A recent pilot randomized controlled trial at Sichuan Jinxin Xi’nan Women and Children Hospital investigated the effectiveness of electro-acupuncture (EA) as an adjunct therapy for women undergoing in vitro fertilization (IVF). The study aims to determine whether EA improves clinical pregnancy rates (CPR) compared to placebo electro-acupuncture (pEA) or IVF alone. Preliminary results indicate that EA may enhance pregnancy outcomes by modulating reproductive function and improving uterine receptivity [1].

The study enrolled 118 women diagnosed with infertility who were scheduled for IVF. Participants were randomly assigned to one of three groups: EA combined with IVF (EA+IVF), placebo electro-acupuncture with IVF (pEA+IVF), and IVF alone, in a 1:1:1 ratio. The primary outcome measured was the CPR, defined as the presence of a gestational sac in the uterine cavity confirmed by ultrasound 28 days post-embryo transfer [2].

 

• Acupuncture Protocol

Patients in the EA+IVF group received electro-acupuncture three times per week, beginning on the first day of ovarian stimulation and continuing until the day of the human chorionic gonadotropin (hCG) trigger injection. A minimum of five sessions was administered per participant. Acupuncture points were selected based on traditional Chinese medicine principles and their known influence on reproductive function [3]. The acupoints included:

· CV4 (Guanyuan): Located on the anterior midline, 3 cun below the umbilicus, traditionally used to tonify Kidney Qi and regulate the uterus [4].

· CV3 (Zhongji): Positioned on the anterior midline, 4 cun below the umbilicus, used to enhance ovarian function and regulate menstruation [5].

· ST29 (Guilai): Situated 2 cun lateral to the anterior midline at the level of CV3, selected for its function in improving uterine blood flow [6].

· SP10 (Xuehai): Located 2 cun proximal to the superior border of the patella, used to invigorate blood circulation in the uterus [7].

· SP6 (Sanyinjiao): Positioned 3 cun directly above the medial malleolus, known for regulating menstruation and stimulating ovulation [8].

· DU20 (Baihui): Found at the vertex of the head, used for calming the nervous system and balancing endocrine function [9].

· ST36 (Zusanli): Located 3 cun below ST35, one finger-breadth lateral to the anterior crest of the tibia, selected for its ability to regulate the immune response and reduce stress [10].

· PC6 (Neiguan): Positioned 2 cun above the transverse crease of the wrist, used to reduce anxiety and regulate cardiovascular function, which may influence uterine receptivity [11].

Sterile, single-use stainless steel needles (0.25 mm in diameter, 40 mm in length) were inserted to appropriate depths to elicit the “deqi” sensation, characterized by soreness, numbness, distension, or heaviness. Electro-acupuncture stimulation was applied using an EA device set to a frequency of 2/100 Hz, with intensity adjusted according to patient tolerance. Each session lasted approximately 30 minutes [12].

 

• Placebo Electro-Acupuncture Protocol

Participants in the pEA+IVF group underwent a similar protocol using placebo needles that did not penetrate the skin, and no electrical stimulation was applied. This placebo-controlled design ensured methodological rigor by accounting for potential psychological effects [13].

 

• Clinical and Biomedical Findings

Preliminary results demonstrated that the CPR was significantly higher in the EA+IVF group compared to the control groups. The study found that the clinical pregnancy rate (CPR) in the electro-acupuncture (EA) group was 56.8%, compared to 35.2% in the placebo electro-acupuncture (pEA) group and 32.6% in the IVF-only group. Additionally, Doppler ultrasound showed a 22.4% increase in endometrial blood flow in the EA group, serum estradiol (E2) levels were 18.7% higher, and inflammatory cytokine TNF-α levels were 21.3% lower compared to controls, all contributing to improved implantation outcomes. The mechanisms underlying these findings suggest that EA may enhance reproductive function through several physiological pathways:

· Increased Uterine Blood Flow: Doppler ultrasound studies revealed that EA improved endometrial blood perfusion, which is crucial for embryo implantation [14].

· Hormonal Modulation: Serum estradiol (E2) and progesterone (P) levels were more balanced in the EA+IVF group, optimizing the hormonal environment for conception [15].

· Immune System Regulation: Cytokine analysis indicated a decrease in inflammatory markers such as tumor necrosis factor-alpha (TNF-α), which can impair implantation [16].

· Neuroendocrine Effects: Functional MRI scans suggested EA modulates activity in the hypothalamic-pituitary-ovarian axis, improving ovarian response to stimulation [17].

 

• Clinical Implications

This study provides an evidence-based protocol for licensed acupuncturists seeking to incorporate EA into IVF treatment plans. The specified acupoints, needle specifications, insertion techniques, and treatment frequency offer a replicable model that may significantly benefit patient outcomes. The rigorous methodology, including the use of a placebo-controlled group, strengthens the study’s validity and clinical relevance [18].

 

• Conclusion

The trial at Sichuan Jinxin Xi’nan Women and Children Hospital suggests that electro-acupuncture is a viable adjunctive therapy for women undergoing IVF. By improving uterine receptivity, balancing reproductive hormones, and regulating immune function, EA may enhance pregnancy outcomes. Licensed practitioners should consider these protocols as additional tools in fertility treatment [19].

Sources
1-3. Zhang, Wei et al., “Efficacy of Electro-Acupuncture on Pregnancy Outcomes for Women Undergoing In Vitro Fertilization: A Pilot Randomized Controlled Trial,” Frontiers in Endocrinology (2024).
4-11. Deadman, P., Al-Khafaji, M., & Baker, K., A Manual of Acupuncture (Journal of Chinese Medicine Publications, 2007), 180.
12-19. Zhang et al., “Efficacy of Electro-Acupuncture on Pregnancy Outcomes.”