Acupuncture researchers from the USA have carried out a study to re-examine the effect of an adjuvant acupuncture protocol that was previously reported to have a negative effect on clinical pregnancy rates (CPR) in women undergoing vitro fertilization (IVF). In 2007 Craig et al. reported the results of a randomised controlled trial in which a standardised acupuncture protocol performed on the day of embryo transfer (ET) resulted in lower CPR after IVF. In the new study, authors unaffiliated with Craig et al. carried out a retrospective review of clinic records at a fertility clinic that had been using the Craig protocol prior to the publication of the paper. In this observational study, the Craig protocol was not found to lower the number of live births (LB). In non-donor IVF cycles, no differences in LB were found when comparing acupuncture carried out according to the Craig protocol with no acupuncture controls. However, in donor IVF cycles, the Craig protocol was associated with a 30% higher rate of LB compared to those who did not have acupuncture. The authors examine factors in the Craig et al. study that may have contributed to its negative findings, which include the fact that participants received acupuncture at an offsite location (and thus may have suffered additional stress due to travel), and that Craig et al. did not consider differences between donor versus non-donor cycles in their data analysis. This may be significant since non-donor IVF cycles require that the embryo recipient’s ovaries be stimulated with GnRH analogues to develop the ovarian follicles and endometrium. Donor IVF cycles do not necessitate ovarian stimulation, only oestrogen supplementation to develop the endometrium. The authors suggest that these differences may require different acupuncture protocols, and recommend that the type of IVF cycle should be considered when developing acupuncture protocols and conducting data analysis in future studies. Finally, unlike Craig et al. who used CPR, the new study used LB as its main outcome, rationalising that this is ultimately the most important measure of the success of an IVF cycle. (Acupuncture and In Vitro Fertilization: A Retrospective Chart Review. J Altern Complement Med. 2013 Jan 30. [Epub ahead of print]).
Categories: Infertility
