• Acupuncture and Chinese herbal medicine for fertility treatment

    by
    John Jackson
    Published on 10th March 2010 08:58 AM
    Today, the British Fertility Society published a press release to issue new guidelines on the use of acupuncture and traditional Chinese herbal medicine (TCM). The message is that "there is currently no evidence that having acupuncture or Chinese herbal medicine treatment around the time of assisted conception increases the likelihood of subsequent pregnancy."

    See: http://www.britishfertilitysociety.o...upuncture.html

    What has been done is a 'meta analysis' of all the available data from previous trials to come to an overall conclusion. Individual clinical trials will occasionally give positive results even if the treatment doesn't actually work because it is an inherent feature of experimental testing that erroneous positive results will occur (even perfectly designed and executed trials will yield false positives 5% of the time). It is also possible to get false negatives in trials too (where something that does work fails in an individual trial).

    The way to iron out these false positives and negatives is to consider all (or as many as possible) trials that have been done to a high standard and look to see whether there really is an overall positive effect or if the few positive trials are just 'noise in the data'.

    This is important because proponents of things such as acupuncture will normally focus on the positive trials that have been done and use these as evidence that acupuncture treatments work. So, as an example, if there have been 100 trials done and 5 of them have been positive, proponents will select these 5 positive trial results and ignore the others. The significance of this becomes clear when we remember that we would expect 5 positive trials out of 100 (5%) purely by chance.

    Here is the abstract of the research that was carried out:

    Acupuncture and herbal medicine in IVF: a review of the evidence for clinical practice. British Fertility Society, Policy and Practice Guidelines

    Ying Cheong1, Luciano G Nardo2,3, Tony Rutherford4, William Ledger5
    1Division of Developmental Origins of Adult Diseases (DOHaD), Level F, Princess Anne Hospital, Southampton, UK; 2Department of Reproductive Medicine, St. Mary’s Hospital, Manchester, UK; 3North West Fertility, IVF Unit, UK; 4Reproductive Medicine Unit, Leeds General Infirmary, Leeds, UK; and 5Academic Unit of Reproductive and Developmental Medicine,University of Sheffield, UK.


    The objectives of this systematic review were to determine the effectiveness of (a) acupuncture and (b) Chinese herbal medicine on the treatment of male and female subfertility by assisted reproductive technologies (ART). All reports from RCTs of acupuncture and/or Chinese herbal medicine in ART were obtained via searches through The Cochrane Menstrual Disorders and Sub-fertility Group’s Specialised Register of controlled trials, and other major databases. The outcome measures were determined prior to starting the search, and comprised: live birth rate, ongoing pregnancy rate, clinical pregnancy rate, the incidence of ovarian hyperstimulation syndrome and multiple pregnancy, miscarriage rate and adverse effects arising from treatment. Overall, 14 trials (a total of 2670 subjects) were included in the metaanalysis. The results provided no evidence of benefit in the use of acupuncture during assisted conception. Further studies should attempt to explore the potential placebo, as well as treatment, effects of this complimentary therapy. Essential elements for a quality RCT will be the size of the trial, the use of a standardised acupuncture method and of placebo needles.
    The implication of this is that couples who are undergoing fertility treatment may be paying, often a lot of money, for 'complementary' treatments like acupuncture or TCM in the hope that it will improve their chances (even if only slightly); but this research shows that this is money being spent on something completely ineffective.

    If the NHS are funding these 'complementary' treatments, then they are simply wasting taxpayers' money. Money that could be better spent - perhaps on research into fertility treatments!

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    Categories:
    1. Health
    2. Acupuncture

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