05/22/2026
Acupuncture isn't an alternative to IVF. It's a partner.
Why the latest meta-analyses point to integrative care — and what "adjunct" really means inside the cycle that's about to start.
By Mike Berkley, L.Ac., FABORM · The Berkley Center for Reproductive Wellness ·
If you are reading this in the run-up to an IVF cycle, you have probably already heard the line I hear in my office every week: "My doctor said acupuncture can't hurt, but there's no real evidence it helps." I want to take that sentence apart, because the evidence has moved significantly — and it is now reasonable to say something more precise: in vitro fertilization and Chinese medicine are not competitors. They are two halves of the same conversation.
I have spent thirty years treating only fertility patients. The Berkley Center for Reproductive Wellness was the first acupuncture and herbal medicine clinic in the United States to specialize in fertility challenges. In that time, the published literature has shifted from a handful of underpowered studies to dozens of randomized trials and several large meta-analyses. What follows is what those studies actually say, what they don't say, and how to think about whether to add an integrative layer to your cycle.
What IVF does brilliantly — and where it stops
IVF is the most technically advanced fertility treatment ever developed. It is unmatched at four things: retrieving eggs, fertilizing them, growing the resulting embryos in a controlled lab environment, and transferring those embryos back into the uterus. If you have blocked tubes, low s***m count, or anovulation that has not responded to other treatments, IVF is the right answer.
What IVF was not designed to do is improve the biological quality of the egg, the s***m, or the uterine environment that those embryos depend on once they arrive. It is a procedural technology, not a regenerative one. Patients sometimes hear "good embryo, failed implantation" or "good embryo, miscarriage," and assume something went wrong on transfer day. More often, the underlying issue was present long before transfer day — somewhere in the cellular biology that IVF, by design, does not touch.
That biology has names. It includes:
• Oxidative stress in the follicle and the endometrial environment.
• Mitochondrial function in the egg and the s***m — the cellular energy supply that powers fertilization, embryo division, and implantation.
• Pelvic and uterine blood flow, which determines how well nutrients and oxygen reach a developing follicle or a freshly transferred embryo.
• Chronic, low-grade inflammation, especially in patients with endometriosis, autoimmune patterns, or chronic endometritis.
• The HPA axis — the stress system — which directly modulates ovulation, luteal phase stability, and implantation.
Acupuncture and customized Chinese herbal medicine target exactly this layer. That is why "adjunct" is the right word, and "alternative" is the wrong one.
The evidence: acupuncture as an adjunct to IVF.
Let's start with the most recent and largest pooled data, because the picture has gotten clearer in the last two years.
A 2025 systematic review and meta-analysis of 42 randomized trials covering more than 7,400 women undergoing IVF found that acupuncture significantly increased biochemical pregnancy rates (RR 1.28) and clinical pregnancy rates (RR 1.19) compared with sham acupuncture or no treatment.
Across studies, live birth rates also rose, with pooled estimates ranging from RR 1.34 to RR 1.91. Those are not small effects. A relative risk of 1.34 on live birth, applied to a baseline live birth rate of 35%, translates to roughly a 12-percentage-point absolute improvement — closer to 47% — and that's the conservative end of the range.
Timing and dose matter — a lot
A 2024 meta-analysis in the Journal of Integrative and Complementary Medicine looked specifically at when in the cycle acupuncture is delivered. Two windows produced the strongest results: during controlled ovarian hyperstimulation in fresh IVF cycles (RR 1.33 for clinical pregnancy) and in the period leading up to frozen embryo transfer (RR 1.71 for clinical pregnancy, RR 2.40 for live birth).
Dose followed the same pattern. Protocols of three months or more, with twenty sessions or more, consistently outperformed brief protocols limited to the day of embryo transfer. This is the key point I make to every new patient: a single "acupuncture before and after transfer" appointment is not the dose the literature actually studied when it found the largest benefits. The studies that moved the needle gave the body real time to respond.
If you take one practical thing from this post, take that: if you are considering acupuncture for your IVF cycle, start at least three months before retrieval or transfer, not three weeks.
Chinese herbal medicine and IVF outcomes
Acupuncture is the part patients usually hear about first, but in my clinic, individualized herbal medicine is at least as important — and the data backs that up.
A meta-analysis of 20 randomized trials (1,721 women) found that Chinese herbal medicine combined with IVF significantly increased clinical pregnancy rates (OR 2.04) and ongoing pregnancy rates (OR 1.91) compared with IVF alone. A separate systematic review confirmed those findings, showing improved live birth rates (RR 1.34) with herbal medicine as an adjunct to IVF.
Two cautions are worth naming. First, every formula must be customized — there is no single "fertility formula" any more than there is a single fertility patient. Second, herbal medicine and your IVF medications need to be coordinated by someone who understands both.
At the Berkley Center, we manage that coordination directly with your reproductive endocrinologist, and we pause or modify formulas around specific medication windows. Done casually, herbal medicine can complicate a cycle. Done carefully, it is one of the most powerful tools we have.
Why this works: five mechanisms, not magic
Acupuncture is not a placebo, and it is not mystical. It is a reproducible intervention that activates measurable changes across five physiological systems. The reason it pairs so well with IVF is that IVF doesn't touch any of these directly.
1. Pelvic and uterine blood flow
Doppler ultrasound studies have shown that acupuncture increases blood flow to the ovaries and uterus through improved vascular tone. That matters for follicular development, endometrial growth, and implantation. It is especially relevant if you have been told you have thin lining, poor uterine artery perfusion, diminished ovarian reserve, or a history of implantation failure.
2. Neuroendocrine regulation
Ovulation, follicular recruitment, estrogen and progesterone signaling, and luteal phase stability all depend on tight communication between the hypothalamus, pituitary, ovaries, thyroid, and adrenal glands. Acupuncture has been shown to modulate the autonomic nervous system and the hypothalamic-pituitary-ovarian axis. Clinically, this is why patients with irregular cycles, PCOS, anovulation, luteal phase insufficiency, or stress-related cycle disruption tend to respond well.
3. Modulating inflammation
Chronic inflammation is implicated in endometriosis, PCOS, chronic endometritis, recurrent implantation failure, and altered endometrial receptivity. Acupuncture reduces inflammatory signaling and supports immune balance within the reproductive environment. For patients with elevated inflammatory markers, endometriosis-related infertility, or repeated failed transfers, this is often the layer that moves things.
4. Oxidative stress and mitochondrial energy
Eggs sit in the o***y for years before they are recruited, accumulating oxidative damage the whole time. S***m DNA fragmentation rises with the same kind of damage. Inside both eggs and s***m, mitochondria produce the ATP that powers fertilization and embryo division — and oxidative stress directly damages mitochondria.
The research here is striking. Acupuncture has been associated with reductions in malondialdehyde (a marker of oxidative damage) and increases in superoxide dismutase (a key antioxidant enzyme).
Emerging studies show improved mitochondrial activity, better egg quality and embryo development, and improved s***m motility through mitochondrial support. Customized herbal medicine layers on direct antioxidant effects and additional mitochondrial protection.
In plain English, cells with more energy and less damage are more likely to fertilize, divide, and implant. That is what we are trying to set up in the three months before retrieval.
5. The stress axis
IVF is stressful. Anyone telling you to "just relax" is unhelpful at best. But the data on cortisol's effect on ovulation, implantation, and luteal stability is real, and the data on acupuncture as a non-pharmacological tool for reducing anxiety and depression during fertility care is equally real. We are not just "helping you cope" — we are reducing a biological variable that affects outcomes.
What this looks like in practice
A typical Berkley Center patient preparing for IVF starts with us roughly twelve weeks before their planned retrieval or transfer. The first visit is long — usually 90 minutes — and includes a detailed reproductive history, a review of any prior cycle records, your most recent labs, and your partner's semen analysis if relevant. From there, we build a protocol that pairs acupuncture (typically once or twice a week), a customized herbal formula adjusted across the cycle phases, and targeted supplementation based on what your labs show.
Around the IVF cycle itself, we add specific protocols: support during stimulation, acupuncture sessions before and after retrieval if feasible, and uterine-receptivity-focused treatment before transfer.
The literature on pre- and post-transfer acupuncture is mixed when delivered in isolation; in our practice, it is one piece of a longer arc, not the whole arc.
We coordinate directly with your reproductive endocrinologist, send updates as requested, and pause or adjust herbs around specific medication windows. That coordination is a non-negotiable for us, and it is the thing that turns "complementary" from a marketing word into a clinical reality.
The 90-day window — start sooner than you think
The single most common regret I hear is some version of "I wish I'd started sooner."
The reason is biology: follicles take roughly 90 days to mature from early antral stage to ovulation, and s***m take roughly 72 to 90 days to develop. Whatever we do today — improving blood flow, lowering oxidative stress, supporting mitochondrial energy, calming the stress axis — shows up in the eggs and s***m available three months from now.
If your retrieval is six weeks out, we can still help. If it is twelve to sixteen weeks out, we can help substantially. And if you have just been told to start thinking about IVF, this is the moment to begin.
Ready to talk?
If you are preparing for IVF or IUI in New York City and want a clear-eyed conversation about whether and how to add evidence-based acupuncture and herbal medicine to your cycle, the next step is a consultation.
We will review where you are, what the research actually supports for your specific situation, and what a realistic protocol looks like.
Book a consultation at The Berkley Center for Reproductive Wellness — 16 East 40th Street, 4th Floor, New York, NY 10016. Call (212) 685-0985 or visit berkleycenter.com to schedule.
Sources
1. Fu QW, Zhu SM, Chen J, et al. Acupuncture for women undergoing in vitro fertilization: an updated systematic review and meta-analysis with trial sequential analysis. International Journal of Nursing Studies. 2025.
2. Quan K, Yu C, Wen X, et al. Acupuncture as treatment for female infertility: a systematic review and meta-analysis of randomized controlled trials. Evidence-Based Complementary and Alternative Medicine. 2022.
3. Xu M, Zhu M, Zheng C. Effects of acupuncture on pregnancy outcomes in women undergoing in vitro fertilization: an updated systematic review and meta-analysis. Archives of Gynecology and Obstetrics. 2024.
4. Manheimer E, Zhang G, Udoff L, et al. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ. 2008.
5. Cao H, Han M, Ng EH, et al. Can Chinese herbal medicine improve outcomes of in vitro fertilization? A systematic review and meta-analysis of randomized controlled trials. PLoS One. 2013.
6. Kwon CY, Lee B, Lee SH, Jo J. Herbal medicine in women undergoing in vitro fertilization / intracytoplasmic s***m injection: a systematic review and meta-analysis. Complementary Therapies in Medicine. 2020.
7. Wang X, Xu HM, Wang QL, et al. The timing and dose effect of acupuncture on pregnancy outcomes for infertile women undergoing in vitro fertilization and embryo transfer: a systematic review and meta-analysis. Journal of Integrative and Complementary Medicine. 2024.
8. Yang Y, Chen H, Tang H, et al. Different effectiveness of acupuncture treatment schedule on ART pregnancy outcomes: a systematic review and network meta-analysis. Frontiers in Endocrinology. 2025.
The Berkley Center for Reproductive Wellness · 16 East 40th Street, 4th Floor, New York, NY 10016 · (212) 685-0985 · berkleycenter.com
