The Demographics Of Acupuncture’s Impact On IVF Outcomes: Infertility Diagnosis And SART/CDC Age Groups

Conclusions: There were statistically significant differences in the impact of Acupuncture on IVF patients when categorized by Infertility diagnosis. Those patients with Tubal factor, PCOS & Male factor having better outcomes when IVF was combined with Acupuncture treatments. We also observed significantly improved outcomes in patients with female age > 40. The reverse was true with patients in the 35-38 year groups. With multivariance statistical analysis, we determined that the “ideal” patient who would benefit from adding Acupuncture to their IVF treatments were > 38 , with Male factor infertility. Further studies of Traditional Chinese Medicine modalities of treatment are underway. We are organizing a multicenter prospective study to confirm our observations.

Abstract
Background: Over the past 3 years the authors have presented data suggesting that
Acupuncture, when added to Assisted Reproductive Technologies such as IVF, could
enhance reproductive outcomes. Those outcomes included: improved pregnancy rates,
reduced miscarriage rates, markedly reduced ectopic rates, significantly more Take Home
Babies and lower multiples. Our data has been referenced and cooborated in
Prospective Randomized Controlled Trials (RCTs) published May 2006 in Fertility &
Sterility. At ASRM 2006 we recently presented our poster explaining a proposed
mechanism for the observed data, i.e., changes in Prolactin and Cortisol levels during IVF
stimulation mimic the nature cycle more closely than non-acupuncture treated patients.
We continue to dissect the mechanisms involved with the phenomenon of improved
outcomes with Acupuncture treatments.
Objective: We investigate the impact of Acupuncture on the population demographics in
patients treated by a sole Acupuncturist and sole Reproductive Endocrinologist,
specifically based on infertility diagnosis and age groups of our patients.
Materials and Methods: In this study 232 IVF cycles were reviewed in a retrospective
fashion. The following patients’ demographics were reviewed: Age groups as reported to
SART/CDC, infertility disease status, both individually and in combination. All patients
who completed an IVF cycle (retrieval, transfer) were included. There were 60 in the
Control (C) group (no acupuncture) and 172 in the Acupuncture (Ac) group. For the C vs.
Ac groups a summary of their clinical statistics are reported in the table below (Table 1).
The impact of patient Age Groups is reported in Table 2.
Results: Overall pregnancy rates (PR) for the Ac group were statistically similar to the C
(Ac 45% vs. 52%). Summary statistics are in Table 1 below. With regard to infertility
diagnosis, there were statistically significant differences between the Controls and
Acupuncture treated groups for the following factors: Tubal Factor, Failed IUI, PCOS
combined with Male Factor, with the Tubal Factor and PCOS and Male Factor
demonstrating significant improvement with Acupuncture (P < 0.05) and the Failed IUI not
revealing a similar effect. Factors such as Endometriosis diagnosis and pure Male Factor
did not demonstrate statistically significant differences between the groups.
3
When the data for Age groups were analyzed, Acupuncture benefits seem to be best
observed in the > 40 year old group (p < 0.05). No similar benefits were noted for the
other Age groups, with the 35 – 38 group demonstrating statistically significantly better
outcomes when not treated with Acupuncture (Table 2).
Table 1: Impact of Acupuncture on IVF outcomes based on Infertility Diagnosis
# Percent
232
Acupuncture 172 74
Non Acupuncture 60 26
Acupuncture Non-Acupuncture
# Preg % # Preg % p value
Diseases
- PCOS 42 23 55 17 9 53
- Tubal Factor 27 13 48 16 2 12 p<0.05
- Endometriosis 14 8 57 8 4 50
- Over 35 73 22 30 23 8 34
- Failed IUI 24 15 63 12 9 75 p<0.05
- Male Factor 133 61 46 46 24 52
- PCOS & Tubal 2 2 100 2 0 0
- PCOS & endo 3 2 67 2 0 0
- PCOS & >35 8 3 38 4 2 50
- PCOS & IUI 7 4 57 4 4 100
- PCOS & male 35 20 57 14 7 50 p<0.05
- Tubal & endo 3 1 33 4 1 25
- Tubal & >35 11 2 18 7 1 14
- Tubal & IUI 4 4 100 1 0 0
- Tubal & male 18 7 39 12 5 41
- Endo & >35 3 2 67 3 0 0
- Endo & IUI 2 2 100 2 1 50
- Endo & Male 9 6 67 5 2 40
- Tubal/>35/male 8 1 13 6 1 17
Table 2: Impact of Acupuncture on IVF outcomes based on Age Groups of Female
Patients
Age Groups Acupuncture Non-Acupuncture
# Preg % # Preg % p value
< 35 90 49 54 35 20 57
35 – 38 39 16 41 9 6 67 p<0.05
38 – 40 18 3 17 7 2 28
>40 25 8 32 9 2 22 p<0.05
3
Utilizing the Mann-Whitney U test for multivariance, it was found that IVF patients having
a Male Factor diagnosis and a female factor of Age > 38 treated with Acupuncture results
in a 29 % greater chance of pregnancy than controls.

Conclusions: There were statistically significant differences in the impact of
Acupuncture on IVF patients when categorized by Infertility diagnosis. Those patients
with Tubal factor, PCOS & Male factor having better outcomes when IVF was combined
with Acupuncture treatments. We also observed significantly improved outcomes in
patients with female age > 40. The reverse was true with patients in the 35-38 year
groups. With multivariance statistical analysis, we determined that the “ideal” patient who
would benefit from adding Acupuncture to their IVF treatments were > 38 , with Male
factor infertility. Further studies of Traditional Chinese Medicine modalities of treatment
are underway. We are organizing a multicenter prospective study to confirm our
observations.

Paul C. Magarelli, M.D., Ph.D., a Diane Cridennda, L.Ac.b, Mel Cohen, MBA a
a Reproductive Medicine & Fertility Center, Colorado Springs, CO
b East Winds Acupuncture, Colorado Springs, CO