The bottom line of a new review of seven studies, by researchers at the University of Maryland School of Medicine and the VU University Amsterdam on 1,366 women in the United States, Germany, Australia and Denmark who had in vitro fertilization or IVF suggests that complementing the embryo transfer process with acupuncture increased the odds of pregnancy by 65 per cent compared to sham acupuncture or no additional treatment.
IVF is essentially a numbers game as it increases the odds of success by increasing the number of eggs produced. The technique increases the numbers of eggs produced in the hope that at least one will be successful rather than aiming to affect the quality of the egg. The general health of the couple is often of minor concern. In fact the numbers of motile sperm is becoming less important with the use of ICSI.
In contrast Traditonal Chinese Medicine considers the overall health of a person making the gametes as this will translate into healthier gametes.
Acupuncture and Chinese Medicine can also influence the number, motility and genetic quality of sperm.
Although we do not know exactly why acupuncture is so successful in assisting IVF, a number of physiological effects may be contributing to its effectiveness.
One of the reasons acupuncture may have such a dramatic effect on IVF success is through increased blood flow to the uterus. It has also been well documented that infertility causes stress and that stress reduction may in turn improve fertility. The use of acupuncture for reducing anxiety and stress possibly through its sympathoinhibitory effect may provide an excellent alternative for stress reduction in women undergoing infertility treatment especially as the side effects of anti-depressant drugs on infertility treatment outcomes are unknown.
Francis Rock DTCM R.Ac.
Doctor of Traditional Chinese Medicine
www.akuklinik.com
Acupuncture and Fertility: The Media Screws Up
Imagine if one treatment was "powerful" enough to make a 65% improvement IVF pregnancies. I already have the tag line for all our fertility web sites. "one needle, one treatment - 100 % success". Sounds unbelievable? Well a review of the study says that the stats were reported incorrectly. The stats suggest only 10% improvement rather than 65%. I am curious if someone is really searching for the truth or desperately wanting acupuncture to not be an effective complement to IVF. Regardless, careful when quoting percentages as one could lose their credibility if they are over inflated. And remember, preconception care is really the strength of our medicine, treating for several months before an IVF and not just on transfer day. (Article below)
Lorne
www.acubalance.ca
www.prodseminars.com
Acupuncture and Fertility: The Media Screws Up (http://www.stats.org/stories/2008/ acupuncture_fertility_march_3_08.html)
Rebecca Goldin Ph.D, and Jenna Krall
Odds ratios can also be prickly
A study published early February in the British Medical Journal examined the link between acupuncture and successful in vitro fertilization. Editorializing headlines had rewritten the science within a week. The study was covered by news organizations, including Fox News, MSNBC, The Examiner, and The Washington Times, all declaring that “fertility benefits from old remedy.” The message was that scientists have now shown conclusively that acupuncture fosters successful pregnancies.
But embedded in the original article is the caveat that the theory is “far from proven.” In the seven studies conducted for the paper, only three found the effect of acupuncture on IVF patients significant. One of the studies found no relation between IVF success and acupuncture, and the remaining three “found a trend toward benefit.” The authors pooled the seven studies in a meta-analysis to find that the odds ratio – the odds of pregnancy through IVF and acupuncture divided by the odds of pregnancy through IVF without acupuncture – was 1.65. Here the word ‘odds’ is used in the statistical sense, not the layman meaning.
The odds of pregnancy through IVF are given by q/(1-q), where q is the probability that someone gets pregnant through IVF. The odds ratio of getting pregnant with acupuncture compared to getting pregnant without it is given by p/(1-p) divided by q/(1-q), where p is the probability that someone gets pregnant through IVF with acupuncture, and q is that probability without acupuncture. The odds ratio can be useful if it is understood in context. In this case, the study itself notes that:
“the odds ratio significantly overestimates the rate ratio in this context, in which the event (pregnancy) is relatively frequent. In absolute terms, the number needed to treat was 10, suggesting that 10 patients would need to be treated with acupuncture to bring about one additional clinical pregnancy.”
The media reported this figure as if acupuncture increases the success rate of IVF by 65 percent, misunderstanding what is meant by the odds ratio. The actual increase in pregnancy likelihood according to this meta-analysis is about ten percent. This alone makes the results far less impressive than they sound.
Though the news reports of this study acknowledged the lack of conclusive evidence supporting acupuncture, the story received lots of media attention. And editors writing headlines seem to undermine the cautious reporting behind it, while missing the consistent mistake made by the press on the meaning of the odds ratio.