The latest review of evidence is out and yes the results are clear. It seems it has been missed by many as it was published in the holidays on the 2nd January 2019!
This is considered the most up to date evidence from a systematic review and meta-analysis and should help to clarify the benefits and rectify the recent misunderstanding from a study published in 2018 that put the use of acupuncture under question.
If you are interested to read the research in full, follow the link to the review and jump to the discussion section for details on effectiveness.
Here is the link: “Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis” Smith, Caroline A. et al. Reproductive BioMedicine Online, Volume 38 , Issue 3 , 364 – 379
In this review of all of the latest and relevant evidence from English speaking publications, Smith concludes that:
- Acupuncture with IVF may have potentially significant benefits when compared to IVF only in regard to both clinical pregnancy AND live birth rates.
- Acupuncture seems most effective when there are more treatments (higher dose) than just pre and posttransfer acupuncture – especially with treatment in both the stimulation and implantation phase.
- Further benefits are seen when points selected are tailored to the individual rather than using a pre-prescribed treatment protocol.
- Benefits are especially true for women who have had multiple previous IVF cycles.
What has been confusing in recent research and discussed in this review is that when acupuncture is compared to sham acupuncture as the control, the benefits are not seen for acupuncture over sham acupuncture. Rather than negating the effects of acupuncture (which seem clearly beneficial), this begs further questions about the placebo effect of acupuncture and/or the validity of sham acupuncture – these devices or points used may not be inert after all and have some effect.
It seems acupuncture is in fact considered effective when compared to IVF alone and worth pursuing for IVF patients.
Smith also mentions how acupuncture may be working via the stress relieving and psychosocial benefits with a significant anxiolytic effect reported and potential beneficial effects such as increase in uterine blood flow, endogenous endorphins and cytokines. The non-needling benefits of acupuncture treatment (the holistic nature of a consultation with palpation, education, self-care and diagnosis etc) are discussed too.
Smith further states that acupuncture remains a low-risk intervention.
While it is so good to read this validation of the use of acupuncture during IVF, for us, although our patients having a take home baby is obviously a key desired outcome, benefits of treatment are not only about the pregnancy and live birth rates. Reduced anxiety levels and a better ability to cope with infertility and IVF is so important for people with poor outcomes, fragile emotional health, and those doing back to back cycles who need to ‘gear up again’ after a negative result. This effect cannot be underestimated. Sometimes it can be the difference between patients feeling like they have the internal resources to take on the next cycle, or need a break. Regular acupuncture with practitioners skilled in working with IVF patients can provide support they need to navigate their experience as seamlessly as possible, potentially with fewer side effects and positive outcomes more quickly.
We continue to offer acupuncture services to support IVF patients at Fertile Ground Health Group as a 1:1 appointment or in our multi-bed facility which works really well for the flexibility of fitting IVF transfer patients in on the day when they find out their transfer times.
We generally recommend patients come in at least once before the transfer as the follicles are stimulated, one to two times on the day of transfer, and another around five to seven days after transfer for implantation support.
Even more ideally where possible and time permitting, we recommend weekly appointments in the two to three cycles leading up to IVF.
Please help us share this information to anyone you know involved with IVF as a specialist, practitioner or patient to ensure they know about choices available for appropriate supportive treatments.
Our acupuncture team is more than happy to write or speak about this new systematic review and meta-analysis to IVF and fertility groups too. Please be in touch if you have an opportunity for us to be involved in spreading the word about this.
Charmaine Dennis is the founding director of Fertile Ground Health Group and has been practicing naturopathic fertility and preconception health care for nearly 20 years. She is passionate about collaborative health care and ensuring that people going through IVF are given accurate information about all the many ways IVF outcomes can be improved with lifestyle and complementary medicine interventions.