Sub-fertility, or difficulty conceiving a child, affects some 10-15% of couples. Many of these will be offered In-Vitro Fertilisation (IVF) as a means of having a baby. IVF involves the stimulation of egg production, collection of eggs (oocyte collection), fertilisation of the eggs, and then transferring the embryo back into the mother’s uterus (embryo transfer). It is often an emotional journey, and prospective parents quite understandably want to do everything they can to ensure they are able to hold a baby in their arms one day.
In 1999 researchers in Sweden were testing the effect of acupuncture on pain relief during the egg collection procedure, and noticed that the group that received acupuncture had higher pregnancy rates and “take-home baby rates”. This finding sparked significant interest in the area of acupuncture to support IVF. A recent Cochrane review analysed results from thirteen clinical trials and concluded that acupuncture performed on the day of embryo transfer results in a higher birth rate.
How acupuncture might work in supporting IVF
Researchers believe that acupuncture may work in several ways to increase the pregnancy and “take-home baby” rate. Firstly,acupuncture can affect hormonal systems in the body, including the systems that govern reproduction. Secondly, acupuncture can increase the blood flow to the uterus, which may assist with implantation. Thirdly, acupuncture may reduce stress, which increases the chance of conception.
What the research shows
The Cochrane review authors divided the clinical trials into three groups, depending on when acupuncture was given. In the first group, acupuncture was given on the day of embryo transfer. In the second, acupuncture was given on the day of embryo transfer as well as two or three days later. In the third group, acupuncture was given during the egg collection procedure.
In the first group, there was a higher live birth rate in the acupuncture group compared with women receiving no acupuncture or sham acupuncture. On average, 35% of women in the acupuncture group gave birth to live babies compared with 22% in the control group. Clinical pregnancy rate in the acupuncture group was also higher at 39%, compared with 30% in the control group.
In the second group, there was a higher clinical pregnancy rate in the acupuncture group (35%) compared with the control group (19%) but no difference in the live birth rate. In the third group, who received acupuncture during egg collection, there was no difference in either the clinical pregnancy rate or live birth rate between the acupuncture and control groups.
Conclusion
The authors concluded that acupuncture given on the day of embryo transfer shows evidence of benefit. They cautioned that this may be due to the placebo effect and called for more research into the area. They also cautioned against the use of acupuncture in early pregnancy when IVF is not used to conceive, because of the findings that acupuncture given repeatedly in early pregnancy resulted in a higher pregnancy rate but not a higher live birth rate.
Cheong YC, Hung Yu Ng E, Ledger WL. Acupuncture and assisted conception. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD006920. DOI: 10.1002/14651858.CD006920.pub2.
