British Medical Journal Meta-Analysis: Acupuncture & IVF

Conclusion: Canadian Medical Association sent out the following summary to Physicians; Bottom line, Acupuncture administered immediately before and after transfer can increase the rate of clinical pregnancy in women receiving in vitro fertilization. For every 10 woman who received acupuncture, 1 additional pregnancy occurred (number needed to treat = 10).

Manheimer E, Zhang G, Udoff L, et al. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ 2008;336(7643):545-549.

Study design: Meta-analysis (randomized controlled trials)

Synopsis

To perform this meta-analysis, the researchers searched 4 databases, including the Cochrane Library and the Chinese Biomedical Database, to find randomized controlled trials that compared acupuncture with sham acupuncture or no adjuvant treatment. They also scanned conference proceedings and reference lists of identified research articles (3 studies included in this review were published only in abstract form, although additional information was obtained from the researchers). The authors identified 7 studies evaluating the role of acupuncture on achieving pregnancy following in vitro fertilization in 1366 women (740 whop received acupuncture). Five of these studies also reported the rates of ongoing pregnancy beyond 12 weeks and 4 studies reported live births. Two authors independently selected articles and extracted the data. Their analysis was by intention to treat; that is, the authors included results from women who began the in vitro fertilization process but did not have embryo transfer. The quality of the individual studies was high. There was no evidence of publication bias. All included studies evaluated acupuncture treatment that was administered within a day of embryo transfer and within 3 days following transfer, although all but 1 study performed acupuncture immediately before and immediately after transfer. All but 1 of the studies used the same acupuncture points. The rate of pregnancy in the control groups varied by country; countries vary in the number of embryos that can be transferred and whether high-quality embryos can be selected. Achievement of pregnancy, ongoing pregnancy beyond 12 weeks, and live births were all increased in the acupuncture group. The rate of clinical pregnancy was 32% in the acupuncture group and 27% in the control group (odds ratio = 1.91; 95% CI, 1.39 - 2.64). Using pooled data, 1 additional clinical pregnancy occurred for every 10 women (95% CI, 7 - 17) who received acupuncture rather than sham acupuncture or other control treatment.