Acupuncture for fertility is a controversial topic in the infertility community. Does acupuncture directly impact cycle outcomes, or is it just a "nice-to-have" that potentially reduces patient stress?
Research supports both premises. A study published in JAMA found that acupuncture performed during an IVF cycle does not improve live birth rates. However, a literature review published in the International Journal of Women's Health found that, if nothing else, acupuncture may help women cope with infertility. On the other hand, a meta-analysis published in Evidence-Based Complementary and Alternative Medicine found that acupuncture improves IVF pregnancy rates, especially if the program is customized to the patient. Another review of studies published in the Journal of Endocrinological Investigation concluded that acupuncture may improve live birth rates when performed the day of an embryo transfer and be particularly beneficial for patients diagnosed with PCOS.
While the science behind acupuncture and fertility is debatable, many patients want their care to be a combination of Western and Eastern medicine. Below is a guide to how acupuncture works and when it might be most helpful for patients.
Overview of Acupuncture
Using acupuncture to regulate the female reproductive system dates back thousands of years, mainly in China. These practitioners view the human body as a network of channels or meridians — internal and external pressure points that can be manipulated with thin needles. When the energy — called Qi — that flows through these channels is disrupted, health problems arise.
Combined with other aspects of traditional Chinese medicine (TCM), such as herbs, acupuncture may help patients with nearly any infertility diagnosis, especially those with a hormonal component. Advocates of acupuncture believe it increases blood flow, improves follicle growth, helps regulate menstrual cycles and reduces stress. However, acupuncture is not a one-and-done strategy. Typically, to receive these benefits, acupuncturists recommend weekly treatment for at least three months prior to undergoing an IVF cycle.
Traditional Acupuncture and the German Protocol
The German Protocol — where patients receive acupuncture immediately before and after an embryo transfer — was first studied in 2002. According to the original study published in Fertility and Sterility, the method improved clinical pregnancy rates. Since then, other studies have reached the same conclusion. Additionally, the German Protocol may aid uterine lining thickness, reduce stress and improve overall patient satisfaction with their care — an important note for reproductive endocrinologists on the fence about incorporating acupuncture.
Electroacupuncture
Like traditional acupuncture, electroacupuncture uses needles. However, they are attached to a device that generates an electric current. At least two needles are required in order to pass impulses to each other, and several pairs can be stimulated at once.
According to the National Center for Biotechnology Information, this method improves egg quality, clinical pregnancy rates and live birth rates — especially in patients with PCOS.
Laser Acupuncture
A slight variation on electroacupuncture, laser acupuncture uses a low-energy laser beam in place of needles, and most patients feel nothing. A study published in Fertility and Sterility found that laser acupuncture improved implantation, clinical pregnancy and live birth rates compared to both traditional needle acupuncture or no intervention.
Acupuncture for Male Factor
Much like infertility itself, the potential benefits of acupuncture are not limited to women. A systematic review published in the National Journal of Andrology found that acupuncture improves sperm quality more than Western medicine. Additionally, the effectiveness of acupuncture for male factor improves further when combined with Western medicine or TCM.
The Safety of Acupuncture
All acupuncture methods are generally considered safe prior to pregnancy. However, the risk of miscarriage may increase if performed by an acupuncturist who does not specialize in reproductive medicine.
According to Healthline, points to avoid include spleen 6; bladder 32, 60 and 67; pericardium 8 and large intestine 4. An acupuncturist who does not regularly work with pregnant women may not know these points are used to induce labor.
Integrating Western and Eastern Medicine
Given the potential benefits of acupuncture for fertility, many clinics now offer Eastern medicine services in-house to stand out from other facilities. Reproductive endocrinologists should consider hiring — or referring patients to — a practitioner certified by the American Board of Oriental Reproductive Medicine.
The debate about using acupuncture for fertility will likely continue as researchers study how the former impacts the latter. There are many acupuncture and fertility approaches available today for both women and men regardless of their infertility diagnosis — and no downsides to suggesting or offering it alongside fertility treatments. Acupuncture might help, and it might not — but it will not hurt patient outcomes.
