New Health Acupuncture Clinic
1407 York Road Suite 305A Lutherville MD 21093
Tel: 443-310-5382   Fax:667-206-2956   E-mail: zbli2001@gmail.com
Acupuncture for In Vitro Fertilization
     Acupuncture is a very effective supporting treatment for women
undergoing in vitro fertilization (IVF). During recent 20 years, research
papers for acupuncture on IVF have been increased by 20 folds. Those
research works provide many scientific evidences that acupuncture can
increase pregnancy rates by directly balancing
hypothalamic-pituitary-ovarian axis, increasing oocyte maturation, and
reducing endometrial cavity fluid et al during IVF.   
    A randomized, prospective, controlled clinical trial conducted by Stefam
Dieterle et al study the effect of luteal-phase acupuncture on the outcome
of IVF/intracytoplasmic sperm
injection (ICSI). 225 patients undergoing IVF/ICSI were involved in this
study. 116 patients received luteal-phase acupuncture according to the
principles of traditional Chinese medicine. 109 patients received placebo
acupuncture as control. Result showed both clinical pregnancy rate and
ongoing pregnancy rate are 33.6% and 28.4% in acupuncture groups
respectively, which were significantly higher than 15.6% and 13.8% in
control groups.  
.    72 patients undergoing IVF were involved in this study. 36 patients
received acupuncture. 36 patients received placebo acupuncture as
control. This study found positive Beta HCG was detected in 63.9% of
the acupuncture group and 33.3% of control groups. Clinical
pregnancy, ongoing pregnancy, and live birth rates were 23%, 20%
and 19% respectively in acupuncture groups, which are higher than
12%,11% and 10% in control group.
      A randomized clinic trial conducted by Westergaarf et al evaluated
the effect of one session acupuncture before embryo transfer on
reproductive outcome in patients treated with IVF/ICSI.  273 patients
undergoing IVF were involved in this study. 95 patients received one
session acupuncture before embryo transfer. 91 patients received
one acupuncture session before embryo transfer and one session
after embryo transfer respectively.  87 patients did not receive
acupuncture as control.  This study found that clinical and ongoing
pregnancy rates were 39% and 34% in one acupuncture session
before embryo transfer group, 36% and 26% in two acupuncture
sessions before and after embryo transfer group and 21% and 22%
in control group respectively. The clinical and ongoing pregnancy
rates in acupuncture groups are significantly higher than those in
control group There is not significantly difference between one
session and two session acupuncture groups. This study indicated
acupuncture treatment on the day before embryo transfer significantly
improves the reproductive outcome of IVF/ICSI, compared with no
acupuncture.  
Other randomized controlled clinic
trial conducted by Guven et al
investigated the effect of acupuncture
on pregnancy success rates applied
before and after embryo transfer
among women undergoing IVF.
    Diminished ovarian reserve (DOR) is a manifestation of ovarian
ageing. As women increasingly delay childbearing, DOR is becoming a
greater challenge for providers of assisted reproductive technology.
DOR occurs in 10% infertile women.    
    A study conducted by Wang et al found that acupuncture
modulates reproductive hormone levels and the effects seem to
persist for at least 12 weeks with no significant side effects.  21
patients with DOR was involved in this study.  The patients received
12 week acupuncture treatments including five sessions per week
for 4 weeks and followed 3 sessions per week for 8 weeks.   Mean
Follicle-stimulating hormone (FSH) levels fell from 19.33±9.47
mIU/mL at baseline to 10.58±6.34 mIU/mL at week 12 acupuncture
treatments.  Lower level FSH continue remaining at 11.25±6.68
mIU/mL for 24 weeks without acupuncture. FSH level lower than 15
mlU/ml is considered a better chance of pregnancy achievement per
IVH attempt compared to women FSH level over 15 mLU/ml. There
are very few chances for pregnancy If FSH level is higher than 16
mLU/ml. This study suggests that acupuncture might increase
pregnancy rate for patients with DOR.  
The development and maturation of oocytes is potentially a key success
factor for IVF. Because oocyte quality influence on good embryo
development, failure of oocyte maturation is an obstacle that often
causes low success in IVF. A randomized controlled trial conducted by
Kusuma et al investigated effect of acupuncture on mature oocytes and
fertility rates for IVF. 24 patients undergoing IVF were involved in this
study. 12 patients received acupuncture and 12 patients received
placebo acupuncture as control. The study found that there were
significant differences in maturation and fertilization rates of oocyte,
granulosa-cell apoptosis index, Bax-protein expression, GDF9 levels
and BMP15 between the acupuncture and sham-acupuncture groups.
Those results indicate acupuncture not only enhance oocyte maturation
and fertilization rate, but also reduce the granulosa-cell apoptosis index
during IVF.
    Approximately 20% of female infertility attributed to tubal causes. 10% to
25% of them account for the fallopian tube obstruction.  A case report by
Sun showed that acupuncture successfully treated a 39-year-old woman
diagnosed with fallopian tube obstruction and DOR. The patient has been
unable to conceive in the past 5 years and 3-time IVF. The patient was
given 3 times acupuncture per week for 3 months without any other
medical treatment. At 2-months acupuncture treatment, patient’s menstrual
cycle was back to normal. After 3-month acupuncture treatments, she had
a natural pregnancy and then gave birth to a healthy baby boy.   
Level of Endometrial Cavity Fluid is one impotent fact to affect IVF.
Clinical pregnancy rate is highest in women with very less fluid in cavity
(1–2 mm).  Research conducted by Su et al found that 5 sessions
acupuncture per week for 3 weeks can significantly reduce Endometrial
Cavity Fluid. The clinical pregnancy rate increased to 42.9% in
acupuncture group compared with 26.7% in no acupuncture control
group.
How to Schedule Acupuncture Sessions for IVF?
     Acupuncture regulates multiple levels for IVF and each person’s issues is difference, so acupuncture should
be scheduled carefully to have the best chance of success.  
1.Before an IVF Cycle:  We recommend start 2 acupuncture sessions per week for 3 months (3 menstrual
cycles) before starting an IVF. For women with complex or especially challenging health situations, 6 months
would be even better. During this time, acupuncture treatment wil focus on individual issue and general health,
increasing a woman’s reserves.  
4. Prior to Retrieval: Once ovarian follicles are at the correct stage
and size, women will be given a trigger to complete egg maturation in
preparation for retrieval. Acupuncture within the day or two prior to
retrieval can help with the egg final maturation.

5. Between Retrieval and Embryo Transfer: After eggs have been
retrieved you may have some cramping and discomfort from the
procedure.  At this time, acupuncture is focused on relaxing the
uterus, increasing circulation, and preparing the body for embryo
transfer. Studies have shown that acupuncture just before an embryo
transfer will increase the odds of a successful pregnancy. One
acupuncture session will be scheduled at day before embryo transfer

6. After Embryo Transfer: transfer procedures, patient can schedule
for the early morning in necessary.
1. Clinic trials for Acupuncture on IVF
2 Acupuncture for diminished ovarian reserve
3. Acupuncture for oocyte development and maturation
4. Acupuncture for fallopian tube obstruction
5. Acupuncture for endomentrial cavity fluid
2. Priming Phase: During the priming phase we will continue 2 acupuncture sessions per week. For most
cycles, women take medications to temporarily suppress the ovaries in preparation for stimulation.  
Refernces
3. Stimulation Phase: While using medications to stimulate the
growth of eggs in the ovaries, acupuncture will continue 2 sessions
per week.  The main purpose of acupuncture is to support hormone
therapy.