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Can acupuncture boost the success of IVF?

31st January 2012

Researchers are still debating whether acupuncture may help some women conceive through in-vitro fertilisation (IVF), but a new analysis of past research shows a modest improvement in birth rates among women who undergo the treatment.

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The traditional Chinese medicine technique is thousands of years old and has been used for many medical problems.

But the difficulty of finding a placebo treatment to administer to a control group has hampered some studies, and may be muddying the actual benefits of the treatment, Chinese researchers say.

Writing in the journal Fertility and Sterility, Chinese researchers at the prestigious Tongji Medical College combined the results of 24 small clinical trials testing the effects of acupuncture in women undergoing IVF.

The research team, led by Zheng Cuihong, found that the trials varied wildly in terms of their design and their results.

Some trials were limited to needle acupuncture, while others used electro-acupuncture and even laser acupuncture.  

The problem of what to administer to a control group as a placebo, so as to mitigate the "placebo effect," which boosts the outcomes of those who believe they are receiving treatment, was clear from the inconsistency with which control groups were treated in the trials.

Many IVF patients received either acupuncture or nothing, because of the difficulty inherent in designing a technique like acupuncture that has no physiological effect on the patient.

Some trials experimented with "fake" acupuncture using blunt needles, but these were questionable owing to the possibility of using massage to stimulate pressure points (acupressure). Other control groups received acupuncture to non-fertility related pressure points.

Across the 24 studies, acupunture seemed linked to a slightly higher pregnancy rate, but not to a higher birth rate.

But when Zheng's team ruled out five of the studies that used blunt needles as a control, the difference between the groups widened.

The women who received acupuncture had a pregnancy rate of 41%, compared with a rate of 37% among those who had nothing.

When the non-placebo trials were excluded, birth rates among women getting acupuncture were 35%, compared with 25%t among women in control groups.

Zheng's team speculated that the blunt-needle acupuncture used in some trials is not a truly inactive placebo, and may have inadvertently boosted positive outcomes in control groups, diminishing the apparent benefits of needle acupuncture.

However, critics say that the study failed to compare like with like, calling the conclusions into question.

Frederick Licciardi, who heads the New York University Fertility Centre's mind/body programme, said no-one really knows yet whether acupuncture can help women on IVF programmes to have babies, but that the treatment is unlikely to be harmful.

His centre offers the treatment as part of a general "wellness" programme, he said.

A German study 10 years ago found a link between acupuncture and improved pregnancy rates in women undergoing IVF.

Research teams are currently examining the prospect that needle stimulation may improve blood flow to the uterus, or even make the uterine wall more receptive to the embryo.


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