Abstract
OBJECTIVE: Acupuncture performed onsite before and after embryo
transfer has been reported to improve in vitro fertilization (IVF)
outcome in patients with good quality embryos. The purpose of this
investigation was to evaluate whether acupuncture before and after
embryo transfer would alter pregnancy rates in patients undergoing IVF
regardless of embryo quality if the treatment was performed offsite.
DESIGN: Multi-center, prospective, randomized study.
MATERIALS AND METHODS: 107 patients undergoing IVF were
randomized to acupuncture vs. control group. The treatment group
received acupuncture by one of two licensed acupuncturists at an
offsite location for 25 minutes before and after embryo transfer using
a modified Paulus protocol (protocol described by Paulus et. al. 2002
with the addition of Cv6 before and K3 after transfer). The control
group underwent embryo transfer without any other intervention. The IVF
protocol was determined by the treating physician who was blinded to
assigned group. The main outcome measures were a positive quantitative
hCG, clinical pregnancy as manifested by fetal cardiac activity, and
live birth (data pending). Chi-squared analysis and Student’s t-test
were used for statistical analyses. Of the 107 patients randomized, 94
completed the study (10 IVF cycles canceled, 3 patients withdrew).
RESULTS: The proportion of patients with a positive pregnancy
test was higher in the control group (36/46) than the acupuncture group
(25/48) (78.3% vs. 52.1%, respectively; P%0.01). More importantly, the
clinical pregnancy rate was higher in the control group than in the
acupuncture group (69.6% vs. 43.8%, respectively; P%0.03). The groups
were statistically similar with respect to age, peak estradiol, number
of oocytes retrieved, fertilization method, fertilization rate, number
of embryos transferred, and the proportion with blastocyst transfer.
CONCLUSIONS: In contrast to previous reports, acupuncture before
and after embryo transfer was associated with lower biochemical and
clinical pregnancy rates when compared to the control group. The value
of acupuncture in pateints undergoing IVF needs to be further examined
before recommending it to patients.
