15 March 2010
ByAppeared in BioNews 549
Acupuncture and Chinese herbal medicine do not provide any benefit to women trying to become pregnant, the British Fertility Society (BFS) has found after reviewing the available evidence. The new guidelines, published in the journal Human Fertility, state that there is 'currently no evidence' that these methods increase the success rate of assisted conception, when used in conjunction with IVF.
Professor Adam Balen, Chair of the BFS Policy and Practice Committee, advised that women should be informed of the findings before considering such complementary methods. 'The British Fertility Society wants to ensure that all women receive the safest treatment when undergoing fertility procedures, while also maximising their chances that the treatment will be successful', he said. For any treatment, 'it is essential that it has been tested in randomised controlled trials to ensure that it does actually work and does not cause any harmful side-effects,' he added.
Traditional Chinese remedies such as medicinal herbs and acupuncture, in which fine needles are inserted into the skin along energy channels called 'meridians', are widely used to treat many conditions and are among the alternative treatments sought by those looking for help to conceive.
The review included data from 14 trials, involving 2670 patients, and concluded that there was no beneficial effect on live birth rate or clinical pregnancy rate compared to controls, regardless of when the acupuncture was administered. However, they also found no evidence of harm as there was no significant difference in miscarriage rates.
The authors ensured only the highest quality of data was included in the analysis by only using data from published randomised controlled trials - considered the gold standard of clinical trial. Such trials compare the experimental treatment (in this case acupuncture) with a 'control' - usually the standard treatment or a placebo (fake treatment). Participants are randomly allocated an intervention to eliminate any experimental bias.
The guidelines highlighted the large amount of variability in the experimental design of trials. In particular they identified the uncertainty over what constitutes an appropriate placebo for trials involving acupuncture as an area which warranted further investigation. They also emphasised the need to control for any placebo effects in future studies, as the added relaxation experienced by those receiving acupuncture may affect outcomes.
Responding to the new guidelines, the British Acupuncture council said: 'Fertility focused acupuncture treatment has been found to help increase blood flow to the reproductive organs, balance hormone levels, regulate the menstrual cycle and help improve the lining of the uterus and quality of eggs released…as a holistic therapy, acupuncture helps to identify underlying health issues which may cause disruption to the body's natural balance, resulting in symptoms such as infertility'.