Acupuncture for Fertility: Where Do Needles Go and Why?

Why Is Blood Flow Important for Fertility?

Healthy circulation delivers oxygen and nutrients to reproductive tissues. In particular, the uterine lining (endometrium) undergoes significant changes throughout the menstrual cycle to prepare for embryo implantation. Adequate uterine circulation is one component of a healthy reproductive environment.

Researchers have investigated whether acupuncture influences uterine blood flow using Doppler ultrasound. Stener-Victorin et al. (1996) found that electroacupuncture reduced blood-flow resistance in the uterine arteries of infertile women. Similarly, Ho et al. (2009) reported reduced uterine artery blood-flow impedance following electroacupuncture in women undergoing IVF. More recently, Dong et al. (2024) observed improvements in several ultrasound measurements of endometrial blood flow following acupuncture.

These studies suggest that acupuncture may positively influence uterine circulation, providing a physiological rationale for using local abdominal points in fertility treatments.

Where Are CV4, CV6, ST29 and Zigong Located?

• CV4: On the midline of the lower abdomen, below the belly button.
• CV6: Between the belly button and CV4.
• ST29: On either side of the lower abdomen.
• Zigong: On both sides of the lower abdomen, over the pelvic region.

Although these points are close to the reproductive organs, needles are inserted into body tissues, not directly into the uterus or ovaries. Your acupuncturist will determine which points are appropriate based on your fertility history and treatment stage.

How Does Acupuncture Influence Reproductive Hormones?

The reproductive system is regulated by the hypothalamic-pituitary-ovarian (HPO) axis, a communication network connecting the brain and ovaries. This system helps regulate several important hormones:

• FSH (follicle-stimulating hormone): Stimulates ovarian follicle development.
• LH (luteinizing hormone): Helps trigger ovulation.
• Estradiol (estrogen): Supports follicular development and growth of the uterine lining.
• Progesterone: Prepares the endometrium for implantation.
• AMH (anti-Müllerian hormone): Serves as a marker of ovarian reserve.

Acupuncture stimulates sensory nerves that communicate with the central nervous system. Researchers are exploring whether this stimulation may influence neuroendocrine pathways involved in reproductive function. A systematic review and meta-analysis by Cao et al. (2024), involving 775 women with premature ovarian insufficiency, reported improvements in several hormone measurements following acupuncture, including increased estradiol and AMH and reduced FSH. These findings suggest that acupuncture may influence hormonal regulation in certain patient populations. While changes in hormone markers do not necessarily indicate improvements in egg quality or quantity, the findings provide encouraging directions for further research.

Where Are KI3, SP6 and ST36 Located?

• KI3: On the inner ankle, between the ankle bone and Achilles tendon.
• SP6: On the inner lower leg, above the ankle.
• ST36: Below the kneecap, toward the outer side of the shin.

These points are often combined with abdominal or other acupuncture points as part of an individualized treatment plan.

How Does Acupuncture Affect the Nervous System?

The autonomic nervous system regulates involuntary processes such as heart rate, digestion, and aspects of reproductive function. It has two main branches:

• Sympathetic nervous system: Associated with the body’s “fight-or-flight” response.
• Parasympathetic nervous system: Associated with rest, digestion, and recovery.

Acupuncture research suggests that stimulation of sensory nerves may influence autonomic nervous system activity. A meta-analysis by Ma et al. (2025) found improvements in certain heart rate variability measurements following acupuncture, suggesting a potential role in autonomic regulation.

What About Cortisol and Inflammation?

Cortisol is a hormone involved in the body’s response to stress. Its production is regulated by the hypothalamic-pituitary-adrenal (HPA) axis. Acupuncture may influence stress-related neuroendocrine pathways, including those involved in cortisol regulation.

Research has also explored acupuncture’s effects on inflammatory signaling. For example, Liu et al. (2021) identified a neural pathway connecting electroacupuncture stimulation with the vagal-adrenal system and inflammatory responses in an animal model. These findings offer insight into how stimulation at specific body locations may affect broader physiological processes.

In fertility care, acupuncture’s effects on emotional well-being are particularly relevant. A systematic review and meta-analysis by Hullender Rubin et al. (2022) found that acupuncture was associated with a reduction in IVF-related anxiety.

Where Are LR3, LI4, PC6 and DU20 Located?

• LR3: On the top of the foot, between the first and second toes.
• LI4: Between the thumb and index finger.
• PC6: On the inner forearm, above the wrist.
• DU20: Near the top of the head.

These points are commonly incorporated into treatments intended to encourage relaxation and support nervous system regulation.

Why Are Back Points Used?

From an anatomical perspective, the pelvic organs receive autonomic nerve input through pathways involving the lumbar and sacral regions. These neural pathways contribute to pelvic organ function and provide a potential physiological basis for investigating acupuncture in these areas.

Back and sacral acupuncture points may be selected as part of a treatment focused on pelvic function, physical comfort, or general well-being. They also give practitioners flexibility when patients prefer not to receive abdominal acupuncture.

Where Are BL23, BL32 and BL33 Located?

• BL23: On either side of the lower back.
• BL32: In the sacral region, near the second posterior sacral foramen.
• BL33: In the sacral region, near the third posterior sacral foramen.

Your acupuncturist may combine these points with others on the legs or feet. Individual sensitivity varies, but adjusting needle placement, stimulation intensity, and treatment position can help make the experience more comfortable. Back points are not necessarily equivalent to abdominal points, and treatment selection should account for possible pregnancy and other safety considerations.

Ear Seeds and Ear Tacks

Ear seeds are small beads attached to adhesive tape and placed on selected points of the outer ear. They provide gentle pressure without penetrating the skin. Ear tacks work similarly but contain a very short needle.

Auricular stimulation is commonly used to support relaxation and stress management. A randomized study by Li et al. (2025) involving 368 women undergoing ovarian stimulation for IVF found improvements in several measures of psychological distress, including anxiety and depression symptoms, with auricular acupressure. For patients who prefer a needle-free option, ear seeds may be a convenient addition to their treatment plan.

Moxibustion: Gentle Heat Therapy

Moxibustion, or moxa, uses heat generated by burning dried mugwort near selected acupuncture points. Practitioners traditionally use this technique to provide warmth and support circulation. Local heating may influence superficial blood flow and sensory nerve activity.

A network meta-analysis by Bin et al. (2025), examining acupuncture-related treatments in IVF, identified several potentially beneficial approaches, including acupuncture combined with moxibustion. Moxibustion may be considered as part of an individualized treatment, with appropriate precautions regarding heat, smoke, and pregnancy.

Fire Cupping: Supporting Muscle Relaxation

Fire cupping uses suction created by briefly heating the inside of a cup before placing it on the skin. It produces localized changes in superficial tissue circulation and may help relieve muscle tension.

During fertility acupuncture, cupping may be used on the back to promote physical comfort and relaxation. Although its direct effects on fertility have not been established, it can serve as a complementary comfort-focused treatment for suitable patients.