Pacific Wellness Institute Clinic: Bloor-Yorkville Toronto

Treatment of infertility by acupuncture and breathing exercise: Part 2 Placebo versus real acupuncture

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Treatment of Infertility by Acupuncture According to Circalunar and Cardiac Variability Rhythms

Tim H. Tanaka, Ph.D. Director, The Pacific Wellness Institute, Toronto, Ontario, Canada Visiting Research Fellow, School of Health Sciences, Tsukuba University of Technology, Japan

A part of this paper was presented at WFAS International Acupuncture Congress, cosponsored by World Health Organization, in Beijing, China, Oct. 2007.

Page updated on January 31, 2008

‘Placebo’ versus ‘real’ acupuncture

Outcomes of acupuncture trials can be quite different (positive or negative) depending on what type of acupuncture methods and controls (placebo) are used.  This could be one of the reasons why some of the previous acupuncture trials done on the same disease or condition yielded conflicting results. Furthermore, different interpretation of results can be made depending on how ‘placebo’ or ‘real’ acupuncture is defined.

In pharmaceutical trials, a placebo pill (which looks exactly the same as the trial drug but is without active ingredients) is used to create equilibrant psychological impact to the patients (and doctors) as the actual drug. Developing ‘placebo’ acupuncture that mimics real acupuncture is much more complex than placing sugar in a gelatin capsule. Different variations of ‘placebo’ or ‘sham’ acupuncture interventions have been proposed and used by many researchers. The ‘placebo’ acupuncture used by researchers in infertility trials [11-13] was a procedure involving acupuncture needles inserted on sham points that are not considered to enhance fertility.  It should be emphasized that the ‘placebo’ acupuncture utilized by these previous studies is not physiologically inert and should not be considered as an adequate control [14-17].

So what is ‘real’ or ‘genuine’ acupuncture?  The fact of the matter is that a wide variety of acupuncture styles exist and procedures vary even among professional acupuncturists. The ‘real’ acupuncture used in many of the previous infertility studies is different from the procedures commonly used by acupuncturists according to acupuncture educators in the USA [18]. For example, electro-acupuncture has been widely used in acupuncture research in animal and human models because the amount and intensity can be standardized and more easily controlled than manual acupuncture.  Electro-acupuncture however, is not the most commonly practiced form of acupuncture in a clinical setting for treatment of infertility [19]. Further, many previous acupuncture studies on infertility administered only a few standardized treatment sessions. Most acupuncturists in the clinical setting however, utilize non-standardized treatment protocols (points, methods of stimulation, etc.) based on each patient’s individual conditions and administer a series of treatments throughout weeks or months [18]. There was a series of studies in Japan which reported increased fertility rate including in intractable infertility cases with regular long-term (> 3month) administration of acupuncture [20, 21].  Repeated acupuncture treatment is believed to produce cumulative effects over time.

Treatment of infertility by acupuncture and breathing exercise: Part 2 Placebo versus real acupunctureDue to such a wide diversity of acupuncture treatment methods, circumspect consideration is necessary when interpreting the results of acupuncture studies. The results obtained by using one acupuncture method may not be applicable when a different acupuncture method is administered. There is no established standard acupuncture protocol for infertility and the efficacy and safety of different acupuncture methods needs to be clarified by comparative studies in the future. Nevertheless, considering the empirical nature of acupuncture, clinical experience of acupuncturists will likely remain as one of the most crucial elements for achieving highly effective and satisfactory clinical outcomes.

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