Research & Studies: Acupuncture for infertility
In the scientific literature there is a growing body of research which tests the efficacy of using acupuncture in the treatment of infertility. The vast majority of this research focuses more specifically on acupuncture being used as an adjunct treatment to IVF therapy. Unfortunately, very few studies have been conducted in which acupuncture and/ or Chinese herbal medicine have been used as a stand-alone infertility treatment.
Problems with the research
There are known difficulties in designing randomised clinical trials for acupuncture. The scientific method demands standardisation of experimental variables. On the other hand, an acupuncture treatment requires flexibility and is implicitly characterised by an idiosyncratic diagnosis and prescription. Given this, acupuncture and the scientific method are far from compatible. This causes randomised clinical trials for acupuncture to have a number of problems. These include difficulty with standardisation of diagnostic criteria; standardisation of treatment prescriptions; standardisation of treatment protocols; the determination of suitable controls; and the implementation of appropriate measures.
To date, researchers using acupuncture for infertility have not adequately addressed these issues and a suitable balance between the two paradigms is yet to be achieved. As a consequence, the clinical applicability/relevance of the acupuncture within these clinical trials has been compromised. Following are examples of how the clinical trials have failed to maintain the integrity of acupuncture model as it is used in a clinical setting.
- Number of treatments: The clinical trials are generally characterised by few treatment sessions, thereby not giving the acupuncture a chance to work. Using acupuncture for fertility is a process.
- Poor application of Chinese Medicine diagnosis: Many studies fail to implement an inclusion criteria of a specified Chinese Medicine diagnosis. Defining the subjects from a Chinese Medicine perspective is important as it facilitates the testing of a sub-type of infertility in its own right. This avoids testing may types of fertility as a homogenised group. Since most studies in the literature fail to do this, they did not accurately measure how effective acupuncture is in treating each cause of infertility in accordance with its own model.
- Acupuncture point selection: The choice of acupuncture points used is often questionable. Acupuncture point selection needs to follow a diagnosis. Adequate provision for Chinese Medicine diagnosis is rarely given in clinical trials. Additionally, some acupuncture points are more effective than others. In some studies, it could well be argued infective points were selected. Both these factors mean the choice of acupuncture points are often a poor simulation of clinical practice.
Conclusion
The clinical trials which test the efficacy of using acupuncture to treat infertility are often a poor reflection of what happens in clinical practice. This explains why the outcomes of the clinical trials in are so varied/inconsistent.
