IVF and Acupuncture : Unclear Benefits

By Amy Norton

NEW YORK (Reuters Health) Jan 30 – Acupuncture may help some women conceive through in-vitro fertilization (IVF), a new meta-analysis concludes. But the true benefit in the real world, if any, remains unclear.

Ten years ago, a study in Germany was the first clinical trial to report that acupuncture seemed to improve pregnancy rates in women undergoing IVF. But studies since then have had mixed results.

“I counsel women that the literature is not convincing yet that (acupuncture) helps you get pregnant,” said Dr. Frederick Licciardi, who heads the New York University Fertility Center’s mind/body program.

At the center, women can opt for acupuncture sessions, yoga and other “mind/body” services, but the programs are aimed at easing stress and promoting general “wellness” — not at boosting IVF success, said Dr. Licciardi.

For the new meta-analysis, reported online January 12 in Fertility and Sterility, Dr. Cui Hong Zheng and colleagues at Tongji Medical College pooled the results of 24 small clinical trials testing the effects of acupuncture in women undergoing IVF.

The trials varied widely: Many tested needle acupuncture, some electro-acupuncture and some included laser acupuncture in the mix.

There was also no consistency among control groups. In many trials, control groups received no treatment. In others, they received sham treatments – and the sham approaches varied, too.

Dr. Zheng’s team found that overall, women who had acupuncture had a slightly higher pregnancy rate than women who did not have the therapy — but no higher birth rate.

The results looked a little different, though, when the researchers excluded five studies that used blunt needles as a control. When those trials were dropped, women in the remaining studies who received acupuncture fared a little better: 41% became pregnant in the acupuncture groups, vs 37% in the control groups.

Three of those trials also looked at birth rates, which were 35% in the acupuncture groups vs 25% in the control groups.

According to Dr. Zheng’s team, the findings suggest that the blunt-needle acupuncture used in some trials is not a truly “inactive” placebo, and may actually have effects similar to the real thing. That, the researchers say, may explain why those studies failed to find benefits from real acupuncture.

But Dr. Licciardi — who stressed that he is “not anti-acupuncture” — was unconvinced.

One of the big problems with the analysis, he said, is that it combined studies that were all looking at very different things: different types of acupuncture, different controls, and different timing of the acupuncture sessions.

“They’re just too heterogeneous to generalize and draw conclusions,” Dr. Licciardi said.

He was also skeptical of the researchers’ choice to drop certain trials, which then essentially gave them “the results they wanted.”

In the bigger context of acupuncture research, finding a good control has long been a problem.

The bottom line, according to Dr. Licciardi, is that no one yet knows if acupuncture can really make a difference in IVF success. But if a woman wants to try it simply to feel better or de-stress, there would be little harm.

Acupuncture is generally considered safe, with side effects like bruising at the needle site. The cost can vary widely — and may or may not be covered by insurance — but a session would typically start at around $100.

As for why acupuncture would help a woman get pregnant with IVF, no one is sure of that either.

There’s some evidence that needle stimulation may improve blood flow to the uterus. And researchers are looking at whether acupuncture might make the uterine wall more receptive to the embryo.

SOURCE: http://bit.ly/xUSWrV

Fertil Steril 2012.