Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis

Qian Y et al, 2016  Arch Gynecol Obstet Dec p 1-16

Archives of Gynecology and Obstetrics

Data from nearly six and a half thousand women undergoing IVF reveals that acupuncture improves pregnancy rates especially when it is carried out in the stimulation phase of the IVF cycle when the follicles are developing (compared to acupuncture applied only on day of embryo transfer). In general studies carried out in Asia using electro acupuncture showed a stronger trend to improved IVF outcomes than did non Asian studies that did not use electro-acupuncture.

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The Role of Acupuncture in in vitro Fertilization: A Systematic Review and Meta-Analysis

Shen C et al, 2015 Gynecol Obstet Invest 79:1-12

Gynecological and Obstetric Investigations

 

A review of 21 Randomized Controlled trials (that included nearly 5,500 patients) concluded that while acupuncture administered to IVF patients only at the time of embryo transfer did not confer any significant advantage, acupuncture administered during the IVF cycle stimulation phase and/or during implantation phase in addition to treatment at the time of transfer showed  significant improvement in pregnancy rates.

 

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Can Chinese Herbal Medicine Improve Outcomes of In Vitro Fertilization? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Acupuncture-Pregnancy-478Huijuan Cao et al, PLOS one, 2013, Vol 8, 12, e81650

PLOSone

This collaboration between China and the UK analysed 20 eligible randomised trials that looked at the effect of Chinese herbal medicine taken during IVF cycles. Most IVF clinics in the west discourage the use of herbs during IVF, so the 20 trials used in this meta-analysis came from IVF clinics in China, and were reported in Chinese medical journals.The combination of Chinese herbal medicine with IVF significantly increased the pregnancy rate, though the authors express concern about a risk of bias since reporting and analysis requirements are different in Chinese journals. Hence further large RCTs are warranted.

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Evaluating research information on practitioner websites describing the use of acupuncture as an adjunct to IVF

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Fogarty S and Smith C, 2015 Eur Jnl Int Med, 429, pg 1876

European Journal of Integrative Medicine

 

Infertility patients in general, and IVF patients in particular, are a group who are vulnerable to false or inaccurate claims made by medical specialists or practitioners of various therapies. This survey analysed 112 acupuncture websites for claims made relating to fertility and IVF,  and found all but one sadly lacking in accuracy and correct representation of research findings and appropriate clinical therapies. The website you are reading now however, was found to be balanced and reasonable in its representation of Chinese medicine treatment of fertility and IVF patients based on research findings.

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Chinese herbal medicine for female infertility: an updated meta-analysis

Acupuncture-Pregnancy-320Reid K, Comp Ther Med, 2015 Feb;23(1):116-28

Complementary Therapies in Medicine

Chinese medicine compares favourably with pharmaceutical treatment for infertility according to this meta-analysis, which summarises the findings of 40 trials involving more than 4000 patients. The author concludes that management of female infertility with Chinese herbal medicine can improve pregnancy rates 2-fold within a 3-6 month period compared with Western medical fertility drug therapy.

 

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Acupuncture and women’s health: an overview of the role of acupuncture and its clinical management in women’s reproductive health

Cochrane S et al, March 2014 Volume 2014: 6 Pages 313—325
International Journal of Women’s Health

In a thorough and balanced review, a team of researchers from Australia analyse acupuncture and fertility trials from more than 100 reports from around the world. They note that while many trials have looked at acupuncture performed on the day of embryo transfer in IVF cycles, few have looked at how Chinese medicine is usually practiced, and has been practiced for many hundreds of years, in the treatment of infertility in general.  There is some evidence of the effect of acupuncture on menstrual health in general, but more needs to be done researching the treatment of infertility with individualised chinese medicine protocols.

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Acupuncture and assisted reproductive technology

Cheong Y et al, 2013 Cochrane Database Sys Rev.

Cochrane Database of Systematic Reviews

An updated Cochrane review of acupuncture administered either at the time of egg collection or at the time of embryo transfer found no benefit in terms of pregnancy rate or of live birth rate. Analysis of sub groups note that live birth rate improved with acupuncture when compared to no treatment control group (but not compared to sham treatment control group).

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The Effects of Acupuncture on Rates of Clinical Pregnancy among Women undergoing In Vitro Fertilization: a Systematic Review and Meta-analysis

Manheimer E et al, Hum. Reprod. Update (2013) online doi: 10.1093/humupd/dmt026 

Human Reproduction Update

An updated meta-analsyis found no overall benefit of acupuncture at the time of embryo transfer, but did find a benefit when the control group pregnancy rate was low. Read More

A systematic review on use of Chinese medicine and acupuncture for treatment of obesity

Sui Y et al, 2012, Obesity Rev, Vol 3, p 409–430
Obesity Reviews

This systematic review (which is not specific to obesity only in PCOS patients) collected data from RCTs that examined the effect of acupuncture and/or Chinese herbal medicine on nearly 5000 overweight patients, compared with a control group of nearly 4000 overweight subjects. The review reports that in terms of weight loss, acupuncture and Chinese herbal medicine are better than placebo and lifestyle interventions and have similar efficacy to anti-obesity drugs (including Metformin), but with fewer side effects. This review also noted that those who used acupuncture or Chinese herbal medicine to lose weight had a lower risk of relapse. More large RCTs are recommended before recommendations for therapeutic interventions can be made.

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Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis

 Zheng CH et al, 2012 Fert Steril, Vol. 97, Issue 3, 599-611
Fertility and Sterility 

Researchers from China analysed results of nearly 6000 women participating in trials examining the effect of acupuncture during IVF. They found that pregnancy rates and birth rates were improved by acupuncture when compared to women having no acupuncture (but not when compared to women having placebo acupuncture with a non penetrating needle).

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The Role of Acupuncture in Assisted Reproductive Technology

 Zheng CH et al, Evid Based Complement Alternat Med. 2012; vol 2012: 543924.
Evidence Based Complementary and Alternat Medicine

This review represents another analysis by the same team who also published their results in Fertility and Sterility 2012 (see above). In this review they emphasise that the effects of administering individualised acupuncture treatments throughout the IVF cycle rather than just at the time of embryo transfer, produces higher pregnancy rates.

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Chinese Herbal Medicine for Infertility with Anovulation: A Systematic Review

Li Tan et al, Jnl Alt Compl Med, 2012, 18(12): 1087-1100

The Journal of Alternative and Complementary Medicine

A meta-analysis of studies done in China involving 1659 women, reports that Chinese medicine significantly increases frequency of ovulation in women with anovulatory infertility compared to treatment with Clomiphene (Clomid). They observe that pregnancy rates are increased and miscarriage rates reduced in women who use Chinese medicine compared with those who use Clomid. However more randomized controlled trials are needed before evidence-based recommendations regarding the effectiveness and safety of Chinese medicine for infertility with anovulation can be provided. Read More