Review question: does acupuncture improve the outcomes of assisted reproduction?
Background: one in seven couples suffer from subfertility and many will seek help in the form of assisted reproductive technology (ART). Although the use of acupuncture has gained popularity, the use of this traditional Chinese medical treatment in conjunction with ART treatments is still controversial. This review summarised the evidence from well designed studies and evaluated the effectiveness and safety of acupuncture in assisted conception.
Search date: the evidence is current to July 2013.
Study characteristics: there were 20 randomised controlled studies identified. Six studies compared acupuncture at the time of egg collection (912 women) and 14 studies compared acupuncture in assisted conception (3632 women). The studies were further divided into those which used placebo needles in their control groups versus those that had controls who did not undergo any treatment. All the studies identified involved participants undertaking in vitro fertilization (IVF); there were no studies reporting the effect of acupuncture in ovulation induction or intrauterine insemination.
Funding of included studies: no included studies had external funding.
Key results: there is no evidence of benefit for the use of acupuncture in participants undergoing assisted conception treatment around the time of embryo transfer or at egg collection in terms of improving the live birth rate, ongoing or clinical pregnancy rate. There is also no evidence that acupuncture has any effect on miscarriage rate or had significant side effects.
Quality of the evidence: overall, the results are not similar across the studies. This was due to different study designs including the use of different types of control groups that could have introduced bias. More research is needed before recommendations can be made, including studies in which some controls receive placebo needling and others receive no intervention.