If you have searched for acupuncture and fertility, you have probably found two kinds of headline. Some say acupuncture boosts IVF success. Others say it makes no difference at all. Both draw on real research, and the full story sits somewhere between them. If you are going through fertility treatment, or thinking about it, you deserve an accurate account rather than a sales pitch.
Where the optimism started
In 2002, a German team published a trial in Fertility and Sterility that caught a great deal of attention. They gave 80 women acupuncture for 25 minutes before and after embryo transfer, and compared them with 80 women who had transfer alone. Clinical pregnancies followed in 42.5% of the acupuncture group, compared with 26.3% of the control group.
More trials followed, and in 2008 a meta-analysis in the BMJ pooled the results of acupuncture given around embryo transfer. Its authors concluded that preliminary evidence suggested acupuncture improved rates of pregnancy and live birth.
What the larger trials found
Since then, larger and more carefully controlled studies have told a less exciting story.
A Cochrane review in 2013 brought together 20 randomised trials and found no evidence that acupuncture improves live birth or pregnancy rates in assisted conception, whether given around egg collection or around embryo transfer.
In 2018, JAMA published the largest trial so far. Researchers at 16 IVF centres in Australia and New Zealand randomly assigned 848 women to real acupuncture or a sham version, with sessions during ovarian stimulation and before and after embryo transfer. Live births followed for 18.3% of women in the acupuncture group and 17.8% in the sham group, a difference small enough to be down to chance. The authors concluded that their findings did not support acupuncture to improve live birth rates in IVF.
Why did the early trials look so much better? Small trials produce more extreme results by chance. Many early studies compared acupuncture with no treatment at all, so women in the acupuncture group had extra time, attention and reassurance as well as needles. And IVF success rates vary widely between clinics, which brings us to one of the more interesting findings in this field.
A clue about who might benefit
In 2013, the lead author of the 2008 meta-analysis returned to the question with colleagues in a larger review, published in Human Reproduction Update. Across all the trials, they found no overall benefit from acupuncture alongside IVF. But they noticed a pattern. Trials in which the control group had a lower pregnancy rate showed larger effects from acupuncture than trials in which it was higher. This one factor explained most of the variation between trials.
The authors were careful to say this finding needs confirmation, and you should read it with the same caution. It does raise the possibility that acupuncture might help in some settings and not in others. At present, nobody can say which women, or which clinics, those might be.
Stress and the experience of treatment
IVF is demanding, physically and emotionally. A 2009 trial in Fertility and Sterility, run at a US fertility clinic, gave 150 women either the 2002 German acupuncture protocol around embryo transfer or a period of lying still. Pregnancy rates were no different. Women in the acupuncture group, however, reported less anxiety after transfer and felt more optimistic about their cycle.
That result makes sense. IVF can turn a person into a series of scans, injections and blood tests. Time with a practitioner who asks how you are sleeping, eating and coping may help you feel more relaxed and more like yourself during a difficult few months.
How a Chinese medicine practitioner looks at fertility
Classical Chinese medicine places the root of reproduction in the Kidney essence, or Jing. It also pays close attention to the Liver, which keeps Qi and Blood moving, and to the Blood that builds the lining of the womb each month.
In practice, that means a detailed conversation about your cycle: how long it lasts, how heavy and painful your periods are, whether the blood is bright or dark, how you feel in the days before a period, and whether you tend to run warm or cold. It also means asking about sleep, digestion, energy, and the strain that trying for a baby so often brings. A Five-Element practitioner will also look for the element at the root of your wider health, and treat fertility as part of that bigger picture.
None of this replaces a medical fertility assessment. Blocked fallopian tubes or a low sperm count will not show up in a pulse or on a tongue, and only proper investigations can find them.
Integration in practice
The case for integration is modest and specific. Trials have not shown that acupuncture raises your chance of a baby through IVF, and no practitioner should tell you it will. It may help you feel calmer and better supported, and a few studies hint that it could help in some circumstances that researchers have yet to pin down. With that in mind, the people most likely to benefit are those who value support during treatment, know what the evidence says, and want it alongside their medical care.
If you decide to try acupuncture:
- Keep your fertility clinic at the centre of your care, and tell them you are having acupuncture.
- Tell your acupuncturist about every medication and stage of your treatment cycle, so sessions fit around it.
- Avoid adding herbs or supplements without your clinic's agreement.
- Remember that the UK fertility regulator, the HFEA, does not regulate complementary therapies, and licensed clinics do not usually offer them, so the coordination is largely up to you and your practitioner.
If you are trying to conceive without IVF, the evidence for acupuncture is thinner still. The NHS advises seeing your GP if you have not conceived after a year of trying, and sooner if you are 36 or over or already know you may have fertility problems. Investigations can find treatable causes, and acupuncture should never delay them.
Fertility treatment asks a great deal of anyone going through it. Alongside good medical care, and with a practitioner who is open about the evidence, acupuncture can be one way of looking after yourself through a hard stretch of life.