Does acupuncture improve IVF success rates?

Does acupuncture improve IVF success rates?

This is a summary of a blog post by the amazing Dr Lee Hullendar Rubin, she is an acupuncturist and a clinical researcher. So, she is highly qualified to state an expert opinion on this very topic. (The link to her original blogpost is at the end of this article.)

The answer to the question posed depends on two things:

• the number (or dosage) of acupuncture sessions that you have during the whole IVF cycle, and

• what acupuncture was compared with (in the context of randomised clinical trials)

It seems strange to think of acupuncture as having a dosage level. But if you think about it, this completely makes sense. You wouldn’t expect to take one painkiller, and then be free of pain forever; yet, somehow acupuncture is supposed to be this magical thing that “fixes” everything. Now, don’t get me wrong, I think acupuncture is amazing; but it’s just not magic.

In reality, you would expect to take a short course of gonadotrophin injections to stimulate the ovaries, compared to just having the one injection. It’s the same with acupuncture, you need to have a course of acupuncture treatments in order to get the best outcome from your acupuncture sessions.

Getting back to the question: does acupuncture improve IVF success rates?

When patients attended at least 6 acupuncture sessions (including 2 around embryo transfer) throughout the whole IVF cycle, acupuncture does seem to improve chances of pregnancy and live births. [1, 2, 3]

However, some of the research into acupuncture and IVF success rates does produce some confusing results:

• some research only looks at 2 sessions of acupuncture around the timing of embryo transfer, which does seem to provide 30% increase in chances of live birth [4, 5]

• some research compares real acupuncture with sham acupuncture, which produces no significant difference in results between real acupuncture and sham acupuncture

• yet, other studies show that sham acupuncture is not a real placebo, and in some cases has an effect of up to 20% more than a real placebo (sugar pill)[6, 7, 8,9]; which calls into question the results obtained in all studies that utilise sham acupuncture [4,5]

• studies that compare real acupuncture with no treatment does produce a better outcome [1]

So, after all of that; it seems that the research is still undecided on whether acupuncture does improve IVF success rates. But there are a couple of things we can take away from this research:

• the dosage of acupuncture is important; around 6 sessions seems to have a favourable effect [1, 2,3]

• having some acupuncture seems to increase the chances of IVF success rates when you compare it to no additional treatments.[1]

At Bing’s Natural Health, we do recommend combining individualised chinese herbs with your acupuncture treatments for better outcomes. There aren’t any studies that look at combining acupuncture with chinese herbs; I think it’s because having two different treatment arms in a study makes it become too complicated to manage all the variables

As promised, this is the link to Dr Lee Hulllender Rubin’s original blog post. I’ve attended a few of her talks, and find she’s such a knowledgeable acupuncturist and researcher. Many thanks to Dr Lee Hullender Rubin for sharing her knowledge.

Research:

1. Hullender Rubin, L.E., et al., Impact of whole systems traditional Chinese medicine on in vitro fertilization outcomes. Reproductive Biomedicine Online, 2015. 30(6): p. 602-612.

2. Rubin, L.H., et al., Birth outcomes from acupuncture added to frozen embryo transfer (fet) of autologous embryos without genetic screening: a retrospective cohort study. Fertility and Sterility, 2020. 114(3): p. e330.

3. Rubin, L.H., et al., Impact of acupuncture and traditional chinese medicine (TCM) on frozen embryo transfers (FET) of autologous embryos with comprehensive chromosomal screening (CCS): a retrospective cohort STUDY. Fertility and Sterility, 2020. 114(3): p. e450-e451.

4. Smith, C.A., et al., Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis. Reprod Biomed Online, 2019. 38(3): p. 364-379.

5. Xie, Z.Y., et al., The effects of acupuncture on pregnancy outcomes of in vitro fertilization: a systematic review and meta-analysis. BMC Complement Altern Med, 2019. 19(1): p. 131.

6. MacPherson, H., et al., Influence of control group on effect size in trials of acupuncture for chronic pain: a secondary analysis of an individual patient data meta-analysis. PLoS One, 2014. 9(4): p. e93739.

7. Harris, R.E., et al., Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opiod receptors (MORs). Neuroimage, 2009. 47(3): p. 1077-1085.

8. So, E.W., et al., Acupuncture for frozen-thawed embryo transfer cycles: a double-blind randomized controlled trial. Reprod Biomed Online, 2010. 20(6): p. 814-21.

9. Smith, C., M. Coyle, and R.J. Norman, Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer. Fertil Steril, 2006. 85(5): p. 1352-8.