Dados do Trabalho

Title

Enhancing IVF Success Rates: Exploring the Efficacy of Acupuncture and the Paulus Protocol.

Objective

Acupuncture, an ancient Chinese medicine technique, has been integrated into human reproduction treatments. Studies suggest that combining acupuncture with traditional in vitro fertilization (IVF) procedures may enhance success rates. Acupuncture activates the autonomic nervous system, promoting better blood circulation to reproductive organs and regulating the hypothalamic-pituitary-ovarian axis through the sympathetic nervous system. Neurotransmitter release, such as serotonin and gamma-aminobutyric acid (GABA), also induces anxiolytic effects, reducing stress during treatment. These factors create a favorable uterine environment for embryo implantation and increase the likelihood of clinical pregnancy. The renowned Paulus Protocol, developed by Dr. Wolfgang Paulus and his team, involves two 25-minute acupuncture sessions (pre and post embryo transfer) during IVF treatment. Sterile, disposable needles and stainless materials are used in specific acupoints, aiming for the "Deqi" sensation (pain, numbness, or distension). Pre-embryo transfer points include PC6, SP8, LR3, GV20, and S29, while post-embryo transfer points are S36, SP6, SP10, and LI4. Additionally, the following ear acupuncture points were placed: ear point 55 (ShenMen), ear point 58 (Zhigong), earpoint 22 (Neifenmi) and earpoint 34 (Naodian). This study seeks to demonstrate the impact of acupuncture and its potential benefits in IVF treatment.

Methods

A retrospective study was conducted at CITI Hinode, São Paulo, analyzing 284 embryo transfer cycles between January 2022 and June 2023. The in-house team of physicians (gynecologists and acupuncturist) assessed the data. The acupuncture group (141 patients) followed the Paulus Protocol, while the control group (143 patients) received embryo transfer without adjuvant treatment. SPSS 26 software, chi-square test, and T-test analyzed the data for differences between groups. A P value < 0.05 indicated statistical significance. Criteria evaluated: patient age, embryo quality percentage, transferred embryo count, pregnancy rate, embryonic loss rate, and evolutionary pregnancy rate.

Results

No notable age differences were observed between patient groups Controls vs acupuncture (40.17 ± 4.65 and 40.02 ± 6.02, p = 0.800), along with no significant variations in the number of transferred embryos (1.37 ± 0.53 and 1.38 ± 0.50) and embryonic quality (81.8%± 38.8 and 81.8%± 38.8) (p = 1.000). Analyzing plasma B-hCG on the 9th day after transfer, positive results were seen in 76.6%±42.5 with acupuncture and 67.1%±47.1 in controls, but the difference lacked statistical significance (p = 0.076). Although, the gestational losses not present significantly difference between groups, 13.0%± 32.7 in acupuncture and 25.0%± 43.5 in controls, the Paulus Protocol acupuncture during embryonic transfer showed significant benefits for evolutionary pregnancy 87.7%± 33.0 in acupuncture and 74.2%± 44.0 in controls, indicated by the presence of a gestational sac and embryo with heartbeat on ultrasound, compared to the controls.

Conclusion

Acupuncture, particularly the Paulus Protocol, shows promise in enhancing assisted human reproduction success. Analyzed data reveals positive correlation, boosting IVF success rates, reducing losses, and increasing evolving pregnancies. Larger, rigorous studies will further validate acupuncture's benefits in IVF treatment.

Keywords

Acupuncture, Pregnancy, Embryo Transfer