acupuncture Archives - Fertility Fact Checker

Does acupuncture increase IVF success rates? An update.

You don’t have to look far to find stories of women doing IVF reporting that acupuncture was the reason they got their take home baby. Acupuncture has many possible benefits to an IVF cycle including increasing egg quality, uterine blood flow and implantation(1) as well as reducing stress and it is certainly worth considering.

The research

Back in 2014 Nandi and colleagues summed it up perfectly when they said

basically, the evidence regarding the efficacy of acupuncture to improve clinical pregnancy rate is controversial. In spite of 40 clinical trials and nine systematic reviews, the debate still continues.’

If you are going to stop reading now, overall, that still stands.

If you are thinking about spending your hard earned cash on acupuncture, it pays to drill down a little more.

>>>If you are about to do an IVF cycle and are looking for evidence based ways to increase your success rates, make sure you check out Eat Think Grow.

Is it a sham?

In randomized control trials, when researchers are trying to ‘prove’ that a treatment, such as acupuncture, has an effect, it will often be compared to a control. The control could be receiving no treatment at all or in this case it could be the use of sham or placebo needles.

When placebo or sham needles are used the person receiving the treatment, in this case the woman doing IVF, really thinks they are having proper acupuncture. It might be that the needles just don’t penetrate the skin the same way or they are put in just slightly away from known acupoints and therefore aren’t doing what they should.

One recent systematic review looked at all the studies that examined the difference in IVF outcomes (such as clinical pregnancy or live birth) depending on whether they had placebo or actual acupuncture around the day of embryo transfer. What they found was that there was no statistical difference in clinical pregnancy rate, ongoing pregnancy rate or live birth rate between placebo or sham acupuncture and real traditional acupuncture.

When the control though was changed from being placebo to having no treatment at all there was a significant difference, in this case there was an increase in the live birth rates of those women having acupuncture when compared to those that did not. Those women that had the acupuncture were 1.15 times more likely than those that did not have the acupuncture to have a live birth (1). Interestingly it was not associated with clinical pregnancy rate or ongoing pregnancy rate.

Before rushing out to have acupuncture there are a number of things to consider.

Firstly, an odds ratio of 1.15 is still kind of small in the scheme of things. But hey, if that was a definite, I’d try it. Secondly, it’s not a definite. The research is not water tight and there remains lots of conflicting studies and also sometimes the studies they use to get to such numbers can be of low quality.

What is interesting though is that it may not be the actual acupuncture – that is the insertion of needles on the acupoints making the difference- it may be the experience. It might be the stress relieving properties of lying down for 30 minutes while the needles are in, or the placebo effect of really feeling as if you are making a difference to your next cycle or even just the chat with the practitioner.

Who knows.

Building on this theory, if you are thinking about acupuncture but aren’t so sure or can’t afford it, in the first instance I would a) find an activity that you genuinely enjoy and relaxes you and b) find an activity that you genuinely feel is going to make a difference to your cycle (you may find the mindfulness activities in Eat. Think. Grow! fits this bill ;)) It can’t hurt and just might get you some of the side benefits of acupuncture without the actual acupuncture. It would be interesting to see studies in the future that compared the IVF success rates between those that used acupuncture and those that used general relaxation strategies and determine what the difference to IVF success rates is.

It should be noted that other reviews have evaluated the impact of acupuncture in comparison to no treatment and found that it statistically increased the chances of an ongoing pregnancy but not clinical pregnancy rate or live birth rate to any statistical significance (Manheimer as cited in 3). Just to further highlight the fact that the evidence around this one really is conflicted.

Timing and dosage of acupuncture

Embryo Transfer
Many women doing acupuncture will typically go to the acupuncturist once or twice around embryo transfer and call it a day. Generally speaking this is insufficient to increase the possibility of live birth rates – though they are associated with reducing stress (3). This finding was also supported when a systematic review was completed of studies that when combined looked at the cycles of over 6300 women (4).

Egg Retrieval
This finding was similar when studies looked at women who had acupuncture around the time of egg retrieval – there was no difference in live birth rates between those that had acupuncture around the time of egg retrieval and those that didn’t (4). To be fair though, acupuncture done around the time of egg retrieval is generally more focused on pain relief being the goal of the treatment rather than increasing live birth rates, so that is reasonable.

First two weeks of cycle
The next grouping when looking at the timing of acupuncture and its impact on take home baby rates looks at women who have acupuncture during ovarian hyperstimulation – so those having acupuncture in the first half of their cycles while on gonal f, menopur or whichever follicle stimulating drug you are taking. These ladies typically had at least four sessions and it was found that overall, the pooled pregnancy rates were higher for those having acupuncture than those that were not. Specifically those that had the acupuncture throughout ovarian hyperstimulation where 2.41 times more likely to have a live birth than those that did not (4). To reach this figure there was only three studies that used the data from 435 women so it is not a large pool of women in the scheme of things and therefore, again, should be interpreted with caution. But it’s still interesting.

Entire cycle
When looking at how many treatments you would need to during a cycle, one study suggested that eleven acupuncture treatments during an IVF cycle was associated with significantly improved IVF birth outcomes and fewer miscarriages and another suggested 13–14 sessions was associated with significantly more live births compared with no treatment or embryo transfer day only acupuncture (3).

14 sessions in one cycle though is a lot! That is nearly once session of acupuncture every two days. I wonder if there are other forces at play in this group that weren’t measured in the study. For example, it would take a particular type of woman to go to acupuncture every second day during an IVF cycle. Presumably she wouldn’t work (or have a very flexible work situation), has the finances to attend all these sessions and clearly has some firm beliefs that acupuncture and/ or Chinese medicine is going to make an impact and therefore might also engage in other beneficial health practices also. Maybe these other hypothetical situations are also contributing to the increased success rates?

Like all things in fertility, it seems likely that the ultimate dosage will differ person to person (3), from what I have read though, highlighting the ineffectiveness of acupuncture on transfer day only towards live birth rates does seem more or less consistent across the research.

Types of acupuncture

The type of acupuncture can also make a difference to the likelihood of success. There is traditional acupuncture which is where needles are inserted into acupoints (usually around 4 to 10) along meridians in your body (this is the type you are probably most aware of). When these needles are stimulated by a small electrical current it then becomes electroacupuncture. There is also auricular acupuncture and laser acupuncture, which as the name suggests uses small laser beams to effect the acupoints instead of needles (4).

Essentially, out of all these types, electroacupuncture seemed to have the most affect. Those women that had electroacupuncutre in comparison to a control group were statistically more likely to have a clinical pregnancy and live birth. But noteworthy, they did not have higher ongoing pregnancy rates.

Possible harm

As stated earlier, acupuncture is generally believed to do no harm to an IVF cycle. I am only aware of one study where they found acupuncture to lower IVF success rates when done around transfer day. One theory for the reason for this result was that the acupuncturist was not ‘on site’ where the embryo transfer was being completed. It is thought that driving to this extra appointment timed just before and just after the transfer, added stress in an already stressful day and this extra stress helped explain this difference (5). It should also be noted that the group not receiving acupuncture had a freakishly high success rate – nearly double of what it would be expected to be. This in turn would make anything in comparison look bad.

Another point to take into consideration, and this assumes that you believe acupuncture does have the potential to have an impact, is that there are some acupoints that are believed to be associated with miscarriage or at the very least contra-indicated to pregnancy (3). This serves as another reminder to make sure that you are visiting an experienced practitioner.

Things to keep in mind

You can see the research is mixed. Although it may be simply that acupuncture does not work, one of the other reasons the research didn’t indicate any benefit (assuming there is one to reflect in the first place!) is that there was is so many differences in the methodology of administering acupuncture. There is simply too many variances in the methods acupuncture practitioners would use including acupuncture point selection, number of sessions, timing of when sessions are administered, type of needling control and location of treatment (1).

The Final word

As I started off saying the evidence is controversial. I believe that it is an all or nothing thing. If you are only going to go on transfer day because a friend of a friend did and she got a positive result on a pregnancy test, I’d probably give it a miss. If though you believe in Chinese medicine philosophy and are willing to integrate it into your life as well as attend as many as 14 sessions over the course of your cycle, then I think it might be worth a shot.

Also, just because the evidence that says acupuncture increases IVF success rates isn’t necessarily solid, that also doesn’t necessarily mean it doesn’t and with further study, well, who knows?

Reference

1. Cheong, Y.C., Dix, S., Hung Yu Ng, E., Ledger, W. & Farquhar, C. (2013). Acupuncture and assisted reproductive technology (Review). The Cochrane Library, Issue 7
2. Nandi, A., Shah, A., Gudi, A. & Homburg, R. (2014). Acupuncture in IVF: A review of current literature. Journal of Obstetrics & Gynaecology 34 (7) 555-561
3. Hullender Rubin, L., Anderson, B. & Craig, L. (2018). Acupuncture and in vitro fertilisation research: current and future directions. Acupuncture Medicine 36 (2) 119 – 122.
4. Qian, W, Xia, X-R., Ochin, H., Huang, C., Gao, C., Gao, L., Cui, Y-G., Liu, J-Y. & Meng, Y. (2017). Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis. Archives of Gynecology and Obstetrics 295, 543–558.
5. Stener-Victorin, E. & Manheimer, E. 2011. Commentary on the Cochrane Review of acupuncture and assisted conception. Explore (NY). 2011 ; 7(2): 120–123. doi:10.1016/j.explore.2010.12.01

Stress and anxiety: does it really matter to IVF?

For some of us, anxiety feels like your brain can’t stop calculating. Calculating outcomes, calculating consequences, calculating alternatives. All bad obviously. And all meaningless. After all when does an anxious person ever think an unknown outcome is going to be positive? Never, that’s when.

There are times when I have been so, so far into my wave of anxiety, I just couldn’t see out. The triggers for my anxiety are so inconsequential that a ‘normal’ person wouldn’t understand. But if you have ever had anxiety, fertility related or not, you will get what I mean.

When your friends short text message has you obsessing all day that you have somehow offended her (when the logical part of your brain, which is taking a back seat at the moment, knows you couldn’t have), when an exchange with a colleague has you literally sick to the stomach and the thought of a team meeting has your chest tightening.

I know some people won’t know what I mean by that, but I know a lot of you will.

A barrier to IVF

Stress, anxiety, fear of uncertainty, the feeling of your life constantly being on hold, the emotional cost, having ‘had enough’ and thinking that you have a poor IVF prognosis (without doctors actually stating this) are all major reasons why women don’t continue with IVF when the issue of money has been taken out of the equation¹.

A recent small study showed that for women in the US who chose not to continue with IVF despite being insured for more cycles, 39% stated that stress was the reason why they couldn’t continue treatment. Specifically, these women stated that the toll fertility treatments took on their relationship was too much as well as simply being too anxious and depressed to continue¹.

In fact, stress and anxiety being the reason women do not continue with IVF when money isn’t the issue (because their cycles are funded by researchers or government programs) is likely to be higher than 39% with the authors citing a Swedish study where the number is thought to be around 65% and an Australian study where the number was thought to be around 54%.

Women don’t start IVF and fertility treatments lightly. That take home baby is very much wanted and much sacrifice and consideration has already gone into making it happen. Therefore if it is the stress and anxiety associated with fertility treatments that is making women stop it must be HUGE, unbearable. And if so, why isn’t it talked about more and more done to help women before they get to that point?

Impact of stress on IVF success rates

I know that some of the information out there looking at stress and IVF success rates talks about cortisol and the hypothalamic pituitary adrenal (HPA) axis and how this links with our ovaries. But ultimately, at the end of the day is this impacting our chance of a take home baby with IVF?

The impact of stress and anxiety on IVF success rates is mixed, to say the least. One meta analysis reports that emotional stress is unlikely to have an impact on IVF pregnancy rates² and that feelings of tension, worry or depression experienced as a result of a woman’s fertility problems, its treatment, or other co-occurring life events are unlikely to further reduce chances of pregnancy. *phew*

On the other hand, there is a study that suggests that women who experience emotional distress and receive psychological intervention are twice as likely to become pregnant than those that do not³. Whilst there is a number of reasons to NOT take this statistic as a fact it highlights the potential untreated anxiety can possibly have. Although the authors report that the effect size of psychological treatments may not be as big as doubling success rates, they do nonetheless believe that larger reductions in anxiety are associated with improved pregnancy outcomes.

Whether or not stress and anxiety does hinder IVF success rates is yet to be determined. Personally, I think it is not as straight forward as just being ‘anxious’ or not and there are far more significant factors that possibly impact the success of an IVF cycle.

Regardless of whether or not anxiety does impact success rates, I think we are all agreed that when stress and anxiety are better managed, quality of life improves along with the quality of our relationships and just the general ability to feel a little bit ‘normal’.

To sum it up, although its impact on IVF success rates is conflicted, overall, better managing our stress and anxiety can only be a good thing.

What is the best way to manage stress and anxiety when doing IVF?

Mind body interventions, such as yoga, web based interventions, cognitive behavioral therapy, acupuncture, online support groups, education sessions, guided relaxation and mindfulness classes are just some of the ways that have been studied in an effort to try and determine what best helps women doing IVF to reduce their stress and anxiety⁴. On top of this there is the more traditional methods such as exercising and eating a healthy diet.

Just as we all have different triggers and symptoms of stress and anxiety the ‘best’ way to manage it is likely to be unique to everyone.

For me, and many women, mindfulness does the trick to providing that small gap to disrupt the never ending thoughts that run around and around your mind. There has been some early studies that show that women who participated in a particular mindfulness course had improved quality of life measures and also increased pregnancy rates (44% of women in the mindfulness group had a pregnancy versus 26% of women from the control group who did not do mindfulness activities)⁵.

DIY Mindfulness

Although we cannot always be lucky enough to be asked to participate in a mindfulness based study for women doing IVF (!) we can embrace the mindful way of thinking and incorporate it into our everyday lives. We can get the benefits of unwinding and slowing our mind without the need to spend hours lying down to relax or taking time to attend particular courses and classes.

Next time you are in your anxiety wave, try this. When you have a shower (or are doing the tidying or waiting for your train or any number of mundane tasks where you notice your thoughts running away from you), list five things.

Five things that you can see (such as the soap sitting on the soap dish or the tap being twisted slightly off center). Five things that you can hear (such as the water going down the drain or the exhaust fan going around) and five things that you can feel (the tiles under your feet or the water on your back). As you get more practiced at doing this you will start to notice the details in what you are doing more, becoming more absorbed in the task that is at hand and more distanced from the ruminating thoughts in your head.

Mindfulness. Try it. And if you want additional mindfulness exercises have a look at this previous post. If nothing else, at least for a couple of minutes you will have the head space to feel just a little clearer, breaking that negative thought cycle and have the weight lifted from your chest. It does for me. And who knows, it may even improve IVF success rates.

** As always though, this article is just for general information. If your feelings of stress or anxiety is preventing you from living your life and you just don’t find enjoyment in things the way that you used to or if you have ANY feelings of self-harm or harming others, speak to your health professional immediately. They will be able to help you access treatments that you didn’t even know about so it is well worth the conversation**

References

Domar, A., Smith, K., Conboy, L., Iannone, M. & Alper, M. (2010). A prospective investigation into the reasons why insured United States patients drop out of in vitro fertilisation treatments. Fertility and Sterility. 94 (4) 1457 – 1459.
Boivin, J., Griffiths, E. & Venetis, C. (2011) Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies. British Medical Journal. 342:d223 doi:10.1136/bmj.d223
Frederkisen, Y., Farver-Vestergaard, I., Skovgård, N., Ingerslev, H. & Zachariae, R. (2010) Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis. BMJ Open ;5:e006592. doi:10.1136/bmjopen-2014006592
LoGiudice, J. & Massaro, J. (2018). The impact of complementary therapies on psychosocial factors in women undergoing in vitro fertilization (IVF): A systematic literature review. Applied Nursing Research 39 220 -228.
Li, J., Long, L., Liu, Y., He, W. and Li, M. (2016). Effects of a mindfulness based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilisation treatment. Behaviour Research and Therapy 77 96 – 104.

Acupuncture and IVF: Does it help?

***For a 2018 update click here…

Acupuncture. Its one of those things that you feel you should do when having fertility treatments, but you’re not really sure why, when in the cycle you should have it or if it does actually work. I took the time to sift through all the research to see if it is actually worth our while. By the way, this is a long post packed full of evidence and information. If you are limited for time skip towards the end for a quick summary.

I remember my trip to an acupuncturist. And yes, I use the word ‘trip’, as in singular. Having decided to try and leave no stone unturned in the pursuit of a BFP I duly attended the acupuncturist which was attached to a nearby nutritionist (using the theory that if she was attached to other holistic type health people then surely I was on to a winner!). Despite looking up her qualifications, experience and interests (there was ‘women’s fertility’ listed with about 10 other ‘specialty’ areas) I was disappointed about her lack of insight into the fertility world and I definitely got the sense that she considered me to be ‘jumping on the bandwagon’ by pursuing IVF. Sitting down to discuss the treatment I told her my diagnosis, which included PCOS and she didn’t seem to think that there was a problem with the fact that ovulation was few and very far between, along with all the hormonal difficulties women with PCOS can have, and said that pregnancy was just a matter of time. When I asked about the mechanisms behind acupuncture I was told it was just about improving blood flow to the uterus and pointed at a diagram on the wall that was meant to be the explanation. I perhaps wasn’t the best acupuncturist patient and was a little anxious about the whole thing and the sensation of the needles going in was not a pleasurable one (for me anyway). But I think relaxing and discussing problems with a patient is as much part of the therapy as the therapy itself. Well, kind of. But I think the real kicker came when I was left to ‘relax’ for 20 minutes, which incidentally turned into 50 minutes, without music but with the soundtrack of the man next door discussing his bowel habits with the nutritionist! Anyway, convinced that she had forgotten about me and shouting out to attract her attention, she eventually came back and I eventually left– it was all quite bizarre. You hear a lot that the main benefit to acupuncture is taking the time to relax and distress and that’s the main way that it helps you, if that is the case it certainly didn’t help me. For those that are wondering it was a BFN that cycle by the way.

But that’s just me. I know a lot of people who have had acupuncture and rave about it. A lot of people find it relaxing and its stress relieving properties, like I said, seems to be one of its main perceived benefits in fertility treatments. Along with its ability to ‘improve bloodflow’ that is.

So how does acupuncture work?

In its most basic form, acupuncture involves inserting a number of needles into the body at certain points, or acupoints, along meridians in the body. There are around 400 acupoints running along 20 meridians – 12 primary ones which are generally associated with internal organs, and 8 extradordinary ones. Accupuncuretoday goes on to describe that ‘qi’ flows along the meridians. Qi is described as kind of like an energy or a vibration that carries the effects of the acupuncture from one acupoint to another. When the qi flows the body is able to work properly. There are certain acupoints that must be stimulated on various meridians to treat different ailments. For example, the acupoints for treating fertility will be different to those for treating back pain. For a full list of acupoints, have a look here.

But HOW does it work for FERTILITY?

In an overview of the use of acupuncture in gynecology, Napadow et al stated that in her view, recent basic and clinical research has demonstrated that acupuncture regulates uterine and ovarian blood flow, and that the effect is most likely mediated as a reflex response via the ovarian sympathetic nerves, and that the response is controlled via the supraspinal pathways

So it seems as if my acupuncturist was correct in that acupuncture assists with blood flow. AND there seems to be some sort of medical explanation for it. Because of the increased blood flow to the uterus, it also produces a healthier uterine lining and helps with implantation (1)

Besides in just assisting with blood flow, there are a number of other ways in which it can possible help IVF and pregnancy outcomes:

Acupuncture is well utilised for the management of pain. This is due to an increase in a type of endorphin when acupuncture is performed. When endorphin is altered it has a knock on effect of affecting hypothalamic function which is responsible for gonadotropin-releasing hormone which in turn impacts Follicle Stimulating Hormone and Luteinising Hormone and the overall functioning of the menstrual cycle (1). As we know these are all very important hormones in the IVF process (and the ones that are monitored closely when you go for regular bloods) so regulating these with help from acupuncture, should impact positively.
Acupuncture can encourage the production of naturally occurring opioids which are generally pain killers but is part of a chain of events that can also manage stress(1). Which brings us back to that chestnut of ‘relaxing’. Obviously if you are in my situation and find the acupuncture stressful, whether that be due to the process itself, the financial costs or the time it takes, then these benefits are probably not going to be felt and acupuncture may not be your thing.
Another study found that if acupuncture is done in the follicular phase, that is before egg collection, then it may affect the stem cell factor in the follicular fluid that surrounds the eggs causing better quality eggs and hence a better quality embryo (Chen et al as cited in 3)
And finally, acupuncture may also assist in hormonal balance during the implantation stage, again regulating hormones in this way and helping the embryo to implant (3).

So… Does It Work?

There have been quite a number of studies done on acupuncture trying to determine its use and benefit. It seems that each study seems to say a different thing. This is event the case for meta-anaylsis studies (where a researcher looks at all the relevant experiments that have been completed and combines it into one big summary so to speak). One article will state that acupuncture is helpful in increasing pregnancy rates whilst another will say that it does not increase live birth rates.

The most recent Cochrane Review stated that there was no significant difference of acupuncture on fertility treatments. This was regardless of whether acupuncture was done around the day of egg retrieval or around the day of embryo transfer (4).

Interestingly though the Cochrane Review evaluated acupuncture against different types of controls. That is, they compared the effectiveness of acupuncture against having no acupuncture and also examined studies where the effectiveness of acupuncture was compared against sham acupuncture. Sham acupuncture is where needles are used that retract back into themselves after hitting the skin and hence doesn’t penetrate the skin like a normal acupuncture needle – though the feeling is still the same and women receiving this treatment would have definitely have thought they were having acupuncture done. What they found was that when having acupuncture was compared against this sham acupuncture there was no significant differences in the live birth rate; however, when acupuncture was compared against having no treatment at all there was a significant difference in the live birth rate! This perhaps suggests that it is not the actual acupuncture and its effect on qi and manipulation of acupoints but that perhaps some placebo effect is having effect and the act of participating in the treatment is more beneficial then the actual treatment itself.

Saying all that though, there was another study done that looked at when in their cycle women had acupuncture done and if this had any impact on pregnancy. They looked at women who had it done during follicle phase (when eggs are still developing before pick up), on the day of egg pickup, before and/or after embryo transfer and during implantation stage. What they found was that there was ‘no statistically significant difference in … treatment (that was) performed only around the time of embryo transfer, follicle phase or implantation phase’ (3). They did indicate though ‘that acupuncture increased pregnancy rates when performed at follicle phase and 25 min before and after embryo transfer or 30 min after embryo transfer and after the implantation phase in the IVF process’ (3)What this seems to be saying is that acupuncture does seem to have a roll but just going at egg pick up or transfer isn’t going to be enough. It needs to be done consistently throughout the follicular phase, that is when you are being stimulated and taking medications, AS WELL AS before and after embryo transfer and even perhaps during implantation phase.

At exactly what times in these phases isn’t exactly known. Some studies had women having acupuncture at day 1 or 7 or 9 …or more! It varies a lot and seems to be at the whim of whoever designed the experiment. Perphas if you think that acupuncture might be worth trying, and you have the time and the money to give it ago, that should be something that you can discuss with your experienced acupuncturist.

You haven’t really given me an answer here…

No, to reply to my own comment, I haven’t. Although from what I have read, most articles seem to support the theory that acupuncture is not of any significant assistance in fertility treatments there is none the less still wide ranging views.

There are a number of reason why there is so much disparity:

Having acupuncture can come in many different forms. As we have noted, some women go for just a ‘one off’, some may go for the duration of their cycle, some just before egg pickup and some just before and/ or after embryo transfer. There are many different timeframes as to which you can receive acupuncture and to date studies seem to be evaluating the effectiveness of acupuncture (in no consistent format) to no acupuncture, rather than evaluating the effectiveness of the different formats…This makes it more difficult to compare apples with apples, so to speak.
It seems that the skill of the practitioner can and does, impact on success of the acupuncture. When these studies have been completed there are some instances of inadequately trained practitioners performing the acupuncture. If it is not an experienced and knowledgeable practitioner inserting those needles it may as well be as useful as having sham acupuncture (though as we previously noted this has been found to be just as useful! Confusing much?!)
The location of the acupuncturist and the effort it takes to attend such appointments also needs to be taken into account. There was one trial in which acupuncture was found to lower the rate of pregnancy. One theory for the reason for this result was that the study required patients to drive to an acupuncturist before and after embryo transfer rather than have acupuncture ‘on site’ where the transfer was being completed. It is thought that driving to this extra appoinment timed just before and just after the transfer, added stress in an already stressful day and this extra stress helped explain this difference (2). Don’t get scared off though, this (from what I have read) is the only study to have had this ‘negative’ result, it should also be noted that the group NOT receiving acupuncture had a freakishly high success rate – nearly double of what it should be. This in turn would make anything in comparison look bad.
None of the studies seem to break down what the medical conditions are of the women receiving the treatment and the reason they are receiving IVF. That is a woman who is having IVF due to male factor infertility will likely to have different hormone levels then a women with severe PCOS and hence the impact of acupuncture may be different. If further research was completed it may, or may not, help to identify, or rule out, which groups of women are likely to benefit from acupuncture.

So in summary…

Evidence is varied whether or not acupuncture in fertility works and as in many of the topics surrounding fertility more research is needed. Some say it does and some say it doesn’t have any impact on pregnancy rates and increasing the chances of you getting your ‘take home baby’. If you do happen to have the time and the money there does not appear to be any harm done so is perhaps worth a try – even if it is just to get some ‘stress relief’ or benefit from a placebo effect.

If you do decide to that acupuncture is for you, remember that some of the evidence suggests that there is only benefit if done throughout the cycle and not just as a one off, tick the box kind of activity. Unfortunately, there is no set regime for these what days to get acupuncture and you would need to find a reputable acupuncturist specialising in fertility to help you form a treatment plan. Put the effort into finding an acupuncturist who understands the unique challenges that fertility patients face, the various medical conditions that cause fertility and is willing to take the time to tailor your treatment for you.

References

1. Cochrane, S., Smith, C., Possamai-Inesedy, A. & Bensoussan, A. 2014. Acupuncture and women’s health: an overview of the role of acupuncture and its clinical management in women’s reproductive health. International Journal of Women’s Health 6: 313 – 325

2. Stener-Victorin, E. & Manheimer, E. 2011. Commentary on the Cochrane Review of acupuncture and assisted conception. Explore (NY). 2011 ; 7(2): 120–123. doi:10.1016/j.explore.2010.12.01

3. Shen, C., Wu, M., Shu, D., Zhao X. & Gao, Y. 2015. The Role of Acupuncture in in vitro Fertilization: A Systematic Review and Meta-Analysis. Gynaelogical and Obstetetric Investigation 79:1–12 DOI: 10.1159/000362231

4. Cheong YC, Dix S, Hung Yu Ng E, Ledger WL & Farquhar C.2013. Acupuncture and assisted reproductive technology (Review). The Cochrane Library, (http://www.thecochranelibrary.com) issue 7