In Vitro Fertilization (IVF)

Understanding Acupuncture and IVF ( In Vitro Fertilization )

In Vitro Fertilization (IVF) is the uniting of egg and sperm in vitro (in the lab). Standard IVF treatment involves the following process:

Follicle Growth and Egg Collection

Based on each woman’s age, natural hormone levels, and overall reproductive health, an individual protocol of fertility drugs will be administered to stimulate her ovaries to produce multiple follicles. When the follicles reach an optimum size, the eggs within are retrieved with a long thin needle guided through the vaginal wall, using ultrasound and a light anesthetic. The needle is inserted into each follicle and pulls the egg and the fluid into a collection tube. When one follicle is drained, the needle is gently repositioned to collect fluid from each adjacent follicle. This process is done for both ovaries. The follicular fluid is then given to the embryologist who examines it under a microscope to find the eggs.

Fertilization

Once the eggs are identified, they are mixed with several thousand sperm (previously obtained from the partner’s or donor’s sperm sample) in a dish with nutrient liquid and kept in an incubator overnight, and later examined under a microscope to identify which eggs have fertilized normally. When there is an abnormal sperm or egg factor (e.g., poor sperm motility, morphology, low concentration, or previously failed fertilization), egg fertilization can be achieved through intracytoplasmic sperm injection (ICSI). An extremely sharp glass needle is used to inject one normal appearing sperm directly into the center (cytoplasm) of the egg under the guidance of a specially fitted microscope.

Embryo Transfer

Once the eggs are fertilized, they are carefully nurtured in the laboratory and they become embryos which are ready for transfer into the uterus on day 3 or sometimes on day 4 or 5. The embryologist loads the embryos into a very soft catheter along with a small volume of the culture media in which they are growing. The physician then inserts the catheter through the cervix and injects the embryos inside the uterine cavity during a speculum examination. The process is similar to an insemination, although it is done under abdominal ultrasound guidance in order to ensure that the catheter is in the proper position prior to transferring the embryos. The number of embryos transferred depends upon the age of the patient, the quality of the embryos and the stage of their development. Any remaining viable embryos that are not transferred into the woman’s uterus during treatment may be frozen (“cryopreserved”) in small tubes and kept in storage in an embryo laboratory for future use.

Approximately ten days after embryo transfer the first blood pregnancy test is performed and after another two weeks the first ultrasound will confirm the pregnancy.

A study presented in “Highlights in Fertility and Sterility” (Vol. 77, No. 4, April 2002) indicated that pregnancy rates for women undergoing IVF increased from 26.3% to 42.5% with only 2 acupuncture treatments at the time of transfer.

How Chinese Medicine and Acupuncture Can Help IVF Succeed

Chinese Medicine and acupuncture can significantly increase the response and success of all forms of Assisted Reproductive Technologies, including a 50% increase in IVF success rates. Studies have focused on how acupuncture can increase the blood flow in the uterus and ovaries, creating a more suitable and fertile environment for mature follicles to both develop and implant. Additionally, treating the man at the same time will allow him to provide improved sperm samples of higher counts, increased motility, and more regular morphology. Specifically, Chinese medicine and acupuncture can benefit IVF in the following ways:

Acupuncture increases the blood flow to the ovaries to nourish the developing follicles and create better egg quality and stronger embryos. It normalizes the function of the Hypothalamus-Pituitary-Ovarian axis to regulate and improve the body’s natural hormonal production which in turn improves ovarian function and egg quality. Acupuncture relaxes the body and reduces stress levels (elevated stress can prohibit conception by blocking blood flow to the reproductive organs and causing an imbalance in hormonal production, thus resulting in irregular menstrual cycles, lack of ovulation, high FSH levels, poor ovarian production, and diminished egg quality). Acupuncture can also do the following:

Regulate the stimulating hormones to produce an increased quantity of follicles
Increase the blood flow to the uterus and increase the thickness of the uterine lining to improve implantation rates
Improve the blood flow to the reproductive organs and prevent the uterus from contracting
Prevent hyper-stimulation of the ovaries and address its side effects
Diminish the side effects of Clomid, Gonal-F and other ovulation and hormonal support drugs
Decrease the chances of miscarriage by relaxing the uterus and providing increased blood flow
Strengthen the immune system
Improve sperm to increase the fertilization rate of eggs and create better quality and quantity of embryos

Chinese herbs build strong, nutrient-rich blood for the ovaries which will better nourish the developing follicles and create better egg quality and stronger embryos. The herbs also normalize the function of the Hypothalamus-Pituitary-Ovarian axis to regulate and improve the body’s natural hormonal production which in turn improves ovarian function and egg quality. And, Chinese herbs nourish the spleen and kidney system which are responsible for our reproductive health.

Reproductive organ massage is a highly specialized form of therapeutic massage that manipulates the fascia of the pelvic cavity to unblock any obstructions in the reproductive organs and improve the blood flow to these organs. The result is a balance of hormonal production, improved ovarian production and ovulation, regular menstrual cycles, lower FSH levels, better egg quality, and stronger embryos.

Nutritional guidelines are customized for each patient based on the health of her kidney, liver, and spleen functions, which control our reproductive health and underlie our metabolic processes.

When Should I Start Acupuncture for My Upcoming IVF Cycle?

Most patients require a series of ongoing treatments over a month or two to gain all the benefits acupuncture can provide. The recommended treatment schedule is based upon your individual case and can vary. In many cases, we recommend that you start acupuncture treatment two months prior to the commencement of the IVF cycle to ensure you get the most out of it. As the transfer gets closer, the frequency of visits may increase. When the day of the transfer arrives, one of our practitioners will meet you at our Nurture Acupuncture clinic and work with the IVF nurses and doctors to time the treatment correctly. We administer two acupuncture treatments, one immediately before, and one immediately following the embryo transfer. Not only does it help increase your chance of success, but the acupuncture will help relax and calm you during a very stressful procedure. After the transfer day, it’s usually advised to receive a follow up acupuncture session twice weekly until your pregnancy is confirmed.

When Should I Stop Getting Acupuncture?

Typically most miscarriages occur within the first three months of pregnancy. Therefore, treatment of patients may often last through week twelve to help prevent miscarriage.

Ready to get started? Contact us to set up your first appointment to get the most out of your next IVF or IUI cycle.

Research and Related articles on the Effect of Acupuncture with IVF

A Randomized Study Evaluating Acupuncture as an Adjunct to IVF
Department of Obstetrics and Gynecology, Glendale Adventist Medical Center (GAMC) and the Eastern Center for Complementary Medicine, Glendale, CA

Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy
FERTILITY AND STERILITY® VOL. 77, NO. 4, APRIL 2002
Copyright © 2002 American Society for Reproductive Medicine

Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer
Institute of Neuroscience and Physiology, Sahlgrenska Academy, Sweden

Acupuncture and Chinese herbal treatment for women undergoing intrauterine insemination
European Journal of Integrative Medicine. xxx(2011)xxx–xxx

Acupuncture performed before and after embryo transfer improves pregnancy rates
Fertility and Sterility. 2008 Vol. 90, Supplement 1, page S240

Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization-embryo transfer treatment.
Fertility and Sterility. 2009 Dec;92(6):1870-9. doi: 10.1016/j.fertnstert.2008.10.067. Epub 2008 Dec 31.

Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study
Fertility and Sterility. 2006 May;85(5):1347-51. Epub 2006 Apr 17.

Influence of acupuncture on the outcomes of in vitro fertilisation when embryo implantation has failed: a prospective
Acupuncture in Medicine. 2013 Jun;31(2):157-61. doi: 10.1136/acupmed-2012-010269. Epub 2013 Mar 19.