BJOG Release: How Does Acupuncture Influence IVF Outcome?

Despite the prevalence of acupuncture as a complement to in vitro fertilisation (IVF) treatment, a new study to be published in BJOG: An International Journal of Obstetrics and Gynaecology has found that there is little evidence of any benefits.


The study, from Guy's and St Thomas' Hospital in London, was a review and meta-analysis of 13 randomised trials involving the use of acupuncture during IVF treatment and outcome assessment. In total, 2500 women were included.


Five of the 13 trials included a total of 877 women and evaluated IVF outcome when acupuncture was performed at the time of egg retrieval from the woman. All five studies were based in Europe and the mean age of the participants was 30.5 to 34.4 years. Pooling of the results showed no significant difference in the clinical pregnancy rate between the acupuncture and control groups (relative risks (RR) = 1.06, 95% CI 0.82-1.37, P = 0.65).


A further eight trials included a total of 1623 women and assessed IVF outcome when acupuncture was performed at the time of embryo transfer. Four of these studies were conducted in Europe, three in the USA and one in Australia. Again when pooling the results of all the studies, no significant difference between the acupuncture and control groups was detected (RR = 1.23, 95% CI 0.96-1.58, P = 0.28).


Further break down of the results into categories including live birth rate, whether the control groups received no intervention at all or sham (placebo) needle acupuncture, as well as the types of acupuncture used, the number of sessions women were given, and who administered the acupuncture, consistently found no significant difference.


Dr Aravinthan Coomarasamy, Assisted Conception Unit, Guy's Hospital, London, said: "A comprehensive review of evidence has shown acupuncture in IVF treatment may not be as useful as previously claimed. Whilst some studies have shown benefit with acupuncture, others have shown no increase, or worse, a reduction in pregnancy rates with acupuncture.


"The reasons for the conflicting findings are unclear; however, based on the existing evidence, it would not be prudent to recommend routine use of acupuncture with IVF treatment. Large and good quality studies are needed to settle this question."


Professor Philip Steer, BJOG Editor-in-Chief said: "Those undergoing IVF treatment and their clinicians clearly wish for the best possible outcome, a healthy pregnancy and birth. Over the years there has been much back and forth regarding whether acupuncture increases the chances of success.


"This meta-analysis appears to show that, despite its popularity, acupuncture may have no beneficial effect on IVF after all. Further work is required in this area to fully establish whether a link does exist so that women can be assured that they are receiving the most effective care."


Notes


BJOG: An International Journal of Obstetrics and Gynaecology is owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Wiley-Blackwell. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote 'BJOG' or 'BJOG: An International Journal of Obstetrics and Gynaecology' when referring to the journal.


Reference


A systematic review and meta-analysis of acupuncture on in vitro fertilisation.
El-Toukhy T, Sunkara S, Khairy M, Dyer R, Khalaf Y, Coomarasamy A
BJOG 2008; DOI: 10.1111/j.1471-0528.2008.01838.x.

Royal College of Obstetricians and Gynaecologists