A pricky procedure
Acupuncture doesn't boost IVF success for all
A new study suggests that acupuncture does not help women undergoing in-vitro fertilization (IVF) get pregnant.

But the lead researcher says acupuncture may not have worked in her study because, unlike past research, her investigation wasn't limited to women who had good quality embryos available for transfer. "I'm wondering if my sample was just not a good sample, in that most of the patients in my study were probably not the best-prognosis patients," Dr. Alice D. Domar of Boston IVF, Inc., in Waltham, Massachusetts, told Reuters Health.

Domar designed her investigation, she explained, to replicate an "astonishing" 2002 report by German researchers who found that women who had acupuncture before and after undergoing embryo transfer - in which the "test-tube" embryo is placed in a woman's womb - were significantly more likely to get pregnant.

Since then, several other researchers have found strong positive effects for acupuncture on IVF success, and a meta-analysis of current studies showed the same results.

To look into whether the health care team might contribute to any placebo effect, Domar and her team repeated the 2002 study, but "blinded" nurses and physicians to whether a patient was in the acupuncture or the control group.

They randomly assigned 146 women who were about to undergo embryo transfer to have acupuncture for 25 minutes before the procedure and for 25 minutes after the procedure was completed, or to rest quietly for the same amount of time. Women underwent the procedure - or rested - behind a curtain, so that nurses and doctors didn't know to which group they had been assigned.

About 31% of women in the acupuncture group became pregnant, while about 34% of those in the control group did, which wasn't a statistically significant difference. However, the women who received acupuncture were less anxious, more relaxed and enjoyed the IVF procedure more, the researchers found. They were also more optimistic about getting pregnant.

Domar and her team say the most likely explanation for the lack of an acupuncture effect in their study was the fact that they included many women who didn't have good quality embryos available for transfer. While acupuncture may help a woman become pregnant after the transfer of a healthy embryo, the researcher noted in an interview, it can't repair an embryo with chromosomal defects or other abnormalities.

"Despite the results of my own study, I still recommend acupuncture to women going through IVF because there's no downside," Domar added, aside from the $150 an acupuncturist would typically charge - a small fraction of the $12,000 to $14,000 couples typically spent on a single round of IVF.

Nobody knows how exactly acupuncture might boost IVF success, Domar said, although she suggests that it has something to do with a woman's mental state at the time of embryo transfer.

Most researchers looking at IVF have focused on medical aspects, for example how many embryos are transferred or how many cycles of IVF a woman completes, she added. "Our field has ignored the patient's emotional state around the time of embryo transfer. I think this acupuncture research is tapping in to that."

SOURCE: Fertility and Sterility, March 2009.

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