VF/ICSI & IUI support | Fertility Acupuncturist-Emiko Kanematsu R.Ac & R.TCMP

If you are planning to do in-vitro fertilization (IVF) with/without ICSI, it is recommended that you have treatments for at least three months before your IVF/ICSI cycle. On your cycle day 2 or 3, antral follicles on both ovaries are counted (antral follicle count; AFC), which can predict how many eggs will be retrieved after ovarian stimulation. The eggs in these antral follicles start waking up for the maturation process 120 days before they become fully mature, and are retrieved in your IVF/ICS cycle (or before the dominant follicle(s) is ovulated). That's why it is advisable that you start treatment at least three months before your ovarian stimulation to help the immature follicles develop into good-quality eggs.

The recommendation for acupuncture treatment to prepare for IVF is as follows:

Three months before your IVF cycle -- 1~2 treatments/week. Chinese herbs are always recommended especially for certain conditions, such as advanced maternal age, poor egg quality, high FSH, irregular cycles, severe menstrual cramps with clotty menses etc.

Two weeks before your ovarian stimulation cycle and two weeks until your trigger shot -- 2 treatments/week

If you are going to have a fresh embryo transfer -- one treatment between your egg retrieval and transfer day until your pregnancy test

If you are going to have a frozen embryo transfer -- 1 treatment/week until your FET cycle

FET cycle (natural or medicated) -- 2 treatment/week until your FET day and 1/week after it

There are many studies that prove that a set of acupuncture treatment before and after embryo transfer increases the chances of success of IVF/ICSI; however, I would definitely recommend 3-month preparation because Chinese medicine (acupuncture and herbal herbs) is the holistic and natural medicine to improve your health and fertility naturally and gradually. It does not change your body overnight or after a few acupuncture sessions.

Acupuncture & IUI Preparation

If you are going for intrauterine insemination (IUI), it would be the best for you to start preparation three months before as well (please read above)

Three months before your IUI -- 1~2 treatments/week. Chinese herbs are always recommended especially for certain conditions, such as advanced maternal age, poor egg quality, high FSH etc.

Around your IUI day (one day before or after, or on your IUI day) -- 1 treatment

After your IUI (3-5 days after IUI) -- 1 treatment

Until your pregnancy test & during the first trimester -- 1 treatment/week

Modern Research on Acupuncture & IVF/ICSI Support

Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis. Qian at al. Arch Gynecol Obstet. 2017 Mar;295(3):543-558 [PMID: 27995371]: "Based on an analysis of the studies, acupuncture improves the CPR (clinical pregnancy rate) among women undergoing IVF. When the studies were restricted to Asian or non-Asian area patients, compared with traditional acupuncture and other methods, electrical acupuncture yielded better IVF outcomes. Optimal positive effects could be expected using acupuncture in IVF during COH (controlled ovarian hyperstimulation), especially in Asian area. However, as a limitation of this review, most of the included studies did not mention the number of embryos transferred."

Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis. Zheng CH et al. Fertil Steril. 2012 Mar;97(3):599-611. [PMID: 16616748]"Acupuncture improves CPR (clinical pregnancy rate) and LBR (live birth rate) among women undergoing IVF based on the results of studies that do not include the Streitberger control. The Streitberger control may not be an inactive control. More positive effects from using acupuncture in IVF can be expected if an appropriate control and more reasonable acupuncture programs are used."

Increase of success rate for women undergoing embryo transfer by transcutaneous electrical acupoint stimulation: a prospective randomized placebo-controlled study. Zhang R et al. Fertil Steril. 2011 Oct;96(4):912-6 [PMID: 21862001]: "The clinical pregnancy rate, embryos implantation rate, and live birth rate of group I with mock treatment (29.3%, 15.0%, and 21.2%, respectively) were significantly lower than those in group II with single TEAS treatment 30 minutes after ET (42.7%, 25.7%, and 37.3%, respectively) and group III with double TEAS treatment 24 hours before ET and 30 minutes after ET (50.0%, 25.9%, and 42.0%, respectively). Transcutaneous electrical acupoint stimulation (TEAS), especially double TEAS, significantly improved the clinical outcome of ET (embryo implantation)."

Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. Dieterle S et al. Fertil Steril. 2006 May;85(5):1347-51 [PMID: 16616748]: "In group I (who received luteal-phase acupuncture), the clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4%, respectively) were significantly higher than in group II (who received placebo acupuncture; 15.6% and 13.8%). Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI."

Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Paulus WE et al. Fertil Steril. 2002 Apr;77(4):721-4 [PMID: 11937123]: "Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group. Acupuncture seems to be a useful tool for improving pregnancy rate after ART."

Modern Research on Chinese herbs & IVF/ICSI Support

Effects of Chinese herbs combined with in vitro fertilization and embryo transplantation on infertility: a clinical randomized controlled trial. Guo et al. J Tradit Chin Med. 2014 Jun; 34(3):267-73 [PMID: 24992752]: Our findings indicate that Chinese herbs increase endometrial thickness, improve the quality of fertility and embryo, and promote embryonic nidation, thus enhancing the success rate of in vitro fertilization/ intracytoplasmic sperm injection-embryo transplantation cycle. Using Chinese herbs improves the outcomes and safety of assisted reproductive technologies.

More studies will be added soon.