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Acupuncture and Fertility: What the Research Actually Shows

Acupuncture is one of the most heavily researched complementary therapies in reproductive medicine. That research is also one of the most misrepresented. You will find clinics promising acupuncture “doubles your IVF success rate,” and you will find skeptics claiming the entire body of evidence is noise. Neither position holds up when you read the studies.

This page is our attempt to give you the honest middle. Here is what the strongest trials and reviews actually support, where the evidence is thin, and how Marc Sklar and the Reproductive Wellness team translate all of it into the care we provide at our San Diego clinic.

The short version

Across four decades of trials, the pattern is fairly consistent. Acupuncture appears to work best as a course of individualized treatment delivered alongside conventional fertility care, not as a one-off appointment, and not as a replacement for IVF, IUI, or medical management.

The clearest signals in the literature:

  • Endometriosis pain: the strongest and most reproducible finding
  • PCOS ovulation and menstrual regularity: promising, with good mechanistic support
  • Stress and anxiety during fertility treatment: consistent across studies
  • IVF support: supportive when delivered as ongoing care, weak when delivered only on transfer day

What the evidence does not support: any guarantee of pregnancy, or a reliable live birth improvement for every patient. Any clinic telling you otherwise is ahead of the science.

Acupuncture and IVF: the dose matters more than the day

The IVF conversation has been shaped, unhelpfully, by a single 2002 study. Paulus and colleagues gave patients acupuncture immediately before and after embryo transfer and reported a meaningful jump in clinical pregnancy rates. The result was electric, widely publicized, and set the template for how most clinics still deliver “IVF acupuncture”: two sessions, on transfer day, and nothing else.

Then the replications came in. Dieterle (2006) found a benefit. Westergaard (2006) found a benefit. Others found nothing. Pooled reviews of transfer-day-only protocols have been persistently mixed, and that inconsistency is the single most important thing to understand about this literature.

The more interesting work came later. Hullender Rubin and colleagues (2015) looked at whole-systems acupuncture, meaning a full, individualized course of care across an IVF cycle rather than two isolated needling sessions, and found better outcomes than usual care alone. A 2023 systematic review and meta-analysis by Xu and colleagues pointed in a similar direction. More recently, Hullender Rubin’s 2025 work on patient-reported outcomes found that patients receiving acupuncture through IVF reported meaningfully better experiences of the cycle itself.

The takeaway is not “acupuncture works for IVF.” It is more precise than that. A single intervention on transfer day is asking a lot of two needles. A sustained course of care through the cycle is a different intervention entirely, and it performs better.

That distinction is why the IVF support protocols Marc Sklar built for this clinic begin weeks before transfer, not the morning of.

Endometriosis: where the evidence is strongest

If you want the single most defensible claim in this entire field, it is this: acupuncture reduces endometriosis-associated pain.

Li and colleagues (2023) ran a multicenter randomized controlled trial and found significant reductions in dysmenorrhea. Giese and colleagues (2023) pooled the available randomized evidence in a systematic review and meta-analysis and reached a consistent conclusion. Earlier sham-controlled work by Wayne (2008) and a randomized crossover trial by Rubi-Klein (2010) found the same pattern. Armour and colleagues (2021) tested manual acupuncture added to usual care and again saw benefit.

Multiple trial designs. Multiple research groups. Same direction. That is what a real signal looks like.

The measurable improvements cluster around:

  • Reduced period pain
  • Reduced chronic pelvic pain
  • Shorter pain duration
  • Better quality of life during the treatment course

The honest limit: this is pain and quality-of-life evidence, not fertility evidence. Whether acupuncture improves conception rates specifically in women with endometriosis has not been established. Feeling better and getting pregnant are different endpoints, and we won’t blur them.

PCOS: ovulation, cycles, and hormones

PCOS is where the mechanistic story is most satisfying. Elevated sympathetic nervous system activity is a recognized feature of PCOS, and acupuncture, particularly electroacupuncture, measurably modulates it.

Jedel and colleagues (2011) ran an electroacupuncture RCT and reported improvements in menstrual frequency and reductions in circulating androgens. Johansson and colleagues (2013) followed with an RCT focused specifically on ovulation frequency and found improvement. Jo and colleagues (2017) pooled the randomized evidence in a systematic review and meta-analysis, and Wu and colleagues (2020) added a further systematic review.

The reasonable read of that body of work:

  • Ovulation frequency and menstrual regularity may improve
  • Testosterone levels may decrease
  • Selected metabolic markers may improve
  • It works best alongside lifestyle modification and medical care, not instead of it

The same caveat applies here as everywhere else on this page. Improvement in ovulation is not the same as a guaranteed live birth. The pregnancy and live birth data in PCOS remain encouraging but inconclusive.

Stress, anxiety, and the part nobody measures

Fertility treatment is one of the most stressful experiences many people will go through, and the stress is not a side issue. It affects sleep, relationships, adherence, and whether patients continue treatment at all.

This is one of the most consistent findings in the acupuncture literature: patients report lower stress and anxiety during fertility treatment when acupuncture is part of their care. It also shows up in Hullender Rubin’s 2025 patient-reported outcomes work.

We are careful about how we frame this. We are not claiming that lowering stress produces pregnancies, because that causal chain is not established. We are claiming that a treatment cycle you can actually endure is worth something on its own terms, and the evidence supports acupuncture’s role there.

What the evidence does not say

We would rather lose a patient than oversell. So, plainly:

  • Acupuncture does not guarantee pregnancy.
  • Acupuncture is not a substitute for IVF, IUI, medication, or surgical management.
  • The live birth data are not settled, and any clinic quoting you a specific success-rate increase is extrapolating past what the studies support.
  • Transfer-day-only acupuncture has a weak and inconsistent evidence base.
  • Endometriosis evidence is strong for pain, limited for fertility.

Acupuncture is best understood as an evidence-informed adjunct: safe, well-tolerated, and genuinely supportive across symptom relief, hormonal regulation, and the experience of treatment itself.

How this shapes care at Reproductive Wellness

Reproductive Wellness was founded by Marc Sklar, a doctor of acupuncture and Chinese medicine who has spent more than two decades working with fertility patients in San Diego. The through-line of the clinic’s approach is the same one the research keeps pointing at: individualized, sustained care beats isolated intervention.

In practice, that means:

  • We start early. IVF and IUI support begins in the weeks leading up to a cycle, not on transfer day.
  • We treat the whole picture. Diagnosis, cycle history, labs, sleep, stress, and lifestyle all shape the treatment plan.
  • We work with your medical team, not around it. Acupuncture sits alongside your reproductive endocrinologist’s care.
  • We tell you what we don’t know. If the evidence for something is thin, you will hear that from us.

Marc Sklar and the Reproductive Wellness team see patients across San Diego, including those navigating endometriosis, PCOS, unexplained infertility, recurrent loss, and IVF cycles.

Book a consultation at our San Diego clinic

Frequently asked questions

Does acupuncture improve IVF success rates? The evidence is mixed and depends heavily on how acupuncture is delivered. Studies using a single session on embryo transfer day show inconsistent results. Studies using an individualized course of treatment across the IVF cycle, sometimes called whole-systems acupuncture, show more favorable outcomes. No study supports a guarantee of pregnancy or live birth.

How many acupuncture sessions do I need before IVF? There is no universal number, but the research consistently favors a sustained course of care over one or two sessions. Most protocols begin several weeks before an embryo transfer. Your plan will depend on your diagnosis, cycle timing, and treatment history.

Can acupuncture help with endometriosis pain? This is the strongest evidence in the field. Multiple randomized controlled trials and systematic reviews report reduced period pain, reduced chronic pelvic pain, and improved quality of life. Evidence that it improves fertility specifically in women with endometriosis is more limited.

Can acupuncture help me ovulate if I have PCOS? Randomized trials suggest acupuncture may improve ovulation frequency and menstrual regularity in women with PCOS, and may reduce testosterone levels. It works best as a complement to lifestyle changes and conventional medical care rather than a replacement for them.

Is acupuncture safe during fertility treatment? Acupuncture has a strong safety record and is widely used as an adjunct to conventional fertility care. It should always be coordinated with your reproductive endocrinologist.

Is acupuncture a replacement for IVF? No. Acupuncture is an adjunct to reproductive medicine, not an alternative to it.

The studies referenced on this page

IVF

  • Paulus et al. (2002). Original embryo transfer trial. https://pubmed.ncbi.nlm.nih.gov/11937123/
  • Dieterle et al. (2006). Embryo transfer RCT. https://pubmed.ncbi.nlm.nih.gov/16600232/
  • Westergaard et al. (2006). Embryo transfer RCT. https://pubmed.ncbi.nlm.nih.gov/16616748/
  • Hullender Rubin et al. (2015). Whole-systems IVF. https://pmc.ncbi.nlm.nih.gov/articles/PMC4458185/
  • Xu et al. (2023). Systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/37436463/
  • Hullender Rubin et al. (2025). IVF patient-reported outcomes. https://pmc.ncbi.nlm.nih.gov/articles/PMC12138210/

Endometriosis

  • Wayne et al. (2008). Sham-controlled trial. https://pubmed.ncbi.nlm.nih.gov/18794019/
  • Rubi-Klein et al. (2010). Randomized crossover trial. https://pubmed.ncbi.nlm.nih.gov/20728977/
  • Armour et al. (2021). Manual acupuncture plus usual care. https://pubmed.ncbi.nlm.nih.gov/34161143/
  • Li et al. (2023). Multicenter RCT. https://pubmed.ncbi.nlm.nih.gov/36716811/
  • Giese et al. (2023). Systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/38033648/

PCOS

  • Jedel et al. (2011). Electroacupuncture RCT. https://pubmed.ncbi.nlm.nih.gov/20943753/
  • Johansson et al. (2013). Ovulation RCT. https://pubmed.ncbi.nlm.nih.gov/23482444/
  • Jo et al. (2017). Systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/28591042/
  • Wu et al. (2020). Systematic review. https://pubmed.ncbi.nlm.nih.gov/32481448/