May 3, 2012

Acupuncture and Infertility

In 2002, a fertility center in Germany published “Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproductive therapy” (Fertil Steril 77(4):721-4).   In this small study of 80 patients, those receiving acupuncture had a higher IVF pregnancy rate (42.5%) than those without acupuncture (26.3%).  Since this publication, numerous studies have been published in an attempt to ask and answer does acupuncture help and if so by what mechanism.

Many hypotheses have been proposed for acupuncture’s mechanism and nearly all of these have been prefaced with the word “may”.  Acupuncture may modulate ovarian blood flow, may increase uterine blood flow, may inhibit uterine irritability, may reduce anxiety and may modulate immune function.  A study of 34 IVF patients receiving multiple acupuncture treatments showed higher levels of cortisol and prolactin in intermittent cycle days as compared to non-acupuncture patients.  Acupuncture patients in this small study also had a higher clinical pregnancy rate (51% vs 37%) but no definitive association with increased cortisol and pregnancy could be made.  More recent evaluations pooled results of multiple acupuncture studies in a “meta-analysis”.  A Chinese study of over 5000 pooled patients (Fertil Steril March 2012 97(3):599-611) concluded that acupuncture improves live birth rate in IVF patients.  A similar meta-analysis in London of 2500 women ( BJOG 115(10):1203-13) showed no difference in pregnancy rates when using acupuncture.  A Chicago study of 168 patients randomized to acupuncture (Fertil Steril 95(2):583-7) also showed no statistically significant difference in pregnancy rates.

So, 10 years after the initial acupuncture study, where do we stand?  The general consensus is that it may help and it does not seem to hurt.  No large study showed detrimental effects of acupuncture.  There is a patient consensus that acupuncture reduced their anxiety associated with the IVF process and that alone may be cause to pursue its use.

 

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Medical Director,

Medical Director, Fertility Centers of New England