In a surprising finding, a collaboration between the researchers in China, the United States and Europe reveals that acupuncture is ineffective in improving live birth rate in women with Polycystic Ovarian Syndrome, or PCOS, contrary to prevailing wisdom and common practice.
In China and increasingly around the world, acupuncture, a fundamental part of Chinese medicine, is thought to induce ovulation and in turn improve live birth rate—but no substantive research has yet proved its effectiveness.
The first-line treatment to induce ovulation in women with PCOS is clomiphene. Commonly known by its brand name Clomid, it is a safe and inexpensive medicine that appears on the World Health Organization’s Model List of Essential Medicines. However, because the drug has a high failure rate, 23.4 percent, researchers are seeking a secondary treatment to modify and improve its performance.
But acupuncture is not an effective option for co-treatment with clomiphene or alone, the study finds. In the multicenter trial, 1,000 women in China diagnosed with PCOS were administered acupuncture either in combination with clomiphene or with a placebo. The results showed that while the live birth rate was significantly higher in women who received clomiphene compared to those who received the placebo (28.7 percent versus 15.4 percent), there was little difference in the birth rate between women who received acupuncture as an active agent, or as a control (21.8 percent versus 22.4 percent). There was also no interaction between clomiphene and acupuncture that led to a higher birth rate.
“This is a landmark randomized clinical trial conducted to evaluate Chinese and Western medicine in infertility treatment according to the international standards and under formal advisory of international experts,” said a lead researcher Dr. Heping Zhang, Susan Dwight Bliss Professor of Biostatistics at Yale School of Public Health. The study is published in the journal JAMA.
PCOS is the most common form of infertility connected to a lack of ovulation, and affects up to 10 percent of women of reproductive age. Symptoms of PCOS, in addition to the absence of ovulation, can include irregular menstruation; high levels of androgens, a type of hormone; and ovarian cysts.
Dr. Zhang co-led this study through his Yale research center, the Collaborative Center for Statistics in Science (C2S2), which fosters collaborations that use statistics to perform research that examines disease etiology and treatment. As part of this collaboration, Dr. Zhang worked with a team of scientists from a wide range of research institutions in China, and other leaders including Dr. Xiaoke Wu, Dr. Richard Legro and Dr. Elisabet Stener-Victorin.
C2S2 is a part of the six-site Multicenter Reproductive Medicine Network, a cooperative effort founded in 1989 to conduct clinical trials in reproductive medicine.Tags: Yale