Complementary and Alternative Medicine Approaches in Infertility: How Effective Are They?

Goodthings can happen when East meets West.  About five years ago, a study from Germany was published which showed that IVF patients who received acupuncture for 25 minutes before and after embryo transfer had much higher pregnancy rates than women who simply lay quietly for the same amount of time. However, there were problems with the design of the study: For example, only women with good quality embryos were included and the investigators did not control for the placebo effect.  Nevertheless, the concept that acupuncture could increase pregnancy rates swept across the world like wildfire. Some IVF clinics reported that 80% of their patients sought out acupuncture treatment and acupuncture clinics reported huge increases in infertility patients.  It even was featured on an episode of Sex and the City (which certainly made me believe that the trend was for real).

But can it be possible that combining the approaches of Eastern and Western medicine can indeed increase pregnancy rates in infertile women? The answer is a definite maybe. As in, I have no idea.

The reason why it is maybe is that all the subsequent research has been completely confusing. The same group who did the original study did another one a year later which compared real acupuncture needles to sham ones (that is, they look like real needles, they touch the skin like real needles, but they don’t penetrate the skin like real needles) and found no difference in pregnancy rates between the two groups. These results suggest that perhaps acupuncture is effective simply because the patients believe it is going to help them. But last year, three more studies were published which showed that in some patients, real acupuncture was more effective than sham acupuncture. However, some recent research which attempted to replicate the original German research failed to find any differences between acupuncture and the lying quietly group.

So how do you make sense of all this? Can acupuncture help you get pregnant or not? I wish I could give you an answer. Perhaps my actions can help you more than my words. I am the director of a complementary care center and I employ five acupuncturists. I tell prospective patients the truth: I don’t know if acupuncture is going to help them conceive, but I am pretty positive that it can’t hurt (well, the needles might sting a tiny bit) and it might indeed help. I am of the belief that infertility patients need to believe that they did everything they could to get pregnant. If they believe that acupuncture might help them, it is worth doing. It is pretty much risk free (according to published reports, there is a 1/80,000 complication rate), it is not expensive (especially when compared to infertility treatment) and it feels pretty darn good. My office is across the hall from two of our treatment rooms and patients seem to float out after a treatment.

If you would like to try it, make sure you seek out an acupuncturist who has extensive experience with infertility; you can ask your infertility doctor for a recommendation. My only caution: If the acupuncturist promises he or she can get you pregnant if you just keep on coming in for treatment, find another one. No one can make that kind of promise.

What about other kinds of alternative approaches? Unfortunately, there isn’t much data out there that can help people make good decisions. I do feel strongly that unless or until there is solid research on herbs, they should be avoided by women and men. There has never been a study which shows that herbs are safe or effective or beneficial in any way for infertility patients. And there has been some research which shows that, in fact, herbs might be harmful in some situations.

Other approaches such as yoga, massage, and reiki are most likely fine to try. There is no data either way. Personally, I introduce all of my patients to hatha yoga for two reasons. First of all, it is a terrific relaxation technique, especially for individuals whose minds tend to wander. And second, I believe that vigorous cardiovascular exercise might be reproductively harmful to some women, and so I advise my patients to decrease the intensity of their exercise regimens and instead substitute yoga, which will keep them fit and toned but won’t adversely impact their fertility.

The bottom line on alternative approaches is to use common sense.  If you enjoy acupuncture and believe that it might help you, go for it. Avoid herbs. Get a massage, try yoga. And if someone’s promises sound too good to be true (“guaranteed pregnancy if you come in for 150 sessions”),  watch out. And one final piece of advice: Tell your infertility doctor what you are doing. He or she will want to know what contributed to your improved health and well-being.

What kind of alternative treatments have you tried for infertility?

Alice D. Domar, Ph.D, is the executive director of the Domar Center for Complementary Healthcare, Boston IVF, and an assistant professor of obstetrics, gynecology, and reproductive biology, Harvard Medical School. She is also the co-author of Six Steps to Increased Fertility with R Barbieri and K Loughlin, published by Fireside in 2000.

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