A Major New Study Says Acupuncture May Not Improve IVF Outcomes. Here Is the Fuller Story.
Blurred pink flowers on a blue background with the text "So like, what IVF add-on's help???" and the Rosefinch health logo in the lower left corner.
By Lee Hullender Rubin, DAoM, MS, LAc, FABORM
If you are going through IVF and wondering whether acupuncture is worth adding to your treatment, you have probably searched for answers and found a lot of conflicting information. A major new study published in June 2026 may be the most comprehensive look yet at common IVF add-ons, including acupuncture. I want to walk you through what it reported, where I think the picture is still incomplete, and what that means for you as a someone navigating these decisions right now.
“The evidence we are all debating was generated in a clinical context that no longer reflects how most IVF is practiced right now.”
What the Lensen Study Found
The paper, authored by Lensen and colleagues and published in Lancet Obstetrics, Gynaecology and Women's Health, reviewed ten common IVF add-ons: acupuncture, corticosteroids, EmbryoGlue, endometrial scratching, endometrial receptivity testing, intralipid infusion, physiological intracytoplasmic sperm injection (PICSI), platelet-rich plasma injected into the ovary, platelet-rich plasma infused into the uterus, and preimplantation genetic testing for aneuploidy (PGT-A).
What made this review different from earlier ones is that the authors applied a formal trustworthiness screening process to every trial they considered, excluding studies that lacked prospective registration or raised other integrity concerns. Research in reproductive medicine has a recognized problem with unregistered and potentially unreliable trials, and this filter mattered: roughly half of all potentially eligible studies were excluded, including some previously included in Cochrane reviews.
The overall results were sobering. Endometrial scratching showed a possible small increase in live birth (moderate certainty). PICSI appeared to reduce miscarriage rates (moderate certainty). EmbryoGlue showed a possible benefit for pregnancy rates, though the live birth effect was not consistent across analytical models. For the remaining seven add-ons, including acupuncture, the evidence was either unclear or showed no effect.
What the Study Found Specifically About Acupuncture
Of 91 acupuncture trials initially identified, 69 were excluded for trustworthiness concerns or other reasons, leaving 22 trials in the final analysis. That exclusion rate says something important about the state of the acupuncture IVF research literature, a point I will return to shortly.
Acupuncture did appear to be associated with about one-third higher odds of achieving a clinical pregnancy, meaning a confirmed pregnancy on ultrasound, across 21 trials and nearly 5,000 participants. However, when the authors looked at the outcome that matters most, live birth, across only ten trials and 3,735 participants, the result was unclear and the confidence intervals were wide enough that no meaningful conclusion can be drawn in either direction. Both findings were rated very low certainty, the lowest possible rating, meaning the authors had little confidence that these estimates reflect the true effect.
When the authors looked only at trials using a sham acupuncture control, the odds of live birth were slightly lower in the acupuncture group, with results that were inconclusive. When they looked at trials with no sham, the point estimate was nominally higher but the results varied so widely across trials that pooling them is difficult to interpret. I read these subgroups somewhat differently than the authors do and will explain why below.
For miscarriage, the pooled result suggested a nominally higher rate in the acupuncture group, though this finding is very uncertain, and I have questions about how it was calculated. I have reached out to the authors for clarification on the methodology behind this outcome, and I would caution against drawing any conclusions from it.
Why I Think This Study May Be Missing the Bigger Picture
Lensen and colleagues did rigorous, important work. The trustworthiness screening approach is exactly what this field needs. But I have been writing and speaking about meaningful gaps in the acupuncture IVF research architecture since before 2015, formally published those concerns in 2018, 2019, and 2022, and the trials that survived Lensen's screening still have not addressed them. That is not a criticism of Lensen's paper. Clinical trials are expensive and difficult to fund, particularly in complementary medicine where competition for research dollars is extremely tight. The evidence we are all working from has real limitations that deserve enumerating clearly.
The sham control problem. Some acupuncture IVF trial use a sham acupuncture control, a fake needle procedure designed to look and feel like real acupuncture. The problem is that sham needles are not inert. They provoke physiological responses, involve the same therapeutic relationship, the same rest period, and the same quiet time that is part of real acupuncture treatment. Detecting a difference between real and sham acupuncture requires large sample sizes, roughly 400 participants per arm, and no trial in the Lensen review reached that threshold. We also do not yet have a clear answer on what the best control arm for an acupuncture IVF study might be. Until we do, comparing real to sham acupuncture compresses the apparent difference between groups and makes it very difficult to detect a real effect even if one exists. This is likely why results are more favorable when acupuncture is compared to no treatment than when compared to sham, a pattern that appears in Lensen's own subgroup analysis and across other meta-analyses in this literature.
The dose problem. The acupuncture protocols in almost every included trial involve two to three sessions on or around the day of embryo transfer. In my 2018 paper, I argued directly that this is an insufficient dose to meaningfully impact birth outcomes. Observational studies, like my own and others, have found that nine to fourteen sessions across the IVF cycle are associated with better outcomes. No adequately powered RCT has tested this. The trials being reviewed apply to a very specific and likely inadequate version of acupuncture. We also do not have good evidence on the optimal timing, frequency, or duration of treatment within a cycle. The conclusions being drawn apply to embryo transfer-day acupuncture, not to the kind of whole-cycle, individualized care that many experienced practitioners actually provide, and observational studies found possible benefits.
The modern IVF gap. This is perhaps the most important point for anyone reading this today who is undergoing IVF. Of the 22 acupuncture trials in Lensen's review, the vast majority were conducted on fresh embryo transfer cycles. Only one trial, So et al. 2010, was conducted entirely in frozen embryo transfer cycles, and that study predates widespread PGT-A use by several years. Two other trials included small proportions of frozen transfers: fewer than 15% in Morin et al. 2017, and approximately 40% in Gillerman et al. 2018. None of these studies included PGT-A tested embryos. In the U.S. today, the majority of embryo transfers in the United States are frozen transfers with PGT-A tested euploid embryos. To my knowledge, and I am currently researching this formally, there are no published randomized controlled trials in the English language that have studied acupuncture in patients undergoing frozen embryo transfer with PGT-A tested embryos. The evidence we are all debating was generated in a clinical context that no longer reflects how most IVF is practiced right now.
Acupuncture as mental health support. One domain Lensen was not designed to examine is acupuncture's effect on IVF-related anxiety. That was not their research question, and that is fair. But it leaves out something that matters enormously to people undergoing IVF. In my 2022 systematic review and meta-analysis, published in Reproductive BioMedicine Online, we found that acupuncture provided small but meaningful reductions in IVF-related state anxiety compared to any control. We also found very low certainty. Still, it was the clearest signal in studies using two sessions on the day of embryo transfer, exactly the protocol Lensen evaluated for birth outcomes. Research has found that 75% of women and over 60% of men presenting for fertility care meet clinical criteria for anxiety, and anxiety has been associated with people in IVF stopping treatment before achieving pregnancy. If acupuncture supports people through one of the most stressful experiences of their lives, that has real value even when the live birth question remains unsettled. Notably, the same sham-versus-no-treatment pattern appears in the anxiety data: effects are more favorable when acupuncture is compared to no treatment than to sham, again consistent with the argument that sham controls are not inert.
If You Are Going Through IVF, This Is What The Study Means for You Right Now
The best available evidence from rigorous trials does not clearly show that acupuncture increases live birth rates when provided only on or around the day of a fresh embryo transfer. That is an accurate statement. It doesn’t answer the question if acupuncture may or may not improve IVF outcomes. It also doesn’t answer if acupuncture reduces the emotional burden related to IVF embryo transfer. The trials generating the evidence used insufficient doses, likely inadequate comparators, and were conducted in a clinical landscape that no longer reflects how most IVF is practiced in the United States. Excluding roughly half of the existing trial data, while methodologically justified, may over- or underestimate acupuncture's true effects depending on which trials were removed and why. The RCT research has not caught up with modern care, and until it does, neither a confident yes nor a confident no is supported by the data.
What the evidence does suggest is that acupuncture is safe when provided a licensed acupuncturist, that it may provide meaningful relief for IVF-related anxiety, and that some signals in the literature favor acupuncture over no treatment to improve live birth, particularly for people with previously failed cycles.
If you are considering acupuncture alongside your IVF treatment, look for a licensed acupuncturist with specific experience in reproductive medicine, a treatment approach that extends across your cycle rather than just on embryo transfer day, and a provider who understands your specific IVF protocol and can, if you desire, communicate with your care team. Contact us if you have any questions.
The conversation about acupuncture and IVF is not over. The research we need to answer it well has not yet been done.