Researchers in a 2026 meta-analysis combined 15 randomized trials in women with POR or DOR and found that while some forms of acupuncture were linked to slightly more eggs retrieved, they didn’t improve pregnancy rates.
Women with a poor ovarian response (POR) to stimulation typically have only a few eggs retrieved during an IVF cycle. POR is more common with advancing age and is often associated with diminished ovarian reserve (DOR).
Acupuncture is often used as an add-on therapy in IVF to potentially improve success rates, but previous studies have produced inconsistent results.
A meta-analysis by Liu et al. (2026) combined the results of 15 randomized trials to see if acupuncture around the time of ovarian stimulation can improve outcomes for POR/DOR patients. The study compared different forms of acupuncture, including TEAS (transcutaneous electrical acupoint stimulation), manual acupuncture, and electroacupuncture.
🔗 Original studies are referenced in this post or within the linked Remembryo posts.
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Study details
- Study design: Systematic review and network meta-analysis of 15 randomized controlled trials published up to September 2023 (mainly in China).
- Participants: 1,195 women with POR or DOR undergoing IVF (595 received acupuncture, 600 controls). There was no standardized definition for POR or DOR.
- Primary outcome: Clinical pregnancy rate.
Clinical pregnancy rate did not improve with acupuncture
This meta-analysis included 15 randomized controlled trials, 11 of which reported clinical pregnancy rate (875 participants). When these trials were pooled, none of the acupuncture techniques improved clinical pregnancy rate:
- TEAS vs control: No difference (odds ratio [95% CI]: 1.74 [0.76–3.96], 2 RCTs)
- Electroacupuncture vs control: No difference (OR 1.55 [0.89–2.68], 5 RCTs)
- Manual acupuncture vs control: No difference (OR 1.32 [0.71–2.45], 4 RCTs)
Other ovarian markers showed limited improvement with acupuncture
The meta-analysis also examined the number of eggs retrieved, AFC, AMH, etc. to see if acupuncture could improve these outcomes in POR/DOR patients. Most comparisons showed no significant difference between acupuncture and control, but there were some differences:
- Number of oocytes retrieved: On average, about 2.2 more eggs were retrieved with TEAS vs control (mean difference 2.22 [95% CI: 1.59–2.85], 4 RCTs).
- Number of mature oocytes retrieved: On average, about 0.7 more mature eggs were retrieved with manual acupuncture vs control (mean difference 0.66 [0.08–1.25], 3 RCTs).
- AFC: Increased by about 1.5 follicles with TEAS vs control (mean difference 1.46 [1.06–1.86], 4 RCTs).
- AMH: No difference
- FSH: No difference
No safety concerns with acupuncture
Six RCTs evaluated safety issues with acupuncture, with only a few mild side effects noted (ie. mild allergy, bruising, pain).
Conclusion
In patients with POR/DOR, acupuncture didn’t improve clinical pregnancy rates. Live birth rates weren’t included in any of the studies.
Some acupuncture methods were associated with increases in the number of eggs retrieved and AFC, and reported side effects were mild and uncommon.
Biologically, the authors propose that acupuncture can influence the hypothalamic–pituitary–ovarian axis, stress pathways, or ovarian blood flow, but these mechanisms remain theoretical and weren’t directly tested.
There were a few major limitations to this meta-analysis:
- POR and DOR were not defined consistently across studies.
- No study reported live birth.
- Most trials were small and conducted in one country.
- No blinding so researchers knew who received acupuncture.
These limitations make it hard to draw real conclusions about how effective acupuncture is for POR/DOR patients.
Acupuncture appears to be low risk, and this study shows that it could influence ovarian response to produce more eggs for POR/DOR patients, but this didn’t translate into improved pregnancy rates. Larger and better-designed studies in more diverse populations are needed to see if acupuncture can result in real changes to live birth.
Want to read more about POR or DOR?
Researchers in a 2022 study performed a meta-analysis on the impact of acupuncture on FET outcomes and found that there were improvements in clinical pregnancies but not live birth rates, with most included studies small. Read more.
A 2024 meta-analysis combined the results of 38 studies investigating treatments for diminished ovarian reserve patients. DHEA, testosterone, high-dose gonadotropins and delayed start protocols all improved the number of eggs retrieved. Read more.
A 2026 study found that a microfluidic device called FIND-Chip can recover additional eggs from follicular fluid that may have been missed by manual searching after an egg retrieval, with one live birth reported. Read more.
Reference
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About Embryoman
Embryoman (Sean Lauber) is a former embryologist and the founder of Remembryo, an IVF research and fertility education website. After working in an IVF lab in the US, he returned to Canada and now focuses on making fertility research more accessible. He holds a Master’s in Immunology and launched Remembryo in 2018 to help patients and professionals make sense of IVF research. Sean shares weekly study updates on Facebook, Instagram, and Reddit regularly. He also answers questions on Reddit or in his private Facebook group.