Background: Acupuncture has been used as treatment for infertility for hundreds of years, and recently it has been studied in male and female infertility and in assisted reproductive technologies, although its role in reproductive medicine is still debated. Aim: To review studies on acupuncture in reproductive medicine, in experimental and clinical settings. Methods: Papers were retrieved on PubMed and Google Scholar and were included in the review if at least the abstract was in English. Results There is evidence of benefit mainly when acupuncture is performed on the day of embryo transfer (ET) in the live birth rate. Benefit is also evident when acupuncture is performed for female infertility due to polycystic ovary syndrome (PCOS). There is some evidence of sperm quality improvement when acupuncture is performed on males affected by idiopathic infertility. Experimental studies suggest that acupuncture effects are mediated by changes in activity of the autonomic nervous system and stimulation of neuropeptides/neurotransmitters which may be involved in the pathogenesis of infertility. Conclusions: Acupuncture seems to have beneficial effects on live birth rate when performed on the day of ET, and to be useful also in PCOS as well as in male idiopathic infertility, with very low incidence of side effects. However, further studies are necessary to confirm the clinical results and to expand our knowledge of the mechanisms involved.
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Hansen M, Kurinczuk JJ, Bower C, Webb S. The risk of major birth defects after intracytoplasmic sperm injection and in vitro fertilization. New Engl J Med 2002, 346: 725–30.
World Health Organization. Acupuncture: review and analysis of reports on controlled clinical trials. 2003.
Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008, 85: 355–75.
Stener-Victorin E, Lundeberg T, Waldenström U, Bileviciute-Ljungar I, Janson PO. Effects of electro-acupuncture on corticotropin-re-leasing factor in rats with experimentally-induced polycystic ovaries. Neuropeptides 2001, 35: 227–31.
Zhaohui Z, Yugui C, Yuanming Z, et al. Effect of acupuncture on pubertal development of rats and rabbits at different developmental stages. Neuropeptides 2007, 41: 249–61.
Feng Y, Johansson J, Shao R, et al. Hypothalamic neuroendocrine functions in rats with dihydrotestosterone-induced polycystic ovary syndrome: effects of low-frequency electro-acupuncture. PLoS One 2009, 4: e6638.
Zijlstra FJ, van den Berg-de Lange I, Huygen FJ, Klein J. Anti-inflammatory actions of acupuncture. Mediators Inflamm 2003, 12: 59–69.
Rush RA, Chie E, Liu D, Tafreshi A, Zettler C, Zhou XF. Neurotrophic factors are required by mature sympathetic neurons for survival, transmission and connectivity. Clin Exp Pharmacol Physiol 1997, 24: 549–55.
Chao MV, Rajagopal R, Lee FS. Neurotrophin signalling in health and disease. Clin Sci (Lond) 2006, 110: 167–73.
Aloe L, Bracci-Laudiero L, Bonini S, Manni L. The expanding role of nerve growth factor: from neurotrophic activity to immunologic diseases. Allergy 1997, 52: 883–94.
Stener-Victorin E, Jedel E, Mannerås L Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence. J Neuroendocrinol 2008, 20: 290–8.
Stener-Victorin E, Lundeberg T, Cajander S, et al. Steroid-induced polycystic ovaries in rats: effect of electro-acupuncture on concentrations of endothelin-1 and nerve growth factor (NGF), and expression of NGF mRNA in the ovaries, the adrenal glands, and the central nervous system. Reprod Biol Endocrinol 2003, 1: 33.
Manni L, Lundeberg T, Holmäng A, Aloe L, Stener-Victorin E. Effect of electro-acupuncture on ovarian expression of alpha (1)-and beta (2)-adrenoceptors, and p75 neurotrophin receptors in rats with steroid-induced polycystic ovaries. Reprod Biol Endocrinol 2005, 3: 21.
Manni L, Cajander S, Lundeberg T, et al. Effect of exercise on ovarian morphology and expression of nerve growth factor and alpha(1)- and beta(2)-adrenergic receptors in rats with steroid-induced polycystic ovaries. J Neuroendocrinol 2005, 17: 846–58.
Mannerås L, Cajander S, Lönn M, Stener-Victorin E. Acupuncture and exercise restore adipose tissue expression of sympathetic markers and improve ovarian morphology in rats with dihydrotestosterone-induced PCOS. Am J Physiol Regul IntegrComp Physiol 2009, 296: R1124–31.
Stener-Victorin E, Jedel E, Janson PO, Sverrisdottir YB. Low-frequency electroacupuncture and physical exercise decrease high muscle sympathetic nerve activity in polycystic ovary syndrome. Am J Physiol Regul Integr Comp Physiol 2009, 297: R387–95.
Stener-Victorin E, Fujisawa S, Kurosawa M. Ovarian blood flow responses to electroacupuncture stimulation depend on estrous cycle and on site and frequency of stimulation in anesthetized rats. J Appl Physiol 2006, 101: 84–91.
Stener-Victorin E, Waldenström U, Andersson SA, Wikland M. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Hum Reprod 1996, 11: 1314–7.
Yang JR, Ma YY, Liu YL, Wang HL, Liu Z. Controlled study on acupuncture for treatment of endocrine dysfunctional infertility. Zhongguo Zhen Jiu 2005, 25: 299–300.
Gerhard I, Postneek F. Auricular acupuncture in the treatment of female infertility. Gynecol Endocrinol 1992, 6: 171–81.
Stener-Victorin E, Jedel E, Manneras L. Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence. J Neuroendocrinol 2008, 20: 290–8.
Crimmel AS, Conner CS, Monga M. Withered Yang: a review of traditional Chinese medical treatment of male infertility and erectile dysfunction. J Androl 2001, 22: 173–82.
Xinyun H. Acupuncture plus medication for male idiopathic oligospermatic sterility. Shanghai J Acupunct Moxibustion 1998, 5: 35–7.
Ng EH, So WS, Gao J, Wong YY, Ho PC. The role of acupuncture in the management of subfertility. Fertil Steril 2008, 90: 1–13.
Siterman S, Eltes F, Wolfson V, Lederman H, Bartoov B. Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study. Andrologia 2000, 32: 31–9.
Pei J, Strehler E, Noss U, et al. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertil Steril 2005, 84: 141–7.
Franconi G, Mazzilli F, Elia J, De Berardinis D, Caprio M, Fabbri A. Male subfertility and acupuncture: preliminary results. J Endocrinol Invest 2009, 32 (suppl 2): 29.
Zhang M, Huang G, Lu F, Paulus WE, Sterzik K. Influence of acupuncture on idiopathic male infertility in assisted reproductive technology. J Huazhong Univ Sci Technolog Med Sci 2002, 22: 228–30.
Dieterle S, Li C, Greb R, Bartzsch F, Hatzmann W, Huang D. A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia. Fertil Steril 2009, 92: 1340–3.
Siterman S, Eltes F, Schechter L, Maimon Y, Lederman H, Bartoov B. Success of acupuncture treatment in patients with initially low sperm output is associated with a decrease in scrotal skin temperature. Asian J Androl 2009, 11: 200–8.
Stener-Victorin E. The pain-relieving effect of electro-acupuncture and conventional medical analgesic methods during oocyte retrieval: a systematic review of randomized controlled trials. Hum Reprod 2005, 20: 339–49.
Kwan I, Bhattacharya S, Knox F, McNeil A. Conscious sedation and analgesia for oocyte retrieval during IVF procedures: a Cochrane review. Hum Reprod 2006, 21: 1672–9.
Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproductive technology. Fertil Steril 2002, 77: 721–44.
Dieterle S, Ying G, Hatzmann W, Neuer A. Effect of acupuncture on the outcome of in vitro fertilisation and intracytoplasmic sperm injection: a randomised, prospective, controlled clinical study. Fertil Steril 2006, 85: 1347–51.
Westergaard LG, Mao Q, Krogslund M, Sandrini S, Lenz S, Grinsted J. Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertil Steril 2006, 85: 1341–6.
Cheong YC, Hung Yu Ng E, Ledger WL. Acupuncture and assisted conception (review). Cochrane Database Syst Rev 2008, 4: CD006920.
Domar AD, Meshay I, Kelliher J, Alper M, Powers RD. The impact of acupuncture on IVF outcome. Fertil Steril 2006, 86 (Suppl 2): S378.
Smith C, Coyle M, Norman RJ. Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer. Fertil Steril 2006, 85: 1352–8.
Zhang M, Paulus WE, Strehler E, Jelinkova L, Sterzik K. Increase of pregnancy rate in assisted reproduction therapy by acupuncture. Fertil Steril 2001, 76 (Suppl 1): S75.
Quintero R. A randomized, controlled, double-blind, cross-over study evaluating acupuncture as an adjunct to IVF. Fertil Steril 2004, 81 (suppl 3): S11–2.
Magarelli PC, Cridennda DK, Cohen M. Acupuncture and good prognosis IVF patients: synergy. Fertil Steril 2004, 82 (Suppl 2): S80–1.
Magarelli PC, Cridennda DK. Acupuncture & IVF poor responders: a cure? Fertil Steril 2004, 81 (Suppl 3): S20.
Lund I, Lundeberg T. Are minimal, superficial or sham acupuncture procedures acceptable as inert placebo controls? Acupunct Med 2006, 24: 13–5.
Birch S. Controlling for non-specific effects of acupuncture in clinical trials. Clinical Acupuncture and Oriental Medicine 2003; 4: 59–70.
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Franconi, G., Manni, L., Aloe, L. et al. Acupuncture in clinical and experimental reproductive medicine: A review. J Endocrinol Invest 34, 307–311 (2011). https://doi.org/10.1007/BF03347091
- female infertility
- male infertility
- nerve growth factor