Acupuncture as an adjunctive therapy on embryo transfer day: a systematic review and meta-analysis of clinical pregnancy and live birth outcomes

Wang Y, Ji J, Duan N, Yin Y · Frontiers in Reproductive Health · 2025 September 23

DOI 10.3389/frph.2025.1673144

Objective

To investigate the efficacy of acupuncture as a complementary intervention to embryo transfer in managing female subfertility and to clarify the optimal timing of acupuncture administration within fertilization protocols.

Conclusions

Acupuncture demonstrated a positive impact on clinical pregnancy rate in comparison to the blank control group, but not when compared to sham acupuncture. The Delphi Consensus showed no difference in clinical pregnancy rate compared to the Pulus Protocol, while acupuncture did not have a positive impact on live birth rate during embryo transfer.

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Insights

Acupuncture shows enhanced clinical pregnancy rates during embryo transfer compared to no intervention, but the results are similar when compared to sham acupuncture.

To determine the effectiveness of acupuncture on subfertility management, a literature review was conducted considering randomized controlled trials from PubMed, Embase, and Cochrane databases until May 2025. Special consideration was given to the studies involving acupuncture during embryo transfer. The primary measure was the clinical pregnancy rate identified through ultrasound confirmation of an intrauterine gestational sac. Live birth rate was the secondary outcome, captured through pregnancies lasting 20+ weeks or a birth weight of 400g or more. Analyzing the outcomes from eleven selected studies, nine of which were considered tolerable due to their discussion about clinical pregnancy rate, it was observed that acupuncture displayed a positive correlation with clinical pregnancy rates when compared to the control group. However, when grouped with the sham acupuncture trials, no significant benefits were seen. There were also no substantial differences between the Pulus Protocol and Delphi Consensus. Interestingly, no positive influence of acupuncture was found on the live birth rate during the embryo transfer.