Management of Acupuncture as Adjuvant Therapy for In-Vitro Fertilization

MEDICAL ACUPUNCTURE
Volume 31, Number 6, 2019
© Mary Ann Liebert, Inc.
DOI: 10.1089/acu.2019.1394

Management of Acupuncture as Adjuvant Therapy for In-Vitro Fertilization|

Wahyuningsih Djaali, MD,^1,2 Kemas Abdurrohim, MD,² and Dwi Rachma Helianthi, MD²

ABSTRACT

One treatment option for couples with infertility that enables the highest success rate is in-vitro fertilization (IVF). With this technique, various causes of infertility can be overcome, whether they are caused by anatomical abnormalities in women or abnormalities of sexual dysfunction in men. Acupuncture, a nonpharmacologic therapy with minimal side-effects, according to various studies is be beneficial for increasing the success of IVF. There are several mechanisms of acupuncture related to this, such as: (1) modulating neuroendocrine factors; (2) increasing blood flow to the uterus and ovaries; (3) modulating immune factors; and (4) reducing stress, anxiety, and depression. Because acupuncture does not have bad side-effects, it is an adjuvant therapy that can be performed at each stage of the IVF procedure to increase the chances of successful IVF.

Keywords: acupuncture, in-vitro fertilization, infertility

INTRODUCTION

INFERTILITY IS DEFINED as failure to achieve pregnancy after 12 months of regular and unprotected sexual intercourse. The condition is caused by the inability to reproduce, both individually and as a couple.¹ The prevalence of infertility ranges from 9% to 18% in the general population.² According to a recent study, ~ 12.5% of women are not able to become pregnant after 12 months of unprotected sexual intercourse.³

One of the therapeutic options with the highes success rate for couples with infertility is in-vitro fertilization (IVF). IVF can be used to overcome various causes of infertility such as anatomical abnormalities in women and sexual dysfunctions in men. The weaknesses of IVF are that it is quite expensive and the preparation time is quite long; therefore, both doctors and patients spend a lot of time preparing as much as possible to make the IVF attempt successful and result in a baby who is born alive.

Acupuncture, a nonpharmacologic therapeutic modality, involves using fine needles at acupuncture points to address medical conditions. This modality can activate nerve fibers and peripheral afferent receptors, produce sensory interactions at various levels of the central nervous system, and release various transmitters and modulators, thus producing anti-inflammatory signals as well as neuroendocrine and neuroimmune signals.⁴ Many studies have examined the effects of acupuncture as an adjuvant therapy in IVF, but systematic reviews and meta-analyses still yield controversial results.^3,5-7 The purpose of this review is to describe acupuncture as an adjuvant therapy for IVF based on relatively recent studies.

INFERTILITY

Factors that influence infertility include age; time of coitus; duration of pregnancy attempts; and other factors, such as history of contraception, food, lifestyle habits (smoking, caffeine and alcohol consumption), stress, and anxiety.8

Many infertility problems are related to hypothalamic and pituitary dysfunction. This can be caused by structural abnormalities, such as tumors, genetic mutations (whether

 
¹Faculty of Sport Science, Universitas Negeri Jakarta, Jakarta, Indonesia.
²Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.