Press Release, Feb. 8 — Acupuncture during embryo transfer may improve the odds of pregnancy with in vitro fertilization, results of a systematic review suggest.

by Charles Bankhead, Staff Writer, MedPage Today 

Press Release, Feb. 8 — Acupuncture during embryo transfer may improve the odds of pregnancy with in vitro fertilization, results of a systematic review suggest.

Adjuvant acupuncture was associated with significant improvement in clinical pregnancy, ongoing pregnancy, and live birth, Eric Manheimer, of the University of Maryland, and co-authors reported online and in the British Medical Journal.

However, the authors cautioned that when they restricted the analysis only to studies with the highest pregnancy rates, they found the effect of acupuncture to be nonsignificant.

“The dependency of the magnitude of the effect of acupuncture on the baseline pregnancy rate warrants further study,” they said.

More than 120,000 IVF cycles are performed each year in the United States. The cost, time, and stress associated with the process have stimulated interest in the development of strategies to improve success rates, the authors noted. However, efforts have led to little progress thus far.

They also noted that acupuncture has been used in China for centuries to regulate the female reproductive system. Three potential mechanisms for its effects have been suggested: release of neurotransmitters that may stimulate secretion of gonadotropin-releasing hormone, stimulation of blood flow to the uterus, and induction of endogenous opioids that may damp the biological stress response.

To gain perspective on the use of acupuncture in IVF, investigators searched multiple sources of medical literature for randomized, controlled trials that compared acupuncture within one day of embryo transfer with sham acupuncture or no adjuvant treatment.

Seven trials involving a total of 1,366 women met the selection criteria and were included in the meta-analysis.

The data showed that adjuvant acupuncture was associated with significant improvement in IVF outcomes:

Clinical pregnancy, OR 1.65, 95% CI 1.27 to 2.14, number needed to treat (NNT) 10

Ongoing pregnancy, OR 1.87, 95% CI 1.40 to 2.49, NNT 9

Live birth, OR 1.91, 95% CI 1.39 to 2.64, NNT 9

“Because we were unable to obtain outcome data on live births for three of the included trials, the pooled odds ratio for clinical pregnancy more accurately represents the true combined effect from these trials rather than the odds ratio for live birth,” the authors said.

The results remained consistent in sensitivity analyses. However, a pre-planned subanalysis of the three trials with the highest rates of pregnancy resulted in an odds ratio of 1.24, suggesting a nonsignificant effect of acupuncture on pregnancy.

Although the meta-analysis showed a significant effect of acupuncture on pregnancy rates, the studies included in the analysis had methodologic problems, said Ertug Kovanci, M.D., a fertility specialist at Baylor College of Medicine in Houston. Also, he noted, a large effect in one of the studies skewed the results.

“The jury is still out, and that would be a good reason to design a future study, a multicenter, randomized controlled study to settle the issue,” said Dr. Kovanci. “This study didn’t settle it, and I don’t think many people will change their mind about acupuncture on the basis of a meta-analysis.”

The authors reported no competing interests. 

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Published: February 08, 2008


Primary source:

British Medical Journal 

Source reference:

Manheimer E, et al “Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilization: systematic review and meta-analysis” BMJ 2008; DOI: 10.1136/bmj.39471.430451.BE.