Source: Eric Manheimer et al, British Medical Journal, 2008 Mar 8;336(7643):545-9

– In vitro fertilisation is lengthy, expensive and stressful.
– Safe, low cost, complement treatment to improve success rate would benefit patients and reduce cost.
Current evidence from trials showed and odd ratio of more than 1.6 for clinical pregnancy after IVF combined with acupuncture.

Around 10-15% of couples have difficulty conceiving in their reproductive lives and seek specialist fertility treatment. A commonly used option is in vitro fertilisation (IVF), which involves retrieving a woman’s egg, fertilising the egg in the laboratory, and then transferring the embryo back into the woman’s uterus through the cervix. This entire process is typically referred to as an in vitro fertilisation “cycle”. In 2003, over 120 000 treatment cycles were performed in the United States and in 2000, about 200 000 babies worldwide were conceived through in vitro fertilisation. Because each cycle is expensive, lengthy, and stressful, new drugs and technologies have been developed to improve success rates. Progress, however, has been limited.

Acupuncture has been used in Asia for thousands years to regulate the female reproductive system. Three mechanisms for its effects on fertility have been postulated:

  1. Acupuncture mediate the release of neurotransmitters, which may in turn stimulate secretion of gonadotrophin releasing hormone, thereby influencing the menstrual cycle, ovulation, and fertility.
  2. Acupuncture stimulate blood flow to the uterus by inhibiting uterine central sympathetic nerve activity.
  3. Acupuncture stimulate the production of endogenous opioids, which inhibit the central nervous system outflow and the biological stress response.

Seven trials with 1366 women undergoing in vitro fertilisation were included in the meta-analyses. Complementing the embryo transfer process with acupuncture was associated with significant and clinically relevant improvements in clinical pregnancy.

Safety and costs are other considerations. Two large prospective surveys of practitioners show that serious adverse events after acupuncture are rare. Systematic reviews have shown acupuncture to be safe. Average of $12.400 (£6.300, €8.480) per cycle in the United States. If acupuncture increased the likelihood of success of an IVF cycle, then the need for a subsequent cycle would be reduced, and overall costs would be decreased.

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