Study on Acupuncture’s Effect on Fertility in Women with PCOS

Background on PCOS and Fertility Challenges

A recent study investigates the impact of acupuncture on fertility for women diagnosed with polycystic ovary syndrome (PCOS). Women with PCOS often experience anovulatory menstrual cycles, meaning their ovaries do not release an egg during a cycle. As a result, they may require additional medical intervention, such as clomiphene citrate, to achieve pregnancy. Acupuncture has emerged as a potential alternative treatment; however, its effectiveness in enhancing the chances of live births remains uncertain.

Understanding Acupuncture

Acupuncture is a form of alternative medicine that involves the insertion of thin, sterilized needles into specific points on the body to alleviate symptoms associated with various medical conditions. A key aspect of traditional Chinese medicine, acupuncture has recently been explored for its potential benefits in treating infertility among women with PCOS. Given that PCOS is the leading cause of anovulatory infertility and drug therapies can have a failure rate of up to 23.4%, the PCOS Acupuncture and Clomiphene Trial (PCOSAct) aimed to assess whether acupuncture could promote ovulation in Chinese women, either alone or alongside clomiphene citrate, which is typically the first-line treatment for anovulation in this population.

Study Design and Methodology

In a randomized, multicenter clinical trial published in the Journal of the American Medical Association, researchers led by Wu and colleagues enrolled 1,000 Chinese women who met the criteria for PCOS. Participants exhibited symptoms such as oligomenorrhea or amenorrhea (infrequent or absent periods), hyperandrogenism (elevated androgen levels), and polycystic ovaries. The women were randomly assigned to one of four intervention groups: active acupuncture with clomiphene, control acupuncture with clomiphene, active acupuncture with a placebo, and control acupuncture with a placebo.

The acupuncture sessions were standardized, with all participants receiving 30-minute treatments twice a week, up to a maximum of 32 sessions. In the active acupuncture group, needles were inserted into the leg and abdominal muscles, as well as the hands and head, with either manual or electrical stimulation. Conversely, the control acupuncture group received superficial needle insertions at non-acupuncture points in the shoulders and upper arms, without electrical stimulation. Participants began taking either clomiphene or a placebo from days three to seven of their menstrual cycle, with dosage adjustments made if ovulation did not occur. Regular intercourse was advised every two to three days, with treatment ceasing upon a positive pregnancy result.

Study Outcomes and Findings

The primary outcome of the study was the incidence of live births at 20 weeks gestation or later. Secondary outcomes included adverse events, pregnancy loss, instances of multiple pregnancies, ovulation rates, and hormonal changes. Data from 926 women who remained active participants until the end of the study were analyzed. The results indicated a significantly higher live birth rate among women treated with clomiphene (28.7%) compared to those receiving a placebo (15.4%). However, there was no significant difference in live birth rates between the active acupuncture group (21.8%) and the control acupuncture group (22.4%). Additionally, pregnancy loss was reported at 34.9% in the control acupuncture and clomiphene group, while lower instances of back pain during pregnancy were noted in the active acupuncture groups.

Limitations of the Study

Several limitations were identified within the study, including the fixed acupuncture protocol. Participants may have benefited from more personalized treatment approaches. Traditional Chinese medicine typically combines acupuncture with individualized herbal remedies, which were excluded from this study to prevent confounding variables and bias.

Conclusion

In summary, the findings suggest that acupuncture, whether used alone or in conjunction with clomiphene, does not significantly enhance the likelihood of achieving a live birth in women with PCOS. Consequently, acupuncture is not recommended as a viable treatment option for infertility in this demographic.

References

Wu, X., Stener-Victorin, E., Kuang, H., Ma, H., Gao, J., & Xie, L. et al. (2017). Effect of Acupuncture and Clomiphene in Chinese Women With Polycystic Ovary Syndrome. JAMA, 317(24), 2502. http://dx.doi.org/10.1001/jama.2017.7217