Acupuncture is a form of traditional Chinese medicine (sometimes abbreviated as TCM). Acupuncture involves placing hair-thin needles into particular points on the body. These points, according to the Chinese tradition, run along lines of energy, or meridians. From the TCM perspective, the idea is that an imbalance of energy in the body can lead to illness, including infertility. Correcting the imbalance by stimulating particular points along the meridians is thought to improve health. Other mind-body therapies, such as meditation, yoga, guided imagery, and basic relaxation training, have been shown to help those with infertility beat stress (although not necessarily to improve pregnancy rates).
Research in Support of Acupuncture
In 2008, researchers at the Center for Integrative Medicine, at the University of Maryland’s School of Medicine, conducted a meta-analysis of several research studies on the effects of acupuncture on IVF outcomes. (A meta-analysis is a research study that gathers information from several studies and evaluates them together.) The meta-analysis considered seven trials, which altogether included 1,366 women. The researchers found that when acupuncture took place on the day of embryo transfer, statistically significant improvements were found in the rates of clinical pregnancies, ongoing pregnancy, and live births. They also found that 10 women would need to be treated with IVF and acupuncture to see one additional pregnancy. In another study published in 2002, a German fertility clinic offered 160 IVF patients who had good-quality embryos an opportunity to participate in a study on acupuncture and IVF outcomes. Half of the patients received acupuncture treatment, 25 minutes before and after embryo transfer. The control group did not receive any supportive therapy. In the acupuncture group, 34 of the 80 patients got pregnant. In the control group, 21 out of 80 got pregnant. There have been a number of other, smaller sized research studies on acupuncture and fertility. Because of their small size, the results of these studies are controversial. Just a few of the possible connections between acupuncture and fertility found in the smaller studies:
Acupuncture may improve sperm quality and counts in infertile men. Acupuncture may improve the lining of the endometrium, including increased the blood flow to the uterus. Acupuncture may help regulate hormone levels, specifically gonadotropin-releasing hormone, which in turn may improve ovulation rates. Acupuncture may help women with PCOS and anovulatory cycles. Acupuncture may help those with thyroid problems. (And problems with the thyroid can lead to problems with fertility.) Acupuncture may increase the number of follicles produced during an IVF treatment.
Questioning the Efficacy of Acupuncture
While the supportive research sounds promising, none of the studies used the so-called gold standard for research—randomized, double-blind placebo trials. Also, many of these studies were too small to be considered definitive. For example, all the research studies on male infertility and acupuncture involved just 10 to 20 patients. Other research studies have failed to achieve similar results showing that acupuncture for infertility is effective. A 2009 study led by Alice Domar, a proponent of the mind-body fertility connection, looked at the effect of acupuncture on IVF outcomes. In this study, 150 IVF patients awaiting embryo transfer were included. Subjects were randomly assigned to the control group or acupuncture group, and the IVF staff was “blind” to who was receiving the acupuncture treatments. The acupuncture group received treatment 25 minutes before and after embryo transfer. They also filled out forms asking about their anxiety and feelings of optimism. Another study, this one conducted in 2007 by Dr. LaTasha B. Craig at the University of Washington, found that acupuncture treatment on the day of embryo transfer actually decreased the rate of pregnancy. In this study, high embryo quality was not required for inclusion in the study. Similar to previous studies, the acupuncture treatment took place 25 minutes before and after embryo transfer. However, it took place outside of the fertility clinic. In this study, those who received acupuncture treatment had a 46% clinical pregnancy rate, compared to 76% rate for those who did not receive treatment. The live birth rate for the acupuncture treated patients was 39%, compared to a 65% live birth rate those not treated with acupuncture. Dr. Craig theorizes that driving to and from the acupuncturist may have increased the levels of stress, leading to the lower pregnancy rates.
Where the Debate Stands
There is some evidence that acupuncture performed on the day of embryo transfer may improve chances of success. However, acupuncture performed at other times during treatment, and acupuncture performed without IVF treatment, may or may not make a difference. The research is conflicting and unclear. Still, the relaxation response to acupuncture treatment is undisputed. Even in studies where acupuncture didn’t improve pregnancy rates, researchers noted that the patients were more relaxed and more optimistic after treatments. Given the high levels of stress couples go through during fertility treatments, a little relaxation and lowered stress brought on by acupuncture treatment probably won’t hurt, and it may even help.
