Acupuncture as an adjunct therapy during your IVF Cycle
For many people undergoing In vitro fertilisation (IVF), the experience can feel physically demanding and emotionally challenging navigating each step. Alongside conventional fertility treatment, Acupuncture is recognised as an evidence based adjunct therapy that can be beneficial throughout the IVF process.
Acupuncture is commonly used as a complementary therapy during IVF treatment to support follicular development, optimise endometrial lining thickness, reduce stress and regulate the central nervous system, improve uterine blood flow, and enhance implantation outcomes. Research has also explored its role in supporting clinical pregnancy and live birth rates when used alongside conventional fertility treatment.
Considering Acupuncture throughout your IVF cycle? Well firstly, we need to talk about the significance of Acupuncture dose.
It has been demonstrated that Acupuncture has a physiological response on the body, which therefore means it is likely to have a dose. Similar to taking the recommended dose of a medication, the effectiveness of Acupuncture on IVF outcomes depends on the dose, timing, and frequency of the treatment. Interestingly, it was previously a common recommendation to only receive Acupuncture immediately before and after an embryo transfer although, research now indicates that treatment frequency should be optimised pre and throughout the IVF cycle to receive the beneficial outcomes of Acupuncture.
In a systematic review and meta-analysis by Professor Caroline Smith, the effects of acupuncture administered during IVF treatment examined the efficacy, effectiveness and safety of acupuncture as an adjunct to embryo transfer compared with controls to improve reproductive outcomes. The primary outcome was clinical pregnancy.
A dose-response relationship was found with a higher number of acupuncture sessions associated with improved outcomes. This dose-response relationship looked like Women receiving approximately 12 Acupuncture treatments throughout their IVF cycle which demonstrated an improvement in live birth rates compared with those who underwent embryo transfer alone or received acupuncture only on the day of embryo transfer.
The results also found:
- Women who received more than three acupuncture treatments experienced a 50% increase in clinical pregnancy rates compared with control groups
- Acupuncture treatment received only the day after embryo transfer did not appear to improve clinical pregnancy outcomes
- Acupuncture may provide greater benefits for women who had previously experienced poor responses to IVF treatment compared with those undergoing their first IVF cycle
This study highlights the importance of open communication between patients and their Acupuncturist or TCM practitioner regarding treatment expectations before commencing an IVF cycle. An individualised treatment plan, tailored specifically to the patient and their fertility history should be prescribed to help optimise the potential benefits of acupuncture throughout IVF.
Let’s break down how Acupuncture is beneficial during each stage together:
IVF & Preconception Care
An IVF and Acupuncture treatment plan ideally begins 3 months prior to the IVF cycle, both stimulated and non stimulated. In this period of treatment prior to beginning your cycle, an optimal environment is being encouraged to support future implantation. Acupuncture is thought to influence blood circulation, including blood flow to the uterus and ovaries. Improved uterine blood flow has been demonstrated as one mechanism by which Acupuncture can support implantation and reproductive health. From a Traditional Chinese Medicine (TCM) perspective this looks like nourishing the home (Uterus) and the seed (Egg Quality) in addition to considering Sperm quality.
During this time, Acupuncture is used to support an optimal menstrual cycle and regulate the Hypothalamic Ovarian Axis to support efficient Ovulation and Hormonal Health. In TCM, we regulate the Bao Mai channel to support the Heart, Kidney and Uterus connection.
Yang Sheng in Traditional Chinese Medicine relates to lifestyle advice and in this period leading up to an IVF cycle we encourage the body to be warm through Chinese Dietary Therapy by avoiding cold drinks, overexertion, increasing rest and having warm feet. Supplementation adjustments are also made here to prepare a woman and her partner for a future pregnancy.
Your menstrual bleed marks the beginning of the IVF cycle
At The Dao Health, treatment is recommended weekly beginning during the menstrual bleed of your IVF cycle to support follicular development and encourage thickening of the endometrial lining. Acupuncture can also help prepare patients for treatment by reducing stress, supporting relaxation and calming the central nervous system.
Ovarian Stimulation
During ovarian stimulation, Acupuncture can provide support with bloating, discomfort, fatigue and help to manage stress and anxiety levels as hormone levels rise. A recent meta analysis reported improved clinical pregnancy rates when Acupuncture was received during controlled ovarian hyperstimulation in fresh IVF cycles, although benefits were not seen when Acupuncture was given before stimulation or only on embryo transfer day. Another updated review also found Acupuncture was associated with improved pregnancy and live birth outcomes but also concluded that timing and dosing need to be considered for benefit from Acupuncture treatment.
Egg Retrieval
During Egg Retrieval, Acupuncture is prescribed on either side of the egg retrieval procedure to manage pain and discomfort from bloating. This study demonstrated that patients experience lower anxiety and improved pain management when using Acupuncture as an adjunct therapy during this stage of an IVF cycle. Treatment is recommended 48 – 72 hours post Egg retrieval.
Embryo Transfer
Pre and post embryo transfer Acupuncture treatment supports an ideal environment for the embryo and is ideal as close as possible to the transfer. We recommend transfer treatments within 24 hours of your transfer, ideally undertaken on the same day. At this stage of the IVF cycle, Acupuncture is used to support implantation by promoting healthy blood flow to the uterus, helping to optimise endometrial receptivity and regulating the body’s central nervous system to reduce stress and anxiety.
In 2002, the Paulus protocol was a landmark study that recommended a standardised acupuncture protocol used that focused on the embryo transfer day to increase success rates although as mentioned earlier in this journal entry, research now demonstrates an increased dose and frequency of Acupuncture is necessary prior and during the IVF cycle to have a clinically significant implant on pregnancy rates.
The two week wait
During the two week wait Acupuncture treatment can help patients manage anxiety, sleep disruption, and elevated stress while waiting for results. Research suggests that acupuncture can reduce IVF related anxiety and infertility stress. Importantly, even when fertility outcomes are unchanged, the additional support and improved quality of life throughout the IVF process can contribute to a more positive and manageable treatment experience.
Why is the research conflicting?
It is important to note that research investigating acupuncture as an adjunct therapy to IVF has produced mixed results. Systematic reviews and meta analyses suggest that Acupuncture may be associated with improved clinical pregnancy rates and in certain patient groups, improved live birth outcomes.
However, there are two major challenges in Acupuncture research. The first is the lack of standardisation. Studies often differ in their treatment protocols, treatment frequency and timing in relation to embryo transfer making direct comparisons difficult. The second is the quality of the available evidence which also varies considerably. Many studies have relatively small sample sizes and use different research methodologies, resulting in evidence certainty that ranges from very low to moderate. As a result of this, researchers continue to request larger and more high quality clinical trials before definitive conclusions can be made about Acupuncture’s impact on IVF outcomes.
While Acupuncture should not be viewed as a guaranteed way to improve IVF success rates, it is an adjunct therapy that can be a beneficial companion throughout the IVF process by offering a low risk and minimally invasive treatment to manage symptoms. When integrated appropriately alongside fertility treatment, Acupuncture treatment offers individuals support throughout the IVF process with research demonstrating improved pregnancy outcomes with the appropriate dose, frequency and timing.
This article is intended for general educational purposes only and does not constitute individualised medical or healthcare advice.
