Acupuncture for Fertility, IVF and IUI in Denver

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Design

Single-blind randomized trial at 16 IVF centers in Australia and New Zealand. Women got acupuncture (424) or a control with a non-invasive needle placed away from the true points (424). The first treatment came on days 6 to 8 of follicle stimulation, and 2 more came around embryo transfer.

Result

824 women were analyzed. Live births occurred in 74 of 405 women (18.3%) with acupuncture and 72 of 404 (17.8%) with the control (risk difference 0.5%, 95% CI -4.9% to 5.8%). The authors say the findings do not support acupuncture to improve live births in IVF.

Limit

It tested one schedule of 3 sessions in fresh IVF cycles. The confidence interval does not rule out a small gap either way. Stress and anxiety were secondary outcomes, reported in a separate paper (below). It did not test sleep.

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Design

Systematic review of trials that compared acupuncture with a non-invasive placebo needle in women having fresh or frozen IVF. Seven databases were searched to April 2019.

Result

Around embryo transfer, there was no clear difference in pregnancy or miscarriage. Clinical pregnancy: risk ratio 0.99, 95% CI 0.88 to 1.11. Ongoing pregnancy: 0.88, 0.75 to 1.02. Miscarriage: 1.23, 0.89 to 1.71. Live birth: 0.87, 0.75 to 1.01 (4 trials, 1,835 women). The authors rate the miscarriage and live birth findings high certainty. Placebo needling did not differ from usual care. Side effects such as discomfort and bruising were mild to moderate.

Limit

It covers acupuncture around embryo transfer, not other timing. It does not test stress, sleep or comfort.

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Design

Cochrane review of randomized trials of acupuncture for couples having assisted reproduction, compared with no treatment, placebo or imitation acupuncture. Searches ran to July 2013.

Result

Live birth was not clearly different when acupuncture was given around egg retrieval (odds ratio 0.87, 95% CI 0.59 to 1.29, 464 women). It was also not clearly different around embryo transfer (1.22, 0.87 to 1.70, 2,505 women). Both findings were low-quality evidence. There was no evidence of an effect on pregnancy or miscarriage rates, and no significant side effects. The authors conclude there is no evidence that acupuncture improves live birth or pregnancy rates.

Limit

This is the latest Cochrane review of the topic I could find on PubMed. It predates the 2018 trial. The transfer-day finding varied a lot between trials.

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Design

Systematic review and meta-analysis of randomized trials of manual, electrical and laser acupuncture in IVF. Controls were no acupuncture, imitation acupuncture or placebo acupuncture.

Result

Pooled clinical pregnancy (23 studies) was significantly greater with acupuncture. Pooled live birth (6 studies) was not significantly different. The authors found acupuncture improved both when they set aside trials that used the Streitberger placebo needle, which they argue may not be inactive.

Limit

The positive conclusion depends on dropping trials with that placebo needle. The much larger 2018 trial used a non-invasive needle placed away from true points and found no gap in live births.

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Design

Systematic review and meta-analysis of randomized trials of acupuncture in IVF. Controls were no, imitation or placebo acupuncture.

Result

Clinical pregnancy was higher with acupuncture (odds ratio 1.26, 95% CI 1.06 to 1.50), but trials differed a lot from one another. The gain was clearer in trials from Asia (1.51, 1.04 to 2.20). In those Asian trials, acupuncture at embryo transfer was linked with lower biochemical pregnancy (0.67, 0.48 to 0.92) and lower ongoing pregnancy (0.68, 0.49 to 0.96) than controls.

Limit

The results mix control types and vary by region and timing. The authors note most trials did not report how many embryos were transferred.

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Design

European guideline with 42 recommendations on add-ons to fertility treatment. A working group of doctors, embryologists, researchers and patient representatives reviewed the evidence.

Result

In the full text, the section on complementary medicine says the evidence for acupuncture is contradictory on live birth, with no evidence of an effect on miscarriage and only minor side effects. It concludes that acupuncture, Chinese and herbal medicine and other complementary therapies are not recommended. The abstract itself does not mention acupuncture.

Limit

This is European guidance. The authors say none of the 42 recommendations rests on high-quality evidence. It looks at outcomes such as live birth, not stress or comfort.

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Design

Systematic review and meta-analysis of randomized trials of acupuncture in IVF, searched to July 2022. Controls included no acupuncture and placebo acupuncture.

Result

Pooled clinical pregnancy was 43.6% with acupuncture and 33.2% in controls (25 trials, P < 0.00001). Pooled live birth was 38.0% versus 28.7% (11 trials, P < 0.00001). The authors conclude acupuncture can significantly improve both.

Limit

The abstract does not report results by type of control. So it cannot show how much of the gap came from the needles and how much from attention and hope. It conflicts with the larger placebo-controlled trial and the 2021 review above.

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Design

Updated systematic review and meta-analysis with trial sequential analysis. Controls were imitation acupuncture or a blank (wait-list) control. Searched to June 2024.

Result

Biochemical pregnancy was higher with acupuncture (risk ratio 1.28, 95% CI 1.04 to 1.57), and so was clinical pregnancy (1.19, 1.06 to 1.34). Acupuncture was linked with better pain control during surgery and lower anxiety. Local reactions were mostly mild to moderate. Early miscarriage was higher in the acupuncture groups (1.51, 1.10 to 2.08).

Limit

It mixes imitation and no-treatment controls. The authors say the early miscarriage risk warrants caution and that more rigorous trials are needed. The abstract does not explain the miscarriage result.

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Design

Systematic review and meta-analysis of randomized trials of acupuncture around embryo transfer, searched to May 2025. Nine of the 11 trials had usable data on clinical pregnancy.

Result

Clinical pregnancy was higher than with a blank control (risk ratio 1.25, 95% CI 1.05 to 1.50), but not higher than with imitation acupuncture (1.01, 0.87 to 1.17). Live birth was not different (1.01, 0.88 to 1.15).

Limit

Few trials, and the authors say the effect on live birth remains to be clarified.

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Design

Systematic review and meta-analysis of trials that measured state anxiety after embryo transfer or egg retrieval in women having IVF. 1,785 women completed an anxiety scale.

Result

Acupuncture gave a small drop in state anxiety compared with any control (standardized mean difference -0.21, 95% CI -0.39 to -0.04). The authors rate the certainty very low and call acupuncture a drug-free and safe treatment that may help women burdened with IVF anxiety.

Limit

The trials were few and of medium size (median 191 women). The authors note a high risk of performance bias and large differences between trials, and say more research is needed.

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Design

Secondary results from the 2018 randomized trial. Women aged 18 to 42 had a fresh IVF cycle and got acupuncture or the imitation control. Anxiety and quality of life were measured at the start, on transfer day and 14 weeks later.

Result

After embryo transfer, anxiety was lower with acupuncture (adjusted mean difference -1.1, 95% CI -2.2 to -0.1, P = 0.03). Quality of life did not differ. A gain in the general health score among women who followed the protocol was gone by 14 weeks. The authors note that women still had lower emotional well-being 3 months after the cycle.

Limit

Anxiety was a secondary outcome. The abstract does not give the anxiety scale or say whether the anxiety gap lasted to 14 weeks.

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Design

Systematic review and meta-analysis of randomized trials of acupuncture for emotional problems in women with infertility, searched to June 2023. Controls were no treatment, imitation acupuncture or usual care.

Result

Acupuncture improved scores on four anxiety and depression scales compared with controls. No adverse events were reported in any trial.

Limit

The abstract gives no effect sizes and does not say how many trials used imitation acupuncture. The authors say high-quality trials are needed.

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Design

Systematic review and meta-analysis of trials of acupuncture for pain during transvaginal egg retrieval. Searched to June 2021.

Result

Acupuncture plus conscious sedation and pain medicine gave less pain during and after retrieval than sedation alone (during: standardized mean difference -1.03, 95% CI -1.71 to -0.36; after: -1.11, -1.51 to -0.71). Acupuncture plus anti-inflammatory drugs beat the drugs alone for pain afterward. There was no clear agreement on whether acupuncture alone eases pain.

Limit

The authors rate the evidence low or very low quality with a high risk of bias. These trials gave acupuncture during retrieval, which happens in the clinic and not in my office.

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Design

Factorial trial at 21 sites in mainland China. Women with PCOS got active or control acupuncture, twice a week for 30 minutes, and clomiphene or placebo for up to 4 cycles. Control acupuncture used shallow needles, no hand stimulation and mock electricity.

Result

Live births were 21.8% with active acupuncture and 22.4% with control acupuncture (difference -0.6%, 95% CI -5.9% to 4.7%). Clomiphene did raise live births (28.7% versus 15.4%). Diarrhea (5.0% versus 1.6%) and bruising (7.4% versus 1.8%) were more common with active acupuncture.

Limit

It tested live birth in women with PCOS in China, average age 27.9. It did not test stress, sleep or cycle regularity.

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Design

Cochrane review of randomized trials of acupuncture in women with PCOS who rarely or never ovulate. Searches ran to December 2024.

Result

Against imitation acupuncture, there may be little to no difference in live birth (risk ratio 0.97, 95% CI 0.76 to 1.23, 1,000 women), clinical pregnancy or ovulation. One trial of 141 women suggested fewer days between periods, but the review calls this very uncertain. Adverse events were probably more common with acupuncture (1.16, 1.02 to 1.31).

Limit

The authors say the evidence remains uncertain and larger, well-designed trials are needed. Only a few trials measured the outcomes that matter.

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Design

Systematic review and meta-analysis of randomized trials of acupuncture in women of reproductive age with PCOS.

Result

Return of the menstrual period was better with acupuncture (5 trials, 364 women, standardized mean difference -0.52, 95% CI -0.89 to -0.14, low certainty). Luteinizing hormone and testosterone were lower, at very low certainty. There were no clear differences in live birth, pregnancy or ovulation. The authors say the evidence is insufficient to show acupuncture raises live birth, pregnancy or ovulation.

Limit

The certainty was low or very low, and results varied a lot between trials.

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Design

Meta-analysis with exploratory dose-response modeling of trials comparing acupuncture with imitation acupuncture, drugs or usual therapy in PCOS. Searched to January 2025.

Result

Ovulation rates were higher with acupuncture than with imitation acupuncture (risk ratio 1.15, 95% CI 1.04 to 1.27) and than with drugs (1.11, 1.04 to 1.20). The model suggested 30-minute sessions three times a week for 24 weeks.

Limit

This disagrees with the Cochrane review above. It reports ovulation, not live birth. The dose is a model estimate, and three visits a week for 24 weeks is more than most people can do. I do not use it as a plan.

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Design

Systematic review and meta-analysis of trials of acupuncture in men with oligospermia (low sperm count) or asthenozoospermia (low sperm motility).

Result

Acupuncture alone showed no clear gain over placebo acupuncture in sperm motility (standardized mean difference 1.13, 95% CI -0.64 to 2.89). Added to medicine, it may have helped motility, but the trials varied too much for firm conclusions. The authors say the evidence does not support acupuncture as an effective treatment and do not currently recommend it.

Limit

Most trials had significant weaknesses in design. It measured semen tests, not pregnancy.

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Design

Randomized trial in an IVF center in a university hospital. Women with blocked tubes got 30 minutes of electrical stimulation through skin patches at acupuncture points. This was given 24 hours before egg retrieval and 2 hours before transfer, at one of three frequencies. A control group had routine IVF only.

Result

Egg and embryo counts did not differ. Clinical pregnancy, implantation and live birth rates were higher in the 2/100 Hz group than in the other groups (P < .05).

Limit

This is patch stimulation, not needling, and I do not offer it. The control group had no placebo, and only one of three frequencies did better.

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Design

Randomized study of 160 women having assisted reproduction with good-quality embryos. Half got acupuncture 25 minutes before and after embryo transfer. Half got no supportive therapy.

Result

Clinical pregnancy was 42.5% (34 of 80) with acupuncture and 26.3% (21 of 80) without. The authors said acupuncture seemed useful for improving the pregnancy rate.

Limit

There was no placebo group, so women knew who got acupuncture. I cite it as history. The blinded trials since then did not find the same gain.

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Design

Randomized trial in a private fertility center. Women had acupuncture on transfer day (95), on transfer day and again 2 days later (91), or none (87). Each session lasted 25 minutes.

Result

Clinical and ongoing pregnancy were higher with one session than with none (39% vs 26% and 36% vs 22%). The group with a second session was higher than controls but not by a statistically clear margin. The extra session added no benefit.

Limit

There was no placebo group, so hope and attention could play a part. I cite it as history only.

In the best studies, no. In a 2018 trial of 848 women having IVF, live births were 18.3% with acupuncture and 17.8% with imitation acupuncture. The authors said the findings do not support using acupuncture to improve live births. A 2021 review of trials with placebo needling found the same, and the 2013 Cochrane review found no evidence of benefit. Some reviews that include no-treatment groups report higher pregnancy rates, but that gap closed against imitation acupuncture in a 2025 review. I could not find a study of acupuncture for IUI that I could verify, so I make no claim there. I offer acupuncture as support for stress, sleep and comfort, alongside your fertility clinic and never instead of it.

No study I found shows that any start date raises your chance of a baby. The 2018 trial began on days 6 to 8 of ovarian stimulation. Earlier trials gave treatment on the day of embryo transfer. If you want support for stress and sleep, it helps to book before your cycle starts, so I can plan around your calendar. If your cycle has already started, call me and I will fit you in where I can. Please tell your fertility clinic first.

The 2018 trial gave 3 sessions in a cycle: 1 during stimulation and 2 around the embryo transfer. Earlier trials gave 1 session before and 1 after transfer, about 25 minutes each. For support, I can plan a visit every one to two weeks while you prepare. Then I can plan one visit shortly before and one soon after your transfer or insemination, if your clinic agrees. A 30 minute visit is $60. After about three visits, I ask whether your stress, sleep and comfort are better. If they are not, I will tell you.

It may help with stress. A 2022 review of 8 trials and 2,253 women found a small drop in IVF-related anxiety with acupuncture, but the authors rate the certainty very low. In the 2018 trial, anxiety was lower after embryo transfer with acupuncture. I did not find a study of sleep during fertility treatment, so I make no promise there. I track your sleep with you from visit to visit and tell you if it is not changing. The same trial found that women had lower emotional well-being 3 months after the cycle, so ask your clinic about counseling too.

The evidence is weak. PCOS (polycystic ovary syndrome) is a hormone condition that can cause irregular periods and trouble ovulating. A 2017 trial of 1,000 women with PCOS found no gain in live births with acupuncture. The 2025 Cochrane review found no clear difference from imitation acupuncture in live birth, ovulation or regular periods. A 2020 review found periods returned more often with acupuncture, at low certainty. I do not claim acupuncture fixes your hormones or makes you ovulate. If your periods are irregular or missing, see your doctor for tests first.

The evidence does not support it. A 2021 review of 7 trials and 527 men found no clear gain in sperm motility over placebo needling, and the authors do not recommend acupuncture as a treatment. I do not claim it improves sperm. If your partner has a low sperm count or other semen results, he needs a urology or fertility evaluation first. Partners are welcome here for stress and sleep support while you both go through treatment.

A review of 21 prospective studies found serious side effects in about 1 in 10,000 patients. About 9 in 100 noticed a minor effect, such as bleeding or soreness at a needle site. I use points mostly on the hands, forearms, lower legs, feet and ears. Please tell your fertility clinic that you are seeing me, and tell me every medicine and supplement you take. If your clinic asks me to keep needles out of the lower belly after a transfer, I do. Please do not take herbs during treatment unless your reproductive endocrinologist approves them, and I will not suggest herbs without that approval. Call your clinic or doctor first for any of these. A positive pregnancy test with pain, bleeding or dizziness. Heavy bleeding. Severe pelvic pain. Fever. No period for months without a known cause. Any instruction from your reproductive endocrinologist that conflicts with what I suggest. Also see a clinician if you have tried for more than 12 months, or 6 months if you are 35 or older.

I did not find a study I could verify on acupuncture and pregnancy loss, so I do not claim it prevents a loss or improves a future pregnancy. Grief is real, and some people want a quiet place to rest. I can offer calm, unhurried treatment for stress and sleep, and I will go at your pace. Please ask your doctor first if you still have bleeding or pain after a loss. A counselor who works with pregnancy loss can also help. If you have thoughts of harming yourself, call or text 988 right away.

I do not bill insurance directly, but I can provide a superbill you can submit to your insurance company for possible reimbursement. HSA and FSA cards work. At The Subtle Point a 90 minute first visit is $150. Follow-ups are $60 for 30 minutes of acupuncture, $95 for 60 minutes of acupuncture with Tuina massage, or $130 for 90 minutes of acupuncture with Tuina massage and cupping. You can book online with the Book online button on this page or call (720) 285-6251.