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FROzen embryo transfer

Many IVF clinics like to transfer embryos into a natural environment. Embryos that have been frozen and successfully thawed are transferred back into a uterus in its natural state at exactly the right time for implantation. In addition to applying TCM principals and an individual approach we may use mild electro-stimulation on acupuncture points on the abdomen in the weeks before the transfer.

 

before and during the medication phase of ivf

Recent analyses of the benefit of IVF patients receiving acupuncture have shown that patients who have treatment before and during the stimulation and implantation phases may benefit more than those that have acupuncture only on the day of embryo transfer

 

Embryo transfer (including frozen embryo transfer)

At Acupuncture Holistic medicine we offer one or two acupuncture treatments around the time of embryo transfer where appropriate. These are based on protocols used in clinical trials some of which showed an increase in pregnancy rates in certain groups of women receiving acupuncture (most commonly those for whom the expected pregnancy rate was 30% or less). The most recent study has found that this small “dose” of acupuncture showed no effect on live birth rate in a large population of women of all ages undergoing IVF, compared with sham acupuncture . Some researchers report better results with more frequent administration of acupuncture before and during the stimulation phase of the IVF cycle. (You can find the references for these trials here, and here)

In our clinic we find that IVF patients appreciate the calm and relaxation that acupuncture brings on this special day, and gives them space to honour the arrival of the precious embryo.

 

Any phase of IVF treatment

Women undergoing IVF often use acupuncture as a adjunctive support – some report greater relaxation and control of anxiety, and overall greater resilience. The acupuncture treatment will be different for each patient and depends on symptoms.

 

After egg collection

Some IVF patients like to have an acupuncture treatment the day or two after egg collection, to help reduce any abdominal discomfort. We do not recommend having acupuncture on the same day as egg retrieval.

 

Before the pregnancy test

Many IVF patients find the “two week wait” the hardest part (even when its only 10 days!). Acupuncture may be a useful support during this time to keep the mind calm and the stress hormones low.

 

Acupuncture IVF Q&A

IVF Acupuncture research can be a little confusing, as much of the research has focused on treatment applied only at the time of embryo transfer. There has been quite a journey with IVF acupuncture research and while the initial studies looked at embryo transfer acupuncture, more recent research now suggests higher dose acupuncture prior to and during the IVF cycle may be of most benefit. Here we clarify what research suggests in terms of IVF Acupuncture to optimise psychological and physiological benefits. We have put together recommendations on the acupuncture treatments that may help optimise your IVF cycle by drawing on the most recent research findings (including a 2019 Meta-analysis, 2018 randomized controlled trials and 2016 Retrospective Cohort study).

These research-based recommendations aim to clarify:

  1. When to start acupuncture and how many sessions may be of benefit

  2. Considerations surrounding Embryo Transfer Acupuncture and acupuncture in the wait between embryo transfer and pregnancy blood test.

 

  1. When to start acupuncture and how many sessions may be of benefit?

 

The evidence indicates that if you are going to use acupuncture it may be advisable for to have it before and during the stimulation phase of the IVF cycle. It is useful for women to consider acupuncture treatment in the menstrual cycles before their IVF cycle, or before a frozen embryo cycle to improve the uterine lining. As according to the research, dose matters.

 The most recent Meta-analysis showed there is a relationship between the acupuncture treatment dose and pregnancy rate. Higher dose acupuncture before embryo transfer showed a significant benefit and increased pregnancy rate. In studies where more than three treatments were performed, the clinical pregnancy rate significantly improved (N=8 / n=1595, RR 1.50, 95% CI 1.18–1.90, P=0.001) (Smith 2019).

 

One study by Hullender in 2015 showed that acupuncture administered to IVF patients at a dose of 9-12 treatments prior to embryo transfer is associated with more live births. Hullender analysed the outcomes of more than a thousand IVF cycles and found that women who used Chinese Medicine (acupuncture with or without herbs), had a higher live birth rate than those doing IVF alone. The proportion of live births was 61.3% in the Chinese Medicine group and 48.2% in the usual IVF care group and 50.8% in the group having acupuncture only on day of embryo transfer.

 

A whole systems approach, quite similar to the approach studied in the Hullender research, is the approach taken at the Acupuncture Holistic Medicine clinic. While a large dose of acupuncture (9-12 treatments) when possible is what research finds seems to optimise results, research suggests that even 3 or more treatments significantly improve likelihood of clinical pregnancy. At Acupuncture Holistic medicine we are happy to work with you with whatever is possible and/or manageable for you.

When should I book in?

  • Ideally come in 1 month before your start your IVF cycle.

  • We recommend bi-weekly treatment for 4 weeks prior to IVF cycle and 2 weeks during stimulation cycle.

  • Electro Acupuncture and Low Level Laser Therapy LLLT may be used during IVF stimulation and/or prior to Frozen embryo transfer.

 

  1. Embryo transfer acupuncture considerations

Acupuncture on the day of embryo transfer has significant benefit for women who have increased stress levels or who have had multiple previous IVF cycles, or where there was a low baseline pregnancy rate expectation (Smith 2018). Continuing this approach in the two-week wait is also helpful for these women to manage IVF related stress and anxiety.

 

  • Embryo Transfer acupuncture is best done on same day (or within 24 hours if on same day is not possible) and with minimum travel.