Somatosensory Stimulation and Assisted Reproduction

The role of somatosensory stimulation (acupuncture and related techniques) as an adjunct to assisted reproductive technology (ART) has been hotly debated over the past decade. In the last 6 years there have been no fewer than 12 meta-analyses of 34 randomised controlled trials (table 1). Systematic and narrative reviews of the literature often report conflicting findings and opinions. Despite this controversy, subfertility remains one of the most common reasons that women consult an acupuncturist.47 Meta-analysis of acupuncture trials is often challenging due to methodological diversity, and this is especially true for in vitro fertilisation (IVF) due to marked differences in timing (treatment given during the follicular phase, at the time of oocyte retrieval and/or embryo transfer (ET), and/or as luteal phase support) and the variety of interventions including manual acupuncture, electroacupuncture (EA), transcutaneous electrical acupuncture point stimulation (TEAS) and laser acupuncture. Various outcome measures have been used ranging from biochemical pregnancy rate to live birth rate (LBR), depending on the duration of follow-up. LBR (‘take home baby rate’) is considered to be the ideal primary outcome measure and is clearly most important to patients. Interestingly, concordance between studies with respect to point location is relatively high. The acupuncture points targeted generally correspond anatomically to the segmental innervation of the uterus and ovaries, irrespective of whether the primary approach to point selection is traditional or neurophysiological. …