The ancient practice of acupuncture offers a promising complementary therapy to improve fertility in couples.

Introduction

Infertility can be defined as failing to conceive after 12 months of regular unprotected intercourse. It is estimated that 1 in 6 people are affected by infertility, irrespective of the country’s socioeconomic condition.¹ Infertility is often stigmatised. Nonetheless, it can cause significant distress and negatively affect mental well-being as well as lead to financial problems.

Despite the prevalence of this issue, available treatments remain inaccessible for people due to their high prices and the fact that, in most countries, these are paid for out of pocket. Infertility in men can arise due to low sperm count, low sperm mobility or abnormal sperm. In women, conditions such as polycystic ovarian syndrome or hyperprolactinemia, thyroid issues, hormonal imbalances and poor egg quality are some of the main causes of infertility. In both men and women, infertility risk factors include:

• Age
• Obesity
• Smoking 
• Alcohol consumption
• Stress

Acupuncture is a traditional Chinese medical practice that involves inserting needles into specific points on the body. Acupuncture can aid infertility by boosting blood flow to reproductive organs, balancing hormones, reducing stress, and improving overall well-being. This holistic approach addresses physical and emotional health aspects which can help increase the chances of conception.

Understanding acupuncture

Acupuncture dates back to ancient China. Evidence suggests that it was used as early as 100 BC, appearing in texts such as the "Huangdi Neijing". Acupuncture has been used for thousands of years in China and other Asian countries as a part of Traditional Chinese Medicine. It is based on the belief that the body has life force or “Qi” energy that flows through pathways known as meridians. Stimulating certain points along these meridians using needles can influence the flow of Qi, which then promotes balance and healing.

Over the centuries, acupuncture techniques have evolved and the practice has spread to other parts of the world. Today, acupuncture is widely used alongside conventional Western medicine.

While its traditional explanation focuses on the flow of Qi, western medical acupuncture suggests that it may work through various physiological mechanisms, including:

• Nervous system activation: Inserting needles into acupuncture points is thought to stimulate sensory nerves. This leads to the release of chemical substances such as endorphins and serotonin. These chemicals are known to help reduce pain and promote a sense of well-being
• Increased blood flow: Acupuncture may enhance blood flow to specific body areas, improving oxygen and nutrient delivery. This can help with tissue recovery and improve blood flow to regions important in reproduction
• Regulation of hormones: Acupuncture can influence the release of hormones that regulate functions related to the production of reproductive hormones. This is particularly relevant for its role in enhancing fertility

By understanding traditional and modern acupuncture approaches, individuals can better appreciate its benefits and potential to improve fertility and overall health.

Currently, NICE only recommends Western acupuncture as a treatment for the following conditions:

• Chronic pain
• Chronic tension headaches & migraines
• Prostatitis (inflammation of the prostate)
• Hiccups

Acupuncture and fertility: mechanisms and theories

Female fertility

Acupuncture is considered safe for women during in vitro fertilisation (IVF), pregnancy, and after birth. It can help reduce stress and promote overall well-being. Many women use acupuncture alongside other fertility treatments and during the postpartum period.

Stress reduction

When the body is under stress, it releases chemicals such as cortisol and adrenaline which are involved in our ‘fight’ or ‘flight’ response. These stress hormones can interfere with several body functions, including reproductive systems. Stress can interfere with the hypothalamic-pituitary axis in which these stress hormones are produced, thereby causing hormonal imbalances.

Acupuncture can benefit fertility by reducing the impact of stress hormones on the nervous system. Women who undergo acupuncture alongside IVF treatment report greater feelings of relaxation and optimism before and after embryo transfer.^2,3 Low levels of stress are generally associated with higher pregnancy rates.³

Increased blood flow

Acupuncture treatment during the follicular phase of women receiving IVF treatment can help to increase blood flow to the ovaries,⁴ This supports the development of follicles, which are responsible for secreting hormones involved in the menstrual cycle. Additionally, there are claims online that acupuncture can help thicken the endometrial lining, which aids with the implantation of the embryo into the uterus lining. However, an analysis of the research in this area suggests the existence of only a low to moderate effect of acupuncture on the endometrial lining.⁵

Acupuncture and IVF embryo transfer

In a study of 635 patients undergoing IVF treatment, half the participants were given acupuncture on the day of embryo transfer while the other half received placebo acupuncture.⁶ The study found no significant differences in the outcome of IVF treatment between groups.⁶ Another analysis compiling the results of several studies looking at the effects of acupuncture on embryo transfer also concluded that acupuncture does not improve embryo transfer rates.⁷

Male fertility

Blood flow

Electroacupuncture - the application of a small electric current to acupuncture points - has been shown to increase blood flow to the testicles, which can help support healthy sperm production.⁸ Additionally, it has been found to improve both sperm count and sperm movement in men with low semen quality.⁹

Hormonal changes

In men, the luteinizing hormone (Lh) stimulates the production of testosterone which is required for sperm production while the follicle-stimulating hormone (FSH) further supports sperm production. The levels of Lh and FSH can be abnormally high in infertile men suffering from damage to cells in the testes that produce and support sperm. Electroacupuncture has been shown to reduce levels of these hormones in animal studies.¹⁰ Thus, showing potential to improve the production and overall quality of sperm in men suffering from infertility relating to hormonal dysfunction.¹⁰

Safety and side effects

Acupuncture is generally considered a very safe treatment when performed by a qualified professional. However, it is estimated that between 6-15% of people who undergo acupuncture treatment will experience short-term side such as:¹¹

• Drowsiness
• Feeling faint or dizzy
• Feeling sick
• Bleeding or bruising at acupuncture sites
• Pain at acupuncture sites

Summary

The traditional medical practice of acupuncture provides a valuable complementary approach to treating infertility. Research has shown that the practice can improve blood flow to reproductive organs, balance hormones, and reduce stress. This renders it a useful tool for men and women dealing with infertility. Traditional explanations for the benefits of acupuncture emphasise the balancing of Qi energy, while modern science highlights its impact on nervous system regulation.

Although studies show mixed results on acupuncture's direct impact on IVF outcomes, many women find it beneficial for improving overall well-being and reducing stress during fertility treatments. In men, acupuncture may improve sperm count and sperm motility, and help balance hormone levels. Overall, acupuncture is a safe, holistic option that supports individuals on their fertility journey.