Acupuncture

Acupuncture is the most-studied complementary therapy for fertility, with over 5,000 women across 20+ trials.

The Paulus protocol: Acupuncture 25 minutes before and after embryo transfer yielded 42.5% pregnancy rate vs 26.3% in controls in the landmark 2002 trial (Paulus 2002). This protocol is now widely adopted in fertility clinics.

Uterine blood flow: Electro-acupuncture significantly reduced uterine artery pulsatility index (P<0.0001), improving endometrial blood flow — and the effect persisted 10–14 days after treatment (Stener-Victorin 1996). Mechanism attributed to central sympathetic inhibition.

Poor ovarian response: A meta-analysis of 7 RCTs (516 women) found acupuncture significantly increased antral follicle count, reduced FSH, and improved endometrial thickness. Manual acupuncture outperformed electro-acupuncture for AMH improvement (Wang 2023).

Important caveat: A meta-analysis found that while acupuncture outperforms no treatment, it does not significantly outperform sham acupuncture. This suggests some of the benefit may come from non-specific effects (relaxation, therapeutic contact, expectation). Regardless of mechanism, the pregnancy rate improvement is real.