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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02591186
Other study ID # L15-117
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date November 1, 2015
Est. completion date September 1, 2020

Study information

Verified date September 2020
Source Texas Tech University Health Sciences Center
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Experimental Approach: (1) Participants: Women (ages 21 to 42) who seek IVF treatment at the Center for Fertility & Reproductive Surgery will be eligible for the study. Seventy women will be recruited and randomly assigned to either the intervention (acupuncture plus standard care) or the comparison (standard care alone) group. (2) Intervention: Participants in the intervention group will receive 3 acupuncture sessions during the project with the first treatment between day 6-8 of the stimulated IVF cycle, second on the day of embryo transfer and the third one day post transfer. Participants in the comparison group will receive no intervention but will receive standard care. (3) Measures: The primary outcome measures include prostacyclin and thromboxane vasoactive biomarkers. Secondary outcome measures include perceived stress levels. (4) Procedure: Upon IRB approval, an informed consent will be provided to all participants. Pre- and post- acupuncture urinary metabolites of prostacyclin and thromboxane will be assessed. A standardized Perceived Stress Scale will be administered before and after each acupuncture session for the study group, and before and after a 30-40-minute waiting period for the control group.


Description:

Hypothesis and Specific Aims

The purpose of this pilot study is to determine if acupuncture affects the vasoactive molecules (prostacyclin and thromboxane) in women undergoing IVF therapy. The investigators' overall hypotheses for this area of study, to be addressed with future research, are: (1) acupuncture augments IVF success by enhancing the perfusion of pelvic organs including the ovaries and the uterus, and (2) acupuncture reduces the levels of stress and optimizes mind-body interaction in individuals undergoing IVF.

Specific Aims:

1. To measure urine prostacyclin and thromboxane, before and after acupuncture, and

2. to assess the impacts of acupuncture on the psychological well-being of women undergoing IVF treatment.

SIGNIFICANCE OF THE STUDY Results from this study will shed light on the mechanism by which acupuncture improves IVF outcomes. This may lead to other treatment strategies to improve success. Likewise, an established mechanism by which acupuncture improves IVF may lead to greater acceptance of this non-conventional treatment modality by the general population.

Research Design and Methods

This is a prospective, randomized, controlled study. Participants will be women in the Principal Investigator's practice seeking IVF. Participants will be randomized 1:1 into either the acupuncture group or the standard of care (no acupuncture) group. Each group will have 3 study visits.

Rationale for the Control Group:

A sham control group is not used because systematic review suggested that sham acupuncture controls may unnecessarily complicate the RCT evidence base given the nature of objective outcomes in IVF study (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124624/).

Power analysis

With 35 patients allocated to each group, assuming the Student's T-test will be used to determine the differences between two independent samples, effect sizes d>0.6 will be found statistically significant with alpha .05 and power .80. In practical terms, since the PSS validation samples showed a mean about 13.5 with variance=6.2, only averaged differences greater than 1.5 raw score points in PSS will be found statistically significant.

The investigators plan to seek extramural funding in the future. The investigators will use the data obtained from this pilot study to perform power analysis and to calculate the number of participants needed in future proposals.


Recruitment information / eligibility

Status Completed
Enrollment 60
Est. completion date September 1, 2020
Est. primary completion date July 1, 2020
Accepts healthy volunteers Accepts Healthy Volunteers
Gender Female
Age group 21 Years to 42 Years
Eligibility Inclusion Criteria:

- Women between ages 21-42 years seeking IVF.

- Willing to undergo acupuncture

- No contraindications to needle insertion.

Exclusion Criteria:

- Women currently using alternative therapies such as acupressure, herbal supplements and meditation techniques.

- Women with generalized psoriasis, neuropathy or coagulopathies posing increased risk due to needle insertion.

- Women with previous experience with acupuncture.

***Please note that we are unable to give a discount on IVF cost for participating in the study.***

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
Acupuncture
Participants will receive 3 acupuncture sessions during IVF process

Locations

Country Name City State
United States Texas Tech Health Science Center Lubbock Texas

Sponsors (1)

Lead Sponsor Collaborator
Texas Tech University Health Sciences Center

Country where clinical trial is conducted

United States, 

References & Publications (62)

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Huang JC, Goldsby JS, Wun WS. Prostacyclin enhances the implantation and live birth potentials of mouse embryos. Hum Reprod. 2004 Aug;19(8):1856-60. Epub 2004 Jun 17. — View Citation

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Huang JC, Wun WS, Goldsby JS, Matijevic-Aleksic N, Wu KK. Cyclooxygenase-2-derived endogenous prostacyclin enhances mouse embryo hatching. Hum Reprod. 2004 Dec;19(12):2900-6. Epub 2004 Oct 15. — View Citation

Huang JC, Wun WS, Goldsby JS, Wun IC, Falconi SM, Wu KK. Prostacyclin enhances embryo hatching but not sperm motility. Hum Reprod. 2003 Dec;18(12):2582-9. — View Citation

Huang JC, Wun WS, Goldsby JS, Wun IC, Noorhasan D, Wu KK. Stimulation of embryo hatching and implantation by prostacyclin and peroxisome proliferator-activated receptor delta activation: implication in IVF. Hum Reprod. 2007 Mar;22(3):807-14. Epub 2006 Nov 17. — View Citation

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Ni F, So SP, Cervantes V, Ruan KH. A profile of the residues in the second extracellular loop that are critical for ligand recognition of human prostacyclin receptor. FEBS J. 2008 Jan;275(1):128-37. Epub 2007 Nov 27. — View Citation

Pakrasi PL, Jain AK. Cyclooxygenase-2-derived endogenous prostacyclin reduces apoptosis and enhances embryo viability in mouse. Prostaglandins Leukot Essent Fatty Acids. 2008 Jul-Aug;79(1-2):27-33. doi: 10.1016/j.plefa.2008.07.006. Epub 2008 Sep 3. — View Citation

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Planat-Benard V, Silvestre JS, Cousin B, André M, Nibbelink M, Tamarat R, Clergue M, Manneville C, Saillan-Barreau C, Duriez M, Tedgui A, Levy B, Pénicaud L, Casteilla L. Plasticity of human adipose lineage cells toward endothelial cells: physiological and therapeutic perspectives. Circulation. 2004 Feb 10;109(5):656-63. Epub 2004 Jan 20. — View Citation

Ruan CH, Wu J, Ruan KH. A strategy using NMR peptide structures of thromboxane A2 receptor as templates to construct ligand-recognition pocket of prostacyclin receptor. BMC Biochem. 2005 Nov 4;6:23. — View Citation

Ruan KH, Cervantes V, So SP. Engineering of a novel hybrid enzyme: an anti-inflammatory drug target with triple catalytic activities directly converting arachidonic acid into the inflammatory prostaglandin E2. Protein Eng Des Sel. 2009 Dec;22(12):733-40. doi: 10.1093/protein/gzp058. Epub 2009 Oct 22. — View Citation

Ruan KH, Cervantes V, Wu J. A simple, quick, and high-yield preparation of the human thromboxane A2 receptor in full size for structural studies. Biochemistry. 2008 Jul 1;47(26):6819-26. doi: 10.1021/bi702501g. Epub 2008 Jun 5. — View Citation

Ruan KH, Cervantes V, Wu J. Ligand-specific conformation determines agonist activation and antagonist blockade in purified human thromboxane A2 receptor. Biochemistry. 2009 Apr 14;48(14):3157-65. doi: 10.1021/bi801443g. — View Citation

Ruan KH, Deng H, So SP. Engineering of a protein with cyclooxygenase and prostacyclin synthase activities that converts arachidonic acid to prostacyclin. Biochemistry. 2006 Nov 28;45(47):14003-11. — View Citation

Ruan KH, Deng H, Wu J, So SP. The N-terminal membrane anchor domain of the membrane-bound prostacyclin synthase involved in the substrate presentation of the coupling reaction with cyclooxygenase. Arch Biochem Biophys. 2005 Mar 15;435(2):372-81. — View Citation

Ruan KH, Dogné JM. Implications of the molecular basis of prostacyclin biosynthesis and signaling in pharmaceutical designs. Curr Pharm Des. 2006;12(8):925-41. Review. — View Citation

Ruan KH, Li D, Ji J, Lin YZ, Gao X. Structural characterization and topology of the second potential membrane anchor region in the thromboxane A2 synthase amino-terminal domain. Biochemistry. 1998 Jan 20;37(3):822-30. — View Citation

Ruan KH, So SP, Cervantes V, Wu H, Wijaya C, Jentzen RR. An active triple-catalytic hybrid enzyme engineered by linking cyclo-oxygenase isoform-1 to prostacyclin synthase that can constantly biosynthesize prostacyclin, the vascular protector. FEBS J. 2008 Dec;275(23):5820-9. doi: 10.1111/j.1742-4658.2008.06703.x. — View Citation

Ruan KH, So SP, Wu H, Cervantes V. Large-scale expression, purification, and characterization of an engineered prostacyclin-synthesizing enzyme with therapeutic potential. Arch Biochem Biophys. 2008 Dec 1;480(1):41-50. doi: 10.1016/j.abb.2008.09.010. Epub 2008 Sep 22. — View Citation

Ruan KH, Wijaya C, Cervantes V, Wu J. Characterization of the prostaglandin H2 mimic: binding to the purified human thromboxane A2 receptor in solution. Arch Biochem Biophys. 2008 Sep 15;477(2):396-403. doi: 10.1016/j.abb.2008.05.022. Epub 2008 Jun 17. — View Citation

Ruan KH, Wu J, Cervantes V. Characterization of the substrate mimic bound to engineered prostacyclin synthase in solution using high-resolution NMR spectroscopy and mutagenesis: implication of the molecular mechanism in biosynthesis of prostacyclin. Biochemistry. 2008 Jan 15;47(2):680-8. Epub 2007 Dec 15. — View Citation

Ruan KH, Wu J, So SP, Jenkins LA, Ruan CH. NMR structure of the thromboxane A2 receptor ligand recognition pocket. Eur J Biochem. 2004 Jul;271(14):3006-16. — View Citation

Ruan KH, Wu J, So SP, Jenkins LA. Evidence of the residues involved in ligand recognition in the second extracellular loop of the prostacyclin receptor characterized by high resolution 2D NMR techniques. Arch Biochem Biophys. 2003 Oct 1;418(1):25-33. — View Citation

Ruan KH, Wu J, Wang LH. Solution structure of a common substrate mimetic of cyclooxygenase-downstream synthases bound to an engineered thromboxane A2 synthase using a high-resolution NMR technique. Arch Biochem Biophys. 2005 Dec 15;444(2):165-73. Epub 2005 Nov 2. — View Citation

Ruan KH. Advance in understanding the biosynthesis of prostacyclin and thromboxane A2 in the endoplasmic reticulum membrane via the cyclooxygenase pathway. Mini Rev Med Chem. 2004 Aug;4(6):639-47. Review. — View Citation

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So SP, Wu J, Huang G, Huang A, Li D, Ruan KH. Identification of residues important for ligand binding of thromboxane A2 receptor in the second extracellular loop using the NMR experiment-guided mutagenesis approach. J Biol Chem. 2003 Mar 28;278(13):10922-7. Epub 2003 Jan 27. — View Citation

Stener-Victorin E, Humaidan P. Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer. Acupunct Med. 2006 Dec;24(4):157-63. Review. — View Citation

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Wu J, Feng M, Ruan KH. Assembling NMR structures for the intracellular loops of the human thromboxane A2 receptor: implication of the G protein-coupling pocket. Arch Biochem Biophys. 2008 Feb 1;470(1):73-82. Epub 2007 Dec 3. — View Citation

Wu J, So SP, Ruan KH. Solution structure of the third extracellular loop of human thromboxane A2 receptor. Arch Biochem Biophys. 2003 Jun 15;414(2):287-93. — View Citation

Xu N. [Effect of electroacupuncture at "taixi" point on plasma thromboxane A2 and prostacyclin in the rabbit with renal ischemia]. Zhen Ci Yan Jiu. 1993;18(3):240-2. Chinese. — View Citation

Yuan J, Westney OL, Ruan KH, Wang R. A new strategy, SuperEnzyme gene therapy in penile rehabilitation. J Sex Med. 2009 Mar;6 Suppl 3:328-33. doi: 10.1111/j.1743-6109.2008.01191.x. Review. — View Citation

Zhang L, Bastepe M, Jüppner H, Ruan KH. Characterization of the molecular mechanisms of the coupling between intracellular loops of prostacyclin receptor with the C-terminal domain of the Galphas protein in human coronary artery smooth muscle cells. Arch Biochem Biophys. 2006 Oct 1;454(1):80-8. Epub 2006 Jul 25. — View Citation

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Zhang L, Wu J, Ruan KH. Solution structure of the first intracellular loop of prostacyclin receptor and implication of its interaction with the C-terminal segment of G alpha s protein. Biochemistry. 2006 Feb 14;45(6):1734-44. — View Citation

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* Note: There are 62 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Urine prostacyclin before and after acupuncture Measurement of the vasoactive molecule prostacyclin (pg/mg creatinine) in women undergoing IVF therapy. Within 8-week course of IVF treatment
Primary Urine thromboxane before and after acupuncture Measurement of the vasoactive molecule thromboxane (pg/mg creatinine) in women undergoing IVF therapy. Within 8-week course of IVF treatment
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