Effect of acupuncture vs sham acupuncture on live births among women undergoing in vitro fertilization: a randomized clinical trial

Caroline Smith et al, JAMA, 2018 DOI: 10.1001/jama.2018.5336

Journal of the American Medical Association.

 

848 women at 16 different IVF centres in Australia and New Zealand were given acupuncture (with real or sham needles)  by 80 different acupuncturists. A standardised protocol was delivered on Day 6 of the stimulation phase and another at some point before and after the embryo transfer. The data indicated that at this dose of acupuncture, and using these protocol points, there was no significant difference in live births between those who received the real or the sham needles.

The authors admit that ” the lack of frequent treatments was a limitation of our trial” since in real clinical practice acupuncture treatment is individualised with variation in dosing, including more frequent treatment prior to and during the IVF cycle.

They also noted that while a very short course of acupuncture may statistically be no better than sham at improving live birth and pregnancy outcomes, a psycho-social benefit from acupuncture was reported by women undergoing IVF.

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Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin. A randomized controlled trial.

Gaudernack LC1, Forbord S, Hole E    ,  2006;85(11):1348-53.

Acta Obstetrica Gynecologica Scandinavia

Labour times were reduced in women who’s waters had broken if they had acupuncture. There was also significant reduction in the need for oxytocin infusion to augment labor if acupuncture was administered.

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The effectiveness and safety of acupuncture for poor semen quality in infertile males: a systematic review and meta-analysis

Ui Min Jerng et al

Asian J Androl. 2014 Nov-Dec; 16(6): 884–891

This review looks at a selected number of RCTs that examined the effect of acupuncture on sperm motility and count, but not morphology. From the 4 trials they examined, they report that motility and sperm concentration were significantly increased in the acupuncture groups (If trial designs are heterogeneous, as they were in this meta analysis, it makes it more difficult to draw firm conclusions at this stage).
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ACUPUNCTURE, HERBS AND MISCARRIAGE: Systematic Review of Chinese Medicine for Miscarriage during Early Pregnancy

Lu Li et al, Volume 2014 (2014), Article ID 753856
Evidence-Based Complementary and Alternative Medicine

 

Chinese data bases were screened for published studies on the effect of chinese herbal medicine on threatened miscarriage. While more than 300,000 papers were found, the trials generally did not meet the clinical research standards that would be required in the west. That said, it is not always easy or ethical to carry out placebo controlled randomised trials with pregnant women who are worried about miscarrying. Meta-analysis of some of the clinical trials indicated that Chinese medicines alone or Chinese medicines combined with Western medicines were more effective than Western medicines alone to treat threatened miscarriage in relieving the clinical signs, including vaginal bleeding, low back pain, and abdominal pains.

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ACUPUNCTURE, HERBS AND PCOS: Autonomic nervous system activation mediates the increase in whole-body glucose uptake in response to electroacupuncture

Foundation of American Experimental Biology Journal

 

Applying just one session of low frequency electroacupuncture has been shown to reduce blood sugar in overweight women with PCOS. This adds to the mounting evidence we have that indicates that electroacupuncture is a valid and desirable treatment option for PCOS patients trying to improve their ovary function and fertility.

 

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Herbal Medicines for Treating Metabolic Syndrome: A Systematic Review of Randomized Controlled Trials

Jang et al, Evid Based Complement Alternat Med. 2016;2016:5936402

Evidence Based Complementary and Alternative Medicine

 

One of the main concerns with PCOS is elevated insulin levels and abdominal obesity.  A reduction in these is correlated with better ovary function in patients with PCOS.

This review examined the effect of Chinese herbs on such parameters and concluded that they were an effective treatment.

 

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Electroacupuncture for reproductive hormone levels in patients with diminished ovarian reserve: a prospective observational study

Yang Wang et al, 2016, BMJ Acup Med, Vol 34, Issue 5

BMJ Acupuncture in Medicine

 

This study from Beijing examined the effect of electro-acupuncture on women who were diagnosed with poor ovarian reserve, indicated by their baseline FSH level being elevated on Day 2 or 3 of their menstrual cycle, ie between and 11 and 40 mIU/ml.

After 12 weeks of treatment mean FSH levels dropped by nearly a half, a highly significant result.

 

 

 

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Effectiveness of acupuncture in women with polycystic ovarian syndrome undergoing in vitro fertilisation or intracytoplasmic sperm injection: a systematic review and meta-analysis

Junyoung Jo and  Yoon Jae Lee, 2017 Acup in Med, online

British Medical Journal; Acupuncture in Medicine

 

A review of randomised and controlled trials that examined the effect of acupuncture on 430 PCOS patients undergoing IVF, indicates that acupuncture (both electro acupuncture and manual acupuncture) improved pregnancy rates and reduced the risk of OHSS. Acupuncture was delivered only during the IVF cycle and did not improve live birth outcomes in this review.

 

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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. 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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ACUPUNCTURE AND BLOOD FLOW: Effects of Acupuncture on the Endometrium in Anovulatory Cases Treated by Clomiphene: A Clinical Observation

HU Wenxiao, J Taishan Med College. 2016, (9):1029-1031

Journal of Taishan Medical College

 

Researchers in Taishan medical university discovered that when they gave women with anovulatory infertility Clomid alongside acupuncture and moxibustion treatment, they did significantly better than those who had just Clomid, or Clomid plus estrogen. The blood flow to the uterus and endometrium increased and the pregnancy rate was improved in the acupuncture group.

 

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Effects of transcutaneous electrical acupoint stimulation on ovarian reserve of patients with diminished ovarian reserve in in vitro fertilization and embryo transfer cycles.

Zheng Y et al, J Obstet Gynaecol Res. 2015 Dec;41(12):1905-11

The Journal of Obstetric and Gynecological Research

 

240 women with poor ovarian reserve who were undergoing IVF treatment, were divided into either a group that received electrostimulation to acupuncture points or into a control group. The study showed that the 56 women who received the electrostimulation to acupuncture points had a significantly higher clinical pregnancy rate than the other groups. This is an encouraging finding for these patients since it is often thought that not much can be done to improve the chances of IVF patients with low ovarian reserve.

 

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