Globally, infertility affects 15% of couples of reproductive age, and the prevalence rate has been demonstrating an upward trend since 1990.  The World Health organization has declared infertility as a global public health issue and recognizes the overall burden of subfertility/infertility as significant and likely underestimated.
In the recent decades, more women are delaying marriage and pregnancy. The mean age at which women deliver their first baby has delayed from 27.9 years in 1995 to 30.5 years in 2017.  Due to the natural decline in fertility with age, an increasing number of couples count on Assisted Reproductive Technologies such as In Vitro Fertilization ( IVF) treatment to conceive. In 2017, 7463 women in Hong Kong underwent 5099 fresh and 4487 frozen-thawed embryo IVF cycles, resulting in life birthrate of 27.8% per transfer. 
Modern IVF cycles include ovarian stimulation, oocyte retrieval, fertilisation / culture in vitro, and embryo transfer to the uterus. Despite the techniques of IVF have progressed rapidly since the 1sttest tube baby born on 1978, the life birth rate per transfer remain around 30% in the past decade.  In recent years, a good number of IVF receivers, in both China and other developed countries, turn to Chinese medicine and other alternative treatments to enhance the success rate of IVF process.
Factors influencing the success of IVF may be summarized in to 3 areas, i.e.
1. Egg and Embryo Quality
2. Receptivity of the Uterus
3. Oocyte Retrieval and Embryo Transfer Technique
In the long history of Traditional Chinese medicine (TCM), there is a wealth of knowledge on how to enhance fertility. TCM treatments may not have any direct impact on the oocyte retrieval and embryo transfer operation procedures, however, it serves well to strengthen the overall health of the male and female for better egg and sperm quality, improve the internal environment for egg maturity, and ensure a thicken uterine lining to set up an ideal environment for implantation.
Parent’s health directly impact the quality of the embryo. Prior to the IVF cycle, we recommend a 3-6 months’ preparation period. During the preparation period, herbal medicine can be used to regulating hormones, enhancing the function of the digestive and reproductive systems, improving the menstrual cycle and promoting ovulation. Herbal medicine could also help males with sub-optimal sperm health to increase the sperm counts and activities. This preparation period is particularly important to female, a healthier and balance physical condition will help the female to endure the shock of hormone injection during the IVF process, and probably minimize the side effects.
For patients who elect not to take herbal medicine, they may count on acupuncture and moxibustion treatments to regulate their body conditions.Emotional burden and aging can lead to a decline in blood flow to the uterus and ovaries. Acupuncture could enhance the blood flow by regulating the sympathetic nervous system to dilate the blood vessel. As a result, the ovaries will be better nourished and the uterus lining will be thickened. Moxibustion is an effective non-pharmacological method to warm up the body. Warmth promotes the blood and energy (Qi) flow in the body. Clinical research also indicates that moxibustion could increase the concentrations of haemoglobin and immunoglobulin, which could boost the overall health and immunity.
When undertaking IVF, most physicians advise their patients not to take any herbal medicine or non-prescribed supplements. During this period, acupuncture treatment continues to serve as an adjuvant treatment. Apart from enhancing the blood flow and general health, acupuncture mayalso assist in alleviating stress and serve to relax the uterus at the time of transfer. A clinical research indicates that stress reduction is positively associated with a higher pregnancy rate.  Another study further reveals that acupuncture, as a promising stress-lowering tool for women undergoing IVF, is dosage dependent. The stress level of patients who receive acupuncture treatment 1 month or more prior to embryo transfer, is significantly lower than those who only receive the treatment on the embryo transfer day. 
Overall speaking, TCM treatments could be used to prepare the IVF receiver for a smoother clinical fertility treatment. There is also a good number of studies indicating that acupuncture could increase quality of life and lower stress levels during clinical fertility treatments. Acupuncture could continue to be used as an adjuvant treatment after becoming pregnant. Combining acupuncture treatment with proper nutrition and healthy lifestyle, the IVF receivers may better manage the anxiety and stress associated with early pregnancy, better endure the side effects of hormone therapy used at this stage and be more tolerant to other common symptoms of early pregnancy.
*For inquiries on acupuncture or TCM treatments related to pregnancy and the IVF journey, please call 2530 3315 or firstname.lastname@example.org.
1. Sun, H., Gong, T. T., Jiang, Y. T., Zhang, S., Zhao, Y. H., & Wu, Q. J. (2019). Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990-2017: results from a global burden of disease study, 2017. Aging, 11(23), 10952–10991.
2. Organisation for Economic Co-operation and Development. OECD Family Database. SF2.3.B. Age of mothers at childbirth and age-specific fertility. Available from: here
3. Lui, M. W., Yeung, W. S., Ho, P. C., & Ng, E. H. (2019). In vitro fertilisation in Hong Kong: the situation in 2019. Hong Kong Medical Journal.
4. Yu, Z., Yuan, H., Xu, L., Zhan, Z., Cheng, H., & Song, Y. (2011). Effects of moxibustion on hemoglobin and immunoglobulin in cervical cancer patients undergoing radiotherapy. Journal of Acupuncture and Tuina Science, 9(6), 359-361.
5. Balk, J., Catov, J., Horn, B., Gecsi, K., & Wakim, A. (2010). The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: a pilot study. Complementary therapies in clinical practice, 16(3), 154-157.
6. Sutton, C., Pentland, S., & Roberts, J. (2015). A comparison of stress levels in women undergoing single versus multiple acupuncture session prior to embryo transfer. Fertility and Sterility, 103(2), e36-e37.