.png)
Research into the effectiveness of Acupuncture alongside medical reproductive technologies IVF, IUI, ICSI
Can acupuncture treatment improve the success rate of In Vitro Fertilization? (IVF)
It’s a tricky question because it’s hard to prove but after reading the literature and from personal experience in clinic, I think it can and here’s why!
The randomised controlled trial by Paulus et al (2002) found positive results from acupuncture treatment alongside the IVF protocol, sparking the interest of fertility clinics and acupuncturists alike. This study encouraged many more studies, called randomized controlled trials (RCT's) on the topic providing a rich source of literature for us to draw on.
Subsequent studies found that there is some evidence to support the efficacy of acupuncture treatment alongside IVF, but most researchers agree larger scale studies need to be done to prove this conclusively. (Anderson, B., Rosenthal, L. (2007)). The problem with randomized controlled trials is that they are not good indicators of acupuncture’s success. Better designed studies are needed, such as “case studies”, which are qualitative in nature and well suited to clinical practice. However, they are not as respected by the medical community so until views change, we are stuck with RCT’s.
"Where there is much desire to learn, there of necessity will be much arguing, much writing, many opinions. For the difference of opinion in good people is but knowledge in the making." - Milton
A new problem developed!As studies continued a new invention was added into RCT's. The new control was the "fake needle" which produced a prick to the skin but went no deeper. Unfortunately this has turned out to be a poor control as the needle does affect the patient. There are many brands of this fake needle but one used is called the "Streitberger" needle as this next meta analysis shows. "Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis." Zheng CH, Huang GY, Zhang MM, Wang W. Fertil Stertil. 2012 April:97(4):1017. Researchers found if they used the studies with the fake needle there was poor evidence of acupuncture effect but when they excluded the fake needle (the Streightburger needle) an acupuncture effect was noticed.CONCLUSION(S):Acupuncture improves CPR and LBR among women undergoing IVF based on the results of studies that do not include the Streitberger control. The Streitberger control may not be an inactive control. More positive effects from using acupuncture in IVF can be expected if an appropriate control and more reasonable acupuncture programs are used.
A brief history (very) on IVFThe first baby born as a result of in vitro fertilisation was Louise Brown in England in 1978. New Zealand’s first IVF cycle was undertaken on July 23rd 1983 at National Women’s and the first pregnancy occurred soon after.Fertility Clinics in New Zealand are accredited by the Reproductive Technology Accreditation Committee (RTAC) and peer reviewed by the Fertility Society of Australia. Pregnancy and cycle data must also be sent to ANZARD for audit purposes.Reasons for offering in vitro fertilization include tubal infertility, endometriosis, unexplained infertility, male factor and ovulatory disorders.IVF involves stimulating the ovaries to produce more than one egg, egg collection, addition of sperm to the eggs, fertilization assessment and subsequent embryo culture, transfer and freezing.
Acupuncture on the day of embryo transfer significantly improves the reproductive outcome infertile womenWestergaard, L., Mao, M., Krogslund, M., Sandrini, S., Lenz, S., and Grinsted, J.(2006) Acupuncture on the day of embryo transfer significantly improves the reproductive outcome infertile women: a prospective randomized trial)They evaluated the effect of acupuncture on the reproductive outcome of IVF patients treated on the day of egg transfer (ET) and two days after. They concluded that, like the Paulus study (Paulus et al (2002)) acupuncture treatment on the day of ET improves reproductive outcome.
Unfortunately, this study did not support (luteal phase acupuncture) where acupuncture was done two days post transfer. Perhaps some design flaws here, as I have found good results and certainly use different acupuncture points to this study.
(Dieterle S., Ying, G., Hatzmann, W., Neur, M. (2006). Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study) research was also designed to determine the effect of acupuncture after ET and luteal-phase acupuncture with their results supporting acupunctures efficacy in both scenarios.
Some other RCT’s include (Magarelli et al (2008)), (Manheimer et al (2008)), (Smith et al(2002)), (Westergaard et al, (2006)), Paulus et al(Steiner-Victorian et al (1999)) (Steiner-Victorian et al (1999)) (Ho et al (2009)), (Ng et al (2008)), (Cheong et al (2009)).
One study was looking at inducing ovulation (Steiner-Victorian et al (2000) and the other thirteen studies were looking at increasing the pregnancy rate ( Wang et al (2007)), (Anderson et al(2007)), (Johnson, D. (2006)), (Westergaard et al, (2006)), (Dieterle et al (2006)),(Magarelli et al (2008)), (Manheimer et al (2008)), (Smith et al(2002)), (Westergaard et al, (2006)), (Paulus et al(2002)),(Steiner-Victorian et al (1999)) (Steiner-Victorian et al (1999)) (Ho et al (2009)), (Ng et al (2008)), (Cheong et al (2009))Some of this literature can be accessed freely as full free texts and others need to be purchased from journals. The databases searched were PubMed, Cochrane and National Centre for Complementary and Alternative Medicine (NCCAM).From these databases, eighteen relevant studies were found using the keywords: “acupuncture”, “in vitro fertilization”, “IVF”, “assisted reproduction”, “embryo transfer”, “E.T”, “pregnancy rate”, and “clinical trial”. The papers were restricted to females of reproductive age, published in English.
Sixteen of these studies were found in Pubmed, seven were published in the journal Fertility and Sterility , eight were from Europe and five from USA and six were meta-analysis studies. Of the eighteen studies, fourteen were published over four years (2006-2009).Ten of the studies described acupuncture as useful, seven found no statistical improvement and one study was inconclusive. Only one meta-analysis used research from China. About half of the studies used ninety subjects or less.The studies I found included a large cross section of researchers. Only two researchers had published twice on the topic.All of the studies were randomized controlled trials.
To date, acupuncture research trials have focused on the time frame 30 minutes before and after embryo transplant (ET). I think we can conclude from these studies that at the minimum acupuncture is safe around this time and has even proven to help with the IVF process. However, acupuncture was never meant to be a one-off procedure. To get the full benefits of acupuncture and other modalities used such as herbs, supplements and lifestyle changes the woman and sometimes her partner need to have weekly sessions for a minimum of three months.
To view any of the above literature you can visit the Acupuncture Health Clinic, where they are available in hard copy form.
If you would like more information on acupuncture alongside IVF please don’t hesitate to call or email Angelique 021 2034 203 or angelique@xtra.co.nz
This article was written by Angelique and contains her ideas and research. It is not meant to be scholarly but rather providing insights that might be useful to the patient in navigating the literature of Medical and Acupuncture interventions in getting pregant and having a baby.
Article reviewed 24/6/2023
Bachelor of Health Science (BHSc) includes a 4 yr full-time degree in Chinese Medicine
Hours
Closed weekends and Public Holidays
To see available times please click the booking link above.
Phone:
Email:
Address:
182 Mt Albert Rd, Sandringham, Auckland 1025
* Indicates required field