title: Massage therapy improves in vitro fertilization outcome in patients undergoing blastocyst transfer in a cryo-cycle.
abstract: BACKGROUND
  Massage therapy is increasingly used to relieve physical and mental discomfort and is suggested as a safe therapeutic modality, without any significant risks or any known side effects. Although a multitude of complementary therapies, such as acupuncture, are applied in reproductive medicine, no information is available with regard to the application of massage as an adjuvant therapy in assisted-reproduction techniques (ARTs).
  
  
  OBJECTIVE
  This study was intended to assess the effectiveness of a deep relaxation (andullation) therapy based on oscillating vibrations when used prior to embryo transfer (ET) in in vitro fertilization (IVF) cryo-cycles.
  
  
  METHODS
  The research team designed a retrospective, observational study. Participants willing to undergo the massage treatment were allocated to the intervention (andullation) group.
  
  
  METHODS
  The study was performed at the IVF Centers Prof. Zech-Bregenz in Bregenz, Austria.
  
  
  METHODS
  A total of 267 IVF patients, with a mean age of 36.3 y, participated in this single-center study.
  
  
  METHODS
  All patients receiving a transfer of vitrified and warmed blastocysts between January and December 2012 were included in the evaluation. Prior to ET, the andullation group received a standardized program of therapy-a 30-min, deep relaxation massage on an oscillating (vibrating) device, whereas the control group did not.
  
  
  METHODS
  To determine efficacy, the primary outcomes that the study measured were (1) pregnancy rates (PRs), by testing urine and obtaining a positive β-human chorionic gonadotropin (β-hCG); and (2) ongoing, pregnancies (oPR), by observation of fetal heartbeat and birth rates (BR) as well as miscarriage rates. The patients' medical histories and types of infertility as well as the quality of the embryo transfers (ETs) were evaluated.
  
  
  RESULTS
  In patients using the massage therapy prior to ET, significantly higher PRs, oPRs, and BRs were observed compared with the control group-PR: 58.9% vs 41.7%, P<.05; oPR: 53.6% vs 33.2%, P<.01; and BR: 32.0% vs 20.3%, P<.05. No differences were detected among groups for patients' ages, hormonal substitution protocols, endometrium structures and buildups, quality of transferred embryos, or quality of transfers. No adverse effects were noted in the massage group.
  
  
  CONCLUSIONS
  The research team's results suggested that andullation therapy prior to blastocyst transfer in a cryo-cycle improves embryo implantation, most likely due to a reduction in stress (ie, a relaxation effect on patients), a reduction in uterine contractions, and, probably, an enhancement of the blood flow in the abdominal region. These findings provide support for use of andullation as a complementary therapy for ART.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Okhowat
authors.forename: Maximilian
authors.initials: M
authors.lastname: Murtinger
authors.forename: Maximilian
authors.initials: M
authors.lastname: Schuff
authors.forename: Johannes
authors.initials: J
authors.lastname: Wogatzky
authors.forename: Dietmar
authors.initials: D
authors.lastname: Spitzer
authors.forename: Pierre
authors.initials: P
authors.lastname: Vanderzwalmen
authors.forename: Barbara
authors.initials: B
authors.lastname: Wirleitner
authors.forename: Nicolas Herbert
authors.initials: NH
authors.lastname: Zech
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D004624:Embryo Transfer / Q000706:statistics & numerical data*; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D008405:Massage; D011247:Pregnancy / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006063:Chorionic Gonadotropin