Effects of acupuncture on rates of pregnancy and
live birth among women undergoing in vitro
fertilisation: systematic review and meta-analysis:
Manheimer E, et.al. British Medical Journal
2008 Feb 7; [Epub ahead of print]
- This was a meta-analysis looking at all the available, high quality acupuncture research. When taking all
factors into account the investigators found that "acupuncture increased the odds of
clinical pregnancy by 65% compared with the control groups." What the authors did not
mention was that the analysis was biased AGAINST acupuncture (see the upcoming June 2008 issue of
the Journal of Chinese Medicine for a publication written by Judith Balk, MD, MPH and
Brandon Horn, PhD, JD, LAc for detials). Therefore, the true effects of acupuncture are
even higher than this.
A Pilot Study Evaluating the Combination of
Acupuncture with Sildenafil on Endometrial Thickness: Yu et.al. Presented at the Pacific Coast
Reproductive Society Meeting 2007 Apr 20.
- This was an interesting study utilizing a dynamic acupuncture protocol that
changed according to the patients'individual needs. Participants in the
study all had poor uterine linings in prior cycles (less than 8 mm). Although
it was only a pilot study, all subjects achieved lining thickness of 10 mm or
greater. Lining thicknesses of 8mm or less have been shown to have
substantially lower pregnancy rates than those over 9mm so this is a very
significant finding and may be another mechanism by which acupuncture is
improving pregnancy rates.
Acupuncture and IVF: New Evidence for an Unlikely
Duo. Horn, B. Alternative Therapies in Women's
Health. 2007 Vol. 9(2)81-88.
- This is an excellent article :-) that analyses the current acupuncture literature related to IVF.
It points out a number of fallacies that have been perpetuated by commentators that are not
familiar with acupuncture. When filtering out studies that had improper study design or
improper use of acupuncture (such as the use of acupuncture points that are contraindicated
during pregnancy), this article certainly reinforces others that properly conducted
acupuncture can greatly improve IVF outcomes.
Effect of acupuncture on the outcome of in
vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled
clinical study.: Dieterle S, et.al.Fertility and Sterility 2006; Vol. 85: 1347-51
- This is the most recent study once again demonstrating that acupuncture increases
ongoing pregnancies by 106% when compared to control subjects.
It is important to emphasize that getting pregnant is only part
of the story. We want HEALTHY pregnancies. To have the best chances to
achieve a healthy pregnancy requires a comprehensive approach to your health. We
cannot emphasize how important addressing your health comprehensively is for giving
your baby the best chance at having a healthy and happy life.
Acupuncture on the day of embryo transfer significantly improves the reproductive
outcome in infertile women: a prospective,randomized trial: Westergaard LG,
et.al. Fertility and Sterility 2006 Apr 4; [Epub ahead of print]
- This study once again demonstrates that properly applied acupuncture results in
IVF ongoing pregnancy increases of over 60%.
Influence of acupuncture stimulation on pregnancy rates for women undergoing
embryo transfer.: Smith C, et.al.Fertility and Sterility 2006 Apr 4; [Epub
ahead of print]
- This study examined 228 IVF patients. The group that received true acupuncture showed improvements
in ongoing pregnancies of over 50% compared to subjects that received a sham acupuncture treatment.
This is very clinically significant, though it did not rise to the level of
statistical significance.
Positive effects of acupuncture in ART are not mediated by changes in ovarian and endometrial production of estradiol,
progesterone, and placental protein 14: Westergaard LG, et.al.Fertility and Sterility 2006 Apr 4;
[Epub ahead of print]
- This is a discussion of the use of acupuncture in IVF relative to the authors' most recent study.
Though they are not exactly sure how it is working, the authors state: "The present data corroborate previous studies
demonstrating a significant beneficial effect of acupuncture in IVF"
Influence of Acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy: Paulus, et.al.
Fertility and Sterility Vol: 77, No. 4, APRIL 2002
- This landmark study published in one of the most prestigious medical journals in reproductive medicine demonstrated that women
undergoing acupuncture treatments had an increase in ongoing pregnancy rates of over 60%, compared to control subjects
that did not receive acupuncture.
A Randomized, Double-Blind, Controlled Cross-Over Study Evaluating Acupuncture as an Adjunct to In-Vitro Fertilization:
Quintero et.al.Fertility and Sterility Vol: 81, Supplement 3, April, 2004
- This was a pilot study where researchers used a completely different acupuncture protocol than the Paulus protocol, but found that
in addition to duplicating the 60% increase in ongoing pregnancies of the Paulus study, there was a 180% increase in
implantation rates and a significant reduction in the amount of gonadotrophins used (for an average cost
savings greater than the cost of acupuncture for the cycle).
Acupuncture & IVF poor responders: a cure?: Magarelli et.al. Fertility and Sterility Vol: 81, Supplement 3, April, 2004
- This was an interesting retrospective study that found a significant increase in IVF pregnancy rates with acupuncture (40% increase). Though these increases were not as high as in the Paulus and Quintero studies, this study did not have exclusion
criteria. Of particular interest in this study was that poor responders that received acupuncture had the same pregnancy rates as
normal prognosis patients. In this study, poor responders were defined as those with elevated Peak FSH, longer history of
infertility or poor sperm morphology.
A matched controlled study to evaluate the efficacy of acupuncture for improving pregnancy
rates following in-vitro fertilization - embryo transfer.Wang et al. Fertility and
Sterility Vol: 83, issue 5, Supplement ,May 005
- This study further demonstrates the importance of proper acupoint selection and
proper administration of acupuncture protocols. The point protocol in this study
varied greatly from previous studies that demonstrated positive pregnancy outcomes.
This particular acupoint selection did not produce any increases in pregnancy rates.
Ovarian blood flow responses to electro-acupuncture stimulation at different
frequencies and intensities in anaesthetized rats: Stener-Victorin et.al. Auton
Neurosci. 2003 Oct 31;108(1-2):50-6.
- This study demonstrated that acupuncture can significantly increase ovarian blood flow
It also demonstrated that, even using the same acupuncture protocol, by a small
modification in manipulation, you get the exact opposite effects. That is, you can
decrease the ovarian blood flow. This study, therefore, is very important to
illustrate the importance of using acupuncturists that have very thorough
training in both acupuncture and infertility. Unfortunately, most patients are unaware of
this and many medical professions practice acupuncture with as little as a weekend
course. You should look for an acupuncturist that has extensive training (in California,
for example, Licensed Acupuncturists must complete a four year program of study). It
is best to find an acupuncturist with specialized training in infertility. If you
are undergoing IVF, it is imperative that your acupuncturist have significant
experience with the IVF process. IVF is a subspecialty and there are many issues that
will not be apparent to those without significant experience with IVF.
Auricular acupuncture in the treatment of female infertility: Gerhard et.al. Gynecol
Endocrinol 1992 Sep;6(3):171-81
- This study compared acupuncture to standard hormone therapy in the treatment of infertility. For women with
menstrual irregularities (a subgroup of the patients in the study), acupuncture increased
pregnancies by 28% over hormone therapy. There were no side effects in the acupuncture
group but there were in the hormone group. Taking all women in the study into account,
combined acupuncture and hormone therapy achieved the best results, producing 10% more
pregnancies than hormone therapy alone.
Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture:
Stener-Victorin et.al. Hum Reprod. 1996 Jun;11(6):1314-7
- Successful in-vitro fertilization (IVF) and embryo transfer require optimal endometrial receptivity at the
time of implantation. The amount of blood flow to the uterus is considered valuable in
assessing endometrial receptivity. This study showed that acupuncture treatments performed
twice per week for four weeks significantly increase blood flow to the uterus and may
explain one mechanism for the substantial increases in pregnancies when acupuncture is
incorporated.
Clinical studies on the mechanism for acupuncture stimulation of ovulation: Mo et.al. J Tradit
Chin Med 1993 Jun;13(2):115-9
- This study examined the effects of acupuncture on stimulating ovulation and regulating ovulatory
problems. The researchers concluded that acupuncture seems to increase progesterone
levels and regulate FSH, LH and E2 levels. This study involved 30 acupuncture treatments
and had an 82.35% effective rate.
Effect of acupuncture on sperm parameters of males suffering from subfertility related to low
sperm quality: Siterman et.al. Arch Androl,39(2):155-61 1997 Sep-Oct
- This study demonstrated that acupuncture can increase both sperm quality and quantity
Effects of acupuncture and moxa treatment in patients with semen abnormalities. Gurfinkel
et.al. Asian J Androl. 2003 Dec;5(4):345-8
- This study showed that men receiving acupuncture had significant increases in the percentage of
normal-form sperm relative to controls.
Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for
idiopathic male infertility. Pei J. et.al. Fertil Steril. 2005 Jul;84(1):141-7.
- This study showed that men receiving acupuncture had statistically significant improvements in sperm
morphology.
The pain-relieving effect of electro-acupuncture and conventional medical analgesic methods during
oocyte retrieval: a systematic review of randomized controlled trial.Stener-Victorin E. Hum Reprod.
2004 Nov 11
- This review demonstrated that acupuncture analgesic effects are equal to conventional analgesic medication
for oocyte retrieval. This is an important alternative for patients who are allergic or
sensitive to analgesic medications.
Possibilities of therapy by ear acupuncture in female sterility. Gerhard, et al. Geburtshilfe
Frauenheilkd. 1988 Mar;48(3):165-71.
- A simple application of ear acupuncture was shown to be as effective as drug therapy in improving
fertility.
Acupuncture for reproductive disorders. Lin J. et al. Probl Vet Med. 1992 Mar;4(1):155-61.
- This article notes the excellent results achieved in improving reproductive outcomes with mammals and
proposes that acupuncture influences the hypothalamic-pituitary-gonadal axis as well as
steroidogenesis.
Controlled study on acupuncture for treatment of endocrine dysfunctional infertility Yang JR, et. al.
Zhongguo Zhen Jiu 2005 May;25(5):299-300
- In this study, acupuncture was compared to Clomid administration in the treatment of
endocrine dysfunction infertility. The study found acupuncture to have significantly higher
pregnancy rates than Clomid administration (65% versus 45%). The study concluded that
acupuncture is an effective treatment for infertility secondary to endocrine dysfunction.
Clinical observation and study of mechanisms of needle-picking therapy for primary infertility of
abnormal sperm. Dong C, et al. Zhongguo zhen jiu 2006;26:389-91
- Although the actual abnormalities of the sperm were not mentioned in the abstract,
this study is important to show how acupuncture can lower cadmium levels and
increase activity of superoxide dismutase. It can also increase zinc levels in semen.
The researchers stated that they achieved an effective rate of 83.5% and a subsequent
pregnancy rate of 78.8%.
