February 8, 2008
Study: Acupuncture Improves IVF Success
Dutch and U.S. researchers reported this week that acupuncture might improve the odds of pregnancy through in-vitro fertilization if done right before or after embryos are placed in the womb. The researchers said that for every 10 in-vitro fertilization (IVF) cycles accompanied with acupuncture, there would be one additional pregnancy.
However, the conclusion is far from proven, and at this time there are only theories for how and why acupuncture might improve IVF pregnancy rates. Fertility experts say they are hopeful that acupuncture treatments might someday prove to be a useful add-on to traditional IVF methods.
The analysis, led by Eric Manheimer of the University of Maryland School of Medicine, examined findings from seven previous studies on 1,366 women in the United States, Germany, Australia and Denmark who were going through in-vitro fertilization. IVF involves mixing sperm and eggs in a lab dish to create embryos that are then placed in the womb.
Women were randomly assigned to receive IVF alone, IVF with acupuncture within a day of embryo transfer, or IVF plus sham acupuncture, in which needles were placed too shallowly or on parts of the body so as not to be effective.
Three of the studies found acupuncture beneficial, three found a trend toward benefit and one found no benefit. When results of these smaller studies were collected, researchers concluded that the odds of conceiving went up about 65 percent for each woman who received acupuncture.
However, medical experts warn against focusing on that specific number because this type of analysis with pooled results is not proof of the extent to which acupuncture helps, if at all. To put the results in perspective, IVF results in pregnancy about 35 percent of the time, and adding acupuncture might boost that to around 45 percent, according to the researchers.
Acupuncture involves placing very thin needles at specific points on the body to try to control pain and reduce stress. In fertility treatments, it is thought to increase blood flow to the uterus, relax the cervix and inhibit stress hormones that can make it difficult for an embryo to implant, Manheimer said in an Associated Press report.
"It is being taken more seriously across our specialty, and more doctors are training in it," Dr. William Gibbons, who runs a fertility clinic in Baton Rouge, La., told Associated Press. Gibbons is past president of the Society for Assisted Reproductive Technology. "I have not seen proof ... but we wouldn't mind at all" if it turned out to work, he said.
One believer is Dr. Ann Trevino, a 37-year-old, pregnant family physician who recently moved to Houston. She had three unsuccessful pregnancy attempts with intrauterine insemination before trying acupuncture with IVF at a fertility clinic in San Antonio. Dr. Francisco Arredondo, who runs Reproductive Medicine Associates of Texas where Trevino was treated, began offering acupuncture last October after requests from patients.
"I had been reading about acupuncture, probably like every other patient, on the Internet. I was just willing to do anything possible to improve our chances," Trevino told AP. With acupuncture, "I just felt very warm and relaxed" when the embryos were placed.
Acupuncturist Kirsten Karchmer said she places about a dozen needles in the ears, hands, feet, lower legs, abdomen and sometimes the lower back. The treatments cost about $500 a month for twice-weekly sessions, and patients typically go for three months, she told AP.
IVF costs approximately $12,000 per attempt, so any treatment that improves its effectiveness might save money in the long run, Manheimer said.
"It looks like, from the body of evidence out there, that some patients benefit," Dr. James Grifo, head of the infertility program at New York University, told AP.
However, Dr. Zev Rosenwaks, director of infertility treatment at New York-Presbyterian Hospital/Weill Cornell Medical Center, said other studies did not find acupuncture helpful.
"The jury is still out," he told AP, "[but] it's unlikely that acupuncture does any harm."
Eleanor Nicolle, a spokeswoman for the American Society for Reproductive Medicine told AP the organization has no policy on acupuncture. "There's been a lot of conflicting research" on its usefulness, she said.
The study's authors include doctors from the Netherlands and Georgetown University in Washington, D.C.
The study was paid for by the National Center for Complementary and Alternative Medicine. Results were published Friday in the British medical journal, BMJ.