Acupuncture and in vitro fertilization: critique of the evidence and application to clinical practice.

Women undergoing in vitro fertilization (IVF) commonly use adjunctive therapies to improve IVF outcomes and reduce stress, anxiety and depression. Among these acupuncture is a popular choice. Despite 40 clinical trials and 9 systematic reviews investigating the efficacy of acupuncture for improving IVF outcomes, evidence-based guidelines are difficult to devise. The methodology used in the clinical trials does not closely resemble the use of acupuncture in real world acupuncture clinics, limiting the applicability of this research. Since many women undergoing IVF are currently using acupuncture there is a pressing need for a broader understanding of the use of acupuncture for female infertility. This paper offers a critical examination of the research on acupuncture and IVF and its limitations, details the differences between these studies and real world clinical practice, and discusses Chinese medicine theory for improving fertility and its possible scientific mechanisms within the context of clinical practice.