human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy ( ART ) by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no acupuncture . DESIGN Prospect i ve r and omized study . SETTING Fertility center . PATIENT(S ) After giving informed consent , 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through r and om selection : embryo transfer with acupuncture ( n = 80 ) and embryo transfer without acupuncture ( n = 80 ) . INTERVENTION(S ) Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer . In the control group , embryos were transferred without any supportive therapy . MAIN OUTCOME MEASURE(S ) Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer . RESULT ( S ) Clinical pregnancies were documented in 34 of 80 patients ( 42.5 % ) in the acupuncture group , whereas pregnancy rate was only 26.3 % ( 21 out of 80 patients ) in the control group . CONCLUSION ( S ) Acupuncture seems to be a useful tool for improving pregnancy rate after ART OBJECTIVE To replicate previous research on the efficacy of acupuncture in increasing pregnancy rates ( PR ) in patients undergoing IVF and to determine whether such an increase was due to a placebo effect . DESIGN Prospect i ve , r and omized , controlled , single blind trial . SETTING Private , academically affiliated , infertility clinic . PATIENT(S ) One hundred fifty patients scheduled to undergo embryo transfer . INTERVENTION(S ) Subjects were r and omized to either the acupuncture or control group . Acupuncture patients received the protocol , as first described by Paulus and his colleagues , for 25 minutes before and after embryo transfer . Control subjects laid quietly . All subjects then completed question naires on anxiety and optimism . The IVF staff remained blind to subject assignment . MAIN OUTCOME MEASURE(S ) Clinical PRs , anxiety , optimism . RESULT ( S ) Before r and omization both groups had similar demographic characteristics including age and psychological variables . There were no significant differences in PRs between the two groups . Acupuncture patients reported significantly less anxiety post-transfer and reported feeling more optimistic about their cycle and enjoyed their sessions more than the control subjects . CONCLUSION ( S ) The use of acupuncture in patients undergoing IVF was not associated with an increase in PRs but they were more relaxed and more optimistic BACKGROUND In a previous study on the effect of electro-acupuncture ( EA ) in combination with a paracervical block ( PCB ) as an analgesic method during oocyte aspiration in IVF treatment , EA appeared to increase the pregnancy rate . This study was design ed to test the hypothesis that EA as an analgesic during oocyte aspiration would result in : ( i ) a better IVF pregnancy rate than with alfentanil ; ( ii ) peroperative analgesia that was as good as that produced by alfentanil ; ( iii ) less postoperative abdominal pain , nausea and stress ; and ( iv ) a reduction in the use of additional analgesics . Neuropeptide Y ( NPY ) concentrations in follicular fluid ( FF ) were analysed when possible . METHODS AND RESULTS In this prospect i ve , r and omized , multicentre clinical trial , 286 women undergoing oocyte aspiration were r and omly allocated to the EA group ( EA plus a PCB ) or to the alfentanil group ( alfentanil plus a PCB ) . No significant differences were found between the EA and alfentanil groups in any of the IVF variables . NPY concentrations in FF were significantly higher in the EA group compared with the alfentanil group . No correlation between pregnancy rate and NPY concentrations was found in either analgesic group . Both EA plus a PCB and alfentanil plus a PCB induced adequate peroperative analgesia during oocyte aspiration evaluated using the visual analogue scale . After 2 h , the EA group reported significantly less abdominal pain , other pain , nausea and stress than the alfentanil group . In addition , the EA group received significantly lower amounts of additional alfentanil than the alfentanil group . CONCLUSION EA does not improve pregnancy rate in the present clinical situation . The observation that NPY concentrations in FF were higher in the EA group may be important for human ovarian steroidogenesis . The analgesic effects produced by EA are as good as those produced by conventional analgesics , and the use of opiate analgesics with EA is lower than when conventional analgesics alone are used OBJECTIVE To evaluate the influence of " true " versus " sham " acupuncture on pregnancy rates ( PRs ) in women undergoing IVF . DESIGN R and omized controlled trial , double-blinded with independent observer . SETTING Academic infertility clinic . PATIENT(S ) One hundred sixty patients < 38 years old undergoing IVF with or without intracytoplasmic sperm injection . INTERVENTION(S ) Subjects were r and omly allocated to the true or sham group and underwent acupuncture 25 minutes before and after ET . Subjects completed a McGill Pain Question naire regarding their clinical symptoms during ET . MAIN OUTCOME MEASURE(S ) Clinical PR and clinical symptoms during ET . RESULT ( S ) While the overall clinical PR was 51.25 % , there was no significant difference between the arms of the study ( true = 45.3 % vs. sham = 52.7 % ) ; 33.1 % of the patients had ultrasound-documented singleton pregnancy , and 15 % of patients had twin gestations , while one patient in the true arm had a triplet gestation . There were significant differences in the subjective , affective , and total pain experience between both arms . The subjects in the true arm described their acupuncture session as being more " tiring " and " fearful " and experienced more " achiness " compared with their sham counterparts . CONCLUSION ( S ) There was no statistically significant difference in the clinical or chemical PRs between both groups . Patients undergoing true acupuncture had differing sensory experiences compared with patients in the sham arm . There were no significant adverse effects observed during the study , suggesting that acupuncture is safe for women undergoing ET OBJECTIVE To determine the effect of luteal-phase acupuncture on the outcome of  IVF/intracytoplasmic sperm injection ( ICSI ) . DESIGN R and omized , prospect i ve , controlled clinical study . SETTING University IVF center . PATIENT(S ) Two hundred twenty-five infertile patients undergoing IVF/ICSI . INTERVENTION(S ) In group I , 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine . In group II , 109 patients received placebo acupuncture . MAIN OUTCOME MEASURE(S ) Clinical and ongoing pregnancy rates . RESULT ( S ) In group I , the clinical pregnancy rate and ongoing pregnancy rate ( 33.6 % and 28.4 % , respectively ) were significantly higher than in group II ( 15.6 % and 13.8 % ) . CONCLUSION ( S ) Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI OBJECTIVE To assess the effects of acupuncture combined Chinese materia medica for tonifying shen and soothing gan ( CMMTSSG ) on the anxiety and depression of patients with in vitro fertilization and embryo transplantation ( IVF-ET ) , and to observe the treatment outcomes . METHODS Totally 97 IVF-ET patients were r and omly assigned to two groups , the acupuncture combined CMMTSSG ( group A , 51 cases ) and the Western medicine treatment group ( group B , 46 cases ) . The long protocol of IVF-ET in a mid luteal phase was performed in all patients . Patients in group A received acupuncture and CMMTSSG ( erzhi tiangui granule and xiaoyao granule ) during the process of ovarian hyperstimulation , while those in group B only received the routines of IVF-ET . The improvement of Shen deficiency Gan depression syndrome ( SDGDS ) between after and before treatment were observed in the two groups . The changes of self-rating anxiety scale ( SAS ) and Beck depression inventory ( BDI ) score were observed . The endometrial thickness , typing , and endometrial blood flow resistance index ( RI ) on the day of injecting HCG , the number of retrieved oocytes , the rate of high quality oocytes , the fertilization rate , the rate of high quality embryos , and the clinical pregnancy rate were respectively compared between the two groups . RESULTS The scores of SDGDS , SAS , and BDI were improved more obviously in group A than in group B , showing statistical difference ( P < 0.01 ) . There was no statistical difference in the endometrial thickness on the day of injecting HCG between the two groups ( P > 0.05 ) . The proportion of type A endometrium was 74.5 % ( 38/51 cases ) in group A and 45.7 % ( 21/46 cases ) in group B , showing statistical difference between the two groups ( P < 0.01 ) . The RI was significantly lower in group A ( 0.48 + /- 0.03 ) than in group B on the day of injecting HCG ( 0.52 + /- 0.06 , P < 0.01 ) . There was no statistical difference in the number of retrieved oocytes and the fertilization rate between the two groups ( P > 0.05 ) . The rate of high quality oocyte , the rate of high quality embryos , and the clinical pregnancy rate were all improved more significantly in group A than in group B , showing statistical difference between the two groups ( P < 0.05 ) . CONCLUSIONS Acupuncture combined CM-MTSSG could obviously alleviate unfavorable emotions as anxiety and depression in patients with IVF-ET , effectively improve the treatment outcomes . Its effects might be correlated with lowering the excitability of the sympathetic nervous system , elevating the quality of oocytes , and improving the endometrial receptivity Background Different mechanisms have been described for the effects of acupuncture on fertility . Acupuncture may mediate neurotransmitter release , which results in the stimulation of gonadotrophin-releasing hormone secretion . The production of neurotransmitters such as endogenous opioids may also inhibit central nervous system outflow and biological stress response . Acupuncture may also stimulate blood flow to the uterus by inhibiting uterine central sympathetic nerve activity . Despite some evidence suggesting beneficial effects of acupuncture on in vitro fertilisation ( IVF ) success rates , recent clinical trials could not duplicate these effects , especially in patients who are infertile with polycystic ovarian syndrome ( PCOS ) who are undergoing IVF . Methods A total of 62 women with PCOS undergoing IVF/intracytoplasmic sperm injection ( ICSI ) at Shayamehr IVF Clinic in Tehran ( Iran ) participated in a r and omised , controlled trial . Participants were r and omly allocated to one of two groups : there were 31 women each in the acupuncture ( group I ) and control groups ( group II ) . Acupuncture based on traditional Chinese medicine was performed in group I versus no adjunctive treatment in group II . All acupuncture procedures were performed in five sessions : start of downregulation , start of stimulation , 2 days before ovum pick-up , and immediately before and after embryo transfer . We measured the rate of oocytes in metaphase II , the fertilisation rate and the quality of embryos . Results Our results showed a statistically higher mean of good quality embryos in group I compared with group II ( p=0.044 ) . However , the mean number of metaphase II oocytes retrieved and fertilisation rate were similar between the two groups . We also could not find any significant differences among clinical , biochemical or ongoing pregnancy rates . Conclusions Acupuncture at an early stage of oocyte recruitment may have a beneficial effect on embryo quality . However , it seems to have no significant effect on other IVF/ICSI outcomes of women with PCOS . Trial Registration Number ( I RCT ID : 201011275181N4 Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background Acupuncture has recently been used as a complementary technique in the management of infertility . It has physiological and psychological effects and may be considered an alternative for stress reduction in women undergoing infertility treatments . Objective To examine the hypothesis that acupuncture treatment may increase the pregnancy rate in patients undergoing intracytoplasmic sperm injection cycles . Methods Patients enrolled in the study were stratified according to age and r and omised to either a control group ( n=208 ) or acupuncture group , ( n=208 ) . The pregnancy , implantation and abortion rates of the two groups were compared . Results No influence of acupuncture treatment on clinical outcomes was seen ; however , when cycles in which the causes of infertility were exclusively tubal-uterine or idiopathic were evaluated separately , a positive influence of acupuncture on pregnancy ( OR=5.15 , 95 % CI 1.03 to 34.5 ; p=0.048 ) was noted . Moreover , trends toward an increase in implantation were seen when acupuncture was performed ( regression coefficient : 0.645 ; p=0.092 ) 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy ( ART ) by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no acupuncture . DESIGN Prospect i ve r and omized study . SETTING Fertility center . PATIENT(S ) After giving informed consent , 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through r and om selection : embryo transfer with acupuncture ( n = 80 ) and embryo transfer without acupuncture ( n = 80 ) . INTERVENTION(S ) Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer . In the control group , embryos were transferred without any supportive therapy . MAIN OUTCOME MEASURE(S ) Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer . RESULT ( S ) Clinical pregnancies were documented in 34 of 80 patients ( 42.5 % ) in the acupuncture group , whereas pregnancy rate was only 26.3 % ( 21 out of 80 patients ) in the control group . CONCLUSION ( S ) Acupuncture seems to be a useful tool for improving pregnancy rate after ART OBJECTIVE To replicate previous research on the efficacy of acupuncture in increasing pregnancy rates ( PR ) in patients undergoing IVF and to determine whether such an increase was due to a placebo effect . DESIGN Prospect i ve , r and omized , controlled , single blind trial . SETTING Private , academically affiliated , infertility clinic . PATIENT(S ) One hundred fifty patients scheduled to undergo embryo transfer . INTERVENTION(S ) Subjects were r and omized to either the acupuncture or control group . Acupuncture patients received the protocol , as first described by Paulus and his colleagues , for 25 minutes before and after embryo transfer . Control subjects laid quietly . All subjects then completed question naires on anxiety and optimism . The IVF staff remained blind to subject assignment . MAIN OUTCOME MEASURE(S ) Clinical PRs , anxiety , optimism . RESULT ( S ) Before r and omization both groups had similar demographic characteristics including age and psychological variables . There were no significant differences in PRs between the two groups . Acupuncture patients reported significantly less anxiety post-transfer and reported feeling more optimistic about their cycle and enjoyed their sessions more than the control subjects . CONCLUSION ( S ) The use of acupuncture in patients undergoing IVF was not associated with an increase in PRs but they were more relaxed and more optimistic BACKGROUND In a previous study on the effect of electro-acupuncture ( EA ) in combination with a paracervical block ( PCB ) as an analgesic method during oocyte aspiration in IVF treatment , EA appeared to increase the pregnancy rate . This study was design ed to test the hypothesis that EA as an analgesic during oocyte aspiration would result in : ( i ) a better IVF pregnancy rate than with alfentanil ; ( ii ) peroperative analgesia that was as good as that produced by alfentanil ; ( iii ) less postoperative abdominal pain , nausea and stress ; and ( iv ) a reduction in the use of additional analgesics . Neuropeptide Y ( NPY ) concentrations in follicular fluid ( FF ) were analysed when possible . METHODS AND RESULTS In this prospect i ve , r and omized , multicentre clinical trial , 286 women undergoing oocyte aspiration were r and omly allocated to the EA group ( EA plus a PCB ) or to the alfentanil group ( alfentanil plus a PCB ) . No significant differences were found between the EA and alfentanil groups in any of the IVF variables . NPY concentrations in FF were significantly higher in the EA group compared with the alfentanil group . No correlation between pregnancy rate and NPY concentrations was found in either analgesic group . Both EA plus a PCB and alfentanil plus a PCB induced adequate peroperative analgesia during oocyte aspiration evaluated using the visual analogue scale . After 2 h , the EA group reported significantly less abdominal pain , other pain , nausea and stress than the alfentanil group . In addition , the EA group received significantly lower amounts of additional alfentanil than the alfentanil group . CONCLUSION EA does not improve pregnancy rate in the present clinical situation . The observation that NPY concentrations in FF were higher in the EA group may be important for human ovarian steroidogenesis . The analgesic effects produced by EA are as good as those produced by conventional analgesics , and the use of opiate analgesics with EA is lower than when conventional analgesics alone are used OBJECTIVE To evaluate the influence of " true " versus " sham " acupuncture on pregnancy rates ( PRs ) in women undergoing IVF . DESIGN R and omized controlled trial , double-blinded with independent observer . SETTING Academic infertility clinic . PATIENT(S ) One hundred sixty patients < 38 years old undergoing IVF with or without intracytoplasmic sperm injection . INTERVENTION(S ) Subjects were r and omly allocated to the true or sham group and underwent acupuncture 25 minutes before and after ET . Subjects completed a McGill Pain Question naire regarding their clinical symptoms during ET . MAIN OUTCOME MEASURE(S ) Clinical PR and clinical symptoms during ET . RESULT ( S ) While the overall clinical PR was 51.25 % , there was no significant difference between the arms of the study ( true = 45.3 % vs. sham = 52.7 % ) ; 33.1 % of the patients had ultrasound-documented singleton pregnancy , and 15 % of patients had twin gestations , while one patient in the true arm had a triplet gestation . There were significant differences in the subjective , affective , and total pain experience between both arms . The subjects in the true arm described their acupuncture session as being more " tiring " and " fearful " and experienced more " achiness " compared with their sham counterparts . CONCLUSION ( S ) There was no statistically significant difference in the clinical or chemical PRs between both groups . Patients undergoing true acupuncture had differing sensory experiences compared with patients in the sham arm . There were no significant adverse effects observed during the study , suggesting that acupuncture is safe for women undergoing ET OBJECTIVE To determine the effect of luteal-phase acupuncture on the outcome of  IVF/intracytoplasmic sperm injection ( ICSI ) . DESIGN R and omized , prospect i ve , controlled clinical study . SETTING University IVF center . PATIENT(S ) Two hundred twenty-five infertile patients undergoing IVF/ICSI . INTERVENTION(S ) In group I , 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine . In group II , 109 patients received placebo acupuncture . MAIN OUTCOME MEASURE(S ) Clinical and ongoing pregnancy rates . RESULT ( S ) In group I , the clinical pregnancy rate and ongoing pregnancy rate ( 33.6 % and 28.4 % , respectively ) were significantly higher than in group II ( 15.6 % and 13.8 % ) . CONCLUSION ( S ) Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI OBJECTIVE To assess the effects of acupuncture combined Chinese materia medica for tonifying shen and soothing gan ( CMMTSSG ) on the anxiety and depression of patients with in vitro fertilization and embryo transplantation ( IVF-ET ) , and to observe the treatment outcomes . METHODS Totally 97 IVF-ET patients were r and omly assigned to two groups , the acupuncture combined CMMTSSG ( group A , 51 cases ) and the Western medicine treatment group ( group B , 46 cases ) . The long protocol of IVF-ET in a mid luteal phase was performed in all patients . Patients in group A received acupuncture and CMMTSSG ( erzhi tiangui granule and xiaoyao granule ) during the process of ovarian hyperstimulation , while those in group B only received the routines of IVF-ET . The improvement of Shen deficiency Gan depression syndrome ( SDGDS ) between after and before treatment were observed in the two groups . The changes of self-rating anxiety scale ( SAS ) and Beck depression inventory ( BDI ) score were observed . The endometrial thickness , typing , and endometrial blood flow resistance index ( RI ) on the day of injecting HCG , the number of retrieved oocytes , the rate of high quality oocytes , the fertilization rate , the rate of high quality embryos , and the clinical pregnancy rate were respectively compared between the two groups . RESULTS The scores of SDGDS , SAS , and BDI were improved more obviously in group A than in group B , showing statistical difference ( P < 0.01 ) . There was no statistical difference in the endometrial thickness on the day of injecting HCG between the two groups ( P > 0.05 ) . The proportion of type A endometrium was 74.5 % ( 38/51 cases ) in group A and 45.7 % ( 21/46 cases ) in group B , showing statistical difference between the two groups ( P < 0.01 ) . The RI was significantly lower in group A ( 0.48 + /- 0.03 ) than in group B on the day of injecting HCG ( 0.52 + /- 0.06 , P < 0.01 ) . There was no statistical difference in the number of retrieved oocytes and the fertilization rate between the two groups ( P > 0.05 ) . The rate of high quality oocyte , the rate of high quality embryos , and the clinical pregnancy rate were all improved more significantly in group A than in group B , showing statistical difference between the two groups ( P < 0.05 ) . CONCLUSIONS Acupuncture combined CM-MTSSG could obviously alleviate unfavorable emotions as anxiety and depression in patients with IVF-ET , effectively improve the treatment outcomes . Its effects might be correlated with lowering the excitability of the sympathetic nervous system , elevating the quality of oocytes , and improving the endometrial receptivity Background Different mechanisms have been described for the effects of acupuncture on fertility . Acupuncture may mediate neurotransmitter release , which results in the stimulation of gonadotrophin-releasing hormone secretion . The production of neurotransmitters such as endogenous opioids may also inhibit central nervous system outflow and biological stress response . Acupuncture may also stimulate blood flow to the uterus by inhibiting uterine central sympathetic nerve activity . Despite some evidence suggesting beneficial effects of acupuncture on in vitro fertilisation ( IVF ) success rates , recent clinical trials could not duplicate these effects , especially in patients who are infertile with polycystic ovarian syndrome ( PCOS ) who are undergoing IVF . Methods A total of 62 women with PCOS undergoing IVF/intracytoplasmic sperm injection ( ICSI ) at Shayamehr IVF Clinic in Tehran ( Iran ) participated in a r and omised , controlled trial . Participants were r and omly allocated to one of two groups : there were 31 women each in the acupuncture ( group I ) and control groups ( group II ) . Acupuncture based on traditional Chinese medicine was performed in group I versus no adjunctive treatment in group II . All acupuncture procedures were performed in five sessions : start of downregulation , start of stimulation , 2 days before ovum pick-up , and immediately before and after embryo transfer . We measured the rate of oocytes in metaphase II , the fertilisation rate and the quality of embryos . Results Our results showed a statistically higher mean of good quality embryos in group I compared with group II ( p=0.044 ) . However , the mean number of metaphase II oocytes retrieved and fertilisation rate were similar between the two groups . We also could not find any significant differences among clinical , biochemical or ongoing pregnancy rates . Conclusions Acupuncture at an early stage of oocyte recruitment may have a beneficial effect on embryo quality . However , it seems to have no significant effect on other IVF/ICSI outcomes of women with PCOS . Trial Registration Number ( I RCT ID : 201011275181N4 Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background Acupuncture has recently been used as a complementary technique in the management of infertility . It has physiological and psychological effects and may be considered an alternative for stress reduction in women undergoing infertility treatments . Objective To examine the hypothesis that acupuncture treatment may increase the pregnancy rate in patients undergoing intracytoplasmic sperm injection cycles . Methods Patients enrolled in the study were stratified according to age and r and omised to either a control group ( n=208 ) or acupuncture group , ( n=208 ) . The pregnancy , implantation and abortion rates of the two groups were compared . Results No influence of acupuncture treatment on clinical outcomes was seen ; however , when cycles in which the causes of infertility were exclusively tubal-uterine or idiopathic were evaluated separately , a positive influence of acupuncture on pregnancy ( OR=5.15 , 95 % CI 1.03 to 34.5 ; p=0.048 ) was noted . Moreover , trends toward an increase in implantation were seen when acupuncture was performed ( regression coefficient : 0.645 ; p=0.092 ) 
    Output:
    