reproductive Medicine, founded in 1944, is
an organization of more than 8,500 physicians, researchers, nurses, technicians, and other professionals dedicated to advancing
knowledge and expertise in reproductive biology. Affiliated societies
include the Society for Assisted Reproductive Technology, The Society for Male
Reproduction and Urology, the Society for Reproductive Endocrinology
and Infertility, and the Society of Reproductive Surgeons.
Fertility and Sterility is now available on-line. For instructions
on how to access it, contact asrm-dc@asrm.org
For more information go to www.asrm.org
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