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Acupuncture & Fertility What is the research telling us?. Vicki Ball M.BHSc (Acu). Fertility and Acupuncture what can we do. Research. ACUPUNCTURE & IVF. Acupuncture & IVF. Reduce uterine artery resistance Modulate immune response Relaxation prior to surgical procedures.
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Acupuncture & FertilityWhat is the research telling us? Vicki Ball M.BHSc (Acu)
Research ACUPUNCTURE & IVF
Acupuncture & IVF • Reduce uterine artery resistance • Modulate immune response • Relaxation prior to surgical procedures
Acupuncture onDay of Transfer • Choong, 2008 (Cochrane Review) –13 RCTs reviewed in meta-analysis
Acupuncture on Day of TransferChoong, 2008 (Cochrane Review) –13 RCTs reviewed in meta-analysis
Acupuncture on Day of TransferChoong, 2008 (Cochrane Review) –13 RCTs reviewed in meta-analysis
Acupuncture on Day of TransferChoong, 2008 (Cochrane Review) –13 RCTs reviewed in meta-analysis
Miscarriage rates- Acupuncture on day of transfer No statistical difference
Acupuncture before & after transfer + 2 days2 studies (Dieterle, 2006; Westergaard, 2006)
Miscarriage rates- Acupuncture before & after transfer +2 days No statistical difference
Acupuncture around time of oocyte retrieval • Studies performed show no significant difference in quality or quantity of oocytes retrieved. Better live birth rates if electro-acupuncture used as anesthetic rather that alfentanil (28/75 acupuncture 19/74 alfentanil)
Acupuncture around time of oocyte retrieval • Clinically – too late • Beneficial to have acupuncture following day to help speed recovery after surgical procedure – swelling, pain, inflammation. • Ensure integrity of endometrium to allow for viable implantation.
Hypothalamic-Pituitary-Adrenal-Ovarian Axis (HPAO) Stress and its role in unexplained infertility..?
How does acupuncture affect the HPA? affects plasma beta endorphin affect the HPA by altering the release of hypothalamic gonadotrophin releasing hormone (GnRH) & pituitary gonadotrophin secretion.
Women • Ovulation induction • Increase microcirculation to reproductive organs • Regulate hypothalamic-pituitary-ovarian axis • Increase up-regulation of body’s own hormones
Acupuncture modulates immune factors • influences specific and nonspecific cellular and humoral immunities. • activates cell proliferation, including blood, reticuloendothelial, and traumatised cells. • activates leucocytosis, microbicidal activity, antibodies, globulin, complement, and interferon. • modulates hypothalamic-pituitary control of the autonomic and neuroendocrine systems. Rogers, 1992 Acupuncture for Immune-Mediated Disorders
Immune/ Inflammatory related disorders causing fertility problems Immune • Endometriosis • Failure of embryo to implant & miscarriage • Thyroid disorders eg.Hashimotos Inflammatory • High TNF alpha associated with repeated implantation failure in IVF
Treatment – men vs. women www.flatrock.org.nz
Man • Increase sperm quality & quantity – morphology - motility • Increase semen quality Faster results combining Chinese Herbal medicine with acupuncture
Moxa heat radiating down Stomach channel Schlebusch, K. P., Maric-Oehler, W., & Popp, F. A. (2005). Biophotonics in the infrared spectral range reveal acupuncture meridian structure of the body. J Altern Complement Med, 11(1), 171-173.
Propagated sensations along channels (PSCs/PSMs) • Reported PSCs during acupuncture correspond to EMG changes (Bensoussan, 1984) • PSCs follow pathways which closely correspond to channels (Ji, 1981) • PSCs travel at a slower rate than nerve conduction PSCs travel at 3.5 – 10 cm/sec (Bensoussan,1994) Ad fibres conduct at 6.3 m/sec [630 cm/sec] C fibres conduct at 0.5 – 2 m/sec [50-200 cm/sec] • PSCs have been observed in many races (Deng, 1993) • PSCs are frequently associated with clinical efficacy of acupuncture (Deng, 1993) • PSCs can be blocked by mechanical pressure of more than 500 -1,00gm/mm2(Ji, 1981)