Acupuncture has been used in China for centuries to regulate the female reproductive system. Three potential mechanisms for its effects on fertility have been postulated. Firstly, acupuncture may mediate the release of neurotransmitters, which may in turn stimulate secretion of gonadotropin releasing hormone, thereby influencing the menstrual cycle, ovulation, and fertility. Secondly, acupuncture may stimulate blood flow to the uterus by inhibiting uterine central sympathetic nerve activity. Thirdly, acupuncture may inhibit the central nervous system out flow and the biological stress response.
IVF is lengthy, expensive and stressful. Safe, low cost, adjuvant treatments to improve success rates would be beneficial to patients. Several studies have examined whether acupuncture may be one such adjuvant treatment.
The first study on the effect of acupuncture given with embryo transfer was published in 2002. It was a randomized study on 160 women undergoing IVF. Acupuncture was performed on fixed selected points before and after embryo transfer. The clinical pregnancy rate was 42.5% (34 pregnancies among 80 women) among the group treated with acupuncture compared with 26.25% (21 pregnancies among 80 women) among the control group. A statistically significant difference was demonstrated, suggesting acupuncture given at the time of embryo transfer might be beneficial.
A meta-analysis [“a study summarizing several studies of similar experimental design and study population on the same topic”] examining seven randomized controlled trials with a total of 1306 patients conducted in four different Western countries was published in 2008 from the British Medical Journal. It concluded that the effects of adjuvant acupuncture in IVF are significant and clinically relevant. An odds ratio of more than 1.65 was found, suggesting that acupuncture increased the odds of clinical pregnancy by 65% compared with the control groups. In absolute terms, the number needed to treat was 10, meaning 10 patients would need to be treated with acupuncture to bring about one additional clinical pregnancy.
However, the magnitude of the beneficial effect depended on the baseline pregnancy rate. When the analysis was restricted to the three trials with higher pregnancy rates at baseline, a smaller non-significant benefit of acupuncture was found. In other words, the added value of acupuncture was reduced. The authors concluded that further studies are warranted to investigate the relation between baseline rate of pregnancy and the efficacy of adjuvant acupuncture.
While it is still unsettled if, and how much, acupuncture could positively affect IVF success, its safety is well established. Many studies have confirmed that acupuncture performed by well trained practitioners is safe and serious adverse effects are rare.
Family Fertility Center offers on-site acupuncture, typically for IVF, before and after embryo transfer. Most patients who have been treated with acupuncture reported a positive calming effect. Dr. Lee is a licensed physician acupuncturist in the state of Pennsylvania. Our on-site acupuncture service on the day of embryo transfer eliminates the stress and hassle of traveling between offices on a day when it is critical to stay calm and relaxed.
It is beyond the scope of this writing to address the medical uses of acupuncture. For those who would like to learn more about this ancient art of healing, please visit the website at the American academy of medical acupuncture.
- Acupuncture and Infertility Treatment
- American Academy of Medical Acupuncture
- Paulus WE, et al, Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproductive therapy. Fert Steril 2002; 77 (4):721:724
- Manheimer E, et al, Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilization: systematic review and meta-analysis. BMJ 2008
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