The Effect of Complementary and Alternative Medicine on Subfertile Women with In Vitro Fertilization

Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2014, Article ID 419425, 22 pages http://dx.doi.org/10.1155/2014/419425 Review Article The Effect of Complementary and Alternative Medicine on Subfertile Women with In Vitro Fertilization Yuehui Zhang,1,2 Yiman Fu,3 Fengjuan Han,1 Hongying Kuang,1 Min Hu,1 and Xiaoke Wu1 1 Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China 2 Center for Post-Doctoral Studies, Heilongjiang University of Chinese Medicine, Harbin 150040, China 3 Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, Harbin 150040, China Correspondence should be addressed to Xiaoke Wu; Received 13 September 2013; Revised 13 December 2013; Accepted 15 December 2013; Published 16 January 2014 Academic Editor: Ernest Hung Yu Ng Copyright © 2014 Yuehui Zhang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. About 10–15% of couples have difficulty conceiving at some point in their reproductive lives and thus have to seek specialist fertility care. One of the most commonly used treatment options is in vitro fertilization (IVF) and its related expansions. Despite many recent technological advances, the average IVF live birth rate per single initiated cycle is still only 30%. Consequently, there is a need to find new therapies to promote the efficiency of the procedure. Many patients have turned to complementary and alternative medical (CAM) treatments as an adjuvant therapy to improve their chances of success when they undergo IVF treatment. At present, several CAM methods have been used in infertile couples with IVF, which has achieved obvious effects. However, biologically plausible mechanisms of the action of CAM for IVF have not been systematically reviewed. This review briefly summarizes the current progress of the impact of CAM on the outcomes of IVF and introduces the mechanisms. 1. Introduction With rapid economic development, lifestyle changes, and increased environmental pollution, the incidence of infertility has gained increased worldwide attention. Almost 10–15% of couples have suffered from infertility and seek specialist fertility care worldwide [1]. In vitro fertilization-embryo transfer (IVF-ET) is the most commonly used treatment option for these couples [2]. For many people, it provides the last possibility for pregnancy. Despite many recent technological advances, the average IVF live birth rate per single initiated cycle is still only 30% [3]. At the same time, the latent safety problems associated with using large doses of ovulation stimulants to obtain more eggs for IVF cannot be ignored [4]. Furthermore, IVF is an expensive procedure, and some couples can afford only a limited number of treatments. Repeated cycles will place enormous economic pressure on the patients. Consequently, there is a need to maximize the efficiency of the procedure [5]. Many patients have turned to complementary and alternative medical (CAM) treatments as an adjuvant therapy to improve their chances of success when they undergo IVF treatment [6–8]. CAM has been defined as diagnosis, treatment, and/or prevention which complements mainstream medicine by contributing to a common whole, satisfying a demand not met by orthodoxy or diversifying the conceptual frameworks of medicine [9]. Recently, complementary and alternative medicine (CAM) modalities have become a popular therapy all over the world as a health care option due to the apparent acceptance of naturalness and harmlessness of CAM [10, 11] and the dissatisfaction with problems associated with conventional medicine [6, 7]. CAM mainly contains the following methods: (i) alternative medical system: TCM (traditional Chinese medicine), Ayurveda, and homeopathy; (ii) mind-body intervention: meditation and biofeedback; (iii) biologically based therapies: herbal therapy and special diet therapy; (iv) manipulative and body-based methods: chiropractic and massage; and 2 Evidence-Based Complementary and Alternative Medicine (v) energy therapies [12]. At present, several CAM methods have been used in infertile couples with IVF, which has acquired obvious consequences. However, biologically plausible mechanisms of action of CAM for IVF have not been systematically reviewed. This review briefly summarizes the current progress of the impact of CAM on the outcomes of IVF and introduces the mechanisms. Acupuncture was administered 25 minutes before and after ET. Higher pregnancy rates were found in the acupuncture group compared with the group that did not undergo acupuncture (42.5% versus 26.3%; 𝑃 < 0.03) [19]. Since then numerous randomized controlled trials [20–23] and cohort studies [24–27] proved this finding that acupuncture had a positive impact on reproductive outcomes for IVF patients. Manheimer et al. also demonstrated that adjuvant treatment with acupuncture for IVF patients resulted in a 10% improvement in reproductive outcomes [28]. As a result, more and more infertile patients were treated with acupuncture, and a number of patients who undergo IVF were advised by specialists to receive an adjuvant treatment with acupuncture [29, 30]. Some randomized, controlled, prospective studies demonstrated higher pregnancy rates in the acupuncture group than in the control group [19– 22], even though the differences did not reach statistical significance in one study, while the acupuncture subjects who achieved higher pregnancy rates than in the control group (31% versus 23%) in this study [21]. Magarelli and Cridennda carried out a retrospective clinical study and reported higher pregnancy rates (51% versus 36%, 𝑃 < 0.05) and lower miscarriage rates (8% versus 20%, 𝑃 < 0.05) among those subjects who received acupuncture compared with subjects in the control group [24]. Another retrospective study focused on the impact of acupuncture in subjects with poor responders to IVF found out a significant increase in the pregnancy rate in the acupuncture group than in the control group (53% versus 38%, 𝑃 < 0.01) [25]. Dieterle et al. also demonstrated the benefit of acupuncture on clinical pregnancy and ongoing pregnancy rates [22]. Except common acupuncture, electroacupuncture (EA) is another style of acupuncture commonly used in the clinic in China. EA is a therapy where the needle was inserted into the acupoints, inputting currents flow in the near human body bioelectricity. EA combines two stimulations of needle and electric and has some advantages, such as could continuous operation for a long time compared with hand-acupuncture (operate acupuncture with hand), being able to objectively control the amount of stimulation and play an exciting role, and at the same being able to promote blood circula (...truncated)