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Infertility

Our Infertility Support forum is a space to connect with others in the same position, discuss causes, treatment and IVF, and share infertility stories of hope and success.

Evidence for / against acupuncture alongside fertility treatments

2 replies

OstrichRunning · 22/06/2017 10:45

I'm due a second FET in a few weeks. Recently, I've spent a bit of time trying to get my head around what the good quality evidence on acupuncture and fertility is telling us, because the whole thing seems so damned woolly and unclear. Anyway, I thought it might be an idea to start a thread on the subject - it might be useful for anyone trying to make up their mind as to whether or not to acupuncture alongside IVF etc.

Please don't give anecdotal/personal experiences here - the internet is full of them! Just links to recent studies.

Here's what I've picked up so far.

NHS The NHS Knowledge Service reviewed a 2007 study of efficacy of acupuncture that got a lot of press coverage; it showed higher rates of pregnancy and live birth for those that had acupuncture on the day of embryo transfer. This was a systematic review of randomised controlled trials - so good quality evidence. The NHS article concludes that it does suggest a benefit, but maybe not as much as might first appear to be the case:

'The results of this review suggest that acupuncture has a positive effect of pregnancy rates when given with IVF. An interpretation of the 65% benefit quoted by the papers must be considered in light of the fact that they represent relatively small absolute benefits considering that the rates of pregnancy in the non-acupuncture groups were high.'
See article here

NICE guidelines According to the NHS, the NICE guidelines currently only recommend acupuncture for headaches and migraines, so not for fertility. (NICE used to recommend acupuncture for lower back pain but stopped doing so last year after new evidence showed it was no better than sham treatments - see here)

Cochrane review A 2013 Cochrane review, where they systematically assess all the existing primary research in a field and then review the good quality research, asked: 'does acupuncture improve the outcomes of assisted reproduction?' They concluded:

'There is no evidence of benefit for the use of acupuncture in participants undergoing assisted conception treatment around the time of embryo transfer or at egg collection in terms of improving the live birth rate, ongoing or clinical pregnancy rate. There is also no evidence that acupuncture has any effect on miscarriage rate or had significant side effects.'

They also called for more research, as the methods and quality of research are v mixed in this field.

WHO - In 2003, WHO published a review of the evidence re acupuncture generally (so quite dated) pdf here The only mention in it that I could find regarding fertility is 'Although acupuncture was reported to be effective in the treatment of female anovular infertility (156), no methodologically sound, controlled trials have been reported.'

And: ' Acupuncture is also worth trying in the treatment of female infertility due to inflammatory obstruction of the fallopian tubes, where it seems to be superior to conventional therapy with intrauterine injection of gentamicin, chymotrypsin and dexamethasone (158).'

This report lists female infertility as a 'condition for which the therapeutic effect of acupuncture has been shown but for which further proof is needed'.

The US-gov agency NCCIH has a page on acupuncture in general here. It says 'research suggests that acupuncture can help manage certain pain conditions, but evidence about its value for other health issues is uncertain'.

OP posts:
OstrichRunning · 22/06/2017 10:46

Sorry, forgot to add link to Cochrane Review

OP posts:
OstrichRunning · 22/06/2017 12:25

Also, Mumsnet did a Q&A with Sense about Science on fertility claims, I think in 2014. Here are the expert answers on acupuncture and IVF:

'In 2010 the British Fertility Society published a review of the existing data/publications and found no evidence that acupuncture has a positive effect on the outcome of IVF. Another review published in 2012 saw no clear benefit, but found that the type of clinical trial influenced the outcome. In any case, it is difficult to say with any conviction that acupuncture has a direct influence on the outcome of IVF.'

'The evidence is conflicting and rather weak. Some studies have found a benefit but others have found that it is not helpful. One study compared real acupuncture with sham acupuncture and found no benefit of sticking the needles in the right place. Indeed an article published in Human Reproduction in 2009 found that placebo or sham acupuncture had a higher pregnancy rate than real acupuncture. Clearly acupuncture can produce strong placebo effects. The perceived benefit of acupuncture may lie with the stress reduction and relaxation it can induce.'

'Acupuncture aids stress management and stress has been associated with unexplained infertility (via raised prolactin and cortisol levels). The frequency of unexpected pregnancies that occur when couples give up fertility treatment and go on holiday are good evidence for this.'

God help me I am an awful nerd.

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