A Comparison of Stress Levels in Women Undergoing Single Versus Multiple Acupuncture Session Prior to Embryo Transfer


      Stress associated with the process of in vitro fertilization (IVF) has well recognized effects on outcomes of these treatments [1-4]. Acupuncture is one of several stress-lowering treatments that has been studied for the improvement of IVF outcomes. Stress is difficult to quantify and various tests range from standardized questionnaires, to endocrine assays as biomarkers of stress [5,6]. In this study, we employed a validated questionnaire, the perceived stress scale (PSS), to quantify stress [7].


      The objective of this study was to compare stress on the day of embryo transfer (ET) for IVF in women undergoing single versus multiple acupuncture session prior to IVF.

      Materials and Methods

      This retrospective cohort study included 87 women undergoing IVF at a private fertility clinic. Women were divided into three groups: one session of acupuncture on the ET day (n=32), >1 month of acupuncture at a Traditional Chinese Medicine (TCM) reproductive clinic prior to ET (n=20), and >1 month of acupuncture at a non-reproductive acupuncture clinic prior to ET (n=35). All women completed PSS on the ET day. PSS scores were then compared using the two-tailed T-test and the one-way ANOVA with post-hoc analyses using the Bonferroni criterion for significance.


      Stress appeared to be lower for women receiving >1 month of acupuncture at the TCM reproductive clinic versus those with acupuncture on the ET day only, with a PSS of 13.4 versus 19.3 (p=0.001), 95% CIs [11.1,15.6] and [17.4,21.2], respectively. There was no significant difference between women receiving > 1 month of acupuncture from the non-reproductive based acupuncture clinic and those receiving acupuncture on the ET day only, with a PSS of 17.6 versus 19.3 (p=0.60), 95% CIs [15.6,19.6] and [17.4,21.2], respectively. When all women from the reproductive and non-reproductive acupuncture clinic were combined, stress was significantly lower when compared to those undergoing acupuncture on the ET day only, with a PSS of 16.1 vs. 19.3 (p=0.011), 95% CI [-5.75, -0.76].


      Stress remains significantly elevated for women undergoing only one session of acupuncture on the ET day. However, when undergoing multiple acupuncture sessions, stress scores were significantly lower. As demonstrated by a dose-dependent effect, acupuncture appears to be a promising stress-lowering tool for women undergoing IVF. Further research will require a comparison of IVF outcomes with and without acupuncture.

      Financial Support



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