Fertil Steril. 2012 Jan 11
Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis.
Zheng CH, Huang GY, Zhang MM, Wang W.
Source
Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China.
Abstract
OBJECTIVE:
To evaluate the effect of acupuncture on in vitro fertilization (IVF) outcomes.
DESIGN:
Systematic review and meta-analysis.
PATIENT(S):
Women undergoing IVF in randomized controlled trials (RCTs) who were evaluated for the effects of acupuncture on IVF outcomes.
SETTING:
Not applicable.
INTERVENTION(S):
The intervention groups used manual, electrical, and laser acupuncture techniques. The control groups consisted of no, sham, and placebo acupuncture.
MAIN OUTCOME MEASURE(S):
The major outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Heterogeneity of the therapeutic effect was evaluated with a forest plot analysis. Publication bias was assessed by a funnel plot analysis.
RESULT(S):
Twenty-four trials (a total of 5,807 participants) were included in this review. There were no significant publication biases for most of the comparisons among these studies. The pooled CPR (23 studies) from all of the acupuncture groups was significantly greater than that from all of the control groups, whereas the LBR (6 studies) was not significantly different between the two groups. The results were different when the type of control was examined in a sensitivity analysis. The CPR and LBR differences between the acupuncture and control groups were more obvious when the studies using the Streitberger control were ignored. Similarly, if the underlying effects of the Streitberger control were excluded, the LBR results tended to be significant when the acupuncture was performed around the time of oocyte aspiration or controlled ovarian hyperstimulation.
CONCLUSION(S):
Acupuncture improves CPR and LBR among women undergoing IVF based on the results of studies that do not include the Streitberger control. The Streitberger control may not be an inactive control. More positive effects from using acupuncture in IVF can be expected if an appropriate control and more reasonable acupuncture programs are used.
The Effect of Acupuncture on Psychosocial Outcomes for Women Experiencing Infertility: A Pilot Randomized Controlled Trial
To cite this article:
Caroline A. Smith, Jane M. Ussher, Janette Perz, Bridget Carmady and ,Sheryl de Lacey. The Journal of Alternative and Complementary Medicine. -Not available-, ahead of print. doi:10.1089/acm.2010.0380.
Online Ahead of Print: October 6, 2011
Caroline A. Smith, PhD,1
Jane M. Ussher, PhD,2
Janette Perz, PhD,2
Bridget Carmady, BNat,1 and
Sheryl de Lacey, PhD3
1Centre for Complementary Medicine Research, The University of Western Sydney, Sydney, Australia.
2Health Services and Outcomes Research Group, The University of Western Sydney, Sydney, Australia.
3School of Nursing and Midwifery, Flinders University, Flinders, Australia.
Address correspondence to:
Caroline A. Smith, PhD
Centre for Complementary Medicine Research
The University of Western Sydney
Penrith South, New South Wales
Sydney 1797
Australia
E-mail: Caroline.smith@uws.edu.au
Abstract
Objectives: The study objectives were to examine the effectiveness of acupuncture for reducing infertility-related stress.
Design: The study design was a randomized controlled trial of acupuncture compared with a wait-list control.
Setting: The study was conducted at The University of Western Sydney.
Subjects: Thirty-two (32) women aged 20–45 years, with a diagnosis of infertility, or a history of unsuccessfully trying to conceive for 12 months or more, were the subjects of the study.
Interventions: Women received six sessions of acupuncture over 8 weeks.
Outcome measures: The primary outcomes were infertility self-efficacy, anxiety, and infertility-related stress. The women’s experience of infertility and acupuncture is also reported.
Results: At the end of the 8-week intervention, women in the acupuncture group reported significant changes on two domains on the Fertility Problem Inventory with less social concern (mean difference [MD] ?3.75, 95% confidence interval [CI] ?7.58 to 0.84, p=0.05), and less relationship concern (MD ?3.66, 95% CI ?6.80 to ?0.052, p=0.02). There were also trends toward a reduction of infertility stress on other domains, and a trend toward improved self-efficacy (MD 11.9, 95% CI ?2.20 to 26.0, p=0.09) and less anxiety (MD ?2.54, 95% CI ?5.95 to 0.86, p=0.08) in the acupuncture group compared with the wait-list control. Women described the experience and impact of acupuncture as positive relating to a sense of relaxation and time out, the engagement with the practitioner, and an intervention that had very few negative side-effects. Changes were also perceived after treatment with women describing a physical and psychologic sense of relaxation and calmness, and a changed perspective in relation to coping.
Conclusions: Acupuncture may be a useful intervention to assist with the reduction of infertility-related stress. Further research is justified.
Increase of success rate for women undergoing embryo transfer by transcutaneous electrical acupoint stimulation: a prospective randomized placebo-controlled study
Objective
To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on pregnancy rates (PR) in women undergoing ET.
Design
Prospective, randomized, single-blinded placebo-controlled clinical trial.
Setting
Research and laboratory facilities.
Patient(s)
A total of 309 patients, less than 45 years old, undergoing cryopreservation embryos transplant or fresh cycle IVF with or without intracytoplasmic sperm injection (ICSI).
Intervention(s)
The subjects were randomly allocated to three groups: mock TEAS treatment: 30 minutes after ET (group I, n = 99); single TEAS treatment: 30 minutes after ET (group II, n = 110); and double TEAS treatments: 24 hours before ET and 30 minutes after ET (group III, n = 100).
Main Outcome Measure(s)
Clinical PR, embryos implantation rate, live birth rate.
Result(s)
The clinical PR, embryos implantation rate, and live birth rate of group I (29.3%, 15.0%, and 21.2%, respectively) were significantly lower than those in group II (42.7%, 25.7%, and 37.3%, respectively) and group III (50.0%, 25.9%, and 42.0%, respectively).
Conclusion(s)
Transcutaneous electrical acupoint stimulation, especially double TEAS, significantly improved the clinical outcome of ET.
Key Words: Acupuncture, transcutaneous electrical acupoint stimulation (TEAS), pregnancy rate (PR), in vitro fertilization (IVF), embryo transfer (ET), intracytoplasmic sperm injection (ICSI)
Effect of acupuncture-moxibustion therapy on sperm quality in infertility patients with sperm abnormality
Objective
Working on seminal plasma acid phosphatase, to explore the mechanism by which acupuncture improves sperm quality (concentration, viability and motility) in infertility patients.
Methods
A total of 118 patients received acupuncture-moxibustion treatment. Before and 3, and 6 months after the treatment were detected their seminal plasma acid phosphatase, sperm concentration, sperm viability and sperm motility were measured.
Results
The differences between before and after treatments in sperm motility and seminal plasma acid phosphatase levels were statistically significant (P<0.01).
Conclusion
Acupuncture-moxibustion can improve seminal plasma acid phosphatase levels in infertility patients.
Authors: An Chen, Aiming Shen, Renhua Li and Zhiping Xia
Key Words Acupuncture Therapy – Infertility, Male – Acid Phosphatase – Spermatozoa

Abstract
Objective
To observe the clinical efficacy of acupuncture-moxibustion therapy for infertility due to sperm abnormality (SAI).
Methods
We treated a series of 35 cases of SAI with electroacupuncture combined with herb cake-partitioned moxibustion, observing the variation before and after treatment in symptom integral, sperm status, sex hormone and prostate function.
Results
After treatment, the patients were remarkably improved in symptom integral, sperm status, sex hormone and prostate function as compared with those prior to treatment.
Conclusion
Acupuncture is an effective therapy for SAI.
Key Words Acupuncture-moxibustion Therapy – Infertility, Male – Spermatozoa – Azoospermia – Oligospermia
Author: He Jinsen, doctor of medicine, professor

Title: Effect of electro-acupuncture on ovarian expression of ? (1)- and ? (2)-adrenoceptors, and p75 neurotrophin receptors in rats with steroid-induced polycystic ovaries
Author: Manni Luigi ; Lundeberg Thomas ; Holmäng Agneta ; Aloe Luigi ; Stener-Victorin Elisabet
Abstract:
Abstract
Background
Estradiol valerate (EV)-induced polycystic ovaries (PCO) in rats is associated with an increase in ovarian sympathetic outflow. Low-frequency (2 Hz) electro-acupuncture (EA) has been shown to modulate sympathetic markers as well as ovarian blood flow as a reflex response via the ovarian sympathetic nerves, in rats with EV-induced PCO.
Methods
In the present study, we further tested the hypothesis that repeated 2 Hz EA treatments modulate ovarian sympathetic outflow in rats with PCO, induced by a single i.m. injection of EV, by investigating the mRNA expression, the amount and distribution of proteins of ?1a-, ?1b-, ?1d-, and ?2-adrenoceptors (ARs), as well as the low-affinity neurotrophin receptor (p75NTR).
Results
It was found that EV injection results in significantly higher mRNA expression of ovarian ?1b- and ?1d-AR in PCO rats compared to control rats. The p75NTR and ?2-ARs mRNA expression were unchanged in the PCO ovary. Low-frequency EA resulted in a significantly lower expression of ?2-ARs mRNA expression in PCO rats. The p75NTR mRNA was unaffected in both PCO and control rats. PCO ovaries displayed significantly higher amount of protein of ?1a-, ?1b- and ?1d-ARs, and of p75NTR, compared to control rats, that were all counteracted by repeated low-frequency EA treatments, except for ?1b-AR.
Conclusion
The present study shows that EA normalizes most of the EV-induced changes in ovarian ARs. Furthermore, EA was able to prevent the EV-induced up regulation of p75NTR, probably by normalizing the sympathetic ovarian response to NGF action. Our data indicate a possible role of EA in the regulation of ovarian responsiveness to sympathetic inputs and depict a possible complementary therapeutic approach to overcoming sympathetic-related anovulation in women with PCOS.
Journal: Reproductive Biology and Endocrinology
Issn: 14777827
Selecting a control for in vitro fertilization and acupuncture randomized controlled trials (RCTs): how sham controls may unnecessarily complicate the RCT evidence base
Eric Manheimer M.S.Corresponding Author Contact Information, a, E-mail The Corresponding Author
a Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, Maryland
Received 5 April 2011;
revised 11 April 2011;
accepted 13 April 2011.
Available online 13 May 2011.
Objective
To examine the theoretical and methodologic rationales for the use of sham acupuncture controls in trials of adjuvant acupuncture for in vitro fertilization (IVF), and to identify the drawbacks of using a sham acupuncture control that may have its own effects on the pregnancy outcome. More »
Title: Effect of electro-acupuncture stimulation of different frequencies and intensities on ovarian blood flow in anaesthetized rats with steroid-induced polycystic ovaries
Author: Stener-Victorin Elisabet ; Kobayashi Rie ; Watanabe Orie ; Lundeberg Thomas ; Kurosawa Mieko
Abstract:
Abstract
Background
Maintenance of ovarian blood flow (OBF) is suggested to be important for regular ovulation in women with polycystic ovaries (PCO). More »
Gynecol Endocrinol. 2010 Jun;26(6):473-8.
Current evidence of acupuncture on polycystic ovarian syndrome.
Lim CE, Wong WS.
Faculty of Medicine, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia. celim@unswalumni.com
Abstract
OBJECTIVE: This paper aims to provide a literature review on evaluating the efficacy of acupuncture therapy in the treatment of polycystic ovarian syndrome (PCOS) by reviewing clinical trials; randomised and non-randomised and observational studies on PCOS. The paper will also determine the possible mechanism of acupuncture treatment in PCOS, limitations of recruited studies and suggest further improvements in future studies.
More »
Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: a randomized controlled trial
Elizabeth Jedel1, Fernand Labrie2, Anders Odén3, Göran Holm4, Lars Nilsson5, Per Olof Janson5, Anna-Karin Lind5, Claes Ohlsson6, and Elisabet Stener-Victorin7,8
More »
Role of acupuncture in the treatment of female infertility
Fertility and Sterility, Volume 78, Issue 6, Pages 1149-1153 (December 2002)
Raymond Chang M.D.a,b, Pak H. Chung M.D. b* and Zev Rosenwaks M.D.c
Received 24 June 2002; revised 19 July 2002; accepted 19 July 2002.
Abstract
Objective: To review existing scientific rationale and clinical data in the utilization of acupuncture in the treatment of female infertility.
More »
J Altern Complement Med. 2010 Feb;16(2):193-8.
Unexplained infertility treated with acupuncture and herbal medicine
Park JJ, Kang M, Shin S, Choi E, Kwon S, Wee H, Nam B, Kaptchuk TJ.
Asian Medicine & Acupuncture Research, Department of Physical Medicine & Rehabilitation, University of North Carolina at Chapel Hill, NC, USA.
Erratum in:
J Altern Complement Med. 2010 Jul;16(7):817.
Abstract
AIM: We aim to determine the safety and effectiveness of a standard therapeutic package of Korean medicine for the treatment of unexplained infertility in a cross-section of women who sought treatment at an integrative hospital in Seoul, Korea.
More »
Zhongguo Zhen Jiu. 2009 Oct;29(10):775-9.
[Effects of electro-acupuncture on in vitro fertilization-embryo transfer (IVF-ET) of patients with poor ovarian response]
[Article in Chinese]
Chen J, Liu LL, Cui W, Sun W.
Department of Reproduction, The Second Affiliated Hospital of Shandong University of TCM, Jinan 250001, China. fusantai@126.com
Abstract
OBJECTIVE: To observe the effect of electro-acupuncture therapy on oocyte quality and pregnancy outcome of patients with poor ovarian response or decreased reserve in the course of in vitro fertilization (IVF).
METHODS: Sixty cases accepting IVF-ET were randomly divided into an observation group and a control group, 30 cases in each group. The two groups were both treated with antagonist scheme for ovulation induction, and the electro-acupuncture intervention was also added in the observation group, Guanyuan (CV 4), Taixi (KI 3), Sanyinjiao (SP 6) etc. were selected. The therapeutic effects in the two groups were compared after treatment.
RESULTS: There was no significant difference between the two groups before treatment. The symptoms of kidney difficiency in the observation group were significantly improved after treatment, and the levels of serum estradiol (E2), fertilization rate, oocyte maturation rate, good quality embryos rate, and implantation rate in the observation group were superior to those in the control group on human Chorionic Gonadotropin (hCG) injection day (all P<0.05); the levels of stem cell factor (SCF) in follicular fluid and serum in the observation group were significantly higher than those in the control group (both P<0.05). The pregnancy rate in the observation group was higher than that in the control group, and the abortion rate in the observation group was lower than that in the control group, but there was no significant difference between the two groups (both P>0.05).
CONCLUSION: Electro-acupuncture therapy has a good clinical effect for IVF patients with poor ovarian reserve, and can improve oocyte (egg) quality and pregnancy outcome.
PMID: 19873910 [PubMed - indexed for MEDLINE]
Complement Ther Clin Pract. 2010 Aug;16(3):154-7. Epub 2009 Dec 24.
The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: a pilot study.
Balk J, Catov J, Horn B, Gecsi K, Wakim A.
University of Pittsburgh, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA. jbalk@magee.edu
Abstract
The aim of this paper was to determine the effect of acupuncture on perceived stress levels in women on the day of embryo transfer (ET), and to determine if perceived stress levels at embryo transfer correlated with pregnancy rates. The study was an observational, prospective, cohort study based at the University IVF center.
PATIENT(S): 57 infertile patients undergoing IVF or IVF/ICSI. INTERVENTIONS(S): Patients were undergoing Embryo Transfer with or without acupuncture as part of their standard clinical care.
MAIN OUTCOME MEASURE(S): Perceive Stress Scale scores, pregnancy rates.
RESULT(S): women who received this acupuncture regimen achieved pregnancy 64.7%, whereas those without acupuncture achieved pregnancy 42.5%. When stratified by donor recipient status, only non-donor recipients potentially had an improvement with acupuncture (35.5% without acupuncture vs. 55.6% with acupuncture). Those who received this acupuncture regimen had lower stress scores both pre-ET and post-ET compared to those who did not. Those with decreased their perceived stress scores compared to baseline had higher pregnancy rates than those who did not demonstrate this decrease, regardless of acupuncture status. CONCLUSIONS(S): The acupuncture regimen was associated with less stress both before and after embryo transfer, and it possibly improved pregnancy rates. Lower perceived stress at the time of embryo transfer may play a role in an improved pregnancy rate.
PMID: 20621276 [PubMed - in process]PMCID: PMC2904299 [Available on 2011/8/1]
Acupuncture PCOS
1 Institution of Neuroscience and Physiology
2 Osher Center for Integrative Medicine
3 inst. neuroscience and physiology
* To whom correspondence should be addressed. E-mail: elisabet.stener-victorin@neuro.gu.se.
Context: We have recently shown that polycystic ovary syndrome (PCOS) is associated with high muscle sympathetic nerve activity. Animal studies support the concept that low-frequency electro-acupuncture (EA) and physical exercise, via stimulation of ergoreceptors and somatic afferents in the muscles, may modulate the activity of the sympathetic nervous system. Objective: The aim of the present study was to investigate the effect of these interventions on sympathetic nerve activity in women with PCOS. Design: Randomized controlled trial. Setting: Sahlgrenska University Hospital, Gothenburg, Sweden. Outcome Measures and Subjects: Twenty women with PCOS were randomly allocated to one of three groups; low-frequency EA (n=9), physical exercise (n=5) or to an untreated control (n=6) group during 16 weeks. Direct recordings of multiunit efferent postganglionic muscle sympathetic nerve activity (MSNA) in a muscle fascicle of the peroneal nerve before and following 16 weeks of treatment. Biometric, hemodynamic, endocrine and metabolic parameters were measured. Results: Low-frequency EA (P = 0.036) and physical exercise (P = 0.030) decreased MSNA burst frequency compared to the untreated control group. Low-frequency EA group reduced sagittal diameter (P = 0.001), while physical exercise group reduced body weight (P = 0.004) and body mass index (BMI) (P = 0.004) as compared to the untreated control group. Sagittal diameter was related to MSNA burst frequency (Rs = 0.58, P < 0.005) in the EA group. No correlation was found for BMI and MSNA in the exercise group. There were no differences between the groups in hemodynamic, endocrine and metabolic variables. Conclusions: For the first time we demonstrate that low-frequency EA and physical exercise lowers high sympathetic nerve activity in women with PCOS. Thus, treatment with low-frequency EA or physical exercise with the aim to reduce MSNA may be of importance for women with PCOS.
Am J Physiol Regul Integr Comp Physiol (June 3, 2009). doi:10.1152/ajpregu.00197.2009
Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization–embryo transfer treatment
Paul C. Magarelli, M.D.aCorresponding Author Informationemail address, Diane K. Cridennda, L.Acb, Mel Cohen, Ph.D.a
Received 22 May 2008; received in revised form 24 October 2008; accepted 28 October 2008. published online 31 December 2008.
Corrected Proof
Objective
To determine whether changes in serum cortisol (CORT) and PRL are affected by acupuncture (Ac) in Ac-treated IVF patients.
Design
Prospective cohort clinical study.
Setting
Private practice reproductive endocrinology and infertility clinic and private practice acupuncture consortium.
Patient(s)
Sixty-seven reproductive-age infertile women undergoing IVF.
Intervention(s)
Blood samples were obtained from all consenting new infertility patients and serum CORT and serum PRL were obtained prospectively. Patients were grouped as controls (IVF with no Ac) and treated (IVF with Ac) according to acupuncture protocols derived from randomized controlled trials.
Main Outcome Measure(s)
Serum levels of CORT and PRL were measured and synchronized with medication stimulation days of the IVF cycle (e.g., day 2 of stimulation, day 3, etc.). Reproductive outcomes were collected according to Society for Assisted Reproductive Technology protocols, and results were compared between controls and those patients treated with Ac.
Result(s)
CORT levels in Ac group were significantly higher on IVF medication days 7, 8, 9, 11, 12, and 13 compared with controls. PRL levels in the Ac group were significantly higher on IVF medication days 5, 6, 7, and 8 compared with controls.
Conclusion(s)
In this study, there appears to be a beneficial regulation of CORT and PRL in the Acupuncture group during the medication phase of the IVF treatment with a trend toward more normal fertile cycle dynamics.
Arch Androl. 1997 Sep-Oct;39(2):155-61.
Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality.
Siterman S, Eltes F, Wolfson V, Zabludovsky N, Bartoov B.
Institute of Chinese Medicine, Tel Aviv, Israel.
The aim of this prospective controlled study was to assess the effect of acupuncture on the sperm quality of males suffering from subfertility related to sperm impairment. Semen samples of 16 acupuncture-treated subfertile patients were analyzed before and 1 month after treatment (twice a week for 5 weeks). In parallel, semen samples of 16 control untreated subfertile males were examined. Two specimens were taken from the control group at an interval of 2-8 months. The expanded semen analysis included routine and ultramorphological observations. The fertility index increased significantly (p < or = .05) following improvement in total functional sperm fraction, percentage of viability, total motile spermatozoa per ejaculate, and integrity of the axonema (p < or = .05), which occurred upon treatment. The intactness of axonema and sperm motility were highly correlated (corr. = .50, p < or = .05). Thus, patients exhibiting a low fertility potential due to reduced sperm activity may benefit from acupuncture treatment.
Acupuncture and exercise restore adipose tissue expression of sympathetic markers and improve ovarian morphology in rats with dihydrotestosterone-induced PCOS
Louise Mannerås,1 Stefan Cajander,2 Malin Lönn,3 and Elisabet Stener-Victorin1
1Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2 Department of Pathology and Cytology, Sunderby County Hospital, Luleå, Sweden; and 3 Institute of Medicine, Wallenberg Laboratory, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Submitted 22 November 2008 ; accepted in final form 15 January 2009
Altered activity of the sympathetic nervous system, which innervates adipose and ovarian tissue, may play a role in polycystic ovary syndrome (PCOS). We hypothesize that electro-acupuncture (EA) and physical exercise reduce sympathetic activity by stimulating ergoreceptors and somatic afferent pathways in muscles. Here we investigated the effects of low-frequency EA and physical exercise on mRNA expression of sympathetic markers in adipose tissue and on ovarian morphology in female rats that received dihydrotestosterone (DHT) continuously, starting before puberty, to induce PCOS. At age 11 wk, rats with DHT-induced PCOS were randomly divided into three groups: PCOS, PCOS plus EA, and PCOS plus exercise. The latter two groups received 2-Hz EA (evoking muscle twitches) three times/week or had free access to a running wheel for 4–5 wk. In mesenteric adipose tissue, expression of ?3-adrenergic receptor (ADRB3), nerve growth factor (NGF), and neuropeptide Y (NPY) mRNA was higher in untreated PCOS rats than in controls. Low-frequency EA and exercise downregulated mRNA expression of NGF and NPY, and EA also downregulated expression of ADRB3, compared with untreated rats with DHT-induced PCOS. EA and exercise improved ovarian morphology, as reflected in a higher proportion of healthy antral follicles and a thinner theca interna cell layer than in untreated PCOS rats. These findings support the theory that increased sympathetic activity contributes to the development and maintenance of PCOS and that the effects of EA and exercise may be mediated by modulation of sympathetic outflow to the adipose tissue and ovaries.
sympathetic activity; ?3-adrenergic receptor; androgen receptor; nerve growth factor; neuropeptide Y
The Role of Acupuncture in the Management of Subfertility
Ng E H et al Fertil Steril. 2008 Jul;90(1):1-13.
Fertility and Sterility
Abstract
OBJECTIVE: To review systematically the use of acupuncture in the management of subfertility.
DESIGN: A computer search was performed via several English and Chinese databases to identify journals relevant to the subject.
RESULT(S): The positive effect of acupuncture in the treatment of subfertility may be related to the central sympathetic inhibition by the endorphin system, the change in uterine blood flow and motility, and stress reduction. Acupuncture may help restore ovulation in patients with polycystic ovary syndrome, although there are not enough randomized studies to validate this.
There is also no sufficient evidence supporting the role of acupuncture in male subfertility, as most of the studies are uncontrolled case reports or case series in which the sample sizes were small. Despite these deficiencies, acupuncture can be considered as an effective alternative for pain relief during oocyte retrieval in patients who cannot tolerate side effects of conscious sedation.
The pregnancy rate of IVF treatment is significantly increased, especially when acupuncture is administered on the day of embryo transfer.
CONCLUSION(S): Although acupuncture has gained increasing popularity in the management of subfertility, its effectiveness has remained controversial.

pcos acupuncture
Stener-Victorin E, Jedel E, Mannerås L.
Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden. elisabet.stener-victorin@neuro.gu.se
Abstract
This review describes the aetiology and pathogenesis of polycystic ovary syndrome (PCOS) and evaluates the use of acupuncture to prevent and reduce symptoms related with PCOS. PCOS is the most common female endocrine disorder and it is strongly associated with hyperandrogenism, ovulatory dysfunction and obesity. PCOS increases the risk for metabolic disturbances such as hyperinsulinaemia and insulin resistance, which can lead to type 2 diabetes, hypertension and an increased likelihood of developing cardiovascular risk factors and impaired mental health later in life. Despite extensive research, little is known about the aetiology of PCOS. The syndrome is associated with peripheral and central factors that influence sympathetic nerve activity. Thus, the sympathetic nervous system may be an important factor in the development and maintenance of PCOS. Many women with PCOS require prolonged treatment. Current pharmacological approaches are effective but have adverse effects. Therefore, nonpharmacological treatment strategies need to be evaluated. Clearly, acupuncture can affect PCOS via modulation of endogenous regulatory systems, including the sympathetic nervous system, the endocrine and the neuroendocrine system. Experimental observations in rat models of steroid-induced polycystic ovaries and clinical data from studies in women with PCOS suggest that acupuncture exert long-lasting beneficial effects on metabolic and endocrine systems and ovulation.