Evaluating Complementary and Alternative Treatments for Infertility

Today’s post was written by Dr. Elena Yanushpolsky, an infertility specialist with the Center for Infertility and Reproductive Surgery at Brigham and Women’s Hospital (BWH). Dr. Yanushpolsky is also the Director of the Brigham and Women’s Center for Infertility and Reproductive Surgery at South Shore Hospital in South Weymouth.

When conventional fertility treatments do not result in successful pregnancies, couples suffering from infertility often search for alternative or complementary treatment options. Before considering these complementary treatments, it’s essential that patients have a good understanding of the associated risks and benefits, and overall effectiveness, much as they would with conventional therapies.

Since the publication of two European research studies, there has been interest in the addition of acupuncture to fertility treatment regimens .The first study, published in 2006, compared pregnancy rates among patients who underwent acupuncture during their in vitro fertilization (IVF) cycles to those who did not have acupuncture. A larger, follow-up study in 2010 compared pregnancy rates between IVF patients who underwent acupuncture using predetermined acupressure sites to those who underwent acupuncture using random needle placement. The conclusion of both studies was that acupuncture has a placebo effect in improving pregnancy rates during IVF cycles. That is, patients undergoing acupuncture may see an improvement in their pregnancy rates, regardless of whether acupuncture was determined to be effective. The studies also found that patients undergoing acupuncture felt more relaxed after their sessions and there did not appear to be a detrimental effect on fertility outcomes. Patients wishing to try acupuncture while going through fertility treatments should discuss the choice with their physician.

The main ingredient of many herbal supplements claiming to improve fertility is chasteberry extract. The impact of chasteberry extract on fertility outcomes has not been adequately evaluated in scientific studies so its risks and benefits are not known; however, chasteberry extract is believed to suppress libido.

DHEA supplements have been promoted to both patients and providers for improvement in IVF outcomes. These claims are based on one prospective study, published in 2010, whose scientific methods have been criticized. Several subsequent and carefully conducted studies found that women who took DHEA supplements had no improvement in IVF success rates and actually produced fewer eggs.

CoQ10 supplements have also been marketed for improved fertility outcomes. Unfortunately, these fertility claims are based on one small, preclinical study whose findings of increased egg production have not been duplicated in humans. Studies of sperm characteristics after CoQ10 exposure failed to demonstrate any improvements in pregnancy rates.

Patients and physicians should carefully evaluate complementary and alternative fertility therapies using the same scientific criteria as conventional medical therapies to be sure that infertility outcomes are improved, not harmed.

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