Acupuncture to improve fertility rates?
The University of Maryland Center for Integrative Medicine says that acupuncture, when used as a complementary or adjuvant therapy for in vitro fertilization, may be beneficial - depending on the baseline pregnancy rates of a fertility clinic. If the baseline success was not very high, it went up a little. For clinics with more success, acupuncture had no effect.
In vitro fertilization is a process that involves fertilizing a woman's egg with sperm outside the womb and then implanting the embryo in the woman's uterus. According to the researchers, acupuncture is the most commonly used adjuvant, complementary therapy among couples seeking treatment at fertility clinics in the United States.
"Our systematic review of current acupuncture/IVF research found that for IVF clinics with baseline pregnancy rates higher than average (32 percent or greater) adding acupuncture had no benefit," said Eric Manheimer, lead author and research associate at the University of Maryland Center for Integrative Medicine. "However, at IVF clinics with baseline pregnancy rates lower than average (less than 32 percent) adding acupuncture seemed to increase IVF pregnancy success rates. We saw a direct association between the baseline pregnancy success rate and the effects of adding acupuncture: the lower the baseline pregnancy rate at the clinic, the more adjuvant acupuncture seemed to increase the pregnancy rate."
The meta analysis examined 16 studies with more than 4,000 patients and builds on the Center for Integrative Medicine's 2008 review of acupuncture and IVF, published in the British Medical Journal. That study found positive results for using acupuncture for women undergoing IVF when acupuncture was performed during embryo transfer.
According to the authors, international differences may be one factor in varying baseline pregnancy rates in the studies they analyzed. For example, they say European clinics may have lower IVF pregnancy rates than U.S. clinics because European countries are increasingly moving towards single embryo transfers.
"Another potential explanation for the different effects of acupuncture in trials with higher versus lower baseline rates may be that in IVF settings where the baseline pregnancy rates are already high, the relative added value of additional co-interventions, such as acupuncture, may be lower," adds Manheimer.
The researchers say that more study is needed to examine if acupuncture might be a useful add-on procedure in IVF clinics with lower baseline rates, including considerations of safety and cost-effectiveness. Properly done, acupuncture is a safe enough procedure, but research has not determined whether any benefits on IVF success rates resulting from adding acupuncture are worth the extra costs involved with administering acupuncture.
Citation: Eric Manheimer, Daniëlle van der Windt, Ke Cheng, Kristen Stafford, Jianping Liu, Jayne Tierney, Lixing Lao, Brian M. Berman, Patricia Langenberg, and Lex M. Bouter, 'The effects of acupuncture on rates of clinical pregnancy among women undergoing in vitro fertilization: a systematic review and meta-analysis', Hum. Reprod. June 27, 2013 doi:10.1093/humupd/dmt026
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