Research

Acupuncture trials for infertility: a summary

Controlled trials

Gerhard and Postneek (1992) [Germany] – Hormone induced infertility

[n=45+45] – retrospective matched pairs – ear acupuncture v best orthodox treatment
Various hormonal disorders - 40% amenorrhoea, 60% oligomenorrhoea Semi-standardised treatment using Nogier’s indications

Similar pregnancy rates but many fewer miscarriages, side effects, menstrual problems etc. with acupuncture

Stener-Victorin et al (1999) & (2003) [Sweden] – anaesthesia for oocyte aspiration in IVF

1999: [n=75] – prospective RCT – electro-acupuncture v standard opiate anaesthetic

Secondary outcome (primary was concerned with the degree of anaesthesia
provided): acupuncture gave a higher chance of implantation and higher take-home baby rate: 28/75 (37.3%) v 19/74 (25.7%) (p<.05)

2003: [n=286] – prospective RCT, as above

No difference in pregnancy rates (but acupuncture is as good an analgesic and gives less post-operative pain, nausea and stress)

Ji et al (1999) [China] – ovulation induction for infertility/amen-/oligomenorrhoea

[n=68+30] – {allocation method unknown but randomisation unlikely} – acupuncture v. drugs (clomiphene, HCG, stilbestrol, progesterone)

Acupuncture gave 54/68 (79.4%) ovulated; 47/68 (69.1%) pregnant
Medication gave 25/30 (83.3%); 12/30 (40%)

Emmons and Patton (2000) [USA] – adjunctive effect in Intracytoplasmic
Sperm Injection (ICSI)

[n=6] – case series of n=1 type – the patients acted as their own controls: for one or more cycles they had acupuncture and for one or more they did not – acupuncturegiven to stimulate
follicle development, in conjunction with conventional medication – 3-4 treatments over the 9-11 days leading up to egg retrieval – part formula/part individual TCM

Significantly more follicles recruited with acupuncture: overall means 8.4 v. 3.7, but much individual variation. The 3 high responders all became pregnant but only one maintained it

Zhao and Jin (2001) [China] – ovulation induction for pubertal
oligomenorrhoea

[n=20+20+20] – {prospective RCT} - acup v. oestrogen v. acup plus oestrogen

Successful ovulation in 5/20 with oestrogen, 12/20 with acup, 14/20 with both

Jin (2002) [China] – ovulation induction with pubertal dysfunctional
uterine bleeding

[n=22] – {source of patients for the 2 groups, and allocation method, unknown} – acupuncture v clomiphene

87% ovulated with acupuncture; 70% with clomiphene

Paulus et al (2002) [Germany] – adjunctive effect in Assisted
Reproductive Therapy (ART)

[n=80+80] – prospective RCT – acupuncture plus ART (IVF or ICSI) v. ART alone
2 treatments, 25 minutes before and after embryo transfer – 2 different
TCM formulae plus auricular points

42.5% pregnancy with acupuncture, 26.3% without (p=.03)
(no significant differences in plasma oestradiol, endometrial thickness, pulsatility index of uterine arteries)

Zhang et al (2003) [China] – adjunctive effect in Assisted Reproductive
Therapy

[n=70+70+70] – RCT – acupuncture (body points) v. sham acupuncture (details unknown) v. no acupuncture, as adjunct to ART (IVF or ICSI)

Two treatments in the acupuncture groups, one before and one after embryo transfer.

Pregnancy rates: acupuncture 44.3%, sham 27.1%, no acupuncture 24.3%
(p<.05 for acupuncture v. either of the other groups)
Contraction frequency of the uterine junctional zone: significantly lower in the acupuncture group after embryo transfer

Magarelli et al (2004) [USA] – adjunctive effect in good prognosis IVF patients

[n=53+61] – retrospective case controlled study – acupuncture v. no acupuncture, as adjunct to IVF in women with a good prognosis (based on various physiological measurements)

Two acupuncture approaches were used: a) electro-acupuncture aimed at reducing the uterine artery pulsatility, b) ‘traditional’ acupuncture combined with auricular and given pre- and post- embryo transfer. Some women had a), some had b) and some had both: all grouped into the acupuncture group

Pregnancy rate: acupuncture 51%, control 36% (p<.05)
Miscarriage rate: acupuncture 8%, control 20% (p<.05)
Acupuncture also reduced the risk of tubal pregnancies (p<.008) and increased the rate of live births: rate per IVF cycle was 23% higher in the acupuncture than the control group (p<.05)

Magarelli and Cridennda (2004) [USA] - adjunctive effect in IVF poor responders

[n=53+94] – same methodology and treatment approaches as in Magarelli et al above, but here the subjects had a poor IVF prognosis

Conclusions: similar improved pregnancy rates to those with the good prognosis
patients: acup. 53% vs. control 38% - but only after a statistical correction
(The rationale for this requires viewing the whole paper rather than the web site summary used here)