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Over the last ten years research into the efficacy of acupuncture as an adjunct to IVF has produced conflicting results. A number of trials have been carried out, many with small sample sizes and varying levels of heterogeneity. Several meta-analyses have also been conducted, which attempted to overcome these problems by analysing pooled data from the original studies. Four meta-studies were published in 2008/9, all with the aim of systematically reviewing the effects of acupuncture on the outcomes of IVF treatments. While the majority of these concluded that acupuncture at the point of embryo transfer increased live birth rates, the conclusion of the Cochrane Database systematic review published by Cheong et al (2009) included a warning that acupuncture should not be carried out around the time of embryo implantation, because the available data did not prove that acupuncture was ‘free of harm’ at this juncture. The suggestion that acupuncture might be unsafe in early pregnancy potentially discredits the use of acupuncture as an adjunct to IVF in the eyes of doctors of Western medicine and the general public. This article aims to explain why Cheong et al reached this negative conclusion by reviewing data from two of the original studies (Westergaard et al, 2006 & Dieterle et al, 2006). This analysis suggests that the less favourable pregnancy outcomes reported in the meta-study may in part have been due to the fact that the original studies used acupuncture protocols that were modified inappropriately, were unsuitable for the luteal phase of the menstrual cycle (whilst implantation may have been occurring), and which contained points contraindicated in pregnancy. Furthermore, these original trials could be considered unethical, since they present as accepted standard care acupuncture protocols that may indeed be harmful in early pregnancy.
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