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02/11/2008

Monday morning omnibus

Needles in the news

Short version: Acupuncture at embryo transfer seems to dramatically increase pregnancy and live birth rates among women undergoing IVF.

Longer, pointier version: This study contradicts a 2007 finding that women who had acupuncture were less likely to get pregnant.  The researcher who presented that finding suggested that women undergoing IVF should not be advised to have acupuncture, but stopped short of saying the acupuncture itself had harmed the patients' chances of conceiving; instead she "said she believed the stress of having to drive to and from the acupuncture sessions was more likely to have reduced pregnancy rates than the acupuncture itself." 

Yeah, I don't know quite what to say about that, either.

The current study, appearing in the British Medical Journal, examines seven trials including 1,366 women undergoing IVF.  In some of those trials, a group of patients received fake treatments so that they thought they were getting the real deal.  In other trials the control groups received no treatment at all.  Although the researchers say the placebo effect is unlikely to be in play here since the outcome measures are so objective — either you get pregnant and deliver a live baby or you don't — other researchers disagree.  "IVF may not seem to be 'placebo-prone' but it probably is," says Edzard Ernst, a professor of complementary medicine.  "If women expect it to be helpful, they are more relaxed which, in turn, would affect pregnancy rates."  ("GAAAAAAH," says Julie.)

As reported in the Telegraph, the paper itself makes short work of that objection: "The research paper said if the results were largely down to a placebo effect then there would have been increased pregnancy rates among the women who thought they were receiving real acupuncture, but were actually receiving a sham therapy, where the needles were placed at random. However, this was not the case."

The idea that acupuncture could increase your chances of pregnancy with IVF might not be new to you if you're an infertility old-timer.  A 2002 paper fondly known as "the German study" found an increased pregnancy rate among IVF patients who had acupunture before and after embryo transfer.  That was what sent me to an acupuncturist during ill-starred IVF #2, chanting, "Can't hurt, might help."  To date, that remains my most turbulent, heartbreaking cycle — dominant follicle, retrieval cancelled, Hail Mary IUI, pregnancy, miscarriage — and I'll never know exactly what effect those needles had. 

I never went back, but perhaps the only conclusion to be drawn from that is that I worried that the driving might stress me out.

...

Low, blood sugar

Diabetes is getting me down.  I'm on insulin twice a day now, long-acting in the morning and regular right at dinner, and I am still occasionally failing my postprandial testing.  Every time I get a high reading, I think, Birth defects.  Was that the 2/3 cup of whole-wheat pasta that'll do it?

I recognize this as a morbid imagining, and moreover a tardy one, since most malformations occur during the first trimester.  I know the chances, even elevated by diabetes, are still small.  But imagine I do, and certainly will, until at least 20 weeks, when my congenital anomalies scan takes place.  Because unlike other complications, this one is at least partially, at least in some small way, under my control, and I am terrified I'm handling it badly.

...

Dispatch from Davy Jones' cubby

I'm glad y'all enjoyed Charlie's pillow.  I heard nothing specific about it from his teachers, but there have been two intriguing little clues since the pillow's maiden voyage:

First, Charlie's rest period has been no more restful since the introduction of Cap'n Scurvy's Rum-Soaked Sleepy-Time Sandbag.

Second, on Friday his teacher sent home a note that said, "Can you please send an additional comfort item for Charlie to help him settle down at nap time?"

I am not one to leap to conclusions, so I'll stop short of blaming the pillow, but just to be safe I won't be sending his favorite rusty cutlass, I can tell you that right now.

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