Can Acupuncture improve IVF outcomes?

In Vitro Fertilisation  and Acupuncture

Statistically you have a 25% chance of falling pregnant and staying pregnant with first cycle of IVF. It’s no wonder that women and couples turn to acupuncture to try to increase chances of conception and full-term pregnancy. Women and men can receive acupuncture prior to IVF. On the day of embryonic transfer the women may have acupuncture within an hour after the procedure. A woman may continue having acupuncture through the first trimester and until the risk of miscarriage is very low.

Outcome measures:

This meta-anlaysis of several studies from six countries has a varied treatment scope. This study chose to look at six outcomes.

Clinical pregnancy, biochemical pregnancy, on-going pregnancy, live birth, implantation rate, and miscarriage.

Using the random-effects model, pooling of the effect estimates from all of the 17 trials showed no significant difference in the clinical pregnancy outcome between the acupuncture and the control groups
(RR= 1.09, 95% confidence interval (CI) 0.94–1.26, p = 0.25). No significant differences in the biochemical pregnancy, ongoing pregnancy, implantation rate, live birth, or miscarriage outcomes were found between the acupuncture and the control groups
(biochemical pregnancy: RR = 1.01, 95% CI 0.84–1.20, p = 0.95;
ongoing pregnancy: RR = 1.20, 95% CI 0.93–1.56, p = 0.16; implantation rate: RR = 1.22, 95% CI 0.93–1.62, p = 0.16;
live birth: RR = 1.42, 95% CI 0.92–2.20, p = 0.11;
miscarriage outcomes: RR = 0.94, 95% CI 0.67–1.33, p = 0.74).

Conclusions: No significant benefits of acupuncture are found to improve the outcomes of IVF or ICSI.

More information about treatment

In this meta-analysis acupuncture was viewed as any form of acupuncture used in clinical practice. This included auricular acupuncture, laser acupuncture, electro-acupuncture and traditional acupuncture. This study chose not to conduct an analysis of outcomes for each type of acupuncture instead focusing on the IVF outcomes.

However most of the case studies report using traditional acupuncture. Some case studies had control groups with sham acupuncture or alternative treatment , for example lying down for an hour was used in one study’s control group.

Comments on study

This meta-analysis also referred to previous smaller meta-anlaysis pointing out that there were contradictory findings. For example one meta-analysis had reported acupuncture significantly improved the pregnancy rate, whilst another meta-analysis reported no significant improvement for clinical pregnancy.

This meta-analysis concludes that across all the outcomes measured in the selected seventeen trials acupuncture does not produce any significant improvement against placebo or sham.

The study recommends future large TCM theory based randomised trials are needed.

This meta-analysis highlights the challenges facing evidence based acupuncture. How do you design and complete trails that will result in conclusive evidence?

References

ingender.com (stats on IVF pregnancy)

Long-Term Effect of Acupuncture for Treatment of Tinnitus” A Randomized , Patient and Assessor Blind, Sham-Acupuncture-Controlled, Pilot Trial. The Journal of Alternative and Complementary Medicine , Vol 18, No 5, 2012 pp.429-439. Fan Qu, PhD,1  Jue Zhou, PhD,2  and Ru-Xiang Ren, MD –

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