Effects of acupuncture and moxibustion therapy on endometrial receptivity of infertile women with in vitro fertilization-embryo transfer: status quo and countermeasures.

If you're struggling with infertility and considering IVF, you may have heard that the success of embryo transfer depends on more than just the embryo itself — the lining of the uterus, called the endometrium, plays a huge role. When the uterine lining isn't receptive enough, embryos have difficulty implanting, which can mean failed IVF cycles, emotional heartbreak, and significant financial strain.

A new comprehensive review published in Frontiers in Medicine examined whether acupuncture and moxibustion — a Traditional Chinese Medicine therapy that uses heat from burning herbs near the skin — can help improve uterine lining receptivity in women undergoing IVF. Researchers analyzed 214 studies published between 2020 and 2025, making this one of the most thorough reviews on the topic to date.

The findings are encouraging. Both acupuncture and moxibustion showed meaningful benefits for uterine receptivity. Specifically, these therapies helped improve the thickness of the uterine lining, increased blood flow to the uterus, and balanced key reproductive hormones like estrogen and progesterone. Researchers identified several forms of treatment that showed promise, including traditional manual acupuncture, electroacupuncture (which uses gentle electrical stimulation), and various moxibustion techniques. Combining therapies — such as warm needling alongside acupuncture — appeared to produce even better results.

On a deeper level, scientists found that these treatments may work by influencing molecular pathways involved in cell health, blood vessel growth, and the expression of proteins that help embryos attach to the uterine wall.

While researchers note that more high-quality, standardized clinical trials are still needed, these results suggest acupuncture and moxibustion could be valuable supportive therapies alongside conventional IVF treatment.

If you're interested in exploring acupuncture as part of your fertility journey, seek out a licensed acupuncturist with specific experience in reproductive health.

This systematic review, published in Frontiers in Medicine, synthesized 214 studies (January 2020–June 2025) from PubMed, Web of Science, CNKI, and WanFang databases to evaluate acupuncture and moxibustion as adjunctive interventions for improving endometrial receptivity (ER) in IVF-ET patients. Methodological quality was assessed via RoB 2.0 for RCTs and NOS for non-RCTs. Modalities reviewed included traditional manual acupuncture, electroacupuncture, TEAS, and wheat, herbal cake, and warm uterus moxibustion. Key clinical outcomes included improvements in endometrial thickness, uterine blood flow parameters (reduced PI/RI), serum E2 and P levels, and type A endometrium ratio. Combination protocols (e.g., warm needling plus acupuncture) demonstrated enhanced efficacy. Proposed mechanisms include modulation of the AMPK/mTOR autophagy pathway, upregulation of pinopode-associated molecules (LIF, integrin αvβ3), non-coding RNA expression (miR-449a, circRNAs), and VEGF-mediated angiogenesis. Clinical takeaway: acupuncture and moxibustion show multi-mechanistic promise as ER-enhancing adjuncts in ART, though standardized, adequately powered RCTs remain necessary to establish definitive protocols.