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Akupunktur bei assistierter Reproduktion und PCOS

Acupuncture in assisted reproductive technology and PCOS

  • Leitthema
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Mehrere kontrollierte Studien konnten durch Akupunktur eine Verringerung der Schmerzintensität bei Follikelpunktion vor In-vitro-Fertilisation/Embryotransfer (IVF/ET) und die Regulation der uterinen und ovariellen Durchblutung zeigen. Bei Patientinnen mit polyzystischem Ovarsyndrom (PCOS) und in experimentellen Modellen konnte durch Modulation von endokrinen, neuroendokrinen und endogenen Regulationen ein anhaltend günstiger Einfluss auf Ovulation, endokrine und metabolische Funktionen beobachtet werden. Einige randomisierte Studien konnten beim zusätzlichen Einsatz der Akupunktur in Verbindung mit dem ET sogar eine Verbesserung der Schwangerschaftsraten zeigen. Die vorhandenen Studien werden erläutert, methodische Probleme bei Durchführung, Darstellung und Interpretation von kontrollierten Akupunkturstudien erörtert und Lösungsmöglichkeiten, z. B. STRICTA, aufgezeigt. Da die Akupunktur durch erfahrene Anwender eine sichere und preiswerte Behandlungsmethode ist, wird die Durchführung größerer Studien im Bereich der assistierten Reproduktion gefordert, um sowohl die physiologischen Wirkungen der Akupunktur besser zu verstehen als auch ihren möglichen Nutzen eindeutiger zu belegen.

Abstract

In controlled trials, acupuncture alleviated pain during oocyte aspiration for in vitro fertilization/embryo transfer (IVF/ET) treatment and regulated uterine and ovarian blood flow. Recent clinical and experimental data on the effect of acupuncture in polycystic ovary syndrome (PCOS) clearly demonstrate that acupuncture affects PCOS via modulation of endocrine, neuroendocrine and endogenous regulatory systems and exerts long-lasting beneficial effects on ovulation and on metabolic and endocrine systems. Some trials even suggest that acupuncture at embryo transfer has a positive impact on pregnancy rates. Results of recent trials are discussed, as are the difficulties and confounders associated with the interpretation of controlled trials and an attempt to standardize reporting of acupuncture interventions (STRICTA). Acupuncture is a safe intervention in the hands of competent practitioners and is low in cost, but well-designed studies are lacking. Clinicians and scientists are encouraged to conduct large, prospective, randomized trials to demonstrate more precisely the physiological impact of acupuncture on the reproductive system and its possible impact on pregnancy rates.

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Literatur

  1. Gejervall AL, Stener-Victorin E, Moller A et al. (2005) Electro-acupuncture versus conventional analgesia: a comparison of pain levels during oocyte aspiration and patients‘ experiences of well-being after surgery. Hum Reprod 20(3): 728–735

    Article  PubMed  Google Scholar 

  2. Humaidan P, Brock K, Bungum L, Stener-Victorin E (2006) Pain relief during oocyte retrieval--exploring the role of different frequencies of electro-acupuncture. Reprod Biomed Online 13(1): 120–125

    Article  PubMed  Google Scholar 

  3. Humaidan P, Stener-Victorin E (2004) Pain relief during oocyte retrieval with a new short duration electro-acupuncture technique – an alternative to conventional analgesic methods. Hum Reprod 19(6): 1367–1372

    Article  PubMed  Google Scholar 

  4. Stener-Victorin E, Waldenstrom U, Nilsson et al. (1999) A prospective randomized study of electro-acupuncture versus alfentanil as anaesthesia during oocyte aspiration in in-vitro fertilization. Hum Reprod 14(10): 2480–2484

    Article  PubMed  CAS  Google Scholar 

  5. Stener-Victorin E, Waldenstrom U, Wikland M et al. (2003) Electro-acupuncture as a peroperative analgesic method and its effects on implantation rate and neuropeptide Y concentrations in follicular fluid. Hum Reprod 18(7): 1454–1460

    Article  PubMed  CAS  Google Scholar 

  6. Paulus WE, Zhang M, Strehler E et al. (2002) Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertility Sterility 77(4): 721–724

    Article  Google Scholar 

  7. Dieterle S, Ying G, Hatzmann W, Neuer A (2006) Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. Fertil Steril 85(5): 1347–1351

    Article  PubMed  Google Scholar 

  8. Smith C, Coyle M, Norman RJ (2006) Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer. Fertil Steril 85(5): 1352–1358

    Article  PubMed  Google Scholar 

  9. Westergaard LG, Mao Q, Krogslund M et al. (2006) Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertil Steril 85(5): 1341–1346

    Article  PubMed  Google Scholar 

  10. Wang W, Check JH, Liss JR, Choe JK (2007) A matched controlled study to evaluate the efficacy of acupuncture for improving pregnancy rates following in vitro fertilization-embryo transfer. Clin Experimental Obstetrics Gynecol 34(3): 137–138

    Article  Google Scholar 

  11. Stankiewicz M, Smith C, Alvino H, Norman R (2007) The use of complementary medicine and therapies by patients attending a reproductive medicine unit in South Australia: a prospective survey. Australian New Zealand J Obstetrics Gynaecol 47(2): 145–149

    Article  Google Scholar 

  12. Stener-Victorin E, Jedel E, Manneras L (2007) Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence. J Neuroendocrinol 20(3): 290–298

    Article  PubMed  CAS  Google Scholar 

  13. Chen BY, Yu J (1991) Relationship between blood radioimmunoreactive beta-endorphin and hand skin temperature during the electro-acupuncture induction of ovulation. Acupunct Electrother Res 16(1–2): 1–5

    Google Scholar 

  14. Stener-Victorin E, Waldenstrom U, Tagnfors U et al. (2000) Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome. Acta Obstet Gynecol Scand 79(3): 180–188

    Article  PubMed  CAS  Google Scholar 

  15. Xiaoming MO, Ding LI, Yunxing PU et al. (1993) Clinical studies on the mechanism for acupuncture stimulation of ovulation. J Traditional Chinese Med 13(2): 115–119

    Google Scholar 

  16. Cai X (1997) Substitution of acupuncture for HCG in ovulation induction. J Tradit Chin Med 17(2): 119–121

    PubMed  CAS  Google Scholar 

  17. Carman N (2007) The treatment of ovarian hyperstimulation syndrome (OHSS) with acupuncture in women undergoing assisted reproductive techniques (ART). J Chinese Med 85: 16–24

    Google Scholar 

  18. Gerhard I, Postneek F (1992) Auricular acupuncture in the treatment of female infertility. Gynecol Endocrinol 6(3): 171–181

    Article  PubMed  CAS  Google Scholar 

  19. Barria A, Leyton V, Ojeda SR, Lara HE (1993) Ovarian steroidal response to gonadotropins and beta-adrenergic stimulation is enhanced in polycystic ovary syndrome: role of sympathetic innervation. Endocrinology. 133(6): 2696–2703

    Google Scholar 

  20. Manni L, Holmang A, Cajander S et al. (2006) Effect of anti-NGF on the ovarian expression of {alpha}1- and {beta}2-adrenoceptors, TrkA, p75NTR, and tyrosine hydroxylase in rats with steroid-induced polycystic ovaries. Am J Physiol Regul Integr Comp Physiol 290(3): R826–835

    PubMed  CAS  Google Scholar 

  21. Stener-Victorin E, Lundeberg T, Cajander S et al. (2003) Steroid-induced polycystic ovaries in rats: effect of electro-acupuncture on concentrations of endothelin-1 and nerve growth factor (NGF), and expression of NGF mRNA in the ovaries, the adrenal glands, and the central nervous system. Reprod Biol Endocrinol 8;1(1): 33

    Google Scholar 

  22. Stener-Victorin E, Lundeberg T, Waldenstrom U et al. (2000) Effects of electro-acupuncture on nerve growth factor and ovarian morphology in rats with experimentally induced polycystic ovaries. Biol Reprod 63(5): 1497–1503

    Article  PubMed  CAS  Google Scholar 

  23. Stener-Victorin E, Lundeberg T, Waldenstrom U et al. (2001) Effects of electro-acupuncture on corticotropin-releasing factor in rats with experimentally-induced polycystic ovaries. Neuropeptides 35(5–6): 227–231

    Google Scholar 

  24. Stener-Victorin E, Lindholm C (2004) Immunity and beta-endorphin concentrations in hypothalamus and plasma in rats with steroid-induced polycystic ovaries: effect of low-frequency electroacupuncture. Biol Reprod 70(2): 329–333

    Article  PubMed  CAS  Google Scholar 

  25. Stener-Victorin E, Kobayashi R, Watanabe O et al. (2004) Effect of electro-acupuncture stimulation of different frequencies and intensities on ovarian blood flow in anaesthetised rats with steroid-induced polycystic ovaries. Reprod Biol Endocrinol 26;2(1): 16

    Google Scholar 

  26. Manni L, Cajander S, Lundeberg T et al. (2005) Effect of exercise on ovarian morphology and expression of nerve growth factor and alpha(1)- and beta(2)-adrenergic receptors in rats with steroid-induced polycystic ovaries. J Neuroendocrinol 17(12): 846–858

    PubMed  CAS  Google Scholar 

  27. Manni L, Lundeberg T, Holmang A et al. (2005) Effect of electro-acupuncture on ovarian expression of alpha (1)- and beta (2)-adrenoceptors, and p75 neurotrophin receptors in rats with steroid-induced polycystic ovaries. Reprod Biol Endocrinol 7;3(1): 21

    Google Scholar 

  28. Cacciatore B, Simberg N, Fusaro P, Tiitinen A (1996) Transvaginal Doppler study of uterine artery blood flow in in vitro fertilization-embryo transfer cycles. Fertil Steril 66(1): 130–134

    PubMed  CAS  Google Scholar 

  29. Steer CV, Campbell S, Tan SL et al. (1992) The use of transvaginal colour flow imaging after in vitro fertilization to identify optimum uterine conditions before embryo transfer. Fertil Steril 57: 372–376

    PubMed  CAS  Google Scholar 

  30. Stener-Victorin E, Waldenstrom U, Andersson SA, Wikland M (1996) Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Hum Reprod 11(6): 1314–1317

    PubMed  CAS  Google Scholar 

  31. Stener-Victorin E, Kobayashi R, Kurosawa M (2003) Ovarian blood flow responses to electro-acupuncture stimulation at different frequencies and intensities in anaesthetized rats. Autonomic Neurosci Basic Clinical 31;108(1–2): 50–56

    Google Scholar 

  32. Stener-Victorin E, Fujisawa S, Kurosawa M (2006) Ovarian blood flow responses to electroacupuncture stimulation depend on estrous cycle and on site and frequency of stimulation in anesthetized rats. J Appl Physiol 101(1): 84–91

    Article  PubMed  Google Scholar 

  33. Sator-Katzenschlager SM, Wolfler MM, Kozek-Langenecker SA et al. (2006) Auricular electro-acupuncture as an additional perioperative analgesic method during oocyte aspiration in IVF treatment. Hum Reprod 21(8): 2114–2120

    Article  PubMed  Google Scholar 

  34. Stener-Victorin E (2005) The pain-relieving effect of electro-acupuncture and conventional medical analgesic methods during oocyte retrieval: a systematic review of randomized controlled trials. Hum Reprod 20(2): 339–349

    Article  PubMed  Google Scholar 

  35. Streitberger K, Kleinhenz J (1998) Introducing a placebo needle into acupuncture research. Lancet 352(9125): 364–365

    Article  PubMed  CAS  Google Scholar 

  36. Paulus W, Zhang M, Strehler E et al. (2003) Placebo-controlled trial of acupuncture effects in assisted reproductive therapy. Abstract of the 19th Annual Meeting of teh ESHRE, Madrid, Spain. 2003: O-052

  37. Craig LB, Criniti AR, Hansen LA et al. (2007) Acupuncture lowers pregnancy rates when performed before and after embryo transfer (O-106). Fertil Steril. 88(Suppl 1)

  38. Manheimer E, Zhang G, Udoff L et al. (2008) Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ published online 7 Feb 2008; doi:10.1136/bmj.39471.430451.BE

  39. Collins J (2006) The play of chance. Fertil Steril 85(5): 1364–1367

    Article  PubMed  Google Scholar 

  40. Andersson S, Lundeberg T (1995) Acupuncture – from empiricism to science: functional background to acupuncture effects in pain and disease. Med Hypotheses 45(3): 271–281

    Article  PubMed  CAS  Google Scholar 

  41. Stener-Victorin E, Wikland M, Waldenstrom U, Lundeberg T (2002) Alternative treatments in reproductive medicine: much ado about nothing: Acupuncture – a method of treatment in reproductive medicine: lack of evidence of an effect does not equal evidence of the lack of an effect. Hum Reprod 17(8): 1942–1946

    Article  PubMed  Google Scholar 

  42. She Y (1985) Research on mechanism of acupuncture and herbs promoting ovulation. J of Comb of TCM and Western Med 4:210

    Google Scholar 

  43. Kim J, Shin KH, Na CS (2000) Effect of acupuncture treatment on uterine motility and cycloxygenase-2 expression in pregnant rats. Gynecol Obstet Invest 50: 225–230

    Article  PubMed  CAS  Google Scholar 

  44. Dyrehag LE, WiderstromNoga EG, Carlsson SG, Andersson SA (1997) Effects of repeated sensory stimulation sessions (electro-acupuncture) on skin temperature in chronic pain patients. Scand J Rehab Med 29 (4): 243–250

    CAS  Google Scholar 

  45. Han JS (2003) Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends Neurosci 26(1): 17–22

    Article  PubMed  CAS  Google Scholar 

  46. List T, Helkimo M (1992) Acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders. II. A 1-year follow-up study. Acta Odont Scand 50: 375–385

    Article  PubMed  CAS  Google Scholar 

  47. Lundeberg T, Hurtig T, Lundeberg S, Thomas M (1998) Long-term results of acupuncture in chronic head and neck pain. Pain Clinic 2(1): 15–31

    Google Scholar 

  48. Magarelli P, Cridenda D, Cohen M (2004) Acupuncture and good prognosis IVF patientes: synergy. Fertil Steril 82 (Suppl 2): S80–81

    Article  Google Scholar 

  49. Magarelli P, Cridenda D (2004) Acupuncture and IVF poor responders: a cure? Fertil Steril 81 (Suppl 3): S20

    Article  Google Scholar 

  50. White P, Lewith G, Hopwood V, Prescott P (2003) The placebo needle, is it a valid and convincing placebo for use in acupuncture trials? A randomised, single-blind, cross-over pilot trial. Pain 106(3): 401–409

    Article  PubMed  Google Scholar 

  51. Olausson H, Lamarre Y, Backlund H et al. (2002) Unmyelinated tactile afferents signal touch and project to insular cortex. Nat Neurosci 5(9): 900–904

    Article  PubMed  CAS  Google Scholar 

  52. Lund I, Lundeberg T (2006) Are minimal, superficial or sham acupuncture procedures acceptable as inert placebo controls? Acupunct Med 24(1): 13–15

    PubMed  Google Scholar 

  53. Linde K, Streng A, Jurgens S et al. (2005) Acupuncture for patients with migraine: a randomized controlled trial. Jama 4;293(17): 2118–2125

    Google Scholar 

  54. Domar AD (2006) Acupuncture and infertility: we need to stick to good science. Fertil Steril 85(5): 1359–1361; discussion 68–70

    Article  PubMed  Google Scholar 

  55. Moher D, Schulz KF, Altman D (2005) The CONSORT Statement: revised recommendations for improving the quality of reports of parallel-group randomized trials 2001. Explore (NY) 1(1): 40–45

  56. MacPherson H, White A, Cummings M et al. (2001) Standards for reporting interventions in controlled trials of acupuncture: the STRICTA recommendations. Complement Ther Med 9(4): 246–249

    Article  PubMed  CAS  Google Scholar 

  57. Vincent C (2001) The safety of acupuncture. BMJ 323(7311): 467–468

    Article  PubMed  CAS  Google Scholar 

  58. White A (2004) A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med 22(3): 122–133

    Article  PubMed  Google Scholar 

  59. Benson MR, Elkind-Hirsch KE, Theall A et al. (2006) Impact of acupunture before and after embryo transfer on the outcome of in vitro fertilization cacles: a prospective single blind randomized study, Fertil Steril 86,3 (Suppl 1): S135

  60. Udoff LC, Zhang G, Patwardhan S et al. (2006) The effect of acupuncture on outcomes in invitro fertilization (IVF). Fertil Steril 86,3 (Suppl 1): S145

  61. Craig LB, Criniti AR, Hansen KR et al. (2007) Acupuncture lowers pregnancy rates when performed before and after embryo transfer. Fertil Steril 88(Suppl 1): S40

    Article  Google Scholar 

  62. Domar AD, Meshay I, Kelliher J et al. (2006) The impact of acupuncture on IVF outcome. Fertil Steril 86,3 (Suppl 2): S378

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Authors and Affiliations

  1. Institution for Neuroscience and Physiology, Department of Physiology/Endocrinology, Sahlgrenska Academy, Göteborg University, Box 434, 40530, Göteborg, Schweden

    E. Stener-Victorin

  2. Ambulanz für Naturheilkunde und Integrative Medizin, Abteilung Gynäkologische Endokrinologie und Fertilitätsstörungen, Universitätsfrauenklinik Heidelberg, Voß-Straße 9, 69115, Heidelberg, Deutschland

    C. von Hagens

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  1. E. Stener-Victorin
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  2. C. von Hagens
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Correspondence to E. Stener-Victorin or C. von Hagens.

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Stener-Victorin, E., von Hagens, C. Akupunktur bei assistierter Reproduktion und PCOS. Gynäkologische Endokrinologie 6, 67–71 (2008). https://doi.org/10.1007/s10304-008-0255-8

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