The effects of acupuncture on the secondary outcomes of anxiety and quality of life for women undergoing IVF: A randomized controlled trial

Acupuncture has been increasingly sought by women undergoing in vitro fertilization treatments, both in the hope of improving their chances of becoming pregnant and in the search for relief from the emotional stress that accompanies this process. In vitro fertilization treatment is known to have a significant impact on women's quality of life, generating anxiety and uncertainty throughout the process, especially during waiting periods. Although many fertility clinics offer psychological support services, not all women use these resources, either because they do not recognize the need or because they do not feel comfortable seeking help.

This Australian-New Zealand study specifically examined whether acupuncture could help reduce anxiety and improve quality of life in women during in vitro fertilization treatment. The researchers conducted a randomized controlled clinical trial, considered the gold standard of medical research, involving 848 women aged 18 to 42 years, recruited between June 2011 and October 2015 at 16 fertility centers in Australia and New Zealand. Participants were randomly assigned to two groups: one received true acupuncture and the other received sham acupuncture, serving as a control. The protocol was developed by expert consensus and consisted of only three sessions: the first between days 6 and 8 of ovarian stimulation and two on the day of embryo transfer.

Results showed that 608 women reached the embryo transfer stage, of whom 526 completed all three treatment sessions. To measure anxiety, the researchers used a scientifically validated scale, applied at three time points: at baseline, on the day of embryo transfer, and 14 weeks after the start of treatment. Quality of life was assessed using a comprehensive questionnaire that examines different aspects of physical and emotional health. The study found a statistically significant reduction in anxiety in women who received true acupuncture at the time of embryo transfer compared with those who received sham treatment.

Regarding quality of life, there was an improvement in the "general health" domain in the acupuncture group, although this benefit was not sustained at the 14-week follow-up.

These findings have important implications for both patients and assisted reproduction professionals. For women undergoing in vitro fertilization, the study suggests that acupuncture may provide some relief from anxiety during one of the most stressful moments of treatment — the day of embryo transfer. This period is often described by patients as extremely distressing, as it represents the culmination of weeks of preparation and the anticipation of results. However, it is important to note that the observed benefits were temporary and were not sustained over time.

For health care professionals, the results indicate that, although acupuncture may have some role in managing anxiety during in vitro fertilization treatment, it should not be viewed as a complete solution for patients' emotional needs.

The study has some important limitations that should be considered when interpreting the results. First, the acupuncture protocol used was relatively brief, with only three sessions, which may not have been sufficient to produce more lasting benefits. In addition, there was a significant dropout rate in questionnaire responses, especially at the long-term follow-up, when many women already knew the outcome of their treatments. The researchers also observed that women who completed all treatments tended to have a more positive view of their general health, suggesting that this group may have been more engaged in caring for their own well-being.

It is important to note that, three months after the start of treatment, regardless of the group to which they belonged, women showed elevated anxiety scores and reduced emotional well-being, highlighting the ongoing need for psychosocial support during and after in vitro fertilization treatment. These findings suggest that, although acupuncture may offer punctual benefits, the emotional needs of women undergoing fertility treatments are complex and require more comprehensive and sustained approaches over time.