Objective:
Acupuncture seems to be a useful tool for improving pregnancy rate after assisted reproduction therapy (ART) as we have shown in a former study. Uterine peristaltic waves may displace the embryo droplet at the time of embryo transfer. To investigate the possible influence of acupuncture on uterine contractility, we visualized the motility of the endometrium by ultrasound comparing two groups with/without acupuncture treatment shortly before and after embryo transfer.
Design:
Prospective cohort study.
Materials and Methods:
164 patients undergoing ART (ICSI, IVF) in our fertility centre were included in this study. Only patients with a morphologically normal uterus were admitted. After in-vitro fertilization up to three embryos were transferred into the uterine cavity on day 2 to 6 after oocyte retrieval. Acupuncture was performed in 95 patients 25 minutes before and after embryo transfer with sterile disposable stainless steel needles (0.25 x 25 mm) at the following locations: Cx 6 (Neiguan), Sp8 (Diji), Liv3 (Taichong), Gv20 (Baihui), S29 (Guilai) before embryo transfer; S36 (Zusanli), Sp6 (Sanyinjiao), Sp10 (Xuehai), Li4 (Hegu) after embryo transfer. After 10 min the needles were rotated in order to maintain Deqi sensation. Additionally we used small stainless needles (0.2 x 13 mm) for auricular acupuncture at the following points without rotation: ear point 55 (shenmen), ear point 58 (Zhigong), ear point 22 (Neifenmi), ear point 34 (Naodian). In the control group (n=69) embryos were transferred without any supportive therapy. Just before and after embryo transfer all patients underwent ultrasound scans of a sagittal uterine plane using a 7 MHz transvaginal probe (LOGIQ 400 PRO, GE Medical Systems). A sequence of two minutes was video recorded. For evaluation of uterine contractions the videotape was visually assessed in a fivefold speed. The total time of endometrial movements during the 40 s period of accelerated reproduction was measured. The main outcome measure was the change of uterine motility after embryo transfer. For statistical evaluation of endometrial motility t-test was used.
Results:
The basic uterine motility before embryo transfer did not differ between acupuncture group and control group: 19.0 vs 20.1s (p=0.53). Comparing the endometrial motility before and after embryo transfer we failed to find a significant change by acupuncture treatment: acupuncture group vs control group 2.6s ± 11.0s vs 2.3s ± 9.3s (t-test: P=0.84).
Conclusion: Acupuncture treatment does not inhibit uterine motility. Other mechanisms may be responsible for the increase of pregnancy rate after acupuncture treatment in ART.