📌Acupuncture and assisted reproduction: what science says

What science says about acupuncture and assisted reproduction

As we discussed 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 the case of polycystic ovary syndrome (PCOS), fibroids or endometriosis; It achieves regularity in the cycles and improves the composition and quality of the sperm, in any situation of seeking pregnancy.

Benefits of acupuncture in assisted reproduction

In assisted reproduction processes, acupuncture helps to alleviate some of the side effects associated with fertility drugs -such as swelling and nausea-, and helps to find the necessary serenity for the days of pregnancy. beta wait, among other benefits. 

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

(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 studies, more complex and better structured, to be able 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 on acupuncture and in vitro fertilization say?

A recent meta-analysis (this is the highest level of treatment effect research) reviewed the effects of acupuncture on women with fertility problems during assisted reproduction. 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 3188 women with fertility problems, and concluded that acupuncture significantly improved the live birth rate of women undergoing IVF or ICSI. 

This showed 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 limited acupuncture sessions at the time of egg collection or embryo transfer, but also included those with more extensive acupuncture treatment. 

In fact, this more extensive 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 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 reach different conclusions about the benefits of acupuncture, for example, around the day of the 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 difference 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 condition its success.  

Among other factors, the following are very important: 

• The particular knowledge of therapists.
• The specialization of 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). 
• The regularity in the sessions. 
• The duration of treatment. 
• The prior particular situation from which each patient starts.

These very disparate conclusions of 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 of its evaluation in a way that not only analyzes short-term results but also respects the times and the holistic treatment on which this therapy is based. 

How does acupuncture work in assisted reproduction processes?

As we have already seen, most of the 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, the neuroendocrine and endocrine systems, ovarian blood flow, and metabolism. 

Research shows that when needles are placed into the skin, the body releases its own natural pain relievers (endorphins). For this reason, after an acupuncture session, an enormous sensation of relaxation is usually felt. 

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

The body leaves 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 Ovarian 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

Second, acupuncture may improve IVF outcome through 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 partner in 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 more unstable. Acupuncture can increase blood flow by slowing down or down-regulating the sympathetic nervous system, which will impact the dilation of blood vessels. 

When the vessels dilate, they release a rush of nutrient-dense blood to the ovaries and uterus. Increased ovarian blood flow may also help with 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 the modulation of immune function also suggests that it is useful for improving implantation processes and, with it, the result 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, either. 

A modulated immune response is essential for the implantation to take place in a harmonious way.

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 aim of improving the quality of the embryo or blastocyst.

Soon we will 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
reproductive 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's perceptions of the use of acupuncture as an
adjunct to In Vitro Fertilization. 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).
 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 Jul.-Aug. 2011

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