Acupuncture for infertility is probably the most popular and commonly recognized alternative treatment for those trying to get pregnant. The media seems to report on research related to acupuncture and fertility every few months, and more and more fertility clinics offer or recommend acupuncture services along with conventional fertility treatments like IVF and IUI.
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 these energies in the body can lead to illness, including infertility. Correcting the imbalance by stimulating particular points along the meridians is thought to improve health.
Given all the hype and excitement over acupuncture and infertility, you might think that the benefits have been well documented.
However, that's not exactly so. Some studies have shown improved pregnancy rates for those who try acupuncture, while other studies have shown no or non-statistically significant results.
What's all the Fuss About?
Researchers on either side of the issue agree that acupuncture is generally harmless, and just about everyone agrees it enhances relaxation, lowers stress levels, and increases beta-endorphins - the feel good, pain-busting hormones.
If it can't do any harm, why invest so much time and research into the issue? Why not send everyone for acupuncture treatment?
Well, if acupuncture really can improve pregnancy rates, then acupuncture treatment should be included as a matter of protocol when treating infertility. Doctors should encourage patients to see an acupuncturist for treatments, and insurance companies should also be willing to foot some of the bill (if they cover fertility treatments at all).
While not inexpensive, acupuncture is certainly less expensive than many fertility treatments. If acupuncture could help couples get pregnant, while spending less money, less time, and risking less side effects (assuming they'd need less help from conventional medicine), then of course acupuncture should be moved out from the "alternative" realm and into the mainstream.
However, if acupuncture cannot be shown to improve fertility rates, then the treatment shouldn't be automatically incorporated into Western medicine's approach to infertility.
Acupuncture isn't the only method of achieving relaxation, and while doctors should help their patients when it comes to stress reduction, pushing acupuncture over other methods would be uncalled for. Meditation, yoga, guided imagery, and basic relaxation training can help those with infertility beat stress, and for far less cost than acupuncture treatments.
Plus, when a fertility doctor - or any doctor, for that matter - recommends a treatment, the patient assumes the recommendation is backed up by evidence-based research. Before recommending acupuncture to patients, doctors want to be sure they are suggesting a treatment that will really help, and not just waste time, money, or provide a false sense of increased hope.
In Support of Acupuncture
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 all together 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 woman would need to be treated with IVF and acupuncture to see one additional pregnancy.
In another study, often referred to as the "German study," 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.
Controversy and Ambiguity
While the supportive research looks great, critics claim that the studies are less than sufficient to show a true connection between acupuncture and improved pregnancy rates. None of the studies have 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 anywhere from 10 to 20 patients. Not nearly enough to judge the effectiveness of the results.
Perhaps most importantly, other research studies have failed to achieve similar results. A research study led by Alice Domar, a big 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 into 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. The acupuncture group reported feeling less anxious and more optimistic than the control group. However, unlike the "German Study," this study did not find any improvement of pregnancy rates.
Another study, this one conducted by Dr. LaTasha B. Craig while she was with 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.
The acupuncture method was the same one used during the German Study, with treatment 25 minutes before and after embryo transfer. However, unlike the German Study, acupuncture treatment took place somewhere besides the fertility clinic. This is more realistic, considering that few fertility clinics offer acupuncture treatment onsite.
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 It Stands
There does seem to be evidence that acupuncture performed on the day of embryo transfer may improve your chances of success. Maybe, if you don't get stressed driving to and from the acupuncturist.
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.
But that doesn't mean acupuncture is without merit. Further research is needed, and no one is saying that acupuncture absolutely makes a difference, or definitely doesn't. Not yet, anyway.
Plus, 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.
More on acupuncture and infertility:
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