Table 1: Comparison of patients <38 by FSH level 67 million/ml; Sperm motility (%) were 48 vs.

Sperm motility (%) were 48 vs. 53%, and Sperm morphol-

ogies were 6% normal vs. 7%.
⬍38 and FSH ⱖ10 ⬍38 and FSH ⬍10 Results: Pregnancy rates for the Ac group were statistically similar to the
n⫽34 n⫽173 P value C (Ac 49.5% vs. 46.3%). Summary statistics are in the table below. There
were no statistically significant differences between the Controls and Acu-
Mean Age (yrs) 33.8 ⫾ 1.7 33.1 ⫾ 1.2 NS puncture treated groups:
Age Range (yrs) 23–37 24–37 NA
Mean FSH (mIU/mL) 11.5 ⫾ 0.25 6.2 ⫾ 0.10 ⬍.001 Control Acupuncture
AFC 9.18 ⫾ 0.31 15.2 ⫾ 0.76 ⬍.005 Not Not Control Acupuncture
Oocytes (number) 8.8 ⫾ 0.54 14.4 ⫾ 0.73 ⬍.001 Pregnant Pregnant Pregnant Pregnant
Gonadotropins (IU) 4556 ⫾ 268 2775 ⫾ 75 ⬍.001
Peak E2 (pg/mL) 1572 ⫾ 125 2316 ⫾ 68 ⬍.005 Number Eggs retrieved 12.8 12.5 15.4 15.0
Average # tx 2.06 ⫾ 0.09 2.05 ⫾ 0.03 NS Number Fertilized Normally 7.1 7.2 7.9 8.5
IR 46.6% 48.4% NS Number Embryo Transferred 3.1 3.3 3.4 3.7
PR 57.6% 62.4% NS Number Frozen 1.4 1.2 2.3 1.7
Day of Transfer 3.0 3.1 3.1 3.1
Table 2: Comparison of patients by age and FSH level
Conclusions: There were no discernable statistical differences between
⬍38 and FSH ⱖ10 ⬎38 and FSH⬍10 embryology characteristics in patients treated with or without Acupuncture.
n⫽34 n⫽62 P value
Further studies of Traditional Chinese Medicine modalities of treatment are
Mean Age (yrs) 33.8 ⫾ 1.7 39.7 ⫾ 1.4 ⬍.05 underway. We are organizing a multicenter prospective study to confirm our
Age Range (yrs) 23–37 38–43 NA observations.
Mean FSH (mIU/mL) 11.5 ⫾ 0.25 6.4 ⫾ 0.17 ⬍.001
AFC 9.18 ⫾ 0.31 11.26 ⫾ 0.61 ⬍.05
Oocytes (number) 8.8 ⫾ 0.54 12.02 ⫾ 0.58 ⬍.05
Gonadotropoins (IU) 4556 ⫾ 268 3928 ⫾ 112 ⬍.05
Peak E2 (pg/mL) 1572 ⫾ 125 2177 ⫾ 106 ⬍.05 O-8
Average # tx 2.06 ⫾ 0.09 2.85 ⫾ 0.07 ⬍.001
IR 46.6% 22.7% ⬍.001 Reproductive Urinary Metabolites during the Perimenopause.
PR 57.6% 48.6% NS J.E. Jackson, M.L. Evans, D. Moore, M.I. Cedars Department of Obstetrics
and Gynecology, University of California, San Francisco, USA.

Background: The exact nature of hormonal changes in the perimeno-

O-7 pausal period is not fully understood. The evaluation of urinary metabolites
Acupuncture: Impact on Eggs & Embryos of IVF Patients. of reproductive hormones allows a longitudinal non-invasive measure of
Paul C. Magarelli, M.D., Ph.D.a, Diane Cridennda, L.Ac.b, hormone secretion. Prior studies have shown that evaluation of urinary
Mel Cohen, MBAa. aReproductive Medicine & Fertility Center, Colorado metabolites is a viable method of assessing menstrual function, but only a
Springs, CO. bEast Winds Acupuncture, Colorado Springs, CO. minority of studies evaluated these metabolites in perimenopausal women.
Objective: This study aims to compare reproductive urinary metabolite
Background: Each IVF program strives to improve reproductive out- secretion in regularly cycling perimenopausal women versus younger
comes (low ectopic rates, low miscarriage rates and improved take home women.
baby rates – live births). Usually the approach to these improvements are Materials and Methods: Daily morning urine samples were obtained from
changes in IVF protocols, media adjustments in the IVF lab, patient selec- normally cycling women ages 25-50 years old for an entire menstrual cycle,
tion, and subtle nudges towards egg donors for poor responders. Another and were analyzed by ELISA for estrone-3-gluduronide (E1G) and preg-
approach has been the inclusion of alternative medical modalities: acupunc- nanediol-3-glucuronide (PdG). Day of ovulation was assessed with ultra-
ture, massage therapy, stress reduction techniques, herbal medicine. We, sound monitoring.
and others, have chosen to incorporate Acupuncture into our IVF treatment Results: Urine samples were obtained from a total of 109 women, 28 were
protocols. Recently we presented three studies that demonstrated improve-
between 25 and 35 years old (mean age 27.9 ⫾ 3.8), and 81 were between
ments in pregnancy rates and birth outcomes in Good and Poor IVF
35 and 50 years old (mean age 40.7 ⫾ 3.9). There were significantly lower
Responders with the inclusion of two specific Acupuncture Protocols
(Steiner-Victorin and Paulus et. Al). In the Poor Responders study we progesterone levels in the older versus the younger group throughout the
demonstrated a positive adjustment to pregnancy rates with improvements entire cycle as well as during the follicular and the luteal phases. In addition,
in Poor Responders group pregnancy rates (PR) equivalent to Good Re- there was significantly lower estrogen in the older versus the younger group
sponders. In the Good Responders study we demonstrated a trend towards during the luteal phase (82.4 nmol/L vs 106.5 nmol/L, p⫽0.015). The mean
improved PR (5% above controls, not significant at p ⬍ 0.05). In both length of the follicular phase was significantly shorter in the older group
groups, significantly more live births per cycle start and per pregnancy were (13.9 days versus 15.5 days, p⫽0.006) but there was no significant differ-
found (p ⬍ 0.05). Understanding the root cause of these improvement ence in the average length of the luteal phase between groups.
remains our research focus.
Objective: In this research, we examine the impact of Acupuncture on the AUC of Urinary Metabolites
embryology characteristics of our IVF patients, i.e., are there changes in the
numbers of eggs generated, embryos fertilized, embryos transferred or Younger Older P
remaining embryos for freezing. (n⫽28) (n⫽81) value**
Materials and Methods: In this study 178 IVF cycles were reviewed in a
retrospective fashion. Patients demographics, years infertile, age of male E1G total* 94.0 ⫾ 38.5 86.2 ⫾ 32.1 0.326
partners, sperm parameters, Day 3 FSH, Pulsatility Indices, Weight, BMI, E1G Follicular* 80.5 ⫾ 34.5 87.5 ⫾ 38.3 0.361
infertility diagnoses, IVF treatment protocols were statistically similar for E2 Luteal* 106.5 ⫾ 52.1 82.4 ⫾ 30.7 0.015
both the Controls (C) and Acupuncture (Ac) treatment groups. All patients PdG total* 10.9 ⫾ 4.4 6.2 ⫾ 3.0 ⬍0.001
that completed an IVF cycle (retrieval, transfer) were included. There were PdG Follicular* 5.6 ⫾ 2.3 2.6 ⫾ 1.3 ⬍0.001
97 in the C group (no acupuncture) and 81 in the Ac group. For the C vs. PdG Luteal* 17.2 ⫾ 8.7 10.5 ⫾ 5.0 ⬍0.001
Ac groups a summary of their statistics are as follows: Mean Age was 32.6
vs. 32.7, Day 3 FSH was 5.5 vs. 6.4, Pulsatility Indices for right and left * Mean value of AUC, ⫾ SD. Values are standardized by cycle length.
uterine arteries were 1.5 and 1.2 vs. 1.4 and 1.0; Sperm counts were 69 vs. ** P value calculated by log transformation

FERTILITY & STERILITY威 S9