IVF Acupuncturist Explains Benefits of Fertility Acupuncture

Does acupuncture help with IVF success rates? When during your IVF cycle should should you do acupuncture & how much does it cost? Here's what we found out from an IVF acupuncturist.
As an embryologist, I had always heard that acupuncture was popular among some patients going through in vitro fertilization.
It’s not something that was mentioned at the clinic or by any of the doctors or nurses I worked with, I heard about it through IVF patients.
Many fertility patients incorporate acupuncture as part of their fertility treatment to help them relax throughout a stressful process and possibly improve blood flow to their uterus to help improve chances of embryo implantation.
I’ve never had acupuncture done before so I wanted to learn a little more about what the process is like from an expert. 

Meet Melsa! An IVF acupuncturist with nearly a decade of experience supporting fertility patients throughout infertility treatment & through pregnancy.
Meet Melsa! An IVF acupuncturist with nearly a decade of experience supporting fertility patients throughout infertility treatment & through pregnancy.

We talked with Melsa Maher, who specializes in fertility acupuncture for IVF patients at her acupuncture studio in San Antonio, Texas.
Melsa has been treating IVF patients for almost a decade and has seen women at all stages of the fertility journey, including those trying to get pregnant naturally, those undergoing IUI or IVF, and even women who are currently pregnant.

🙋‍♀️Local to the area? Check out fertility clinics in San Antonio, Texas.

What’s the deal with acupuncture and fertility?

There are 361 acupuncture points that run 14 along meridians up and down the body. 
Acupuncture focuses on circulation in the body so specifically for fertility, the focus is on improving blood flow to the uterus.

Who can benefit from fertility acupuncture?

Everyone! Acupuncture can help people at all stages of the fertility process.
Even women who aren't actively trying to conceive can do fertility acupuncture to help with their period, such as painful periods due to endometriosis or women with PCOS.
Fertility acupuncture is for women:
👉with painful periods (endometriosis)
👉with PCOS (irregular periods)
👉trying to get pregnant naturally
👉in fertility treatment (IUI or IVF)
👉in early pregnancy
👉at any stage of pregnancy

Can men benefit from fertility acupuncture?

Yes. Melsa does see men for fertility acupuncture as well.
She sees them to help improve blood flow and circulation for the purposes of improving sperm health and for stress reduction.

What to expect on your first visit for acupuncture

Prior to beginning the first session, Melsa asks questions to try to understand how acupuncture can best help with certain concerns and issues.
Her top 5 questions she always asks her fertility patients are:
👉What are your periods like? Regular? Irregular?
👉How is your digestion?
👉How are your stress levels?
👉What is your sleep like?
👉What’s your general body temperature? (Always cold? Always hot & cranking the A/C?)
This helps start the conversation and then answers to certain questions may lead to further probing to further understand what issue a patient may be dealing with.
For example, if sleep is poor, she’ll ask more questions to find what exactly about your sleep is disrupted. Do you get night sweats? Have trouble falling asleep? Have trouble staying asleep?
These questions also help an acupuncturist identify where underlying inflammation in the body may be coming from so that they can create a targeted plan for where to place the acupuncture needles.
Melsa also asks questions about where a patient may be in their IVF treatment and any details associated with the fertility treatment process that may be affecting things such as stress levels.

How many needles are used for fertility acupuncture?

About 15-20 needles, however, your acupuncturist may adjust this number.
Melsa noted that she also may adjust the number of needles if additional issues need to be addressed, such as headaches, allergies, or constipation.

Where are the acupuncture needles placed for fertility purposes?

In general, she places needles below the elbows, below the knees, the abdominal region, top of the head, and between the eyebrows.

How long do the needles stay in?

You relax on the table with the needles in for about 30 minutes.

Can you feel the acupuncture needles? Does it hurt?

Melsa made a really good point here!
IVF patients are used to injecting themselves with fairly large needles daily during treatment. In comparison, an acupuncture needle is tiny.
For example, Gonal-F uses a 27-gauge needle, which is 0.413mm in total diameter. 
The trigger shot you take in an IUI or IVF cycle uses a 25-gauge needle, which is 0.515mm in diameter. 
And during the embryo transfer, many women have to administer progesterone in oil, which is injected using a 22-gauge needle at 0.718mm in diameter! 
A standard acupuncture needle is only 0.25mm in diameter while a facial acupuncture needle is just 0.12mm, which is about the size of a human hair! 🤯

IVF Medication Needle vs Acupuncture Needle Size
Needle for Gauge Needle diameter
FSH (Gonal-F, Follistim, Bravelle) 27-gauge 0.413mm
hCG trigger (Pregnyl, Novarel, Ovidrel, etc) 25-gauge 0.515mm
Progesterone in oil 22-gauge 0.718mm
Lupron 25-gauge 0.515mm
Body Acupuncture Needle 32-gauge 0.25mm
Facial Acupunture Needle 44-gauge 0.12mm
Acupuncture needles are much smaller than the typical needles you use for IVF injections. The smallest acupuncture needles are about the size of a human hair!
🪡They’re nothing to be feared. You don’t really feel them going in. Hands and feet are a little more sensitive… but if you’re putting a needle in the belly or thigh or calf muscle, you don’t feel them.
She did note that while the needles are in during the treatment, you may feel a pulsing sensation, dull ache or throbbing sensation where the needles are.
However, most people find acupuncture very relaxing and fall asleep during the session, so any sensation must not be too noticeable!
If you do feel any discomfort, your practitioner can adjust the placement for you and afterwards it should be painless.

Are acupuncture needles reused?

No. Acupuncture needles are single-use.
They come in a sterile pack and after use are disposed of in a sharps container.

Can you move at all once the acupuncture needles are in?

Yes. Moving around a bit is not a problem.

If you need to scratch an itch or adjust a leg to be more comfortable, you’re free to do so without any worry.
However, don’t go crazy with your movement as the intention is for you to lay still with the needles in.
Melsa added, “I wouldn’t get off the treatment table, although that’s happened to me!”

When is the best time to get fertility acupuncture for IVF?

Melsa suggests beginning acupuncture sessions about 3 months prior to your egg retrieval
The intent is to try to improve blood flow through the ovarian artery to reach the primordial follicles, which will develop months later into the ovulatory follicles that release eggs during an IVF cycle.
Don’t worry if you’ve already started fertility treatments! Not everyone starts their acupuncture sessions in advance.
Many women start acupuncture a month before IVF or even once they've already started fertility medications.

What is the best timing for acupuncture during an IVF cycle?

Melsa noted that some women she works with specifically want to follow the Paulus study in which they have an acupuncture session pre- and post-embryo transfer with specific acupuncture points targeted.
⏰She recommends that IVF patients have their acupuncture session within 24-48 hours of their embryo transfer.
Melsa also sees women during the two-week wait, primarily because that’s the most stressful time for women as they’re waiting for their pregnancy test results from their embryo transfer.
Some women who have a successful cycle continue to do acupuncture during pregnancy to help with nausea and stress relief.

Acupuncture & IVF Success Rates

These were the fertility acupuncture point locations used before the embryo transfer in the Paulus et al. (2002) protocol.
These were the fertility acupuncture point locations used before the embryo transfer in the Paulus et al. (2002) protocol.

According to Melsa, acupuncture for fertility purposes really got on the map in the 2002 Paulus study, in which 160 patients took part in a randomized control trial with no placebo in order to assess whether acupuncture affected embryo transfer success rates.
These patients all had good quality embryos and were randomized into two groups. 
One group had acupuncture 25 minutes before their embryo transfer and then again 25 minutes afterward while the second group had no acupuncture at all throughout their embryo transfer cycle.
Acupuncture locations for before & after embryo transfer - Paulus Study
Before Embryo Transfer After Embryo Transfer Ear points*
Cx6 (Neiguan) S36 (Zusanli) ear point 55 (Shenmen)
Sp8 (Diji) Sp6 (Sanyinjiao) ear point 58 (Zhigong)
Liv3 (Taichong) Sp10 (Xuehai) ear point 22 (Neifenmi)
Gv20 (Baihui) Li4 (Hegu) ear point 34 (Naodian)
S29 (Guilai)
This is the embryo transfer acupuncture protocol used in the Paulus 2002 IVF study. *The ear locations were targeted in both the pre- and post-embryo transfer sessions. Two needles were placed in each ear during a single session. Locations were then alternated between sessions.
The study resulted in a 42.5% clinical pregnancy rate for the acupuncture group and a 26.3% clinical pregnancy rate for the non-acupuncture group.
Since this study came out, there has been further research and clinical trials on the effect of acupuncture on IVF success rates.
To get a good idea of what your chances of pregnancy are from IVF in general, check out the most up-to-date IVF success rates available in 2021 from the CDC’s national reporting of fertility clinics or check success rates for your local fertility clinics.

Results are not conclusive, more studies are needed on acupuncture & IVF

A 2012 systematic review and meta-analysis of 24 randomized control trials including nearly 6,000 patients looked at whether acupuncture significantly affects IVF outcomes.
The authors concluded that the clinical pregnancy rates were significantly improved in patients that had fertility acupuncture versus the control groups.
The study noted that live birth rates were also significant in the acupuncture groups but only when the Streitberger control was not used, one of the 4 control methods used by some of the studies.
The Streitberger control involved blunt needling of fertility acupuncture points or points nearby. It was theorized that this may not have been an optimal control to use as this method still could have had an effect on fertility acupuncture points, perhaps through acupressure.
So, further large randomized control trials are needed to confirm any significant difference acupuncture may have on IVF outcomes.
An article published in the same journal, Fertility & Sterility, commented on this systematic review stating that several variables varied too widely between the studies to be effectively analyzed, such as timing during the IVF cycle for when acupuncture was done, the method of control used, acupuncture methods, etc. and a placebo effect cannot be ruled out.

More recently, a trial published in 2018 was done in Australia & New Zealand that randomized over 800 women undergoing IVF to either the acupuncture or control (sham acupuncture) group and found that there was no significant different in live birth rates or clinical pregnancy rates.

However, the authors acknowledged that the control group had significantly more blastocyst-stage transfers compared to the acupuncture group. This could have affected the results, as blastocyst-stage transfers are known to have a higher pregnancy success rates compared to earlier stage embryo transfers.
The research on acupuncture and IVF success rates:
👉Some studies have shown a significant improvement in IVF success rates among women who did acupuncture
👉Not all studies used the same method for the control group, making it difficult to compare trials
👉A placebo effect cannot be ruled out at this time
👉Further studies with standardized control groups & timing of acupuncture are needed

Acupuncture may provide a psychological benefit during the IVF process

While it’s not yet clear whether acupuncture can improve the success of your embryo transfer, Melsa notes that the reason many fertility patients choose to do acupuncture is to:
  • take advantage of an additional outlet that may help improve their chance of pregnancy
  • reduce stress levels during treatment
A 2020 research paper interviewing IVF patients participating in a randomized control trial for acupuncture effects on IVF found that while women weren’t sure acupuncture actually affected their treatment outcome, they felt that the acupuncture sessions provided a psychological benefit.
Some patients felt acupuncture helped them feel like they were doing something extra in their power to help their treatment.
We included some quotes from the study that patients gave when asked about their perception of acupuncture as part of their IVF protocol.
📄I feel like I'm doing something, I'm taking control of a situation I have no control over… trying to do everything in my power to give the best shot possible…I come out feeling empowered, more calm and in control.
Others perceived the benefits of the sessions were helping them to relax, feel more positive, and allowed them to take some time to themselves while laying in the silence for those 30 minutes on the table.
📄It’s more relaxing than anything else. I don't know how it works I don't know if I was even on the proper acupuncture or the sham, but I certainly felt relaxed and I think that was a positive.
As the demand from fertility patients is substantial, many fertility clinics offer acupuncture in-house as an adjunct to fertility treatment.

Anyone that should avoid acupuncture?

Most people can safely do acupuncture.
While most people really enjoy the experience, Mesla did mention that if you are extremely uncomfortable with needles, this may not be the treatment for you.
She also mentioned that breast cancer survivors who have had a mastectomy should check with their doctors before acupuncture, as some physicians may say no inserted needles on the arms.
If you have had a recent medical procedure or illness, check with your physician first so you can alert your acupuncturist of any areas that may need to be avoided for medical reasons.

How much does fertility acupuncture cost?

Fertility acupuncture costs $70-$120 for an average session.
However the price can vary based on whether your practitioner specifically specializes in fertility acupuncture, is in private practice, and what area of the country they are located.

Some women are able to have this cost covered by insurance, regardless of whether they have infertility coverage.

How to find a fertility acupuncturist

Ask at your fertility clinic! Your reproductive endocrinologist may have a specialist they refer patients to. Some clinics even offer acupuncture in-house.
👀Don't have a fertility clinic yet? You can take a look at fertility clinics in your area and their success rates to get an idea of where you might want to reach out to.
Your OBGYN may also have a contact for you. 
Melsa works with all the fertility clinics in San Antonio, Texas and is referred to for fertility patients regularly.
Her tip on how make sure you're working with a qualified practitioner:
When vetting an acupuncturist, make sure to look for the credential, LAc, which means they are a Licensed Acupuncturist
Melsa noted that there are chiropractors and physical therapists that may have a 100-hour certification but these are not the ideal people to work with.
Licensed Acupuncturists go through over a thousand clinical hours before graduating, so you want someone who has been specialty trained in needling for safety.

Any other tips for women trying to get pregnant?

Melsa’s approach is to look at your overall health as a whole, saying, “Let’s increase your fertility as much as you can and get you really healthy before retrieval.”
🍎Clean up your diet at least 3 months before treatment, if you can. This entails cutting out processed foods and eating more whole foods.
🥂Try to limit alcohol intake as well.
💊Find a high quality prenatal. Do your research to make sure you’re getting a good quality supplement.

You can do fertility acupressure at home!

Some people who live rurally may not have access to a fertility acupuncturist to help them while they’re trying to get pregnant.
Melsa created an IVF acupressure course that you can do yourself at home!
No needles involved.
Instead, she shows you how to use your hands to place pressure on the same fertility points where needles would normally be placed during a fertility acupuncture session. 
She has acupressure lessons for different times throughout the IVF process, such as:
👉Before starting IVF injections
👉During taking IVF injections
👉The acupuncture points used around the embryo transfer in the Paulus study
👉Two-week wait, which are also helpful points during pregnancy
Even if you are seeing an acupuncturist, you can still continue your care at home by activating these points.

Questions? Want to learn more about fertility acupuncture?

Check out Melsa’s acupuncture studio, her 8 tips from a fertility acupuncturist for increasing IVF success, and socials to connect and learn more about how acupuncture and acupressure can help you with your fertility goals.
Feel free to send her a DM for any specific questions!
IVF Acupressure Facebook & Instagram