In vitro fertilization and acupuncture: clinical efficacy and mechanistic basis.

ObjectiveTo provide an overview of the use of acupuncture as an adjunct therapy for in vitro fertilization (IVF), including an evidence-base d evaluation of its efficacy and safety and an examination of possible mechanisms of action. DesignLiterature review using PubMed, the Science Citation Index®, The Cochrane Library (Database of Systematic Reviews and Central Register of Controlled Trials), the New England School of Acupuncture library databases, and a cross- referencing of published data, personal libraries, and Chinese medicine textbooks. ResultsLimited but supportive evidence from clinical trials and case series suggests that acupuncture may improve the suc- cess rate of IVF and the quality of life of patients undergoing IVF and that it is a safe adjunct therapy. However, this conclusion should be interpreted with caution because most studies reviewed had design limitations, and the acupuncture interven- tions employed often were not consistent with traditional Chinese medical principles. The reviewed literature suggests 4 possible mechanisms by which acupuncture could improve the outcome of IVF: modulating neuroendocrinological factors; increasing blood flow to the uterus and ovaries; modulating cytokines; and reducing stress, anxiety, and depression. ConclusionsMore high-quality randomized, controlled trials incorporating placebo acupuncture controls, authentic acupunc- ture interventions, and a range of outcome measures representa- tive of both clinical outcomes and putative mechanistic processes are required to better assess the efficacy of acupuncture as an adjunct for IVF. {Altern Ther Health Med. 2007;13(3):38-48.)