OBJECTIVE: The objectives of this pilot study were (1) to assess the impact of acupuncture on psychological well‐being of women undergoing IVF, and (2) to determine the effects of acupuncture on tissue perfusion using vascular tone (represented as the ratio of urinary 6‐k‐PGF1a to TxB2) as a surrogate. DESIGN: Prospective, Randomized Controlled Trial MATERIALS AND METHODS: Women between ages 21 to 42 years who were seeking in‐vitro fertilization and embryo transfer (IVF‐ET) were recruited for the study. Women were excluded if they were currently using alternative therapies such as acupuncture, herbal supplements or had a contraindication to needle insertion at the acupoints. Fifty participants were enrolled and were randomized by computer to either treatment or control. Those assigned to the treatment group received three sessions of acupuncture during the IVF‐ET process; the control group received standard IVF treatment. The three sessions of acupuncture occurred on day 6, 7 or 8 of gonadotropin stimulation, and pre‐ and post‐embryo transfer. At each time point, all participants completed a 10‐question validated self‐perceived stress questionnaire and provided urine samples for the determination of 6‐keto prostaglandin F1a (6‐k‐PGF1a, a stable metabolite of prostacyclin, PGI2) and thromboxane B2 (TxB2, a stable metabolite of thromboxane A2). Acupuncture was performed by one clinician following a protocol adapted from a Delphi Consensus process developed specifically for patients undergoing IVF. The 6‐k‐PGF1a and TxB2 in the urine were determined using ELISA kits according to manufacturer's protocol with samples run in duplicate and standards and controls in triplicate. The vascular tone (expressed as the ratio of 6‐k‐PGF1a to TxB2) was used as a surrogate for tissue perfusion. The stress levels were analyzed using paired sample t‐tests (SPSS); the ratios of 6‐k‐PGF1a and TxB2 were analyzed using Student's t‐test (SPSS). A p of < 0.05 was considered statistically significant. RESULTS: Self‐perceived stress levels as well as the ratios of 6‐k‐PGF1a to TxB2 decreased over the course of IVF treatment. No significant difference was observed in self‐perceived stress levels or 6‐k‐PGF1a to TxB2 ratios between the acupuncture and control group. CONCLUSIONS: This pilot study showed (1) acupuncture based on Delphi Consensus Protocol at the above time points did not significantly affect the self‐perceived stress levels or tissue perfusion in women undergoing IVF, (2) acclimation during the course of IVF treatment may reduce selfperceived stress levels, (3) increased estrogen levels during IVF may improve tissue perfusion based on reduced vascular tone over the course of treatment. Further studies with more subjects and/or more acupuncture sessions may be required to determine the impact of acupuncture on individuals receiving IVF treatment.
Phy, J. L., Orlando, J., Zhang, Y., Garos, S., Penrose, L., Prien, S., & Huang, J. (2017). Effect of acupuncture on vascular biomarkers and psychological well-being of women undergoing IVF. Fertility and Sterility, 108(3), e302–e303. https://doi.org/10.1016/j.fertnstert.2017.07.894