Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial

This randomized controlled trial investigated the effects of acupuncture on ovulation induction in women with polycystic ovary syndrome (PCOS), a common endocrine condition that affects female fertility. The study was conducted at the University of Gothenburg, Sweden, between June 2009 and September 2010, following rigorous clinical research guidelines. The research included 32 women diagnosed with PCOS by Rotterdam criteria, aged 18-38 years, with a body mass index below 30. Participants were randomized into two groups: acupuncture with low-frequency manual and electrical stimulation, or a control group with therapeutic meetings of equal duration.

The acupuncture protocol used specific points located in abdominal and leg muscles, with innervations corresponding to the ovaries, applying 2 Hz stimuli for 30 minutes twice a week for 10-13 weeks. The control group received equivalent therapeutic attention to control for the effect of attention received during treatment. The main results demonstrated a significantly higher ovulation frequency in the acupuncture group (0.76 ovulations per month) compared with the control (0.41 ovulations per month, p=0.002). Detailed hormonal analyses revealed significant reductions in circulating levels of estrogens, androgens, and androgenic metabolites in the acupuncture group, including estradiol, testosterone, DHEA, and its derivatives.

Surprisingly, there were no changes in luteinizing hormone (LH) pulsatility or cortisol secretion patterns, suggesting that acupuncture's effects are mediated primarily at the peripheral rather than central level. The reduction in inhibin B in the acupuncture group indicates direct effects on ovarian function. The researchers propose that the mechanisms of action involve modulation of sympathetic nervous system activity, both general and ovary-specific, based on previous studies showing reduction in muscle sympathetic nerve activity with acupuncture. The study represents an important advance in understanding the mechanisms by which acupuncture can benefit women with PCOS, offering an alternative or complementary therapy to conventional pharmacological treatments such as clomiphene citrate or laparoscopic ovarian drilling.

The clinical implications are relevant, considering that many conventional treatments have negative side effects. The research demonstrates that acupuncture may represent a natural and safe therapeutic option to improve reproductive function in women with PCOS, particularly those with normal weight or mild overweight.