Ethics of herbs used during the luteal phase of women trying to conceive/IVF Acupuncture Research

[Guest guest]

Rich/Valerie, etc.

 

1. Westergaard, et al 2006, tried replicating the Paulus, et al study

from 2002 which involved acupuncture given just before and after

Embryo Transfer. However, Westergard added a new wrinkle to this

protocol by having two different acupuncture treatment groups: one

group received the standard Paulus Protocol on the day of Embryo

Transfer, the 2nd group also received Acupuncture 2 days later after,

and in addition to the Embryo Transfer treatment. The control group

received no acupuncture at all. Clinical pregnancy rates and live

birth rates were significantly higher in the first group, but the 2nd

group receiving acupuncture 2 days after Embryo Transfer had 33%

higher miscarriage rates than the control (non-acupuncture-treatment)

group.

 

(Westergaard, L., Mao, Q., Krogslund, M., Sandrini, S., Lenz, S., and

Grinstead, J. (2006). “Acupuncture on the day of embro-transfer

significantly improves the reproductive outcome of infertile women: a

prospective randomized trial”. Fertility & Sterility, 85(5), 1341-1346).

 

Of course, the upshot of this study, is that the contra-indicated

pregnancy points (Spleen 6/Large Intestine 4) included in the original

Paulus Protocol (Paulus, et al, 2002) actually do cause miscarriage .

In the original Paulus Protocol, and in the 1st treatment arm of the

Westergaaard Study above, Spleen 6 and Large Intestine 4 are used for

the post-embryo-transfer treatment. This has always caused some

consternation amongst acupuncturists. However, we have to remember

that whether it's a day-3 embryo transfer, or a day-5 blastocyst

transfer, pregnancy/conception/implantation will not have taken place

yet by the time these points are being used immediately after the

Embryo Transfer. Therefore, they are not contraindicated. Conversely,

when Westergaard used these points 2 days after Embryo Transfer - when

implantation/conception/clinical pregnancy might have already

occurred, then these points (Sp 6/LI 4) did result in higher

miscarriage rates.

 

2. In 2007, Craig, et al, modified the 2002 Paulus protocol in both

the selection of acupoints used, and in the timing of the treatments

(treatments were performed off-site, and patients often had to drive

an hour or more after the embryo transfer in order to receive

acupuncture. Pregnancy rates were greatly reduced in the acupuncture

treatment group vs the non-treatment control group (43% vs 69%

respectively. The authors postulated that the modified acupoint

protocol and/or the driving stress may have adversely effected the

outcome of the trial.

 

(Craig, L., Criruti, A., Hansen, K., Marshall, L., & Soules, M.

(2007). “Acupuncture lowers pregnancy rates when performed before and

after embryo transfer”. Fertility & Sterility, 88 supplemental).

 

 

 

Ray Rubio, D.A.O.M. (FABORM)

President/CEO ABORM

Chair: Reproductive Medicine Specialty/Yo San DAOM Program

 

Westlake Complementary Medicine

910 Hampshire Road, Suite A

Westlake Village, CA 91361

Phone: (805) 497-1335

Fax: (805) 497-1336

email: rtoo

 

 

 

On Aug 19, 2009, at 1:42 PM, Sean Doherty wrote:

 

> Valerie,

>

> Do you have references for the studies you mentioned about acupuncture

> decreasing IVF success rates? It seems there are studies that prove

> every

> outcome at this point-increase, decrease, no influence but relaxing

> to the

> patient etc... What did you find compelling about the studies you

> referenced?

>

> Rich,

>

> RE: malpractice cases. I wasn't personally aware of any, but did

> just see

> this case

> http://www.onpointnews.com/NEWS/chinese-medicine-doctor-sued-over-dangerous-

> herbs.html It is alleging a prescription of herbs containing

> aristolochic

> acid caused kidney failure.

>

> Sean

>

>

[Guest guest]

Hello,

 

 

 

The second study that Ray cites (2007, Craig, et al) looks suspicious to me. 69%

pregnancy rate for the control group looks too good to be true.

 

 

 

For most ivf clinics, isn't the average pregnancy rate for the under 35 crowd

45-50%, precipitously dropping as the patients get older?

 

These studies need to be looked at closely and then taken with a grain of salt.

 

 

 

Kristin

 

 

 

Kristin Wisgirda

Lic. Acupuncturist

Posture Alignment Specialist, Egoscue Certified

508-427-6575