By Mo Bahrami
There appears to be an increase in the number of patients turning to traditional Chinese medicine and other alternative therapies to assist with their fertility treatment. Predominately, patients are using acupuncture to complement their cycle. Naturally, one must wonder whether this alternate form of medicine provides any benefit – specifically for patients with infertility.
The theory behind acupuncture is that through the stimulation of specific “acupoints” on the body, a natural self-healing process is initiated. There is some evidence that acupuncture can help with headaches, neck and back pain as well as pain in joints and the face. However, our focus remains on whether acupuncture can act as an effective therapy for infertility.
To answer this we have to consider the scientific evidence. To be fair, there are many studies on the topic, and whilst I cannot go through every single paper, I have tried to find some key studies and discuss the outcomes. Before I go any further, if you disagree with the conclusion of this blog, I would like to invite you to get in touch with us, and provide any studies you may know of that sheds some light on this topic. We love nothing more than a good discussion!
One of the key studies that I looked at was conducted in 2015 by members from the Oregon college of Oriental Medicine. Their primary aim was to determine whether Whole System Tradition Chinese Medicine (WS-TCM), acupuncture or standard IVF alone would impact live birth rates. The secondary outcomes of this study were; spontaneous abortion, ectopic pregnancies, singleton, twin, triplet pregnancies or gestation age. Patients were divided into three groups; those that received WS-TCM, acupuncture alone (ACU) or those that were treated with standard IVF without any alternate medicines. The results from this trial are as follows;
- The proportion of live births was significantly higher in the WS-TCM group (61%) compared to ACU (50.8%) and IVF alone (48.2%).
- WS-TCM was associated with fewer biochemical pregnancies compared to ACU and standard IVF. There was no difference between the ACU and the standard IVF treatment groups with respect to biochemical pregnancy rates.
- When comparing the three groups for the secondary outcomes (spontaneous abortion, ectopic pregnancy, singleton, twin, triplet pregnancy or gestation age), there was no difference between them.
While the evidence from this study suggests an increase in live birth rates, we cannot suggest from this data that acupuncture or even WS-TCM has any impact on IVF treatment. As far as biochemical pregnancy is concerned (based on the results of this study), you’re better off to just have standard IVF without any alternative therapies. Whilst the live birth rate in this trial is higher – the simple fact remains that many multiple variables that can impact this. Variables that were not sufficiently addressed.
Looking further back in the literature, a meta-anaylsis (which is basically a large analysis of many research papers) was conducted by a group from the Department of Obstetrics and Gynaecology at Hong Kong University. They concluded that acupuncture assisted with pain relief after an egg pickup; however, of all the studies they analysed, only one of these suggested acupuncture improved pregnancy rates. Based on the evidence, they were unable to substantiate improved pregnancy rates in IVF patients who received acupuncture.
The same group also conducted a double-blind, placebo-controlled human study; which for all intents and purposes is the gold standard for scientific experimentation. What this means is that neither the patients nor the experimenters know which subject will be allotted to a specific treatment group. Allocation is conducted randomly, by an individual or group not associated with that specific trial. Patients selected for this study had similar parameters; age, duration of infertility, causes of infertility, cycle numbers, insemination methods as well as previous acupuncture experience. What they discovered was that the placebo group (placebo needles were those that give the same sensation as normal acupuncture needles) had higher overall pregnancy rates (55.1%) compared to the real acupuncture group (43.8%) – with no significant differences in ongoing pregnancy and live birth between the two groups. What does this mean? To put it simply, in this study it has been shown that acupuncture does not affect IVF outcome.
I know there are many who swear by alternative therapies because “It worked for me!” but from the scientific evidence it is very difficult to say with confidence that acupuncture (or traditional Chinese medicine) will increase your chances of pregnancy. Your success is likely attributed to other factors – and not the alternate therapy. Having said that, undertaking such treatment can help relieve stress and anxiety, which may be beneficial itself. If the question is one of relieving stress and anxiety (not a very easy thing to do given the emotional rollercoaster patients go through during fertility treatment), then perhaps it is best to look at other (more affordable!) techniques that may help you acheive this, particularly during transfer, and most importantly for the few weeks post embryo transfer. The purpose of this blog is not to prevent you from using acupuncture – if it helps you to relieve stress, then you should explore it as an option. However, what we are trying to explain is that the scientific evidence raises serious doubts about the effectiveness of acupuncture as a remedy for infertility.
If you have any questions, or would like links to the articles used for this blog, please do not hesitate to get in contact with us. As always, please discuss your medical plan (including complementary medicine) with your fertility specialist.
Best of luck!
Mo
