Infertility is extremely common among couples in the United States. On average, 15% of couples will experience issues with infertility (1) ; that means at least 1 in every 7 couples share this struggle. Many of those struggling with infertility at some point begin to contemplate the use of Assistive Reproductive Technology (ART) with or without acupuncture. For those who are considering both and how they might best be used in conjunction with one another, we put together this list of frequently asked questions.
What is ART?
Assistive Reproductive Technology, or ART, is a group therapeutic avenues and procedures employed in cases of subfertility and infertility. They include the use of follicle stimulating drugs with natural cycles (such as Clomid or Letrazole), IUI (Intrauterine Insemination), ovarian stimulation and egg retrieval, egg freezing, IVF (in vitro fertilization), ICSI (intracytoplasmic sperm injection), embryo freezing, genetic testing of embryos, and fresh or frozen embryo transfers.
Doesn’t acupuncture just help you relax before ART procedures?
While acupuncture does help you to relax before ART procedures, it does far more than simply shift your state of mind. Acupuncture has been shown to enhance the flow of blood to the reproductive organs by gently opening the blood vessels that feed them (vasodilation), it decreases uterine motility (the wavelike movement of uterine muscle that promotes sloughing of endometrial tissue) which assists with successful implantation, it decreases the overall activity of the sympathetic (“fight or flight”) nervous system, increases the activity of the parasympathetic nervous system (“rest and digest”), regulates the endocrine system (responsible for the creation and management of hormones), and regulates the immune system (particularly important for those with hyperreactive immune systems).
When should I start acupuncture to have the most impact?
The ideal time to begin acupuncture is 3-6 months prior to any ART. There are several reasons for this:
1) This gives your acupuncturist time to assess and work with any preexisting conditions that may be contributing to subfertility such as amenorrhea, anovulation, irregular menstruation, PCOS, endometriosis, etc.
2) It takes about 120 days (about 4 months) for a secondary ovarian follicle to progress toward full maturation (only the last 10 days) before ovulation; receiving care during the entire lifespan of the follicle provides the most opportunity for acupuncture to benefit overall egg quality.
3) This allows time for you to gradually introduce any recommended lifestyle changes from your acupuncturist.
How often should I receive acupuncture around ART?
Two treatments per week are recommended while taking medications for ovarian stimulation prior to retrieval, and during uterine preparation prior to embryo transfer. Weekly treatments are the typical recommendation for the times leading up to and following ART procedures.
I have an ART procedure coming up very soon, is there still benefit in getting acupuncture?
There is still substantial benefit to receiving acupuncture right before (and after) an ART procedure, even if you haven’t been working with an acupuncturist for months leading up to it. In particular, acupuncture pre- and post-embryo transfer has been demonstrated to have a significant positive impact on successful implantation following transfer (2).
My insurance doesn't cover acupuncture, but does cover chiropractic; can I just get fertility acupuncture from my chiropractor?
It is always recommended to seek acupuncture from someone who is a licensed acupuncturist (or equivalent credential) in their state. Many chiropractors receive some acupuncture training in school, but it is minimal compared to the amount of training required by those who are licensed acupuncturists. Acupuncturists are also generally trained to treat fertility before graduating from their programs, whereas most acupuncture education for chiropractors is limited to the treatment of musculoskeletal conditions and omits instruction in the theory of internal medicine required to perform fertility acupuncture.
Where do they put needles for fertility acupuncture?
Every case is unique, and treatment is individualized, so your acupuncturist will determine based on your presentation where the best places are to put needles. In each session you can expect needles around the wrists and ankles, lower legs, and lower back or abdomen. Your acupuncturist might also insert needles into the ears (not the ear canal), chest, and head depending on your case and their method of practice.
My acupuncturist wants to put needles in my abdomen/use a heat lamp post-transfer. Is that OK?
Generally speaking, once there is a possible (desired) pregnancy, needles should not be placed in the lower abdomen until the very end of the third trimester when such needling sites are used to help encourage labor. Very mild infrared heat to keep the surface of the skin warm during treatment post-transfer is okay for short periods of time; the concern is significant rise of internal body temperature, which is why patients are often instructed not to enter saunas or hot tubs post-transfer.
To learn more about whether acupuncture is right for you, seek out a licensed acupuncturist in your state with NCCAOM board certification and book a consultation. Each individual case is different, and so treatment plans may vary according to your condition and surrounding factors.
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Works Cited
1. Infertility. UCLA Health System. (n.d.). Retrieved February 16, 2023, from https://www.uclahealth.org/medical-services/obgyn/conditions-treated/infertility
2. Arabi, A., Brown, K., Grimm, L., Mowl, S., Beltsos, A., Kamel, L., & Jeelani, R. (2021). The effect of individual pre- and post-embryo transfer acupuncture on implantation and clinical pregnancy rate after embryo transfer. Perceptions in Reproductive Medicine, 4(3). https://doi.org/10.31031/prm.2021.04.000589
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