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This dissertation, A Randomized Double-blind Comparison of Acupuncture in Patients Undergoing in Vitro Fertilization Treatment by Wing-sze, So, 蘇穎詩, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Abstract of thesis entitled A randomized double-blind comparison of acupuncture in patients undergoing in vitro fertilization treatment Submitted by SO WING SZE for the degree of Master of Philosophy at The University of Hong Kong in August 2007 Although acupuncture is extensively being used in the management of female infertility, there is lack of solid evidence to support its potential value to expand its use into assisted reproduction. This is a prospective double-blind, randomized controlled trial with the use of non-invasive placebo acupuncture over the same acupoints to evaluate the effects of acupuncture on pregnancy outcomes, endometrial and subendometrial vascularity, stress and anxiety relief in patients undergoing IVF treatment. This study was carried out in Assisted Reproduction Unit of Department of Obstetrics and Gynaecology at Queen Mary Hospital from August 2006 to June 2007. Three hundred IVF patients were randomly allocated to either real or non-invasive placebo acupuncture treatment according to a computer-generated randomization list in sealed envelopes. All of them received two sessions of real or placebo acupuncture immediately before and after embryo transfer. The primary outcome was pregnancy. Secondary outcomes were endometrial and subendometrial vascularity, cortisol concentration and anxiety level. There was no significant difference in the overall pregnancy rate when compared between groups. Reduction of endometrial and subendometrial vascularity, serum cortisol concentration and anxiety level was observed following placebo and real acupuncture, although there were no significant differences in the changes in all these indices when compared between the placebo and real acupuncture groups. No serious adverse effect was found. No significant difference was found in the patients' response of the treatment allocation. In conclusion, there is a surprising result on the efficacy of the non-invasive placebo acupuncture. As shown in the results, both placebo and real acupuncture were associated with reduction in endometrial and subendometrial 3D power flow indices, serum cortisol concentration and anxiety level following placebo and real acupuncture respectively. Placebo acupuncture may not be an inert control although the placebo needles do not penetrate through the skin. Acupuncture is a safe procedure. The efficacy of blinding of the placebo setting was valid. Further research is needed to evaluate the efficacy of acupuncture by developing a reliable and reproducible control, treatment scheme that is consistent with TCM principles and appropriate study design in order to demonstrate the mechanism of acupuncture more precisely. A greater understanding of the specialized clinical usage of acupuncture for specific infertility conditions will be provided by such rigorous study design. (371 words) DOI: 10.5353/th_b3874023 Subjects: AcupunctureFertilization in vitro, HumanInfertility - Treatment

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