📌Acupuncture and assisted reproduction: what science says

What science says about acupuncture and assisted reproduction

As we already commented in a previous post about the benefits of acupuncture for fertility (link), this ancient technique directly and indirectly improves the entire reproductive process of women. 

Acupuncture is capable of promoting ovulation in cases of polycystic ovary syndrome (PCOS), fibroids or endometriosis; achieves regularity in cycles and improves the composition and quality of sperm, in any situation in search of pregnancy.

Benefits of acupuncture in assisted reproduction

In assisted reproduction processes, acupuncture helps alleviate some of the side effects associated with fertility medications - such as bloating and nausea - and helps find the serenity necessary for the days of pregnancy. betawait, among other benefits. 

In addition, this Chinese medicine technique has been shown to have beneficial effects for the process and the long-awaited result: final pregnancy ratios improve. 

(Lack of) Scientific studies on acupuncture in assisted reproduction

Unfortunately, there is still work to be done and it would be useful to have more, more complex and better structured studies, to definitively contrast the success of acupuncture in fertility processes. 

Some articles conclude that they have not found significant improvements in the final figures of pregnancy rates with certain acupuncture treatments. But they do recognize other positive effects that the technique brings to fertility processes. 

And, at the same time, they highlight the few or no negative symptoms or undesirable side effects derived from the practice. So why not give this ancient technique a try?

What do the (few) studies say about acupuncture and in vitro fertilization?

A recent meta-analysis (this is the highest level of treatment effects research) reviewed the effects of acupuncture on women with fertility problems during assisted reproduction processes. Specifically, they analyzed the effects of acupuncture both in cases of in vitro fertilization (IVF) and in processes with the intracytoplasmic sperm injection (ICSI) technique. 

The review studied 3,188 women with fertility problems, and concluded that acupuncture significantly improved the live birth rate of patients undergoing IVF or ICSI. 

This demonstrated that acupuncture has a significant treatment effect on birth rates, validating its use as a complementary therapy in assisted reproduction treatments. 

In another study, researchers not only focused on acupuncture sessions limited to the time of egg collection or embryo transfer, but also included those with more extensive acupuncture treatment. 

In fact, this longer treatment over time is what acupuncture experts always recommend to treat different alterations in patients that may have a direct or indirect relationship with fertility.

A recent study found that acupuncture administered at the time of egg collection and embryo transfer improved clinical pregnancy rates. And a significant summary of 11 reviews through 2017 concluded that acupuncture significantly improves the clinical pregnancy rate.

Additionally, a 2018 trial from China specifically looked at acupuncture only during the follicular phase of IVF/ICSI and found that it improved ovarian blood supply and pregnancy rate.

Opinions against acupuncture in assisted reproduction 

However, there are some studies that come to different conclusions about the benefits of acupuncture, for example around the day of embryo transfer. 

In some cases it is concluded that it improved pregnancy rates compared to a control group that did not receive acupuncture, while in other studies the researchers saw no significant differences in pregnancy rates. 

How can this be explained? 

Factors that determine whether acupuncture improves pregnancy rates

Acupuncture is not an exact science and depends on very important variables that determine its success.  

Among other factors, the following are very important: 

• The particular knowledge of therapists.
• The specialization of the treatment. (In the same way that it is ideal to have your process carried out by a gynecologist specialized in fertility, it is important to be treated by an acupuncturist specialized in fertility). 
• Regularity in sessions. 
• The duration of treatment. 
• The particular previous situation from which each patient is based.

These disparate conclusions from the studies reflect the difficulties of the scientific methods applied until now to evaluate the effects of techniques such as acupuncture. 

The experimental recommendations for the future are focused on applying the approaches to their evaluation in a way that not only short-term results are analyzed but also that the tempos and the holistic treatment on which this therapy is based. 

How does acupuncture work in assisted reproduction processes?

As we have already seen, the majority of existing studies suggest a positive effect of acupuncture in the treatment of infertility from three main mechanisms: 

Acupuncture can improve ovulation

First, acupuncture can improve ovulation by modulating the central and peripheral nervous systems, neuroendocrine and endocrine systems, ovarian blood flow, and metabolism. 

Research shows that when needles are placed in the skin, the body releases its own natural pain relievers (endorphins). Therefore, after an acupuncture session you usually feel a tremendous feeling of relaxation. 

Thus, these endorphins generated by acupuncture needles relax the muscles, slow down breathing and calm the mind. 

The body abandons the usual state of alarm and gives way to processes led by the parasympathetic nervous system, such as reproduction itself. 

In addition, acupuncture can improve situations with Polycystic Ovary Syndrome, regulate insulin sensitivity, improve brain energy, reduce inflammation in case of endometriosis... That is, address other disorders that hinder fertility.

Acupuncture can improve IVF results

Secondly, acupuncture can improve the outcome of IVF due to increased uterine blood flow, inhibition of uterine motility (rhythmic contractions of the uterus) and beneficial effect on depression, anxiety and stress. 

Stress is a bad companion in the fertility processes. It can cause decreased blood flow to the uterus and ovaries.

Age also contributes to the oxidation of our genetic material, which becomes weaker and unstable. Acupuncture can increase blood flow by slowing or downregulating the sympathetic nervous system, which will have an impact on blood vessel dilation. 

When the vessels dilate, they release a rush of nutrient-dense blood to the ovaries and uterus. Increasing ovarian blood flow may also help with the response to stimulation medications. And with increased uterine blood flow a thick uterine lining is ensured and an ideal environment for implantation is created. 

Acupuncture can improve immune function and promote good IVF

Finally, its effect on modulating immune function also suggests being useful for improving implantation processes and, therefore, the outcome of IVF. 

The communication of the new cell with the endometrium is done through pro-inflammatory substances of the immune system (cytokines). 

If there are many, things will not go well. 

If there are few, neither. 

A modulated immune response is essential for implantation to occur harmoniously.

It is still necessary, however, to expand the studies and improve the methods used to validate the results with greater precision. Experimental research is now exploring the impact of acupuncture on follicular development, with the goal of improving embryo or blastocyst quality.

We will soon post an article in which you can see how acupuncture affects the entire assisted reproduction process (before, during and after). 

References :

 Balk, J. et al. The relationship between perceived stress, acupuncture, and pregnancy rates among IVF
patients: a pilot study. Complement Ther Clin Pract. 2010 August ; 16(3): 154–157.
 Hullender Rubin, L. et al. Impact of whole systems traditional Chinese medicine on in-vitro fertilization
outcomes. Reproductive BioMedicine Online (2015) 30, 602–612
 Stener-Victorin, E. et al. Reduction of blood flow impedance in the uterine arteries of infertile women with
electro-acupuncture. Human Reproduction. Vol.11 no.6 pp.1314-1317, 1996
 Smith, C. et al. Acupuncture performed around the time of embryo transfer: a systematic review and meta-
analysis. Reproductive BioMedicine Online (2019)
 Xi, J. et al. Effects of Acupuncture on the Outcomes of Assisted Reproductive Technology: An Overview of
Systematic Reviews. Hindawi. Evidence-Based Complementary and Alternative Medicine. Volume 2018, Article ID
7352735, 13 pages
 Eshkevari, L. et al. Acupuncture blocks cold stress-induced increases in the hypothalamus–pituitary–adrenal
axis in the rat. Acupuncture and the HPA. Journal of Endocrinology (2013) 217, 95–104
 Smith. C. et al. Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo
transfer Fertility and Sterility_ Vol. 85, No. 5, May 2006
 Paulus, W. et al. Influence of acupuncture on the pregnancy rate in patients who undergo assisted
reproduction therapy. FERTILITY AND STERILITY_VOL. 77, NO. 4, APRIL 2002
 Pei, J. et al. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic
male infertility. Fertility and Sterility_ Vol. 84, No. 1, July 2005
 Wetergaard, L. et al. Acupuncture on the day of embryo transfer significantly improves the reproductive
Outcome in infertile women: a prospective, randomized trial. Fertility and Sterility_ Vol. 85, No. 5, May 2006
 Lacey, S. Building resilience: A preliminary exploration of women'sperceptions of the use of acupuncture as an
adjunct to In Vitro Fertilisation. BMC Complementary and Alternative Medicine 2009, 9:50
 Huang, Dm., Huang, Gy., Lu, Fe. et al. Acupuncture for infertility: Is it an effective therapy? Chin. J. Integr. Med.
17, 386 (2011).
 Female fertility & IVF briefing paper. Acupuncture has positive impact on the birth rate of subfertile women
undergoing IVF/ICSI, studies show. British Acupuncture Council Research Facts Sheet.
 Rojas Quintana, P. et al Infertility. Bibliographic review. Medisur vol.9 no.4 Cienfuegos July-Aug. 2011

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