RESUMO
Acupuncture has been introduced as an adjuvant therapy to in vitro fertilization (IVF) cycles in many randomized controlled trials (RCTs). However, there has been a debate among trials regarding the effectiveness and safety of the procedure. To determine how effective and safe acupuncture is as an adjunct to IVF cycles for primary and secondary female infertility. We conducted a literature search for relevant RCTs and ultimately included nine studies. The main selected outcomes included the rates of clinical pregnancy, ongoing pregnancy, miscarriage, live birth, and side effects. Patients receiving acupuncture were grouped together regardless of the acupuncture points used or the protocol for the insertion of needles. We performed a subgroup analysis according to whether studies originated inside and outside China to investigate the results of the different RCTs. We pooled outcomes as a risk ratio (RR) with 95% confidence interval (CI). The analysis revealed that in China, acupuncture led to lower clinical [RR=0.80, 95% CI (0.66, 0.97), p=0.02] and ongoing [RR=0.78, 95% CI (0.63, 0.97), p=0.03] pregnancy rates than placebo. Outside China, acupuncture increased clinical pregnancy rates [RR=1.38, 95% CI (1.11, 1.71), p=0.003] and ongoing [RR=1.73, 95% CI (1.29, 2.31), p<0.001] pregnancy rates. Rates of live birth and miscarriage did not significantly differ between the arms. Regarding side effects, acupuncture groups had a significantly higher rate of puncture site itching compared to control groups [RR=1.51, 95% CI (1.12, 2.04), p=0.007]. Overall analysis does not show a statistically significant increase in clinical pregnancy rates worldwide when using acupuncture as an adjunct therapy to IVF. There were no issues regarding patient safety from any included study. Subgroup results indicated that better rates for clinical pregnancy seem to be occurring more often in RCTs performed outside China than within.
RESUMO
The possible chemopreventive effects of natural Egyptian flaxseed oil on preneoplasia and cancer formation were investigated in a rat medium-term colon carcinogenesis bioassay. Male Wistar rats were divided into 6 groups. Groups 1, 3 and 5 were initiated by 1,2-dimethylhydrazine (DMH) 20 mg/kg body weight s.c. 8 times, twice a week to initiate colon carcinogenesis. Groups 1 and 3 received 20% or 5% flaxseed oil respectively in diet in post initiation stage until the end. Groups 2 and 4 served as a flaxseed dose corresponding controls without carcinogen initiation, while rats in group 6 served as negative controls. Distribution and total numbers of aberrant crypt foci (ACF), putative preneoplastic lesions, particularly those with ≥4 aberrant crypts (ACs), and the numbers and sizes of colon tumors (adenoma and carcinoma) were significantly decreased by both treatment doses of flaxseeds as compared to group 5. Histochemical investigation revealed that the numbers of mucus-secreting cells in the colonic mucosa were reduced gradually during progression of colon carcinogenesis. Intriguingly, flaxseed oil caused the numbers and integrity of the mucus-secreting cells to retain close to normal levels and in a dose dependent manner. Moreover, the hematological parameters were almost constant between the groups particularly at the dose of 5% as compared to groups 5 and 6. PCNA-labeled indexes (PCNA-LI) in the DMH-initiated colonic mucosa were found to be decreased by both doses of flaxseeds administration. In conclusion, the present study showed that the post initiation dietary administration of flaxseeds oil suppressed DMH-induced colon carcinogenesis in rats without significant side effects. The mechanism is likely to be through its inhibitory effects on early cellular proliferation and modulation of mucin secretion properties in the initiated colonic mucosa.