Acupuncture for fertility treatment has a long history in the Orient and gynaecology has been a specialist subject in Chinese medicine since the Song dynasty (960–1279 AD) when its own specific literature and practice developed. Research involving acupuncture isn’t easy as most studies are required to be ‘double-blind randomised trials’; acupuncture’s not a simple interaction which makes this difficult. Most modern research has concerned the use of acupuncture alongside Western medicine in IVF. The references link to the original articles, P=probability of a random outcome and lower values are more significant.
An acupuncture protocol to improve female fertilityi
In a study comparing acupuncture or lifestyle changes as the intervention for sub/infertile women, the acupuncture protocol doubled the level of fertility awareness compared to the lifestyle group, raised wellbeing and the women who conceived in the acupuncture group did so in half the time.
Acupuncture and assisted conception
During the last decade there’s been research into the affect of acupuncture on the success of IVF; this has mostly been looking at whether having acupuncture at the time of embryo transfer during IVF cycles is helpful. There’ve been a number of systematic reviews of the research; a recent one concluded that acupuncture significantly improves pregnancy rates for women having IVF.ii
Of the systematic reviews into the use of acupuncture at embryo transfer; six of them concluded that acupuncture on the day of embryo transfer improves pregnancy rates. One review showed acupuncture improving birth rates to 35% compared to 22% without acupuncture.iii However there’s genuine confusion and differing conclusions to some of the research as there’s a lack of consistency in the protocols used, the level of training of the acupuncturists, when, how and how much acupuncture is done, and the way outcomes are measured.
When women are given stimulation to maximise the numbers of eggs and follicles reaching maturity during IVF, acupuncture increases the number of follicles produced,iv and increases birth rates.v
Stress and acupuncture in IVF
Stress is a major factor affecting success rates in IVF; this study found that a single session of acupuncture on egg transfer day does little to reduce stress, while multiple sessions significantly reduced a woman’s stress scores.vi
Effects of acupuncture on IVF-ET in patients with low ovarian reservevii
A study looking into the effect of “menstrual cycle-based acupuncture” alongside IVF-ET (in-vitro fertilisation and egg transfer) in patients with reduced ovarian reserve found the addition of acupuncture significantly increased (P < 0.05):
- The number of antral sized follicles
- The levels of (E2) oestrogen
- The number of eggs retrieved
- The number of eggs that fertilised
- The number of high quality embryo’s
- The implantation rates (P < 0.01)
- The clinical pregnancy rates (P < 0.01)
The “menstrual cycle-based acupuncture” also significantly reduced the cycle cancellation rate (P< 0.01)
The study concludes; “The “menstrual cycle-based acupuncture therapy” can effectively improve the ovarian reserve function in patients with decline in ovarian reserve, leading to an improved clinical pregnancy rate of IVF-ET.”
Impacts on pregnancy outcomes with treatment with acupuncture and moxibustion in IVF-ET patientsviii
In IVF-ET treatment the addition of acupuncture and moxibustion significantly (P<0.05):
- Increases estrogen (E2) and progesterone levels on hCG day
- Improves high-quality embryo rate,
- Increases endometrial blood flow state
- Improves endometrial morphology
- Increases endometrial receptivity
The study concludes “the method is expected to be the assistant therapeutic approach for the improvement of IVF-ET outcome”.
Effect of electro-acupuncture on the spindle and oocytes quality in patients with PCOSix
- Electro-acupuncture therapy resulted in significantly (P< 0.05):
- Improved spindle alignment
- Significantly improved rates of high quality embryos
- Significantly reduced the number of days of hormonal stimulation
The clinical pregnancy rate was improved by 8.36% in the electro-acupuncture group.
- Acupuncture for ovulation; evidence supports acupuncture to induce ovulation: in one study 50% of the women who weren’t ovulating responded to acupuncture.x
- PCOS: studies suggest that acupuncture exerts long-lasting beneficial effects on sex hormone levels and promotes ovulation.xiii Women with a relatively low body mass index (BMI), waist-to-hip ratio, and with lower metabolic disturbances (those with lower basal insulin and testosterone serum concentrations, but high serum testosterone/sex hormone-binding globulin concentrations) respond most positively to acupuncture for ovulation.xiv
- Endometriosis related infertility: there’s evidence that acupuncture is very effectivexiv
- Tubal obstruction related infertility: there’s evidence that acupuncture is effectivexv
- Low arterial flow to the uterus: there are a number of studies that show that electro-acupuncture reduces obstruction and increases flow in the uterine arteryxvi
- Premature ovarian failure (POF): there is evidence that some women may resume normal menstrual cycles following acupuncture for POFxvii
How acupuncture works
The view in Chinese medicine is the menstrual cycle reveals important aspects of female health and fertility. The features of menstrual cycles are simple, sensitive, non-invasive diagnostic tools to assess a woman’s fertility. Treatment aims to regulate the cycle and optimise fertility health.
This differs from assisted reproductive technologies (ART) where any problems with a woman’s cycle are controlled through pharmaceutical and surgical interventions. The idea of varying or staging treatment according to the stages of the menstrual cycle has a long history in Chinese medicine; fertility charting (BBT charting) is a recent addition that helps identify the shifting patterns of Yin, Yang, Qi and Blood across the cycle.
i “Prior to Conception: The Role of an Acupuncture Protocol in Improving Women’s Reproductive Functioning Assessed by a Pilot Pragmatic Randomised Controlled Trial” S. Cochrane Et al. Evidence-Based Complementary and Alternative Medicine Volume 2016 (2016)
ii Zheng CH, Huang GY, Zhang MM, Wang W. Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis. Fertility and Sterility. 2012;97(3):599–611.
iii Cheong YC, Hung YU, Ng E, Ledger WL. Acupuncture and assisted conception. Cochrane Database Syst Rev. 2008;(4):CD006920.
iv Emmons S, Patton P. Acupuncture treatment for infertile women undergoing intracytoplasmic sperm injection. Medical Acupuncture. 2000;12(2):18–20.
v Rubin LH, Opsahl M, Ackerman D. P02.15 Acupuncture improves in vitro fertilization live birth outcomes: a retrospective chart review. Scientific Abstracts Presented at the International Research Congress on Integrative Medicine and Health 2012. 2012;12(Suppl 1):P71.
vi “A Comparison of Stress Levels in Women Undergoing Single Versus Multiple Acupuncture Session Prior to Embryo Transfer” Sutton, S. Pentland, J. Roberts Fertility and Sterility, February 2015 Volume 103, Issue 2, Supplement, Pages e36–e37
vii “Effects of “menstrual cycle-based acupuncture therapy” on IVF-ET in patients with decline in ovarian reserve” Zhou L. Et al. Chinese Acupuncture and Moxibustion. 2016, 36(1):25-28
viii “Impacts on pregnancy outcome treated with acupuncture and moxibustion in IVF-ET patients” Chen Q, Hau C. Chinese Acupuncture and Moxibustion. 2015, 35(4):313-317
ix “Effect of electro-acupuncture on the spindle and oocytes quality in patients with PCOS” Li JPMID:25951635
Find all citations by this author (default). Or filter your current search . Et al. Chinese Journal of Integrated Traditional and Western Medicine. 2015,35(3):304-309
x Yu J. ‘Induction of ovulation with acupuncture’; Poster presented at: NIH Consensus Development Conference on Acupuncture; November 3–5, 1997; Bethesda, MD: National Institutes of Health; Nov 3–5, 1997.
xi ‘Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence.’ Stener-Victorin E et al. J Neuroendocrinol. 2008 Mar;20(3):290-8. Epub 2007 Nov 28.
xii ‘Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial.’ Johansson J, Redman L, et al. Am J Physiol Endocrinol Metab. 2013 May 1;304(9):E934-43.
xiii Johansson J, Redman L, Veldhuis PP, et al. Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial. Am J Physiol Endocrinol Metab. 2013;304(9):E934–E943
xiv Chen ZQ, Li LY. The Clinical Practice of Chinese Medicine Male and Female Fertility. Beijing, People’s Republic of China: People’s Medical Publishing House; 2008.
xv Ding HJ. 31 cases of infertility due to salpingemphraxis treated by acupuncture and moxibustion. Journal of Clinical Acupuncture and Moxibustion. 1998;14(10):30.
xvi ‘Electroacupuncture reduces uterine artery blood flow impedance in infertile women.’ Ho M et al. Taiwan J Obstet Gynecol. 2009 Jun;48(2):148-51.
xvii Effect of acupuncture on premature ovarian failure: a pilot study. Evid Based Complement Alternat Med. 2014;2014:718675).