Acupuncture: does it really improve fertility?

Acupuncture: does it really improve fertility?

Does acupuncture really improve fertility? For 10 years or so, press reports have suggested it might. Fertility forums are stuffed with threads debating the matter. So what’s the truth? Here are the key facts on acupuncture and fertility – based on the latest and most trusted research studies.

First, the theory. Acupuncture is supposed to help a woman’s fertility by balancing hormone levels, regulating menstrual cycles and increasing blood flow to the uterus. Let’s assume better blood flow plays a part of creating a thicker endometrial lining. Very generally, a thicker lining (say, 8 mm or more) is more likely to lead to a viable implantation. Patients having assisted reproduction know their lining thickness inside-out because it’s closely monitored during their cycles. So in some ways IVF patients are the key group to assess when it comes to acupuncture and fertility outcomes.

So that’s the blood flow argument, backed up by several studies. But linking it to acupuncture is harder. The problem is, no major study exists to show conclusively, or even compellingly, that acupuncture helps fertility. By which we mean large, randomized trials acceptable to advanced western medical science. That means acupuncture’s role in increasing fertility is unproven.

There’s more bad news. In 2010, the supposed benefits of having acupuncture during an IVF cycle were questioned. Four separate studies concluded it didn’t really make much difference. That’s a kick in the teeth to a landmark (at least then) study from 2002 – the research that got everyone talking. It found 65% improved outcomes when fertility patients had acupuncture before and after their embryo transfers in an IVF cycle.

Other trials have also been sent packing. There’s the one from 2006 that made a connection between luteal-phase acupuncture in IVF using ICSI. Not to mention another from 2007 – a heavyweight, systematic review that looked at several previous trials and concluded acupuncture on transfer day might just cut it. The 2002 study found significantly higher ongoing pregnancy rates. For six or seven years, we all believed it. But the latest research says it was a false dawn.

Why the false hope? We asked a senior UK fertility consultant, working at a leading IVF clinic in Nottingham, what he thought of the acupuncture argument on transfer day. What he said surprised us. He said the jury was out, but that it was slightly better for fertility patients not to have acupuncture than to have it. Risk of infection? Tampering with the body’s physiology at a delicate time? Stressed-out fertility patients hurtling across town on the day they should be super-relaxed? He didn’t say.

What about acupuncture and general fertility, not IVF? Studies show acupuncture may help with endometriosis and polycystic ovaries. Others have looked at the effect of acupuncture on male fertility – better sperm quality and morphology were reported. But these were small trials, some from less illustrious sources than others. Nothing conclusive. Nothing compelling. No game changers. As with IVF, the benefits are unclear.

Let’s take a step back and look at the ‘softer’ benefits of acupuncture for fertility issues. We’re on safer ground when we look at it from the psychosomatic angle. The mind/body approach. Acupuncture can ease stress and anxiety, placebo-effect or not. A new Australian study suggests this, but still says it doesn’t help from the clinical angle. That goes for other non-mainstream, non-scientific treatments too: massage, reflexology, yoga, reiki. For couples battling fertility problems or going through IVF, these treatments are generally safe, if given by a licensed practitioner. Ask for, and check, credentials before you book.

Here’s a final thought on acupuncture and fertility. There’s no proof it works. There’s no proof it doesn’t. Its efficacy exists in a grey area, a no man’s land of research trials that are often inconclusive and contradictory. That’s reason enough to try if it you want to or leave it if you don’t.

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