You are here
Acupuncture and Infertility-Science vs. Hope
a guest blog by Alice Domar, Ph.D., Domar Center for Mind/Body Health at Boston IVF, June 19, 2013
I was asked last week to contribute a brief videotaped interview for Fertility Authority on the topic of my choice and for guidance on the format, was sent a link to the one I did several years ago on acupuncture. The only comment on that interview was highly negative, by Ray Rubio, an acupuncturist in California*. Ray and I have had discussions in the past on how to responsibly portray what the research in the field has shown, so I wasn’t all that surprised that he was critical of me, but I do wish he would have provided the correct facts. I am indeed a psychologist and have absolutely no training in acupuncture, but I am an established researcher and an associate professor in obstetrics, gynecology and reproductive biology at Harvard Medical School. I am the first author of one of the largest studies to date on the impact of pre and post-embryo transfer acupuncture on IVF outcome. Unlike the study he cited in his comment, our study was a randomized controlled trial, the gold standard in research, and was also published in Fertility and Sterility in 2009.
The fact is, I am a huge believer in acupuncture, both personally and for my patients. I am the executive director of a large integrative care center, where we provide more than 5000 acupuncture visits a year; most are infertility patients. I recommend acupuncture to nearly all of my own patients and I have used it myself, successfully, for anything from insomnia to back pain. However, there is a big difference between encouraging my patients to try acupuncture, versus telling patients that acupuncture will get them pregnant.
The research on the impact of acupuncture on fertility is far from clear, and the published randomized controlled trials have been with IVF patients. Some of these trials have shown that women who receive acupuncture before and after embryo transfer have higher pregnancy rates and some of the studies have shown no difference between the women who receive acupuncture and those who don’t. It is mystifying why there is no clear answer but it is possible that acupuncture might only have a significant impact on certain patients. For example, the initial study, by Paulus in 2004, only included women with good quality embryos and that study showed a highly significant positive impact of acupuncture. So perhaps acupuncture improves pregnancy rates in certain patient populations, but these patients have not yet been specifically identified.
A review of the research on acupuncture, published this month in Fertility and Sterility, concluded that any positive impact of acupuncture on pregnancy rates was likely due to a placebo effect. My response to this suggestion- so what? Most of the research on the impact of antidepressant medication indicates that the efficacy is likely due to the placebo effect, and tens of millions of Americans take these medications every day, and feel better. Research on acupuncture for infertility patients may not say for sure that it increases pregnancy rates, but acupuncture does lead to less anxiety, more optimism, and perhaps most importantly, the belief on the part of the patient that she has done everything within her control to maximize the chance that medical treatment will work.
So what is the takeaway message here? This is what I tell my patients:
- acupuncture before and after embryo transfer may increase pregnancy rates for some patients
- women who receive acupuncture report feeling less anxious, more optimistic, and would choose to do it again for a future cycle
- the impact of acupuncture on other aspects of infertility is unknown; for example, there is no research on the impact on FSH levels
- if an acupuncturist tells you that treatment will definitely get you pregnant, find another acupuncturist
Alice D. Domar Ph.D is the executive director of the Domar Center for Mind/Body Health at Boston IVF, an associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School, a member of the Board of Directors of Resolve, and the author of “Conquering Infertility”.
*Permalink Submitted by Ray Rubio, DAOM... on Thu, 10/21/2010 - 12:58pm
Although Dr. Domar is a respected leader in the field of infertility, she is not an authority on Acupuncture - in fact she is not a licensed acupuncturist at all. She has a Ph.D. in psychology, and has done some groundbreaking studies in mind-body therapy for patients trying to conceive. However, just because she employs Acupuncturists in the Domar Center, and because she has done a couple of studies on Acupuncture for IVF, does not make her an authority on Acupuncture or Chinese Medicine as it pertains to Infertility. It is misleading to list her as an authority for a profession that she does not hold licensure in. Randine Lewis, Ph.D. - author of the "The Infertility Cure", or Jill Blakeway, author of "Making Babies", or Dianne Cridennda, co-author of an Acupuncture/IVF Study published in Fertility & Sterility in December, 2009, are each very qualified, and licensed Acupuncturists who are more than capable of representing our Profession as authorities on Acupuncture as it relates to Infertility, ART, and IVF. I do hope that Fertility Authority will rectify this situation. Please feel free to contact me if you have any questions regarding my concerns raised here. Warmly, Dr. Rubio