There is a widespread claim that acupuncture can treat infertility and fertility-related problems. A traditional healing practice from China that can be traced back for at least 2,500 years, acupuncture is largely based on concept of qi or chi (harmony). It is believed that there exists in the body patterns of energy flow which are essential for health, the disruption of which results in disharmony of energy, thus causing bodily ailments and diseases. Supporters of traditional healing modalities claim that such imbalances may be corrected by acupuncture — a family of procedures that involve stimulation of anatomical parts on the skin, the most popular of which is the used of thin, solid, metallic needles to penetrate the skin. These needles may be manually or electrically manipulated (National Institutes of Health, 1997).
The claims are that acupuncture is an important and effective modality in the treatment of infertility and infertility-related problems. The Comox Valley Acupuncture and Traditional Chinese Medicine web site lists the following as among the benefits of acupuncture (n.d.):
- Acupuncture reduces stress, one of the first things that must be addressed when trying to conceive because being highly stressed out reduces one’s likelihood of getting pregnant by 93 percent;
- Acupuncture increases the flow of blood to the uterus, thus thickening the endometrial lining, which is important in implantation;
- Acupuncture improves ovarian function by stimulating blood blow to the ovary thus enabling it to release more follicles and better-quality eggs.
- Acupuncture helps regulate menstruation and ovulation.
- Acupuncture can increase sperm count and improve their motility and morphology.
- Acupuncture can reduce the risk of side effects from hormonal treatments as well as increases the success rate of in-vitro fertilization.
- Acupuncture can reduce the likelihood of miscarriage.
A site devoted solely for the promotion of Chinese traditional medicine, it is without surprise that Comox Valley Acupuncture and Traditional Chinese Medicine would promote the procedure, highlighting only the benefits it supposedly offers while keeping mum on the possible risks and complications associated with it, when the truth is that like other modalities, acupuncture also has risks, however low. According to National Institutes of Health, National Center for Complementary and Alternative Medicine (n.d.) there are “relatively few complications from the use of acupuncture… have been reported to the FDA, in light of the millions of people treated each year and the number of acupuncture needles used. Still, complications have resulted from inadequate sterilization of needles and from improper delivery of treatments” (National Center for Complementary and Alternative Medicine, n.d).
It is also worth mentioning that the studies supporting the use of acupuncture are not of highest medical study design, hence their integrity is questionable.
For this paper, the author wishes to point out that the alleged benefits of acupuncture may just be a myth given the contradictory results in studies, or that, at the very least, the procedure is not as helpful as its advocates and supporters claim it to be. The discussion is focused on the efficacy of acupuncture in in vitro fertilization (IVF) treatment.
A 2008 meta-analysis study by the University of Maryland School of Medicine’s Center for Integrative Medicine found that “acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilization” (Manheimer, 2008; NCBI, 2008). For this study, the researchers looked at the results of seven clinical trials on the efficacy of acupuncture in women who had gone through IVF procedure to see if acupuncture helped improve pregnancy rates. The studies combined involved data of over 1,366 women and compared acupuncture with sham acupuncture, or no additional treatment.
Other studies also showed favourable results on the efficacy of acupuncture on pregnancy, as outlined in Wing Sze So, et al (2008). A meta-analysis (Ng et al., 2008) of 10 randomized studies revealed that acupuncture significantly increased pregnancy rate and that based on a subgroup analysis, pregnancy rate significantly improved with the help of acupuncture treatment when given on the day of ET but no improvement when acupuncture was given only on the day of TUGOR. Ng et al suggests that the “positive effect of acupuncture during IVF treatment may be related to the change in uterine blood flow and uterine contractility, and relaxation of stress” (Ng et al., 2008 as cited in Wing Sze So, 2008).
However, despite the positive results of the forgoing meta-analyses, there is still concern about the efficacy of acupuncture in IVF because “the pregnancy rates of IVF treatment with acupuncture is higher than that for drugs or other procedures given to enhance the success of this treatment and the underlying biological mechanism is difficult to explain” Wing Sze So, et al, 2008).
Moreover, while the studies reviewed in the meta-analyses were randomised, majority of the patients were not blinded “because of the difficulty in achieving blindness in the acupuncture treatment” Wing Sze So, et al. Some were single blind, and only one study was double-blind (Wing Sze So, 2008).
The most convincing argument against the validity of acupuncture as infertility treatment modality thus far is the 2008 study by Wing Sze So, et al which looked at the efficacy of acupuncture in IVF treatment. The study compared the efficacy of real acupuncture treatment with placebo treatment and found that surprisingly, that the placebo acupuncture treatment group had higher rates of pregnancy and birth than did the real acupuncture treatment group (Wing Sze So, 2008). The study is a double blind randomised trial, meaning neither the doctor nor the patient knew which group was receiving placebo treatment and which group was being given real acupuncture treatment. In medical research, randomised double-blind trials are the most authoritative of all the various research designs.
Because of the foregoing reasons, namely: that the studies showing that acupuncture helped improve pregnancy rates were not of highest study design (either non-blind or only singled-blind when the best study design requires double-blind); that the mechanism of how the procedure works is not clearly explained; and that the newest study which had the highest integrity because it was randomised and double-blind did not support the claim that acupuncture helped improve pregnancy, but showing that instead, placebo acupuncture worked better than real acupuncture, thus suggesting that psychological processes might be involved in the positive results of acupuncture in previous studies, it is still unwise to embrace the idea that acupuncture does improve pregnancy rates. Only when there are definitive, highly authoritative studies (randomised and double blind) showing that acupuncture actually improved pregnancy rates and showed how the process actually worked, only then will it be alright to give acupuncture a different look. Until then, its supposed benefits still remain a myth.
Bibliography
- Comox Valley Accupuncture and Traditional Chinese Medicine. N.d. Infertility and Traditional Chinese Medicine. 2008.
- Manheimer E, Zhang, et al. 2008. Acupuncture Shows Promise in Improving Rates Of Pregnancy Following IVF. Web.
- National Center for Complementary and Alternative Medicine. N.d. An Introduction to Acupuncture. 2008. Web.
- National Institutes of Health. 1997. Acupuncture. Web.
- NCBI. 2008. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. Web.
- Wing Sze So, Emily et al. 2008. A randomized double blind comparison of real and placebo acupuncture in IVF treatment.