Does prayer influence the success of in vitro fertilization-embryo transfer?

Kwang Y. Cha, M.D., Daniel P. Wirth, J.D., M.S., and Rogerio A. Lobo, M.D.
Does Prayer Influence the Success of in Vitro Fertilization-Embryo Transfer?:
Report of a Masked, Randomized Trial
J Reprod Med 2001;46:781-787

ABSTRACT

Objective: To assess the potential effect of intercessory prayer (IP) on pregnancy rates in women being treated with in vitro fertilization-embryo transfer (IVF-ET).

Study Design: Prospective, double-blind, randomized clinical trial in which patients and providers were not informed about the intervention. Statisticians and investigators were masked until all the data had been collected and clinical outcomes were known. The setting was an IVF-ET program at Cha Hospital, Seoul, Korea. IP was carried out by prayer groups in the United States, Canada and Australia. The investigators were at a tertiary medical center in the United States. The patients were 219 women aged 26-46 years who were consecutively treated with IVF-ET over a four-month period. Randomization was performed after stratification of variables in two groups: distant IP vs. no IP. The clinical pregnancy rates in the two groups were the main outcome measure.

Results: After clinical pregnancies were known, the data were unmasked to assess the effects of IP after assessment of multiple comparisons in a log-linear model. The IP group had a higher pregnancy rate as compared to the no-IP rate (50% vs. 26%, P=.0013). The IP group showed a higher implantation rate (16.3% vs. 8%, P=.0005). Observed effects were independent of clinical or laboratory providers and clinical variables.

Conclusion: A statistically significant difference was observed for the effect of IP on the outcome of IVF-ET, though the data should be interpreted as preliminary. (J Reprod Med 2001;46:781-787)

Keywords: fertilization in vitro, embryo transfer, prayer, complementary medicine, alternative medicine

Public release date: 28-Sep-2001
Columbia University College of Physicians and Surgeons
http://cpmcnet.columbia.edu/dept/ps

Prayer may influence in vitro fertilization success

Blinded and randomized international study reveals surprising results New York, NY-Prayer seems to almost double the success rate of in vitro fertilization procedures that lead to pregnancy, according to surprising results from a study carefully designed to eliminate bias.

The controversial findings, published in the September issue of the Journal of Reproductive Medicine, reveal that a group of women who had people praying for them had a 50 percent pregnancy rate compared to a 26 percent rate in the group of women who did not have people praying for them. None of the women undergoing the IVF procedures knew about the praying.

The researchers acknowledge the results seem incredible and say unknown biological factors may be playing a role in the difference between the two groups. But they decided to go public with the results in the hope that other scientists may carry out studies to determine if the findings are reproducible and, if so, what factors might be responsible for the improved success rate in the group of women who had people praying for them.

"We could have ignored the findings, but that would not help to advance the field," says Dr. Rogerio Lobo, chairman of obstetrics and gynecology (OB/GYN) at Columbia University College of Physicians & Surgeons and lead author of the study.

"We are putting the results out there hoping to provoke discussion and see if anything can be learned from it. We would like to understand the biological or other phenomena that led to this almost doubling of the pregnancy rate."

The study, which had several safeguards in place to eliminate bias, involved 199 women planning in vitro fertilization and embryo transfers at the Cha Hospital in Seoul, Korea, between December 1998 and March 1999. A statistician randomly assigned the prospective mothers to either a prayer group (100 women) or a non-prayer group (99). Besides the women, the physicians and medical personnel caring for the women did not know a study of prayer was ongoing.

The people praying for the women lived in the United States, Canada, and Australia and were incapable of knowing or contacting the women undergoing the procedures. Which women were in which group was not revealed until the pregnancy data became available at the completion of the study. The people praying were from Christian denominations and were separated into three groups. One group received pictures of the women and prayed for an increase in their pregnancy rate. Another group prayed to improve the effectiveness of the first group. A third group prayed for the two other groups. Anecdotal evidence from other prayer research has found this method to be most effective. The three groups began to pray within five days of the initial hormone treatment that stimulates egg development and continued to pray for three weeks.

Besides finding a higher pregnancy rate among the women who had a group praying for them, the researchers found older women seemed to benefit more from prayer. For women between 30 and 39, the pregnancy rate for the prayer group was 51 percent, compared with 23 percent for the non-prayer group.

The researchers analyzed their data several ways to see if they could find other variables that would have accounted for the differences between the two groups. However, no adjustments altered the results. The group will continue to study whether its findings are genuine and, if so, what mechanisms might be at work.

Other studies have shown that prayer seems to exert a benefit for heart patients. The researchers believe theirs is the first study looking at prayer and infertility.

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None of the researchers are employed by religious organizations and were not asked by religious groups to perform the study. Dr. Kwang Y. Cha, director of the Cha Hospital and an associate research scientist at OB/GYN at Columbia University College of Physicians & Surgeons, funded the research through his hospital.
http://www.eurekalert.org/pub_releases/2001-09/cuco-pmi092801.php

The Power of Prayer in Medicine
People Who Are Prayed for Fare Better
By Jeanie Davis

Nov. 6, 2001 -- Here's more evidence that -- in medicine, as in all of life -- prayer seems to work in mysterious ways.

In one recent study, women at an in vitro fertilization clinic had higher pregnancy rates when total strangers were praying for them. Another study finds that people undergoing risky cardiovascular surgery have fewer complications when they are the focus of prayer groups.

The fertilization study -- conducted at a hospital in Seoul, Korea -- found a doubling of the pregnancy rate among women who were prayed for, says Rogerio A. Lobo, MD, chair of Obstetrics and Gynecology at Columbia University School of Medicine in New York City. His study appears in the September issue of the Journal of Reproductive Medicine.

"It's a highly-significant finding," Lobo tells WebMD. "I'm first to say we don't know what this means."

The randomized study involved 199 women who were undergoing in vitro fertility treatments at a hospital in Seoul, Korea, during 1998 and 1999. All women were selected for the study based on their similar age and fertility factors, Lobo tells WebMD.

Half the women were randomly assigned to have one of several Christian prayer groups in the U.S., Canada, and Australia pray for them. A photograph of each patient was given to "her" prayer group. While one set of prayer groups prayed directly for the women, a second set of prayer groups prayed for the first set, and a third group prayed for both groups.

Neither the women nor their medical caregivers knew about the study -- or that anyone was praying for them.

"We were very careful to control this as rigorously as we could," Lobo tells WebMD. "We deliberately set it up in an unbiased way." That meant not informing patients they were being prayed for, so it would not influence the women's outcome. Whether the patients were praying for themselves -- or if others were praying for them -- "we don't know," he says.

The women in the "prayed for" group became pregnant twice as often as the other women, he says.

"We were not expecting to find a positive result," says Lobo. Researchers have re-analyzed the data several times, to detect any discrepancies -- but have been unable to find any, he says.

Lobo admits there may be some "biological variable" that they have not discovered, which could account for the high success rate among the prayed-for women. He and his colleagues are already planning a follow-up study also involving in vitro fertilization.

The second study involves 150 patients -- all having serious heart problems, all scheduled for a procedure called angioplasty, in which doctors thread a catheter up into a clogged heart artery, open it up, and insert a little device called a stent to prop it open.

Patients who were prayed for during their procedure had far fewer complications, reports lead author Mitchell W. Krucoff, MD, director of the Ischemia Monitoring Laboratory at Duke University Medical Center and the Durham Veterans Administration Medical Center in Durham, NC.

His study appears in the current issue of the American Heart Journal.

Krucoff enrolled 150 patients who were going to have the stent procedure, and then randomly assigned them to receive one of five complementary therapies: guided imagery, stress relaxation, healing touch, or intercessory 'off site' prayer -- which meant they were prayed for by others, or to no complementary therapy.

All the complementary therapies -- except off-site prayer -- were performed at the patient's bedside at least one hour before the cardiac procedures.

Seven prayer groups of varying denominations around the world -- Buddhists, Catholics, Moravians, Jews, fundamentalist Christians, Baptists, and the Unity School of Christianity -- prayed for specific patients during their procedures.

Each prayer group was assigned names, ages, and illnesses of specific patients they were to pray for. None of the patients, family members, or staff knew who was being prayed for. None of the patient-prayer group matchings were based on denomination.

"This was a very rigorously controlled study, just as we would look at any therapeutic -- a new cardiovascular drug, a new stent -- and see the results in terms of patients' outcomes," Krucoff tells WebMD. The goal was to determine which therapies warranted further study in a bigger trial.

Those in the "prayed for" group had fewer complications than any of the patients, including those receiving other complementary therapies, he says. "Although it's not statistical proof, it's not certainty, it is suggestive -- to the point that we've already begun a phase II trial."

He has already enrolled more than 300 people in a phase II study.

Why did prayer produce the best outcome? "There are no satisfactory mechanistic explanations," he says. That's why studies that measure patients' outcomes are best for this kind of study, he says. Even if you don't understand why it's happening, at least you have something to measure -- how the patient did."

Both studies are "well-controlled," preliminary trials "providing more evidence that there's something to it all," says Blair Justice, PhD, professor of psychology and psychobiologist (mind-body medicine) at the University of Texas School of Public Health in Houston.

Justice, who has followed prayer research for several decades, reviewed the reports for WebMD.

"Research into prayer has been going on a lot longer than is reflected in mainstream journals," Justice tells WebMD. "Since the 1980s, there have been several well-controlled prospective studies, good evidence that this wasn't some product of a good imagination."

Some of the studies conducted in Europe involved nonhuman organisms -- enzyme cells, bacteria, plants, animals -- which could not be affected by other complicating factors, including faith. Groups were assigned to pray for their growth; then the prayers were reversed, and people were praying against growth. Each time, the plants responded according to the focus of the prayers.

"There seems to be something to it," he says.

While current technology does not allow researchers to understand the mechanism behind prayer -- what makes it work -- it's much like gravity and other natural phenomena that were considered mysterious forces by earlier cultures, Justice tells WebMD.

"Keppler was accused of being insane when he said tides were due to the tug of lunar gravity, even Galileo considered it to be ravings of a lunatic -- until Marconi proved the theory," he says.

"It's just like anything else, you don't have to believe in it for prayer to have an effect," says Justice.