Table of Contents
Acupuncture Points in Traditional Asian Medical Texts
Important Note: Many acupuncturists who have extensive experience treating female infertility modify their protocols, including the selection of acupuncture points, depending on the woman’s phase of menstrual cycle at the time of the treatment.
Classic Texts Fertility Acupuncture Points
Fertility Acupuncture Points Listed in Ancient Chinese Medical Texts
Posted on May 1, 2013 by TH Tanaka
Acupuncture and Moxibustion have been used to treat infertility problems, enhance fertility, and prevent recurrent miscarriages since ancient times. There are many classical Chinese medical texts (most are written over a thousand year ago) that indicate acupuncture points used to treat infertility. Below are some of the examples:
Zhenjiuzishengjing – Classic of Nourishing Life with Acupuncture and Moxibustion
ST29: Guilai SP5: Shangqiu BL33: Zhongliao BL32: Ciliao KI1: Yongquan KI18: Shiguan LR11: Yinlian (moxibustion) CV3: Zhongji CV4: Guanyuan CV5: Shimen
Zhenjiudacheng – Complete Compendium of Acupuncture and Moxibustion
CV3: Zhongji Uterus (3 cun lateral to the CV3)
Zhenjiujiayijing – A-B Classic of Acupuncture and Moxibustion
ST30: Qichong KI9: Zhubin CV4: Guanyuan CV17: Danzhong (moxibustion)
Qianjinyifang – Supplement to the Essential Prescriptions Worth a Thousand Gold
KI2: Rangu (moxibustion)
CV3: Zhongji (moxibustion)
CV4: Guanyuan (moxibustion)
Beijiqianjinyaofang – Essential Prescriptions Worth a Thousand Gold for Emergencies
LR11: Yinlian (moxibustion)
TCM Fertility Acupuncture Points
Fertility Enhancing Points used in Traditional Chinese Medicine
Posted on May 1, 2013 by TH Tanaka
Many acupuncture points have been used traditionally to treat infertility problems, enhance fertility, and prevent recurrent miscarriages.
Unlike the standardized acupuncture protocols used in clinical trials on infertility, traditionally trained acupuncturists use different acupuncture points depending on each patient’s exhibiting symptoms and constitutional patterns based on traditional diagnosis techniques.
It should be also noted that frequency of treatments is also different between a typical fertility protocol used in research and the one used in clinical acupuncture settings. While the German IVF acupuncture protocol involves only 2 treatments, many Chinese acupuncture textbooks recommend daily or semi-daily treatments over months to treat underlying reproductive health conditions or imbalances.
Related Article: Fertility Acupuncture Procedures
Common TCM diagnostic patterns and acupuncture points for infertility
Most patients manifest mixed patterns (combinations of 2 or 3, or more), the treatment, including the selection of acupoints needs to be modified accordingly
Infertility due to liver depression qi stagnation
Infertility due to phlegm dampness blockage & stagnation
Infertility due to blood vacuity
Infertility due to kidney vacuity
Infertility due to blood stasis
Infertility due to uterine cold
Japanese Acupuncture Points for Infertility
Fertility Enhancing Points used in Japanese Acupuncture
Posted on May 1, 2013 by TH Tanaka
As indicated on Fertility Enhancing Points used in Traditional Chinese Medicine , traditionally trained acupuncturists use different acupuncture points depending on each patient’s exhibiting symptoms and constitutional patterns. In addition, many Japanese acupuncturists further modify their treatment based on acupoint reaction at the time of needling, instead of simply inserting the needles at the pre-prescribed sets of acupoints. Since the treatment is highly individualized, selections of acupoints are very wide and vary greatly between practitioner to practitioner, patient to patient, and treatment to treatment.
In terms of treatment frequency and duration, a Japanese clinical acupuncture protocol typically involves series of regularly scheduled treatments. In particular to acupuncture for IVF patients, an acupuncture protocol used at advanced IVF medical center in Nagoya, Japan involves 2 treatments per week, minimum of 21 treatments before IVF procedure , which is quite a bit more treatments than the one used in most IVF research studies that involve only 2 treatments at the time of embryo transfer.
Commonly used Japanese acupuncture points for infertility
(by Dr. Haruto Kinoshita, a pioneer of modern Japanese acupuncture)
Fundamental acupuncture points used for fertility problems
Points used for Primary Infertility
Points used for recurrent miscarriages
GV4 Mingmen (moxibustion)
KI2: Rangu (moxibustion)
Suzuki, H. Infertility and Acupuncture Treatment. The Japanese Journal of Acupuncture and Moxibustion Therapies, Vol. 65, No. 6, 2006
Kinoshita, H. Infertility, In Latest Clinical Acupuncture, Ido no Nippon Sha, 387-396, 1986
Acupuncture Points Used in Research Studies
Acupuncture Points used in IVF Clinical Trials
April 20, 2013
Note: Acupuncture protocols used in clinical studies are generally simplified, short, and standardized procedures, because the protocols are developed not only with consideration of its potential efficacy but also by considering its experimental design, budgets, time constraint, and other methodological factors. They are compromised acupuncture protocols, and often far from those commonly used in clinical practice.
Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy.
Fertility and sterility 2002; 77(4): 721-4.
One hundred sixty patients who were undergoing IVF and who had good quality embryos were randomly divided into the following two groups: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80).
Each patient in the experimental group received an acupuncture treatment 25 minutes before and after embryo transfer. The needles were left in position for 25 minutes and then removed.
Auricular acupuncture at the following points, without rotation: ear point 55 (Shenmen), ear point 58 (Zhigong), ear point 22 (Neifenmi), and ear point 34 (Naodian). Two needles were inserted in the right ear, the other two needles in the left ear. The four needles remained in the ears for 25 minutes. The side of the auricular acupuncture was changed after embryo transfer. The locations of acupuncture points used in this study are shown in Figures 1 and Figure 2.
Their results showed that clinical pregnancies were documented in 34 out of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.
Figure 1: German Acupuncture Protocol Points before Embryo Transfer
Before embryo transfer, the following Acupoints were used:
PC6 (Neiguan), SP8 (Diji), LR3 (Taichong), GV20 (Baihui), and ST29 (Guilai).
Figure 2: German Acupuncture Protocol Points after Embryo Transfer
After embryo transfer, the following Acupoints were used:
ST36 (Zusanli), SP6 (Sanyinjiao), SP10 (Xuehai), and LI4 (Hegu).
Paulus WE, et al. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertility and sterility 2002; 77(4): 721-4.
Since this preliminary study, a number of studies e.g. 2-7 have attempted to replicate their findings using the same or similar acupuncture around embryo transfer protocols (German Acupuncture Protocol), however, the results were equivocal. A systematic review published in 2008,8 reported a non-significant impact of German acupuncture protocol, based on the meta-analysis of 8 trials on acupuncture during IVF. An updated meta-analysis of 9 trials by the same research group further confirmed their original finding.9 (about Systematic Review and Meta-Analysis)
Despite the less than impressive follow-up data since the highly publicized initial study by Paulus, et al.,1 the German protocol has been widely used among acupuncturists. In fact, it quickly became a “gold standard” acupuncture protocol during IVF cycle.
In my view however, the German acupuncture protocol is a typical example of the standardized, compromised acupuncture used in many acupuncture trials, which does not reflect the practice of classical acupuncture and traditional Chinese medicine.
Update November 2018: A systematic review study on the German acupuncture protocol has been published in October 2018. Based on the results of meta-analysis of previous clinical trials using the German method, the authors do not recommend using this protocol with IVF procedure as this particular acupuncture protocol might negatively impact the pregnancy rate.
Schwarze JE et al.: Does acupuncture the day of embryo transfer affect the clinical pregnancy rate? Systematic review and meta-analysis. JBRA Assist Reprod. 2018 Nov 1;22(4):363-368
Experimental Fertility Points
Reproductive Acupuncture Points Used in Experimental Studies
November 9, 2014
Over the past decade, small groups of researchers have attempted to clarify the potential effects of acupuncture on female reproductive organs under strict laboratory-controlled conditions. Many experimental studies on ovarian and uterine blood flow are conducted using anaesthetized rats. The advantage of studying on anaesthetized animals is that it eliminates potential placebo effects and other unspecific influences that are often prevalent in human clinical studies.
Experimental studies on rats demonstrated influences of acupuncture or acupuncture-like somatosensory stimulation on ovarian and uterine blood flow.1-7 The responses were elicited via spinal and/or supraspinal reflexes. Studies on humans further supported the efficacy of acupuncture on uterine blood flow.8 9
Based on both the experimental studies and traditional Chinese meridian theory, it can be considered that selecting traditional acupuncture points located within the areas of reproductive organ dermatomes (T10-L2 and S2-S4) would produce a profound impact on reproductive organs via spinal segmental reflexes.
There are many acupuncture points traditionally used for fertility that are located outside of the dermatomes. Those points are considered to influence reproductive organs via supraspinal reflexes and other known and unknown mechanisms.
Figure 1: Dermatomes Related to the Reproductive Organs
Figure 2: Commonly Used Back Acupuncture Points within the Reproductive Organ Dermatomes
Figure 3: Commonly Used Abdominal Acupuncture Points within the Reproductive Organ Dermatomes
- Hotta H, Uchida S, Shimura M, Suzuki H. Uterine contractility and blood flow are reflexively regulated by cutaneous afferent stimulation in anesthetized rats. Journal of the autonomic nervous system 1999;75(1):23-31.
- Sato Y, Hotta H, Nakayama H, Suzuki H. Sympathetic and parasympathetic regulation of the uterine blood flow and contraction in the rat. Journal of the autonomic nervous system 1996;59(3):151-8.
- Stener-Victorin E, Fujisawa S, Kurosawa M. Ovarian blood flow responses to electroacupuncture stimulation depend on estrous cycle and on site and frequency of stimulation in anesthetized rats. J Appl Physiol 2006;101(1):84-91.
- Stener-Victorin E, Kobayashi R, Kurosawa M. Ovarian blood flow responses to electro-acupuncture stimulation at different frequencies and intensities in anaesthetized rats. Auton Neurosci 2003;108(1-2):50-6.
- Stener-Victorin E, Kobayashi R, Watanabe O, Lundeberg T, Kurosawa M. Effect of electro-acupuncture stimulation of different frequencies and intensities on ovarian blood flow in anaesthetized rats with steroid-induced polycystic ovaries. Reprod Biol Endocrinol 2004;2:16.
- Uchida S, Hotta H, Kagitani F, Aikawa Y. Ovarian blood flow is reflexively regulated by mechanical afferent stimulation of a hindlimb in nonpregnant anesthetized rats. Auton Neurosci 2003;106(2):91-7.
- Uchida S, Kagitani F, Hotta H, Hanada T, Aikawa Y. Cutaneous Mechanical Stimulation Regulates Ovarian Blood Flow via Activation of Spinal and Supraspinal Reflex Pathways in Anesthetized Rats. The Japanese journal of physiology 2005;55(5):265-77.
- Ho M, Huang LC, Chang YY, Chen HY, Chang WC, Yang TC, et al. Electroacupuncture reduces uterine artery blood flow impedance in infertile women. Taiwanese journal of obstetrics & gynecology 2009;48(2):148-51.
- Stener-Victorin E, Waldenstrom U, Andersson SA, Wikland M. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Hum Reprod 1996;11(6):1314-7.