All Studies summarized by the Texas Center for Reproductive Acupuncture in their Research Findings on the Clinical Efficacy of Reproductive Acupuncture report
Acupuncture Studies
- Acupuncture and Embryo Transfer
- Acupuncture and Pregnancy
- Acupuncture and Endometriosis
- Acupuncture, Stress and Fertility
- Acupuncture and Sperm
- Acupuncture and PCOS
- Acupuncture and Fertility Mechanisms
Use of Acupuncture Before and After Embryo Transfer
Dalton-Brewer N et al Hum Fert 2010 Vol 12 No 4 212-255, Human Fertility (abstracts from UK Fertility Societies Conference 2009)
This report shows outcomes for all patients who attended the London Bridge Fertility, Gynecology and Genetics Centre in London and were reviewed over 2 years. A total of 71 patients underwent 74 cycles involving acupuncture before and after embryo transfer. The results showed positive pregnancy rates were 44.6% compared favourably with the non-acupuncture historic control group. After analyzing outcomes, they discovered acupuncture intervention was particularly effective for women in the 35-39 and over 40 groups.
The Relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: A pilot study
Balk J et al, Compl Therapies in Clinical Practice 2010, 16, 154-157, Complementary Therapies in Clinical Practice
These researchers at a university IVF clinic in Pittsburgh were interested in investigating the relationship between acupuncture, stress and pregnancy rates. The patients who received acupuncture on the day of embryo transfer had a pregnancy rate of 55.6% compared with the control group’s pregnancy rate of 35.5%.
Influence of Acupuncture on Infertility in Rats with Polycystic Ovarian Syndrome
Zhang Wei Yi et al, Chinese Jnl Integrated Traditional and Western Med 2009 Nov (8), 973 Chinese Journal of Integrated Traditional and Western Medicine
This research carried out in Wuhan, China examined the effect of acupuncture administered to rats on various fertility measures including the implantation rate of blastocysts. Acupuncture was used on the abdomen and limbs. This significantly increased ovarian and uterine development and the rate of implantation of embryos compared to the control group rates, which did not have acupuncture
Pilot study: acupuncture may improve results of IVF
Jancin B, 2010, Elsevier News, Elsevier Global Medical News
This trial was presented at the Annual Society for Reproductive Medicine meeting by Dr Omedei from Italy and was reported by Elsevier and ObGyn News. It has not yet been published in a journal. They found that women who had acupuncture at the same time of embryo transfer had a 45% pregnancy rate (determined by ultrasound) compared to women in the control group with no acupuncture who had a pregnancy rate of 28%. The acupuncture-treated women reported a sense of well-being while the control group generally reported feeling emotionally stressed and fatigued.
All Studies summarized by the Texas Center for Reproductive Acupuncture in their Research Findings on the Clinical Efficacy of Reproductive Acupuncture report
Acupuncture for Pre-birth Treatment: An Observational Study of Its Use in Midwifery Practice
Betts D and Lennox S, Med Acup 2006, 17, (3) 16-19, Medical Acupuncture
This survey conducted in New Zealand revealed that women who had acupuncture in the last 4 weeks of their pregnancy had a third less the number of medical inductions, epidurals and emergency caesareans compared to local population rates.
Acupuncture for Depression During Pregnancy: A Randomized Controlled Trial
Manber R et al, Obst and Gynec 2010, 115 (3) 511-520, Obstetrics and Gynecology
Since there is evidence that the use of antidepressants increases the risk of miscarriage there has been much interest in the use of acupuncture to treat depression, which occurs in pregnancy.
Several trials and systematic reviews of the effectiveness of acupuncture in the treatment of depression have been published over the last 5 years and a meta-analysis of these trials concluded that acupuncture is an effective treatment for depression. This trial looked specifically at depression in pregnancy and found that acupuncture was as effective as other standard treatments and worked more quickly.
Cost-effectiveness of breech version by acupuncture-type intervention on BL 67, including moxibustion, for women with a breech fetus at 33 weeks gestation: a modelling approach
Van den Berg I et al, Complement Ther Med. 2010 Apr;18(2):67-77. Complementary therapies in medicine
The use of acupuncture and moxibustion on women presenting with breech babies at week 33 was assessed in this large retrospective Dutch study. Acupuncture was shown to reduce the number of breech presentations at term, thus reducing the number of caesarean sections.
Influence of acupuncture on Doppler ultrasound in pregnant women
Zeisler H et al, Ultrasound Obstet Gyn 2001 volume 17, issue 3, pages 229-232, Ultrasound in Obstetrics & Gynaecology
This study showed that acupuncture performed on pregnant women close to term had a beneficial effect on blood flow in the umbilical artery, leading some researchers to suggest that acupuncture provides an alternative method of preventing preeclampsia or intrauterine growth restriction in high-risk women.
All Studies summarized by the Texas Center for Reproductive Acupuncture in their Research Findings on the Clinical Efficacy of Reproductive Acupuncture report
A controlled study on Shu-Mu point combination for the treatment of endometriosis
Sun YZ, Chen HL Zhongguo Zhen Jiu, 2006 Dec;26(12):863-5, Zhongguo Zhen Jiu
Acupuncture was used on back and front points in this trial, which compared different sorts of point prescriptions with the treatment of endometriosis with Danazol. Acupuncture was superior in relieving pain and in reducing blood markers of the disease.
Acupuncture Combined with Medicine Effects on Outcomes of Patients with Endometriosis Who Accepted IVF-ET
Yu Xiao-Li et al, Liaoning Journal of Traditional Chinese Medicine 2010 Vol 4 Liaoning Journal of Traditional Chinese Medicine
This trial carried out in northeast China, looked at 180 women with endometriosis who were doing a long downregulated IVF protocol. The women who were given acupuncture alongside Chinese medicine achieved significantly higher pregnancy rates than those in the other groups who did not have acupuncture.
All Studies summarized by the Texas Center for Reproductive Acupuncture in their Research Findings on the Clinical Efficacy of Reproductive Acupuncture report
Understanding Women’s Views towards the Use of Acupuncture while undergoing IVF Treatment
Smith C and De Lacey S, 2008 in press, FSA conference 2008
This qualitative study found that most women who had acupuncture as an adjunct to IVF treatment reported increased well-being, reduced anxiety and an increase in capacity to cope with the stress of IVF and infertility treatments.
Building resilience: an exploration of women’s perceptions of the use of acupuncture as an adjunct to IVF
De Lacey S, Smith C and Paterson C, BMC Complementary and Alternative Medicine 2009, 9:50 BioMed Central
Studies of acupuncture involving women with chronic health issues have shown that women experienced relief of presenting symptoms but also increased energy, increase and relaxation and calmness, reduction in the reliance on prescription drugs (such as analgesics), quicker healing from surgery and increased self-awareness and well-being.
The relationship between perceived stress, acupuncture and pregnancy rates among IVF patients: a pilot study
Balk J et al, Complement Ther Clin Pract. 2010 Aug:16(3):154-7). Complementary Therapies in Clinical Practice
These investigators aimed to determine if acupuncture affects the levels of perceived stress at the time of embryo transfer, and whether either acupuncture or changes in stress levels play a role in the success rate of IVF. The patients who received acupuncture in this study had both higher rates of pregnancy, and lower levels of stress both before and after embryo transfer, They postulated that reducing stress at the time of embryo transfer could result in less vasoconstriction and improved uterine receptivity.
Stress reduces conception probabilities across the fertile window: evidence in support of relaxation.
Buck Louis GM et al, Fertil Steril, 2011, 95, 7, pg 2184-2189, Fertility and Sterility
This study showed a clear relationship with higher stress levels and reduced conception rates. This may be one of the ways that acupuncture, which reduces stress hormones can improve fertility
Immunological changes and stress are associated with different implantation rates in patients undergoing in vitro fertilization-embryo transfer
Gallinelli A et al, 2011 Fertil Steril 76, 1, 85, Fertility and Sterility
This study examines the effect of stress on embryo transfer and explores its impact on the immune system. The researchers conclude that stress is associated with high amounts of activated T cells in the peripheral blood, which is in turn associated with a reduced implantation rate in women undergoing IVF. The subject of regulation of T cells by acupuncture is something we are examining currently and is one of the hypothesized mechanisms by which acupuncture may increase implantation in some women.
All Studies summarized by the Texas Center for Reproductive Acupuncture in their Research Findings on the Clinical Efficacy of Reproductive Acupuncture report
Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility
Pei J et al Fertil Steril, 2005 Jul;84(1): 14 1-7, Fertility and Sterility
A group of infertile men, who had pathological semen analyses according to WHO criteria, were treated with acupuncture twice a week for 5 weeks. A statistically significant increase after acupuncture in the percentage and number of sperm with no structural defects was demonstrated compared to the control group of patients who received no treatment. They concluded that male infertility patients could benefit from having acupuncture. A general improvement in sperm quality, specifically in the ultrastructural integrity of spermatozoa was seen after acupuncture.
Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality
Siterman S et al Arch Androl. 1997 Sept-Oct;39(2):155-61, Archives of Andrology
A group of infertile men with abnormal semen analysis were randomly divided into 2 groups; one was given 10 acupuncture treatments over 5 weeks, and the other group, no treatment. Significant improvements were demonstrated in the acupuncture group compared to the control group, in particular improved motility and morphology.
Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study.
Siteman S et al Andrologia, 2000 Jan;23(1):31-9., Andrologia
This pilot study showed a positive effect of acupuncture on sperm count – but this time on men with such low sperm counts (or no sperm) that they would usually require a testicular biopsy to extract sperm for use in an IVF cycle. Seven of the 15 men with no sperm at all produced sperm detectable by the light of a microscope after a course of 10 acupuncture treatments i.e. enough sperm could be produced for ICSI to be performed without a testicular biopsy needed. The control group with similar semen analysis had no treatment and showed no change after 3 months.
Influence of acupuncture on idiopathic male infertility in assisted reproductive technology.
Zhang M et al J Huazhong Univ Sci Tech Med Sci. 2002;22(3):228-30 Journal of Huazhong University
This trial looks at sperm behaviour in an IVF setting. It was a “before and after” study involving 82 infertile men with pathological semen abnormalities whose sperm achieved a poor fertilization rate in at least 2 IVF/ICSI cycles. They were given acupuncture twice a week over 8 weeks and the IVF/ICSI cycles were repeated. The fertilization rates after acupuncture (66.2%) were significantly higher than before treatment (40.2%)
All Studies summarized by the Texas Center for Reproductive Acupuncture in their Research Findings on the Clinical Efficacy of Reproductive Acupuncture report
Investigation on the effect of electroacupuncture intervention on in vitro fertilization and embryo transfer of patients with polycystic ovarian syndrome
Chen Jen et al Maternal and Child Health Care of China 2009;30 pg 28 Maternal and Child Health Care of China
A group of researchers in Shandong, China used electroacupuncture with PCOS patients doing IVF. They found that there was a significant reduction in the incidence of ovarian hyperstimulation syndrome (OHSS) if acupuncture was included.
Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome
Stener Victorin E et al, Acta Obstet Gynecol Scand 2000;79: 180-188 Acta Obstetricia et Gynecologica Scandinavica
This was one of the first trials to look at the effect of acupuncture on polycystic ovarian syndrome. This and subsequent trials have shown that electroacupuncture can stimulate reluctant ovaries to ovulate more often in some women with PCOS.
Acupuncture in Polycystic Ovary Syndrome: Current Experimental and Clinical Evidence
Stener-Victorin E et al, Journal of Neuroendocrinology 2008, 20 (3), 290-298 Journal of Neuroendocrinology
This review evaluates the place of acupuncture in the treatment of PCOS. It explains that many women with PCOS require prolonged treatment. Acupuncture is reported to positively affect PCOS symptoms and markers via modulation of endogenous regulatory systems, including the sympathetic nervous system, the endocrine system and the neuroendocrine system. The changes are most likely mediated via the endogenous opioid system.
Low-frequency electroacupuncture and physical exercise decrease high muscle sympathetic nerve activity in polycystic ovary syndrome.
Sterner Victorin E et al Am J Physiol 2009 Aug;297(2): R387-95. American Journal of Physiology
This trial found that activity of the sympathetic nervous system (which is abnormally pronounced in PCOS) could be reduced with acupuncture or with exercise.
Additionally, they found that acupuncture significantly reduced the level of testosterone in PCOS patients. Those women in the study who were not ovulating reported more regular menstrual cycles after acupuncture treatment.
Low-frequency EA and Physical Exercise Improve Metabolic Disturbances and Modulate Gene Expression in Adipose Tissue with Rates of Dihydrotestosterone-Induced PCOS
Manneras L et al 2008 Endocrinology col. 149 (7) pg3559-3568
Insulin resistance associated with PCOS was reduced by acupuncture in this animal study.
Impact of EA and physical exercise on hyperandrogenism and oligo/amenorrhea in women with PCOS
Jedel E et al, Am J Physiol Endocrinol Metab 2011 300:(1) E37-E45 American Journal of Physiology
This trial found that 4 months of acupuncture effectively reduced testosterone and improved ovulation frequency in PCOS patients, and was superior to exercise in achieving these aims.
All Studies summarized by the Texas Center for Reproductive Acupuncture in their Research Findings on the Clinical Efficacy of Reproductive Acupuncture report
Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilization: systemic review and meta-analysis.
Manheimer E et al. BMJ 2008;336 pg 545-549, British Medical Journal
Early in 2008, the prestigious British Medical published its analysis of acupuncture in a meta-analysis of 7 of these trials. They chose only those that met strict research criteria.
The authors concluded: “The odds ratio of 1.65 suggests that acupuncture increased the odds of clinical pregnancy by 65% compared with the control groups…In absolute terms, 10 patients would need to be treated with acupuncture to bring about one additional clinical pregnancy. These are clinically relevant benefits.
Impressive as these results are, they may still be an underestimate, since the authors included women whose IVF cycles were cancelled before transfer.
The accompanying editorial in the BMJ comments that adding acupuncture to IVF improved pregnancy rates more than any other recent improvement or advance in IVF technology.
Traditional Chinese medicine and infertility.
Huang, S T and Chen, A P C, Current Opinion in Obstetrics & Gynaecology. 2008, 2(3):211-215.
A review of current medical literature carried out by researchers in Taiwan noted “traditional Chinese medicine could regulate the gonadotropin-releasing hormone to induce ovulation and improve the uterus blood flow and menstrual changes of the endometrium. In addition, it also has impacts on patients with infertility resulting from polycystic ovarian syndrome, anxiety, stress and immunological disorders.”
The Role of Acupuncture in the Management of Subfertility
Ng E H et al Fertil Steril. 2008 Jul;90(1):1-13., Fertility and Sterility
Another review of the literature from a group in Hong Kong concludes that the positive effect of acupuncture in the treatment of subfertility may be related to the central sympathetic inhibition by the endorphin system, the change in uterine blood flow and motility, and stress reduction.
Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture.
Stener-Victorin E, et al Hum Reprod 1996; 11:1314-1317, Human Reproductive
Previous studies have shown that reduced blood flow in the uterine arteries is associated with a decreased pregnancy rate following IVF-embryo transfer. This study reported in Human Reproduction (the official journal of the European Society of Human Reproduction and Embryology) shows that after 8 acupuncture treatments blood flow to the uterus was markedly increased.
Ovarian blood flow responses to electro-acupuncture stimulation at different frequencies and intensities in anaesthetized rates
Stener-Victorin E et al Autonomic Neuroscience 2003, Vol 108, Issues 1-2, Pg 50-55 Autonomic Neuroscience.
The blood flow to the ovaries is enhanced by acupuncture. This study was done on anaesthetized rats, however we can assume a similar mechanism will operate in women.
A Pilot Study Evaluating the Combination of Acupuncture with Sildenafil on Endometrial Thickness
Yu W et.al. Presented at the Pacific Coast Reproductive Society Annual Conference 2007
A small pilot study examined the effect of Viagra and acupuncture on the uterine linings of women who had a history of thin linings (<8mm) in previous IVF cycles (including patients who had previously used Viagra alone). They used acupuncture protocols, which improve blood flow to the ovaries and uterus. The researchers found that after acupuncture treatment the thickness of the lining improved by 10 mm or more in all participating patients
Acupuncture treatment for Infertile Women Undergoing Intracytoplasmic Sperm Injection
Emmons S and Patton P, Medical Acupuncture 2000, 12 (2) 18-20 Medical Acupuncture
Several women were referred to acupuncture as a last resort after a very poor response to high doses of FSH. More eggs were collected and more pregnancies were recorded in the acupuncture cycles compared to the non-acupuncture cycles, possibly due to the increased blood supply to the ovaries.