Chinese medicine fertility treatment better than embryo transfer acupuncture.
Utilisation of a comprehensive Chinese medicine fertility program appears to improve fertility significantly. Many studies have focused on minimal acupuncture treatment around embryo transfer, but this is not how Chinese medicine fertility treatment would be practiced in a typical clinic setting. Although we have seen some benefits from this protocol, Chinese medicine fertility specialists know many of these patients are missing an opportunity to help themselves even more. Now a study is backing what we have observed clinically.
A 2015 study showed patients who included a fully personalised course of Chinese medicine as part of their fertility treatment program had the best IVF fresh embryo transfer outcomes. Treatment included Chinese medicine diet and lifestyle advice as well as nutritional supplementation and Chinese herbal medicine when appropriate. These patients had better live birth outcomes than those who just received acupuncture treatments around embryo transfer. This improved outcome applied to both donor and non-donor egg cycles and included both three day and blastocyst embryo transfers.
What makes this even more significant, is that the group receiving a comprehensive Chinese medicine approach had a higher mean age and number of women diagnosed with diminished ovarian reserve. This particular factor in the study supports what I tell my patients – that age is less of an issue than lifestyle. By improving nutrition and lifestyle, many of the negative factors attributed to age can be undone. It may be these women chose the full Chinese medicine protocol because they knew that statistically their age and blood test results didn’t favour them, so wanted to try something safe to improve their chances.
This American study evaluated 1231 fresh embryo transfers. In patients using their own embryos, 61.3% of the comprehensive Chinese medicine group gave birth to live babies. The result of IVF alone was 48.2%. For those using donor eggs, the live birth rate was 85.7% in the Chinese medicine group and 62.5% for IVF alone. In this particular study having acupuncture only on the day of treatment helped relieve stress and marginally improved non-donor outcomes by 2.6%. It did not improve donor outcomes at all. In summary, a whole systems approach as typically practiced in a Chinese medicine clinic gave the best results for both donor and non-donor egg embryo transfer cycles.
All fertility medicine research is ongoing. At the time of writing this article, the latest IVF report for Australia and New Zealand was for 2013 results. From the 71,516 women who started a new round of IVF with either fresh or frozen embryos, the live birth rate was 18.2%. Of those starting an IVF round using fresh embryos, 16.3% would get their baby. Of those starting a frozen embryo cycle, 22% would. Interestingly, whether a fresh or a frozen embryo is used, once embryo transfer occurs the likelihood of achieving live birth is about the same at 23.7% and 23.6% respectively.
I was interested that the IVF alone results in this study are higher than those reported for Australia and NZ. The study did include patients who had undergone pre-genetic testing screening. I am unable to determine how much of a factor this is as neither the Australasian report or this study give any details as to how many had this procedure before embryo transfer. There has also been a trend in NZ and Australia, away from multiple embryos being transferred which may account for birth rate difference. With regards to the study discussed, there was no variation in multiple births between the study groups.
Personally, I find this study exciting. Especially for my patients who are of older maternal age. However I do have a word of caution – women in their thirties and forties need to be treated carefully. Some herbs and moxibustion techniques commonly used in Chinese medicine fertility treatment are harmful to some women. A high level of experience working alongside medical reproductive medicine is required if a whole systems approach is to be utilised and the benefits of this study are to be replicated.
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Bibliography:
http://npesu.unsw.edu.au/surveillance/assisted-reproductive-technology-australia-new-zealand-2013
Hullender Rubin, L. E., M. S. Opsahl, K. Wiemer, S. D. Mist and A. B. Caughey (2015). “Impact of Whole Systems Traditional Chinese Medicine on In Vitro Fertilization Outcomes.” Reproductive biomedicine online 30(6): 602-612.
