The role of acupuncture in the management of subfertility.
OBJECTIVE
To review systematically the use of acupuncture in the management of subfertility.


METHODS
A computer search was performed via several English and Chinese databases to identify journals relevant to the subject.


RESULTS
The positive effect of acupuncture in the treatment of subfertility may be related to the central sympathetic inhibition by the endorphin system, the change in uterine blood flow and motility, and stress reduction. Acupuncture may help restore ovulation in patients with polycystic ovary syndrome, although there are not enough randomized studies to validate this. There is also no sufficient evidence supporting the role of acupuncture in male subfertility, as most of the studies are uncontrolled case reports or case series in which the sample sizes were small. Despite these deficiencies, acupuncture can be considered as an effective alternative for pain relief during oocyte retrieval in patients who cannot tolerate side effects of conscious sedation. The pregnancy rate of IVF treatment is significantly increased, especially when acupuncture is administered on the day of embryo transfer.


CONCLUSIONS
Although acupuncture has gained increasing popularity in the management of subfertility, its effectiveness has remained controversial.
Ng
Ernest Hung Yu
EH
Department of Obstetrics & Gynaecology, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China. nghye@hkucc.hku.hk
So
Wing Sze
WS
Gao
Jing
J
Wong
Yu Yeuk
YY
Ho
Pak Chung
PC
D015670:Acupuncture Therapy / Q000009:adverse effects / Q000266:history; D000698:Analgesia / Q000009:adverse effects / Q000266:history / Q000379:methods*; D000858:Anovulation / Q000628:therapy; D019317:Evidence-Based Medicine; D005260:Female; D005307:Fertilization in Vitro; D049673:History, 20th Century; D049690:History, Ancient; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology / Q000628:therapy*; D007248:Infertility, Male / Q000628:therapy*; D050498:Live Birth; D008297:Male; D054315:Oocyte Retrieval / Q000009:adverse effects; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D011085:Polycystic Ovary Syndrome / Q000628:therapy; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional