Fertility, Pregnancy & IVF Support

2021 Frontiers in Public Health

Based on the current evidence, acupuncture appears to be beneficial to increase the clinical pregnancy rate in women undergoing in vitro fertilization and embryo transfer.

This study reviews the SRs of acupuncture for infertile women undergoing IVF-ET. Based on the current evidence, acupuncture appears to be beneficial to increase the CPR in women undergoing IVF-ET. However, there are severe heterogeneity and methodological quality defects, which limit the reliability of results. Further, high-quality primary studies are still needed.

An Overview of Systematic Reviews of Acupuncture for Infertile Women Undergoing in vitro Fertilization and Embryo Transfer Wang, X., Wang, Y., Wei, S., He, B., Cao, Y., Zhang, N., & Li, M.

2021 Evidence-Based Complementary and Alternative Medicine

Acupuncture therapy on patients with recurrent implantation failure can improve the pregnancy outcome of patients. It is a relatively effective treatment with satisfactory safety and suitable for clinical application.

The aim of this analysis was to identify the efficacy and safety of acupoint stimulation therapy for RIF patients. The results of meta-analysis show that for the outcome measurements including clinical pregnancy rate, biochemical pregnancy rate, embryo implantation rate, and endometrial thickness, the use of acupuncture in the treatment group is higher than the sham or nonacupuncture group, in which the difference is statistically significant. These results are believable and reliable. The included studies are highly homogeneous and there is no obvious publication bias. However, large heterogeneity appears in the statistical analysis of the endometrial thickness. Moreover, there was no statistical significance in the number of embryo transfers and the type of endometrium.

The Effects of Acupuncture on Pregnancy Outcomes of Recurrent Implantation Failure: A Systematic Review and Meta-Analysis Li, M., Liu, Y., Wang, H., Zheng, S., Deng, Y., & Li, Y.

2021 European Journal of Integrative Medicine

Acupuncture may have a positive effect on anxiety relief during IVF treatment, while its effect on depression relief is inconclusive.

Twelve studies with 2867 participants were included. A significant difference was observed for the relief of anxiety comparing acupuncture with controls during IVF treatment. No significant difference was found for clinical pregnancy rate. Only 2 out of 12 studies assessed remission of depression but there was no clear effect shown for acupuncture.

Effects of acupuncture on the relief of anxiety and/or depression during in vitro fertilization: A systematic review and meta-analysis Ye, J.-Y., He, Y.-J., Zhan, M.-J., & Qu, F.

2020 Reproductive BioMedicine & Society Online

Women receiving IVF perceived that acupuncture or sham acupuncture gave them a psychological advantage through increased relaxation, reduced psychological stress, and enhanced well-being and self-efficacy.

In this qualitative study, participants reported that compassionate care and an opportunity to rest during IVF, and especially following embryo transfer, had an emotionally important effect. All women in the trial underwent the same procedural practices which involved bed rest during needling, among other comforts. Some women described benefitting purely from this opportunity to rest quietly in a supportive environment amidst the maelstrom of IVF. There was also recognition that this ‘oasis’, albeit brief, was an important time for allowing the meaning of having an embryo transferred to ‘soak in’, and presented an oppportunity to ‘be in the moment’.

IVF, acupuncture and mental health: a qualitative study of perceptions and experiences of women participating in a randomized controlled trial of acupuncture during IVF treatment Sheryl de Lacey Elizabeth Sanderman Caroline A. Smith

2020 European Journal of Integrative Medicine

Compared with western medicine, acupuncture significantly increased the pregnancy and ovulation rates, as well as reducing the rate of miscarriages among Chinese women with infertility.

Twenty-four eligible RCTs (n=2095) were included in this review. The NMA data showed that warm acupuncture had the highest chances of increasing the rate of pregnancy while acupuncture most positively affected the ovulation rate. On the other hand, a combination of acupuncture and moxibustion had the most significant improvement in endometrial thickness and could reduce the rate of pregnancy loss.

Effectiveness of different acupuncture for infertility: Overview of systematic reviews and network meta-analysis Zhang, J., He, Y., Liu, Y., Huang, X., & Yu, H.

2019 BMC Complementary Medicine and Therapies

Our analysis finds a benefit of acupuncture for IVF outcomes in women with a history of unsuccessful IVF attempt, and number of acupuncture treatments is a potential influential factor.

Our analysis finds a benefit of acupuncture for IVF outcomes among women with a history of unsuccessful IVF attempt, and number of acupuncture treatments is a potential influential factor. As repeated IVF cycle is possibly a proxy for implantation failure, which associated with poor prognoses (i.e. increasing age, longer history of infertility, elevated Peak FSH). In the future, analyses of pooled, patient-level data will be useful to find the true role of these parameters on the efficacy of acupuncture on IVF outcomes.

The effects of acupuncture on pregnancy outcomes of in vitro fertilization: a systematic review and meta-analysis Xie, Z.-Y., Peng, Z.-H., Yao, B., Chen, L., Mu, Y.-Y., Cheng, J., Li, Q., Luo, X., Yang, P.-Y., & Xia, Y.-B.

2019 Journal of Gynecology Obstetrics and Human Reproduction

Acupuncture appears to be beneficial to women with poor ovarian reserve or with previous unsuccessful attempts of in vitro fertilization with embryo transfer.

The present systematic review is designed to summarize the evidence concerning the effect of acupuncture on pregnancy outcomes in vitro fertilization with embryo transfer (IVF-ET). We searched MEDLINE, the Wanfang Database, the China Academic Journal Electronic Full-text Database in the China National Knowledge Infrastructure, and the Index to Chinese Periodical Literature. Randomized controlled trials with intervention groups using acupuncture and control groups consisting of no acupuncture or sham (placebo) acupuncture in IVF-ET treatment were selected. Study characteristics were examined from these studies and an intention-to-treat approach was used to extract outcome data from each study. In total, 31 articles including 4450 women passed our selection criteria. The legitimacy, characteristics, and IVF outcomes of the included trials were summarized. Additional Traditional Chinese Medicine (TCM) theory-based, standardized, large-size, randomized, and multicenter trials are necessary prior to any conclusions being drawn on whether TCM can improve IVF outcomes.

The effects of acupuncture on pregnancy outcomes of in vitro fertilization with embryo transfer: An interdisciplinary systematic review Gu, Y.-E., Zhang, X., Zhang, Q., Dai, M.-C., Wu, Y., Zhou, Y., & Qu, F.

2019 Medicine

Acupuncture and its combined therapy may be effective for treating female infertility, however, the included studies are not robust enough to draw a firm conclusion.

Current evidence identified from this review suggested that acupuncture may be effective in the treatment of female infertility. The conclusion of this present review is limited by the low quality of the included studies. Future multicenter RCTs with rigorous methodological quality are needed to clarify the role of acupuncture in female infertility.

Acupuncture for infertile women without undergoing assisted reproductive techniques (ART) Yun, L., Liqun, W., Shuqi, Y., Chunxiao, W., Liming, L., & Wei, Y.

2019 Acupuncture in Medicine

The use of acupuncture as a monotherapy significantly improved the rate of pregnancy among the study participants compared with the use of clomiphene citrate alone.

The use of acupuncture in the treatment of infertility may be an appropriate alternative for some patients. To our knowledge, this is the first meta-analysis available to date that compares the use of acupuncture alone or together with clomiphene citrate versus clomiphene citrate alone in the treatment of anovulatory infertility. While some results were promising, their validity is limited by questionable methodological designs, lack of sufficient allocation concealment, inadequate sample sizes and limited long-term follow-up. As such, any results drawn from these studies should be interpreted with caution and applied with care to clinical practice.

Acupuncture and clomiphene citrate for anovulatory infertility: a systematic review and meta-analysis Gao, R., Guo, B., Bai, J., Wu, Y., & Wu, K.

2019 Reproductive BioMedicine Online

Acupuncture may have a significant effect on clinical pregnancy rates, independent of comparator group, when used in women who have had multiple previous IVF cycles, or where there was a low baseline pregnancy rate.

Evidence suggests acupuncture may be effective when compared with no adjunctive treatment, with increased clinical pregnancies and live births, but is not an efficacious treatment when compared with sham controls. Future research should focus on different dosing acupuncture regimens, and exploration of the components of acupuncture that are contributing to improved reproductive outcomes. Increased understanding of these components may have broader application to the care and treatment modalities provided to women undergoing IVF. Further exploration of the effects of acupuncture for women with poorer IVF outcomes is warranted.

Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis Smith, C. A., Armour, M., Shewamene, Z., Tan, H. Y., Norman, R. J., & Johnson, N. P.

2018 JBRA Assisted Reproduction

Acupuncture performed on the day of embryo transfer has a significant effect on embryo implantation, however, a negative one.

According to our findings, physicians should encourage their patients to avoid undergoing acupuncture on the day of ET, since it diminishes the chances of getting pregnant. It still has to be elucidated the mechanisms by which acupuncture negatively affects embryo implantation.

In conclusion, acupuncture performed on the day of ET has a significant effect on embryo implantation, however, a negative one. Therefore, clinicians should encourage their patients to avoid this technique the day of ET.

Does acupuncture the day of embryo transfer affect the clinical pregnancy rate? Systematic review and meta-analysis Schwarze, J.-E., Ceroni, J. P., Ortega-Hrepich, C., Villa, S., Crosby, J., & Pommer, R.

2018 European Journal of Integrative Medicine

Acupuncture treatment is beneficial in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) for improving the clinical pregnancy, implantation, and live birth outcomes.

Statistically significant differences were observed in rates of clinical pregnancy, live birth, and implantation rate between the acupuncture and the control groups. No significant differences were found for biochemical pregnancies, ongoing pregnancies, or miscarriage between the two groups. Adverse events were described in 4 studies.

Effects of acupuncture during in vitro fertilization or intracytoplasmic sperm injection: An updated systematic review and meta-analysis Zhang, X., Lee, M. S., Smith, C. A., Robinson, N., Zhou, Y., Wu, Y., Mao, Y.-Y., & Qu, F.

2017 Acupuncture in Medicine

Acupuncture may increase the clinical pregnancy rate and ongoing pregnancy rate and decrease the risk of ovarian hyperstimulation syndrome in women with PCOS undergoing IVF or ICSI.

Acupuncture may increase the CPR and OPR and decrease the risk of OHSS in women with PCOS undergoing IVF or ICSI. Further studies are needed to confirm the efficacy and safety of acupuncture as an adjunct to assisted reproductive technology in this particular population.

Effectiveness of acupuncture in women with polycystic ovarian syndrome undergoing in vitro fertilisation or intracytoplasmic sperm injection: a systematic review and meta-analysis. Jo, J., & Lee, Y. J.

2016 Archives of Gynecology and Obstetrics

Acupuncture improves the clinical pregnancy rate among women undergoing IVF and the IVF outcome results were significantly superior in the acupuncture group when acupuncture was conducted during controlled ovarian hyperstimulation.

When the studies were restricted to Asian or non-Asian area patients, compared with traditional acupuncture and other methods, electrical acupuncture yielded better IVF outcomes. Optimal positive effects could be expected using acupuncture in IVF during controlled ovarian hyperstimulation, especially in Asian area. However, as a limitation of this review, most of the included studies did not mention the number of embryos transferred.

Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis Qian, Y., Xia, X.-R., Ochin, H., Huang, C., Gao, C., Gao, L., Cui, Y.-G., Liu, J.-Y., & Meng, Y.

2015 Gynecologic and Obstetric Investigation

We found pooled benefit of acupuncture for IVF when performed at follicle phase and 25 min before and after embryo transfer, as well as 30 min after embryo transfer and implantation phase.

Our study showed that acupuncture increased pregnancy rates when performed at follicle phase and 25 min before and after ET or 30 min after ET and after the implantation phase in the IVF process. However, there was no statistically significant difference in women undergoing IVF between treatment performed only around the time of ET, follicle phase or implantation phase. The study of Zheng et al. also showed that the pooled CPR result around the time of ET showed no significant differences between all acupuncture groups and the control groups. However, the CPR result of acupuncture performed around the time of controlled ovarian hyperstimulation showed a significant difference. The potential impact of acupuncture in the treatment of female infertility on the hypothalamic-pituitary-ovarian axis and on the uterus was significant, but the specific mechanism was still unknown.

The Role of Acupuncture in in vitro Fertilization: A Systematic Review and Meta-Analysis Shen C.,Wu M., Shu D., Zhao X. and Gao Y.

2015 Complementary Therapies in Medicine

Our review suggests that management of female infertility with Chinese herbal medicine can improve pregnancy rates 2-fold within a 3-6 month period compared with Western medical fertility drug therapy.

Forty RCTs involving 4247 women with infertility were included in our systematic review. Meta-analysis suggested a 1.74 higher probability of achieving a pregnancy with CHM therapy than with WM therapy alone in women with infertility. Trials included women with PCOS, endometriosis, anovulation, fallopian tube blockage, or unexplained infertility. Mean pregnancy rates in the CHM group were 60% compared with 33% in the WM group.

In addition, fertility indicators such as ovulation rates, cervical mucus score, biphasic basal body temperature, and appropriate thickness of the endometrial lining were positively influenced by CHM therapy, indicating an ameliorating physiological effect conducive for a viable pregnancy.

Chinese herbal medicine for female infertility: an updated meta-analysis Ried K.