Background: 15% of patients with severe endometriosis suffer from pain symptoms in spite of pharmacological and surgical treatments. In this retrospective study we aimed to assess the effectiveness of a combined therapy of Traditional Chinese medicine and hypnotherapy (systemic autoregulation therapy, SART) as a novel treatment for endometriosis-associated symptoms. Patients and Methods: 47 patients with severe endometriosis, which were treated with SART, were followed-up by standardized telephone interviews. Follow-up data were compared to baseline assessments. Results: Median follow-up time was 5 years. The median intensity of endometriosis-associated pain had decreased from 8 to 3 points on a 0–10 point visual analogue scale (p < 0.001). 18 patients (38%) were free of pain, and the number of patients using pain medication had decreased from 38 to 19 (from 81% to 40%). 17 out of the 31 women trying for a pregnancy (55%) showed a total of 21 births at follow-up. Exploratory analyses revealed that larger decreases in pain scores correlated significantly with longer treatment durations, suggesting a dose-response relationship. Conclusion: Treatment of endometriosis with a holistic approach of Chinese medicine and hypnotherapy may result in a substantial reduction of pain as well as increased birth rates in patients with therapy-refractory endometriosis. Randomized controlled studies to further investigate the effectiveness of SART are highly warranted.
Fragestellung: Wie wirkt sich eine systemische Autoregulationstherapie SART, ein ganzheitlicher Therapieansatz auf der Basis der traditionellen chinesischen Medizin (TCM), auf die Ergebnisse einer nachfolgenden IVF/ICSI-Behandlung aus? Patientinnen und Methode: Die Behandlungsergebnisse von 36 Patientinnen, die zwischen 1997 und 2004 mit einer systemischen Autoregulationstherapie (SART) wegen unerfüllten Kinderwunsches in der Praxis behandelt wurden und sich anschließend einer IVF/ICSI-Behandlung unterzogen, wurden retrospektiv ausgewertet und mit den Ergebnissen des Deutschen IVFRegisters (DIR) von 2004 verglichen. Die Patientinnen stellen aufgrund des hohen Durchschnittsalters (37,5) und mehrmaligem IVF-Versagen (3,1) eine Auswahl mit schlechten Erfolgsaussichten dar. Ergebnisse: Von den 36 Patientinnen wurden 18 Mutter eines leiblichen Kindes, davon 3 spontan nach erfolgloser IVF/ICSI. Die Schwangerschaftsrate (SSR) betrug 49% pro Embryo-Transfer (ET), die Baby-Take-Home-Rate (BTH) 37%/ET. Für 5 Patientinnen (14%), die schwanger wurden, war es der erste IVF/ICSI-Versuch, alle anderen hatten bereits mehrere, bis zu 16, erfolglose IVF-Behandlungen hinter sich. Schlussfolgerungen: Wenn eine ganzheitliche Behandlung wie eine systemische Autoregulationstherapie (SART) der IVF/ICSI vorausgeht, können deutlich höhere Schwangerschaftsraten erzielt werden. Dies scheint am wirksamsten vor der ersten IVF/ICSI-Behandlung zu sein. Es zeigte sich, dass die IVF/ICSI-Behandlung sehr effektiv die mechanische Seite der Sterilitätsbehandlung abdeckt, aber sich durch eine Beachtung der vegetativen Funktionsregelkreise, wie sie die TCM erfasst, eine Erweiterung der diagnostischen und therapeutischen Möglichkeiten ergibt, die die Erfolgsraten deutlich steigern könnten. Abstract !Purpose: Aim of the study was to examine how a systemic autoregulation therapy (SART), which is a holistic therapy based on traditional Chinese medicine (TCM), affects the results of a subsequent IVF/ICSI treatment. Patients and Method:The results of the treatment of 36 patients who were treated with SART because of their unfulfilled wish to have children and who afterwards underwent an IVF/ICSI treatment between 1997 and 2004 were evaluated and compared with the results of the German IVF register (DIR) from 2004. The patients were an IVF population with repeated IVF failure and high mean age (37.5 years) leading to a low chance of success. Results: 18 of the 36 women delivered a child; of these mothers, 3 women conceived spontaneously after an unsuccessful IFV/ICSI. The pregnancy rate was 49% per embryo transfer (ET) and the baby-take-home-rate was 37% per ET. 5 patients (14%) had their first IVF/ICSI treatment after SART and all of them became mother. All other women who conceived a child had already undergone several, up to 16, unsuccessful IVFs. Conclusion: If a holistic therapy like systemic autoregulation therapy (SART) precedes a IVF/ICSI treatment, the pregnancy rate can perceptibly be increased. The holistic therapy appears to be more effective if ...
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