Acupuncture and Chinese Herbs for IVF Support

In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm outside the body, in vitro. The process involves monitoring and stimulating a woman's ovulatory process, extracting eggs from the woman's ovaries, retrieving a sperm from the man, manually letting sperm fertilise eggs in a liquid in a lab, and transferring the fertilized egg (embryo) or eggs (embryos) to the woman's uterus. One full cycle of IVF takes about three weeks, and more than one cycle may be required. Sometimes these steps are split into different parts and the process can take longer.

IVF is used for the cases of blocked, damaged or removed fallopian tubes, ovulation disorders, endometriosis, uterine fibroids, impaired sperm production or function, unexplained infertility, and genetic disorders. IVF increases the chances of having more than one baby at a time because multiple fertilized eggs are often implanted into the uterus to increase the pregnancy rate.

The success rate depends on several factors including reproductive history, maternal age, the cause of infertility, and lifestyle factors. It is also important to understand that pregnancy rates are not the same as live birth rates. In the United States, the live birth rate for each IVF cycle started is approximate:¹

41-43% for women under age 35
33-36% for women ages 35 to 37
23-27% for women ages 38 to 40
13-18% for women ages over 40

The hormonal fertility medications taken during the preparation for egg retrieval may cause some side effects, such as soreness or bruising from injections, nausea, breast tenderness, headache, bloating, hot flashes, mood swings, and fatigue. Egg retrieval and embryo transfer procedures may cause mild pelvic and abdominal pain and pelvic infection. Emotional stress is common, especially for couples with failed IVF cycle or miscarriage after going through the intense process.

Supporting IVF with TCM

TCM provides natural, least invasive, effective, safe, and cost-effective treatment to enhance both male and female fertility. Not only helping couples achieve natural pregnancy, TCM also improves the success rate of IVF. An increasing number of fertility specialists and centers start recognizing the benefits of acupuncture and suggesting acupuncture as an adjunct therapy of IVF.

Studies have demonstrated that acupuncture and TCM increase the success rate of IVF, enhance the live birth rate, and improve the quality of life of patients undergoing IVF.

In a randomized controlled clinical study published in 2006, the researchers concluded that luteal-phase acupuncture has a positive effect on the outcome of IVF/intracytoplasmic sperm injection (ICSI). The clinical pregnancy rate and ongoing pregnancy rate were significantly higher in the group who received luteal-phase acupuncture according to the principles of TCM (33.6% and 28.4%, respectively), compared to the group who received placebo acupuncture (15.6% and 13.8%).²

Another randomized trial study published in 2006, acupuncture on the day of embryo transfer showed significant improvement in the reproductive outcome of IVF/ICSI, compared with no acupuncture. The clinical and ongoing pregnancy rates were 39% and 36% in the group with acupuncture treatment before and after embryo transfer, while the rates were 26% and 22% in the control group with no acupuncture treatment.³

In a study designed to evaluate the impact of acupuncture on in vitro fertilization outcome, 150 patients undergoing embryo transfer were randomized to either the acupuncture or control group. The patients who received acupuncture before and after embryo transfer reported significantly less anxiety post-transfer and reported feeling more optimistic about their cycle and enjoyed their sessions, compared to the patients with no acupuncture treatment.⁴

Benefits of Acupuncture
before and during IVF cycle

Improves egg and sperm quality
Increases blood flow to the uterus to improve the quality of endometrium lining and overall uterine environment
Improves response to hormonal stimulation
Reduces uterine contraction and enhances embryo implantation
Alleviates the side effects of medications used during IVF
Boosts the body’s energy and overall health
Reduces stress, anxiety and depression

TCM Treatment Plan

Preparation for IVF cycle

We highly recommend starting TCM treatment 3 months before IVF cycle as the eggs begin their maturation 90 days before they are chosen for ovulation, and the sperm maturation process takes about 70-90 days. Starting TCM treatment during IVF cycle, especially right before embryo transfer, can increase the success rate of IVF; however, acupuncture and Chinese herbal medicine for 3 months prior to IVF cycle allow the opportunity to improve egg and sperm quality, optimize hormonal balance, strengthen the uterus, and improve general health and well-being. This becomes especially important if there is a history of previous unsuccessful IVF cycle.

During this time, a weekly acupuncture treatment and daily Chinese herbal medicine are recommended. Depending on TCM diagnosis based on your medical history and presentations, adjustive treatment procedures, such as electro-acupuncture, moxibustion, and cupping, will be added to acupuncture treatments. For women with complex or challenging health situations and for men with low sperm quality and quantity, 6 months or longer preparation time and/or more frequent acupuncture treatment is advisable.

Ovarian Stimulation Phase

During this phase, TCM treatment focus on enhancing the development of follicles and uterine lining, reducing stress and anxiety, and alleviating side effects of fertility medications, such as hot flushes, headaches, and mood swings. Generally, 1-2 weekly acupuncture treatment and daily Chinese herbal medicine are recommended.

Chinese herbs can help stimulate ovulation, improve the uterine lining, and reduce the side effect of fertility medications, and there is no evidence of negative interaction between Chinese herbs and fertility medications. However, many fertility doctors are unfamiliar with, and therefore hesitant about, Chinese herbs. In this case, all herbal formulas will be stopped 2 weeks prior to hormone medications, and only acupuncture treatments will be provided.

Before Egg Retrieval

Acupuncture 1-2 days prior to egg retrieval can help reduce stress and anxiety and relax the body. Additional acupuncture treatment after egg retrieval is not necessary unless you have cramping and discomfort from the procedure. If you were on Chinese herbal medicine, it will be stopped after egg retrieval because different Chinese herbs may be used after embryo transfer, depending on the result of IVF cycle.

Before and After Embryo Transfer

If possible, two acupuncture treatments on embryo transfer day, one before and one after the embryo transfer, are desirable. However, since embryo transfer procedures are typically scheduled for the early morning, we are aiming for acupuncture treatments on the day before and the day of the embryo transfer to reduce uterine contractions and promote general relaxation.

An acupuncture treatment 5-7 days after embryo transfer is advised to further assist implantation and embryo development. When pregnancy occurs, we highly recommend a weekly acupuncture treatment through the end of first trimester to prevent miscarriage and support a healthy pregnancy.