Guest guest Posted September 15, 2008 Report Share Posted September 15, 2008 doi:10.1016/j.fertnstert.2008.07.1252 Copyright 2008 American Society for Reproductive Medicine Published by Elsevier Inc. Oral Presentation Laser acupuncture before and after embryo transfer improves ART delivery rates: results of a prospective randomized double-blinded placebo controlled five-armed trial involving 1000 patients J.L. Fratterellia, M.R. Leondiresa, K. Fonga, A. Thealla, S. Locatellia and R.T. Scotta aReproductive Medicine Associates of New Jersey, Morristown, NJ O-285. Available online 14 September 2008. OBJECTIVE: Acupuncture has been advocated for the treatment of infertility, including immediately prior to and after transfer. Unfortunately, data are conflicting and adequate studies with appropriate controls are lacking. This study evaluates 2 forms of acupuncture on outcomes in ART patients. DESIGN: Prospect randomized double blind and placebo controlled. MATERIALS AND METHODS: On the day of transfer, participants were randomly assigned to a study group; needle acupuncture (AC), laser acupuncture (LZ AC), sham laser acupuncture (LZ sham), relaxation (RX), or no treatment (NT). The AC and LZ AC puncture groups were considered treatment groups, the RX controls for the additional rest before and after transfer, and NT is the non-intervention group. Most significantly, the LZ Sham group provided an important control group. The laser acupuncture device was randomly preprogrammed per case to either fire (and provide LZ AC) or to not fire and thus provide a true double blind control group (LZ sham). It was not possible for the patient or acupuncturist to know if the laser fired. No contact oocurs with the patient in laser acupuncture so there is no acupressure effect or contact with the wrong meridians. All treatments were administered for 25 minutes before and after embryo transfer. Outcomes were compared by Chi-square and multiple logistic regression analysis to control for the potential confounders including female age, embryo quality, and day of transfer (Table 1). RESULTS: All treatments were well tolerated. No differences in terms of patient demographics, cycle type, stimulation outcomes, embryo number and quality, day of embryo transfer, transferring physician, or acupuncturist were found between the 5 study groups. Implantation rates were significantly improved with laser acupuncture. Traditional needle acupuncture had outcomes equivalent to the 3 control groups. Subanalyses of patient age and embryo transfer day produced similar findings with laser acupuncture enhancing outcome rates. CONCLUSIONS: This large prospective randomized and well controlled study consistently demonstrated benefit to LZ AC. Treatment was well tolerated and significantly improved implantation rates. Table 1. Clinical Outcomes (%) Rates AC (n=200) LZ AC (n=202) LZ Sham (n=198) RX (n=203) NT (n=197) P Values Implantation 28.9 33.7 26.8 24.9 30.2 < 0.05 Chemical Pregnancy 61.5 60.9 53.0 53.7 60.4 0.22 Clinical Pregnancy 51.5 54.5 43.9 45.3 50.3 0.19 Ongoing Pregnancy/Delivery 39.0 42.1 35.4 37.4 39.6 0.71 Supported by: EMD Serono. Fertility and Sterility Volume 90, Supplement 1, September 2008, Page S105 doi:10.1016/j.fertnstert.2008.07.1254 Copyright 2008 American Society for Reproductive Medicine Published by Elsevier Inc. Oral Presentation RCT: Effects of acupuncture on pregnancy rates in women undergoing assisted reproductive technologies I. Moya, M. Milada, R. Kazera, E. Confinoa, R. Barnesa and J. Zhanga aObstetrics & Gynecology, McGaw Medical Center Prentice Women's Hosp., Chicago, IL; McGaw Medical Center NMFF, Chicago O-287. Available online 14 September 2008. OBJECTIVE: To evaluate the influence of true versus sham acupuncture on pregnancy rates in women undergoing assisted reproductive technologies. DESIGN: Randomized-controlled trial. Single-blinded (evaluator and patient blinded) with independent observer. MATERIALS AND METHODS: Women aged 18 to 38 years old undergoing in-vitro fertilization with or without intracytoplasmic sperm injection were recruited at Northwestern IVF, Chicago IL from August 2006 until the present time. Women actively undergoing acupuncture or previously randomized to the trial were excluded. Subjects were randomly allocated to study or control group and underwent acupuncture (in Qi-lines vs. non-Qi lines, respectively) 25 minutes before and after embryo transfer at the IVF center. The primary outcome was clinical pregnancy demonstrated by fetal heart activity on an ultrasound scan. Expected enrollment: 220. RESULTS: Thus far, 124 women undergoing day 3 embryo transfer following IVF with or without ICSI were randomized to receiving either true or sham acupuncture. The clinical pregnancy rate was 43.9% in the true arm and 55.2% in the sham arm (P= 0.214). The chemical pregnancy rate was 48.9% in the true arm and 60.3% in the sham arm (P=0.188). Of the patients in the true acupuncture arm, 76.9% of subjects corrently guessed their group allocation compared to 24.1% in the sham arm. Patients allocated to the true study group complained of significantly more pain and discomfort as well as tiredness and fearfulness (P= 0.005 and 0.017 respectively). CONCLUSIONS: There was no difference in the pregnancy rate between groups during this interim analysis. There were no adverse effects observed during the study suggesting that acupuncture was safe for women undergoing embryo transfer. Patients in the study group (true arm) reported more pain, discomfort, fear, and tiredness. Supported by: Grant from the Northwestern Memorial Faculty Foundation. Fertility and Sterility Volume 90, Supplement 1, September 2008, Page S106 Kristin Lorent Pack Lab University of Pennsylvania BRB II/III, Room 1226 421 Curie Blvd Philadelphia, PA 19104 USA phone: 1-215-898-6659 Quote Link to comment Share on other sites More sharing options...
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