Acupuncture for in vitro fertilization in women with poor ovarian response

Approximately 15% of couples worldwide are affected by infertility which is caused by various factors. Poor ovarian response (POR) is one reason for infertility. Poor ovarian response (POR) has been accepted as a predictor of delivery in women over 40 undergoing IVF. The criteria of diagnosis of POR are: 1) advanced maternal age (≥40 years) or any other risk factor for POR; 2) a previous POR (≤3 oocytes after a conventional stimulation protocol); or 3) an abnormal ovarian reserve test (i.e., antral follicle count (AFC) <5-7 follicles or anti-Mullerian hormone (AMH) <0.5-1.1 ng/ml). AMH is used as a predictor for ovarian reserve, and a higher level of AMH tends to increase during natural pregnancy. Low AFC is the basis for diagnosing POR, and AFC testing is more accurate than basal follicle stimulating hormone (FSH) testing for women aged over 44 years in predicting IVF outcome.

Acupuncture has been used to treat infertility and has been very popular in assist IVF. This is because it improves the endometrium, promotes ovulation, and reduces pain during egg retrieval, and improves fertilization rates. Consequently it increases pregnancy rates in women undergoing IVF. A study evaluated the effectiveness of acupuncture in improving clinical pregnancy rate (CPR) after IVF, in women with POR from randomized controlled trials (RCTs). Their result has shown that clinical pregnancy rate is 37.8% in acupuncture group vs 24.3% in control group. This study suggests that acupuncture may improve CPR, AMH, AFC and the number of retrieved oocytes in women with POR undergoing IVF.

References
Jang S et al Integr Med Res. 2020 Jun;9(2):100395. doi: 10.1016/j.imr.2020.02.003. Epub 2020 Feb 27.