Does acupuncture increase birth rates after IVF?
You might be correct when pointing out that this is a rhetorical question.
Why should acupuncture increase the live birth rates after in vitro fertilization (IVF)?
Because it re-balances yin and yang?
Give me a break!!!
Yet acupuncture is widely used by women undergoing IVF, and therefore, we perhaps ought to know whether it works.
Laudably someone has conducted a trial so that we know the answer.
This study determined the efficacy of acupuncture compared with a sham acupuncture control performed during IVF on live births. It was designed as a single-blind, parallel-group RCT, including 848 women undergoing a fresh IVF cycle, and conducted at 16 IVF centres in Australia and New Zealand between June 29, 2011, and October 23, 2015, with 10 months of pregnancy follow-up until August 2016.
The women received either acupuncture (n = 424) or a sham acupuncture control (n = 424). The first treatment was administered between days 6 to 8 of follicle stimulation, and two treatments were administered prior to and following embryo transfer. The sham control used a non-invasive needle placed away from acupuncture points. The primary outcome was live birth, defined as the delivery of one or more living infants at greater than 20 weeks’ gestation or birth weight of at least 400 g.
Among the 848 women, 24 withdrew consent, and 824 were included in the study, 607 proceeded to an embryo transfer, and 809 (98.2%) had data available on live birth outcomes. Live births occurred among 74 of 405 women (18.3%) receiving acupuncture compared with 72 of 404 women (17.8%) receiving sham control.
The authors concluded that among women undergoing IVF, administration of acupuncture vs sham acupuncture at the time of ovarian stimulation and embryo transfer resulted in no significant difference in live birth rates. These findings do not support the use of acupuncture to improve the rate of live births among women undergoing IVF.
This is a clear result and technically a fairly decent study. I say ‘fairly decent’ because, had the result been positive, one would have to question the efficacy blinding as well as the fact that the acupuncturists might have (inadvertently?) influenced their verum-patients such that they were less anxious and thus produced better outcomes. Moreover, the trial was under-powered, and its publication so long after the end of the study is odd, in my view.
There have, of course, been plenty of trials and even systematic reviews of this topic. Here are the conclusions of the three most recent reviews:
- No significant benefits of acupuncture are found to improve the outcomes of IVF…
- No adjuvant therapy has been shown to be definitively advantageous.
- Currently available literature does not provide sufficient evidence that adjuvant acupuncture improves IVF clinical pregnancy rate.
Yet the authors state that “the evidence for efficacy is conflicting”.
The above conclusions seem crystal clear and not at all conflicting!
Is it because the authors needed to justify the no doubt huge costs for their study?
Is it because conducting such a trial while the evidence is already clear (and negative) is arguably not ethical?
Is it because the authors needed this alleged ‘uncertainty’ for getting their trial in a major journal?
I am, of course, not sure – but I am quite sure of one thing: the evidence that acupuncture is useless for IVF was already pretty clear when they started their study.
And pretending otherwise amounts to telling porkies, doesn’t it?
And telling porkies is unethical, isn’t it?