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Meta-Analysis
. 2008 Mar 8;336(7643):545-9.
doi: 10.1136/bmj.39471.430451.BE. Epub 2008 Feb 7.

Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis

Eric Manheimer  1 , Grant Zhang, Laurence Udoff, Aviad Haramati, Patricia Langenberg, Brian M Berman, Lex M Bouter
Affiliations
Meta-Analysis

Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis

Eric Manheimer et al. BMJ. .

Abstract

Objective: To evaluate whether acupuncture improves rates of pregnancy and live birth when used as an adjuvant treatment to embryo transfer in women undergoing in vitro fertilisation.

Design: Systematic review and meta-analysis.

Data sources: Medline, Cochrane Central, Embase, Chinese Biomedical Database, hand searched abstracts, and reference lists. Review methods Eligible studies were randomised controlled trials that compared needle acupuncture administered within one day of embryo transfer with sham acupuncture or no adjuvant treatment, with reported outcomes of at least one of clinical pregnancy, ongoing pregnancy, or live birth. Two reviewers independently agreed on eligibility; assessed methodological quality; and extracted outcome data. For all trials, investigators contributed additional data not included in the original publication (such as live births). Meta-analyses included all randomised patients.

Data synthesis: Seven trials with 1366 women undergoing in vitro fertilisation were included in the meta-analyses. There was little clinical heterogeneity. Trials with sham acupuncture and no adjuvant treatment as controls were pooled for the primary analysis. Complementing the embryo transfer process with acupuncture was associated with significant and clinically relevant improvements in clinical pregnancy (odds ratio 1.65, 95% confidence interval 1.27 to 2.14; number needed to treat (NNT) 10 (7 to 17); seven trials), ongoing pregnancy (1.87, 1.40 to 2.49; NNT 9 (6 to 15); five trials), and live birth (1.91, 1.39 to 2.64; NNT 9 (6 to 17); four trials). Because we were unable to obtain outcome data on live births for three of the included trials, the pooled odds ratio for clinical pregnancy more accurately represents the true combined effect from these trials rather than the odds ratio for live birth. The results were robust to sensitivity analyses on study validity variables. A prespecified subgroup analysis restricted to the three trials with the higher rates of clinical pregnancy in the control group, however, suggested a smaller non-significant benefit of acupuncture (odds ratio 1.24, 0.86 to 1.77).

Conclusions: Current preliminary evidence suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilisation.

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Conflict of interest statement

Competing interests: None declared.

Figures

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Fig 1 Flow of studies through selection process
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Fig 2 Effects of acupuncture on clinical pregnancy, ongoing pregnancy, and live birth outcomes
See this image and copyright information in PMC

Comment in

  • Acupuncture with in vitro fertilisation.
    Pinborg A, Loft A, Andersen AN. Pinborg A, et al. BMJ. 2008 Mar 8;336(7643):517-8. doi: 10.1136/bmj.39503.643727.80. BMJ. 2008. PMID: 18325938 Free PMC article.
  • Commentary: Good, but not perfect.
    Clarke M. Clarke M. BMJ. 2008 Mar 8;336(7643):549. doi: 10.1136/bmj.39490.520046.25. BMJ. 2008. PMID: 18325965 Free PMC article. No abstract available.
  • Acupuncture in in vitro fertilization.
    Stener-Victorin E. Stener-Victorin E. Forsch Komplementmed. 2008 Aug;15(4):228-9. doi: 10.1159/000139129. Forsch Komplementmed. 2008. PMID: 18795462 No abstract available.

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    1. Centers for Disease Control and Prevention. Assisted reproductive technology success rates: national summary and fertility clinic reports 2003 Atlanta, GA: US Department of Health and Human Services, 2005. www.cdc.gov/art/art2003
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