Systematic Reviews
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World J Transplant. Sep 18, 2025; 15(3): 102536
Published online Sep 18, 2025. doi: 10.5500/wjt.v15.i3.102536
Acupuncture-assisted embryo transfer techniques: Research frontiers and future directions
Rui-Yue Mao, Ai-Ling Wang, Yue Zhao, Shuai-Yan Wang, Zhen-Yu Yang, You-Bing Xia, Tian-Cheng Xu
Rui-Yue Mao, Ai-Ling Wang, Yue Zhao, Shuai-Yan Wang, Zhen-Yu Yang, You-Bing Xia, Tian-Cheng Xu, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
Tian-Cheng Xu, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
Co-first authors: Rui-Yue Mao and Ai-Ling Wang.
Co-corresponding authors: You-Bing Xia and Tian-Cheng Xu.
Author contributions: Mao RY was responsible for the idea and conceptual framework; Mao RY, Wang AL, Zhao Y, Wang SY, Yang ZY, Xia YB and Xu TC wrote the first draft of the manuscript; Mao RY and Wang SY reviewed the manuscript and critically revised it for important intellectual content; all authors have reviewed and approved the final version of the manuscript.
Supported by Funding from the Jiangsu Provincial Science and Technology Plan Special Foundation, No. BE2022712; and The Special Research Project on The Development Plan of Traditional Chinese Medicine Technology in Jiangsu Province, No. ZT202120.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest associated with the publication of this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tian-Cheng Xu, MD, PhD, Associate Professor, Nanjing University of Chinese Medicine, No. 138 Xianlin Avenue, Xianlin Street, Qixia District, Nanjing 210023, Jiangsu Province, China. xtc@njucm.edu.cn
Received: October 27, 2024
Revised: January 21, 2025
Accepted: February 6, 2025
Published online: September 18, 2025
Processing time: 175 Days and 4.7 Hours
Abstract
BACKGROUND

Acupuncture, an ancient practice, is gaining recognition as a complementary and alternative medicine, especially in assisted reproductive technology. It plays a crucial role in enhancing embryo transfer success rates. Research indicates that acupuncture can improve blood flow, increase endometrial receptivity regulate pressure, and affect neuroendocrine activities in the ovaries and uterus during embryo implantation, therefore improving pregnancy outcomes.

AIM

To highlight recent developments related to acupuncture's influence on embryo transfer and elucidating the precise mechanisms by which acupuncture influences embryo transfer.

METHODS

We searched database including PubMed, Cochrane Library up to September 2024 for relevant studies and patents to evaluate the effects of acupuncture on women undergoing in vitro fertilization (IVF). The experimental design included an intervention group using needling, and a control group consisting of no needling or sham needling. The main outcome is clinical pregnancy rate (CPR), while secondary includes live birth rate (LBR) and biochemical pregnancy rate (BPR). We examined the influence of adjunctive needling on pregnancy outcomes by analyzing variations in the main outcomes.

RESULTS

A total of 145 randomized controlled trials involving 27748 participants were analyzed. Data revealed that the overall CPR was significantly elevated in all acupuncture cohorts compared to the control group [relative risk (RR): 1.21, 95%CI: 1.07-1.38, P = 0.01]. In contrast, the aggregated LBR did not exhibit a corresponding increase, and notable statistical heterogeneity was observed among the studies. Acupuncture-assisted frozen-thawed embryo transfer enhanced the BPR (RR: 1.51, 95%CI: 1.21-1.89, P = 0.03) and improved endometrial morphology (RR: 1.41, 95%CI: 1.13-1.75, P = 0.01). Furthermore, IVF outcomes were significantly superior in the acupuncture group when acupuncture was administered during controlled ovarian hyperstimulation (RR: 1.71, 95%CI: 1.08-2.13, 95%CI: 1.08-4.21, P = 0.03).

CONCLUSION

We find that acupuncture positively influences pregnancy rates in women receiving IVF treatment. Nonetheless, there are no established guidelines for optimal acupuncture protocols. Considering the methodological limitations identified in current research, there is a need for larger, methodologically rigorous studies.

Keywords: Acupuncture; In vitro fertilization; Embryo transfer; Assisted reproductive technology; Clinical pregnancy rate; Fertility treatment; Acupuncture therapy; Surface stimulation

Core Tip: In vitro fertilization and embryo transfer is one of the most common treatments for couples of childbearing age facing infertility. The correlation among acupuncture locations, treatment frequency, and improved pregnancy rates requires additional research.