On July 3, 2023, an article titled “Effects of Acupuncture on Pregnancy Outcomes in Women Undergoing In Vitro Fertilization: An Updated Systematic Review and Meta-analysis” was published in the journal Archives of Gynecology and Obstetrics. This is a summary of that article. 


Infertility affects a substantial number of women worldwide, with in vitro fertilization with embryo transfer (IVF-ET) often being the last resort. Despite its popularity, the success rates of IVF remain modest, prompting the exploration of complementary and alternative medical (CAM) treatments. Acupuncture, rooted in Traditional Chinese Medicine (TCM), has emerged as a frequently utilized and promising therapy. This article aims to provide a comprehensive review of the role of acupuncture in improving IVF outcomes. 

The Landscape of Infertility and IVF: 

Infertility, defined as the inability to achieve pregnancy after a year of regular unprotected intercourse, affects a significant percentage of women. IVF-ET offers hope to many, but its success rates are hindered by various factors, including low success rates per cycle, safety concerns, and the high cost of treatment. Consequently, patients often face financial constraints, compelling them to seek alternative avenues to enhance IVF success rates. 

Acupuncture in Traditional Chinese Medicine: 

Acupuncture, a key component of TCM, operates on the principles of meridians and acupoints. The meridians connect the body’s organs, and acupoints correspond to specific organs. This ancient practice aims to restore balance by stimulating acupoints, presenting a non-pharmacological approach to infertility. The intricate relationship between acupoints and internal organs, as per TCM theory, forms the basis for the use of acupuncture in addressing infertility. 

Mechanisms of Acupuncture in Improving Pregnancy Outcomes: 

Scientific investigations into acupuncture’s impact on IVF outcomes reveal diverse mechanisms at play. Acupuncture’s ability to regulate hormone secretion, enhance uterine and ovarian blood flow, and modulate relevant cytokines contributes to improved pregnancy outcomes. These mechanisms provide a scientific basis for the efficacy of acupuncture in supporting IVF. 

Conflicting Meta-Analyses and the Need for a New Perspective: 

Numerous systematic reviews and meta-analyses have attempted to analyze the effects of acupuncture on IVF-ET outcomes, yielding conflicting results. While some studies reported positive effects on clinical pregnancy rates (CPR), ongoing pregnancy rates (OPR), and live birth rates (LBR), others found no significant differences. The discrepancies in these conclusions can be attributed to variations in study selection, participant characteristics, interventions, and outcome definitions. New trials published in recent years, not included in previous analyses, highlight the need for a fresh perspective and a definitive conclusion. 

A Comprehensive Meta-Analysis: 

To address these discrepancies, a comprehensive meta-analysis was conducted, focusing on randomized controlled trials (RCTs). A meticulous search of digital databases was performed, including Pubmed, Embase, the Cochrane Library, the Web of Science, and ScienceDirect, up to July 2022. MeSH terms such as acupuncture, in vitro fertilization, assisted reproductive technology, and randomized controlled trial were employed. A total of 58 RCTs were identified, with 25 meeting the inclusion criteria for analysis. 

Key Findings and Implications: 

The meta-analysis provided robust evidence supporting the positive impact of acupuncture on IVF outcomes. Regardless of the acupuncture method (manual, electrical, or transcutaneous), all IVF outcomes, except miscarriage rates, significantly improved compared to control groups. Placebo acupuncture served as a valuable control, reinforcing acupuncture’s efficacy beyond psychological effects. The study revealed specific benefits for manual acupuncture (MA), electrical acupuncture (EA), and transcutaneous acupoint electrical stimulation (TEAS) in improving implantation rates (IR), CPR, and LBR. 

Considerations for Future Acupuncture Programs: 

The meta-analysis highlighted the significance of tailoring acupuncture interventions based on individual characteristics and syndromes. The choice of acupuncture method, timing, and treatment course emerged as crucial factors influencing therapeutic outcomes. The results suggested that the number of acupuncture sessions may not be the sole determinant of efficacy, and future studies should explore the optimal combination of method and course for the best therapeutic effect. 


In conclusion, acupuncture, when performed at different times during IVF cycles and varying acupuncture courses, significantly improves CPR and LBR in women undergoing IVF-ET. Placebo acupuncture emerged as a relatively ideal control measure, affirming the efficacy of acupuncture beyond placebo effects. The findings underscore the importance of personalized acupuncture interventions in IVF protocols, offering hope and optimism to those navigating the complex challenges of infertility and assisted reproductive technologies. As research advances, a nuanced understanding of acupuncture’s role will contribute to more effective and tailored interventions in the realm of reproductive health. 

  • Mark Lewinter, DACM, L.Ac.

    Mark A. Lewinter, DACM, L.Ac. has a Doctor of Acupuncture and Chinese Medicine degree from Pacific College of Health and Science and a Master of Science degree in Oriental Medicine from Southwest Acupuncture College. His interest in studying East Asian Medicine started at age thirteen when he was diagnosed with cancer. While undergoing chemotherapy, he also incorporated alternative medicine to facilitate his recovery.

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