Written 13th March 2019
I am passionate about people being able to make their own informed choices in life. I get constantly frustrated by seeing huge claims in the media, using pseudo science and click bait titles that ultimately affect vulnerable men and women going through one of the hardest decision making times of their life – creating a family.
With that in mind, I have decided to create a series where you can look at the research yourself.
Only this morning I was reading a comment from a woman wondering whether to do acupuncture with her IVF cycle. I see this time and time again. Often they have been recommended by the acupuncture practitioner to have at least weekly sessions, from months before transfer, at a cost of anything from £30-70 depending where you live. Not pennies by any means.
Now this is my interpretation and opinion on the subject. I am coming at this as someone who has had acupuncture during two IVF cycles. Also as someone who’s sister is a qualified and successful medical acupuncture practitioner (and experienced doctor) and also someone who tries to remain a sceptic when looking at research with my past degree head on. However as I say, I really want this to be about you making your own informed decisions, so the research is all linked at the bottom.
What do the headlines say?
- Guardian: Acupuncture doesn’t improve likelihood of IVF success
- Bionews: Acupuncture does not affect IVF success rate
- Telegraph: Acupuncture doubles chance of having a baby with IVF, study suggests
- Dailymail: Acupuncture can boost your chances of getting pregnant
- Science Daily: Fertility study finds acupuncture ineffective for IVF birth rates
- Zita West: We are firm believers that it really can work
- The Times: Course of acupuncture may raise success of IVF treatment by 65%
Confused? Understandably so. Papers write headlines to sell papers and it’s obviously beneficial for those who make money from the field to shout about even the smallest study in their favor, so where do we go from here?
What does the research really say?
The most recent study I could find, and that seems to often be referred to currently, is by Dr Eric Manheimer et al from the University of Maryland School of Medicine, Georgetown University School of Medicine, Washington and the University of Amsterdam, Holland. The study was called “Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis”
The first very important thing to note with this study is that is was funded by National Centre for Complimentary and Alternative Medicine of the US National Institutes of Health. Whilst I do like believe in good people in this world, some would say they may have a vested interest in the results being positive for acupuncture.
They reviewed randomized controlled studies, comparing women given acupuncture within 1 day of IVF transfer, those given fake treatment and those not given any at all. Out of 108 studies they found, only 7 were assessed as good quality and relevant enough to be included. When you consider that for a moment, that is a lot of studies out there who didn’t meet the quality criteria, but will likely have been quoted to women sadly.
“The authors reported that IVF with acupuncture increased the odds of pregnancy by 65% (according to early evidence on ultrasound), increased the odds of ongoing pregnancy by 87% (according to ultrasound evidence of pregnancy at 12 weeks) and increased the odds of a live birth by 91% compared with IVF on its own.
When the researchers only looked at the three studies that showed similar rates of pregnancy to women in the UK, they found that acupuncture did not increase rates of pregnancy with IVF” (NHS)
What does this mean?
Whilst this can look positive at first for acupuncture, don’t rush out to book your appointment just yet.
- The way the researchers have presented the success rates is tricky to me. It actually works out as a 32% success rate with acupuncture, compared to 27% success without. Some of you will notice that this is a lower success rate than some fertility clinics report for the IVF generally anyway. Well when only studies that had the highest rates of pregnancy success were used, there was a negligable amount of difference in success using IVF. Does your clinic have good pregnancy rates? Then it could be that acupuncture would have little affect on success. I totally understand though is a few percent means enough for you to try it though.
- It is positive that a large study has taken place, however these are results from a mixture of studies, which differ in their processes (eg they vary over when the acupuncture was given and how many times for example)
- There isn’t any good quality evidence that I could find, that acupuncture over long periods, as has been suggested by some practitioners, will have a more beneficial effect.
- The placebo affect: Some researchers have voiced that women having acupuncture may be feeling more relaxed and positive about the outcome, which could affect the results. The psycho-social effect isn’t maybe something to be ignored. Perhaps it is not the acupuncture, but the feeling of positivity, relaxation or an hour to themselves that is playing a part here. Something that needs more research in itself (this study covers it, though I wouldn’t cite is as excellent quality)
- It’s difficult when studies rely on bringing together research already out there. Small studies or those with negative results may not have been published at all, therefore this would not have been a totally unbiased study.
- The NHS interpretation is interesting (they have a fab section that reacts to the news, looking at the research behind the headlines). They say “A better reflection of the absolute benefit is to consider that these results mean that 10 women will need to be treated with acupuncture for there to be an extra successful pregnancy. In the other nine women, there would be no additional benefit”. Hardly the huge success rates reported in the papers, but again I do understand anyone feeling it is wirth it in case they are that one woman. As long as you do that informed I see now problem.
- Other studies, such as that by the West Sydney University, have found acupuncture is not a factor in live birth rates.
- There are many women who go through IVF as text book cases…everything goes I plan, all the vitals look great, there seems no reason it shouldn’t work, it also includes acupuncture…and yet it still doesn’t work. There are still just too many unknowns about IVF sadly. These unknown factors could be affecting the outcome of research
Be cautious before parting with your money. If it’s something you can easily afford and you feel you would enjoy it, then why not. Please don’t feel that if you can’t afford it your IVF won’t work. The research to me, doesn’t support that. Similarly if you can afford a few sessions around transfer day, then great, but please don’t feel pressured to sign up to months of regular and costly treatment. Again there doesn’t seem to be research to support that.
Overall though it’s fabulous that this review study took place at all (and more need to be done like this on add-on treatments), but it is still relatively small and not without it’s problems. Another, unbiased and larger study is most definitely needed before claims such as “Acupuncture doubles chance of having a baby with IVF” can really be taken seriously.
If you see someone asking about acupuncture and IVF, please share this page with them, allowing them to make their decision in an informed way. As amazing as so many practitioners are in the fertility field, they do come with some bias and so it is important to educate ourselves and go back to the source of studies. If a practitioner claims their treatment will make your IVF work or cite hundreds of women they have got pregnant, personally I would be incredibly cautious. Ask for their research. A lot of factors go into whether IVF is successful, many that the medical profession still do not fully understand, so to make such claims seems to lack intergrity to me. Last, consider this. If the evidence really was strong, wouldn’t fertility clinics be jumping on that, insisting it is included in treatments anyway to increase their success stats?
To read the study yourself, click here
To read my sister Dr Kerry’s take on it, as a Medical Acupuncture Practitioner, click here
I truly hope this information has helped. If you have any scientific data to add, please pop me an email. I would be very interested to read and consider including it.