Does acupuncture improve the endometrium for women undergoing an embryo transfer: A pilot randomised controlled trial

Abstract

Background: There is a growing body of research suggesting acupuncture may increase pregnancy and live births, when administered on the day of embryo transfer. The physiological effects of acupuncture that may influence the outcome from embryo transfer remain unclear. Aims: To examine the effects of acupuncture on uterine endometrium thickness and pattern, and the level of hormonal medication during an IVF cycle. Design: Randomised controlled trial. Subjects: Women undergoing an IVF cycle with a planned embryo transfer at day 3 or day 5. Setting: A reproductive medicine unit in South Australia. Intervention: Women were randomly allocated to acupuncture or standard care. Women in the acupuncture group received three treatments, the first undertaken on day 9 of stimulating injections, and two on the day of embryo transfer. Outcome measures: The primary outcomes were change in endometrial thickness and pattern, and levels of plasma progesterone, and oestradiol during the IVF cycle, through to seven days post-egg retrieval. Secondary outcomes included number of oocytes retrieved, number of oocytes fertilised, and biochemical pregnancy rate. Results: Endometrial thickness and pattern and levels of hormonal medication did not differ between groups on the day of embryo transfer or in the luteal phase (p > 0.05). There were no differences in any secondary outcomes. Discussion and Conclusion: The results of this pilot study suggest acupuncture did not influence the endometrium or levels of hormonal medication during the IVF cycle. The small number of subjects and incomplete data make conclusions difficult, and consideration must be given to whether the measurement parameters were sensitive to changes from acupuncture, or whether the study sample was too small to detect a change. Interestingly, for the women who received acupuncture, there was a non-significant trend towards a higher fertilisation rate and numbers of women proceeding to embryo transfer.