18
May
2018
|
06:26
Australia/Melbourne

Study finds acupuncture doesn’t help treat fertility

Does acupuncture increase the likelihood of a live birth in women undergoing IVF? No, says a new study.

Acupuncturists have been accused of taking advantage of the vulnerability of women undergoing IVF by one of the authors of a new study on its effectiveness in fertility treatments.

In a randomized clinical trial of 824 women, the rate of live births was 18.3% among women who received acupuncture vs 17.8% among women who received a sham acupuncture control, showing no significant difference in birth rates between the two groups of women.

This statistic suggests acupuncture had no significant effect.

The trial, published in the Journal of the American Medical Association (JAMA) was conducted in Australia and New Zealand by Caroline Smith, Professor Clinical Research, Western Sydney University, Robert Norman, Professor of Reproductive and Periconceptual Medicine, University of Adelaide and Michael Chapman from IVF Australia.

 Professor Chapman told Australian Doctor, IVF clinics should review their marketing of acupuncture.

“Fertility patients are very vulnerable to any suggestion of anything that might improve their chances of pregnancy.”

“There are substantial numbers of acupuncturists in the community that are advertising themselves as fertility specialists and this study, along with many others, is not supportive of that.” 

Professor Chapman says as many as 15% of women undergoing IVF are getting acupuncture, which is only covered by Medicare when administered by a medical doctor. It is also covered by many private health insurance extras policies.

"These findings do not support the use of acupuncture when administered at the time of ovarian stimulation and embryo transfer to improve the rate of live births."

Study limited

"Fertility services can already be a financial burden on couples hoping to conceive. There is no sense adding to those expenses when the evidence is that acupuncture doesn’t help” suggested Dr Stan Goldstein of Bupa.

However Dr Goldstein also clarified that there are a number of health problems for which there is good evidence that acupuncture is helpful; this study was only about whether or not you could use acupuncture to improve fertility outcomes.

"For this reason, any protests from acupuncturists relating to the broader potential for acupuncture are not helpful and somewhat misleading in this discussion.

"There should be no problem in accepting that it is a treatment that works for some things, but not for everything."

Stress reduction shown

Experiencing infertility and undergoing fertility treatment can be a stressful time for women. Acupuncture has been shown to improve mental and emotional wellbeing, increase relaxation and improve psychological coping during IVF treatment.

Previous research has also found an association between acupuncture and lower levels of stress and anxiety and increased pregnancy among women undergoing IVF.

Acupuncturists back its benefits

The Australian Acupuncture and Chinese Medicine Association rejects suggestions the industry promotes false hope.

AACMA President Waveny Holland questioned the efficacy of the study telling The Australian, acupuncture has many physical and psycho-social benefits.

"Acupuncture itself is very powerful and strong and it has been shown to actually increase blood flow to the endometrial lining of the uterus and therefore create a better lining for the placenta to grow and flourish." 

Acupuncture long accepted by WHO

The World Health Organization has long recognised acupuncture as an effective treatment, and established a methodology for locating acupuncture points on the human body, as well as the locations of 361 acupuncture points.

The Standard is applicable for teaching, research, clinical service, publication, and academic exchanges involving acupuncture.

Since 1997, the National Institutes of Health in the US has accepted acupuncture as a valid treatment strategy.

Talking to the role of acupuncture more broadly, an NIH Consensus Development Conference on Acupuncture concluded;

“There is sufficient evidence of acupuncture's value to expand its use into conventional medicine and to encourage further studies of its physiological and clinical value.”

Subsequently calls for more sound research trials have exercised a note of caution.

How did acupuncture come to play a role in fertility treatment?

Writing in The Conversation, the report's authors outlined the history of acupuncture in modern fertility treatment.

An adequate blood flow to develop immature eggs, and the endometrium (the lining of the uterus), is important to female fertility and pregnancy.

Studies on a stronger form of acupuncture, electro-acupuncture, found it may influence central sympathetic nerve activity, and may increase blood flow in parts of the body, including improved blood flow and oxygenation to ovarian and uterine tissue.

However it is important to note the difference between a theoretical possibility, and what is learned from observing almost 100 women on treatment, because that possibility doesn’t seem to have resulted in the desired effect.

This in turn suggests that couples should be looking to other options rather than place their hopes in a therapy that doesn’t seem to significantly change fertility rates for infertile couples.