Motility of the endometrium after acupuncture treatment.
Wolfgang E.Paulus, Mingmin Zhang, Erwin Strehler, Karl
Sterzik, . Christian-Lauritzen-Institut, Ulm, Germany; Tongji
Hosp, Tongji Medical Coll, Huazhong Univ of Science &
Technology, Wuhan, China.
Objective: Acupuncture seems to be a useful tool
for improving pregnancy rate after assisted reproduction
therapy (ART) as we have shown in a former study. Uterine
peristaltic waves may displace the embryo droplet a the
time of embryo transfer. To investigate the possible influence
of acupuncture on uterine contractility, we visualized the
motility of the endometrium by ultrasound comparing two
groups with/without acupuncture treatment shortly before
and after embryo transfer.
Design: Prospective cohort study.
Materials and Methods:164 patients undergoing ART
(ICSI, IVF) in our fertility centre were included in this
study. Only patients with a morphologically normal uterus
were admitted. After in-vitro fertilization up to three
embryos were transferred into the uterine cavity on day
2 to 6 after oocyte retrieval. Acupuncture was performed
in 95 patients 25 minutes before and after embryo transfer
with sterile disposable stainless steel needles. (0.25 x
25 mm) at the following locations: Cx 6 (Neiguan), Sp8 (Diji),
Liv3 (Taichong), Gv20 (Baihui), S29 (Xuehai), Li4 (Hegu)
after embryo transfer. After 10 min the needles were rotated
in order to maintain Deqi sensation. Additionally we used
small stainless needles (0.2 x13 mm) for auricular acupncutre
at the following pints without rotation: ear point 55 (shenmen)
ear point 58 (Zhigong), ear point 22 (neifenmi), ear point
34 (Naodian). In the control group (n=69) embryos were transferred
without any supportive therapy. Just before and after embryo
transfer all patients underwent ultrasound scans of a sagittal
uterine plane using a 7 MHz transvaginal probe (LOGIQ 400
PRO, GE Medical Systems). A sequence of two minutes was
video recorded. For evaluation of uterine contractions the
videotape was visually assessed in a fivefold speed. The
total time of endometrial movements during the 40 s period
of accelerated reproduction was measured. The main outcome
measure was the change of uterine motility after embryo
transfer. For statistival evaluation of endometrial motility
t-test was used.
Results: The basic uterine motility before embryo
transfer did not differ between acupuncture group and control
group: 19.0 vs. 20.1s (p=0.53). Comparing the endometrial
motility before and after embryo transfer we failed to find
significant change by acupuncture treatment: acupuncture
group vs control group 2.6s + 9.3s (t-test p-0.84.
Conclusion: Acupuncture treatment does not inhibit
uterine motility. Other mechanisms may be responsible for
the increase of pregnancy rate after acupuncture treatment
in ART.
