If you’re reading this there’s a good chance you’ve asked one of the MOST frequent of FAQs. “Nicole, exactly WHEN should I come in for acupuncture?” Precisely because I get this question so often, I’ve put together this handy dandy post with why you might come in at various parts of your cycle/life as well as my #1 answer to this question — “Well, it really depends on YOU!”

So here goes!

There are amazing scientifically-backed things that acupuncture can achieve at any time. Hurrah for no stressful special timing needed! Here are the biggest FIVE:

Acupuncture regulates your nervous system and improves endocrine function.

Acupuncture hits the reset button on your nervous system and chills your entire mind and body out. I like to say it’s like closing out all the tabs and hitting restart for your brain!

Lots of research consistently shows acupuncture takes you out of fight or flight and moves you into rest, digest, and reproduce mode. We can see that it slows your heart rate and rhythm, calms your breath, and even makes your brain go “quiet” on an fMRI brain scan. Sounds pretty dreamy right?! (If you want to see the BBC documentary with that fMRI study click here and skip to 49:30.)

When the nervous system is more calm your body and mind feel better and all systems of your body work better. For fertility that’s especially important when we think of endocrine (aka hormonal) system function. Technically this is called regulation of your hypothalamic pituitary ovarian axis — and acupuncture helps do it in loads of ways!

It’s also worth pointing out, a calmer more relaxed brain and nervous system help you get clearer headed and make better decisions. (Lord knows you’ve probably got some big ones to make!)

Acupuncture improves circulation, especially to your reproductive organs.

Acupuncture, especially electro-acupuncture, also helps improve circulation to your digestion and reproductive organs! This can help pretty much any time during fertility struggles because better blood flow influences all sorts of things. Like, say, making sure your hormones or fertility meds get to your ovaries and uterus more consistently, helping thicken your uterine lining for better implantation rates, nourishing and supporting a newly implanted embryo and even helping insure your placenta and uterus is ready to run that “marathon” of labor and delivery when it comes time for baby!

If your fertility clinic flips a switch on their ultrasound machine and suddenly the picture on the screen looks like a weather map, that’s because they’re using a doppler study to measure your pelvic blood flow. Some clinics even prescribe acupuncture when this number is less-than-ideal and this can be a useful treatment for restricted umbilical cord blood flow in pregnancy too!

Acupuncture improves mental health, decreases anxiety, depression, and PTSD risk.

Acupuncture can also generally improve your mental health and regulate stress hormones like cortisol (don’t even get me started on how this creates a domino effect for hormones too - trust me - it does)!

But specific reproductive hormone benefits aside, acupuncture significantly decreases percieved stress as well as statistically lowers both anxiety and depression levels which might just seem like a perk if you think that your mental health is separate from your fertility, but it’s not! There are well-designed studies that show women who are more anxious and depressed have slightly lower success rates in fertility treatments. And I’ve seen stress covered in one Reproductive Endocrinology textbook like this,

“We are most closely related to apes and we know from primate studies there are variations in sensitivity to stress and reproductive function. When stressed, some of the species will continue to reproduce, while others will not. Humans exhibit similar variations stress sensitivity.”

I think it’s important to think about mental health beyond TTC too. 46% of women who go through fertility treatments meet the diagnostic criteria for PTSD. And that’s with or without baby in the end — and we can DO something to change that! The American College of Obstetrics and Gynecology (ACOG) has said that 14-23% of pregnant women suffer from depression. Estimates suggest clinic anxiety rates are around 70%. There are so many ripples for both the pregnant person and baby. Some are immediate like quality of life. Some are long-term like increased risk of postpartum mental health concerns for the pregnant person and an epigenetic shift that predisposes the child to lifelong mental health risks, immunological changes, and more.

Once again, we need to connect the dots and clearly see decreasing your anxiety and depression isn’t just a perk, it actually helps your immediate and long-term goals. Not to mention, you matter! This isn’t just about enduring trauma to get a baby. It’s about a healthier baby happening when YOU are more whole, healthy and supported every step of your path toward parenting.

Acupuncture encourages cell regeneration, repair, and increases stem cells.

Electro-stim acupuncture has been linked to optimizing stem cells that help with tissue regeneration and repair and there have been some really promising studies showing that stem cells levels in the uterus are key to endometrial receptivity! Another study showed infusions of platelet rich plasma into the uterus might be helpful for women who have had failed IVF transfers via optimizing stroma/stem cells. So if you put those two things together, even if your IVF clinic doesn’t offer stem cell infusion therapy, it’s possible that doing some electro-stim acupuncture might help in similar ways!

I could nerd out on the science of acupuncture and fertility for hours! Really. Ask me and we can dive even deeper. But I hope this gives you some solid inspiration for adding acupuncture to your TTC journey!

Acupuncture regulates inflammation.

If you’ve dug into some of the latest fertility treatments, chances are you’ve hit on the topic of inflammation and immune responses. From endometriosis induced inflammation reducing implantation rates to antihistamine and steroid treatments being added for embryo transfer protocols (the evidence-based jury is still out on these). It’s a tricky topic because some inflammation and immune response is normal and even helpful. But too much is a disaster.

As a person who has inflammatory issues (endo & inflammatory bowel disease), with two parents who suffer from auto-immune disease (myasthenia gravis and celiac disease), who is married to someone with an auto-inflammatory disease (ankylosing spondylitis) I’ve been paying attention to inflammation for as long as I’ve been studying reproductive health and infertility. That’s over two decades and counting. I’ve known for decades how powerful acupuncture can be in regulating inflammation. But it’s really cool to see the new research and the latest fertility trends and already be ahead of the curve.

Bonus - Acupuncture supports healthier pregnancies & outcomes.

Hopefully it’s already abundantly clear that acupuncture makes great pregnancy ripples too. But I wanna say just a word or two more about one of the absolutely RADDEST new bits of research in the world of reproductive medicine! Placenta RESEARCH!!! (Can you tell I’m excited!?!)

First off, you have to grow an entirely new organ - a placenta - in seven weeks! These seven weeks just happen to be in the window when your IVF clinic and your OBGYN clinic are doing… precisely NOTHING. Like. Seriously. NOTHING.

This will hopefully change in the not to distant future, because new research on placentas is actually showing that standard mainstream pregnancy care might very well be totally missing the boat on preventing scary outcomes like preeclampsia, HEELP, IUGR, preterm birth and more. Why you ask? (Thanks for asking!) Because how robust and awesome your placenta is, is proving to be key to lowering all these pregnancy risks and more! Big ups to Radiolab for doing a whole show about how awesome placentas are and also comparing them to an invisibility cloak - I love it so much!

Acupuncture before and during the first trimester puts all the above benefits towards building your very best placenta. Woot woot!!

There’s also a growing body of awareness and research going into just how much maternal stress and support can shape and change pretty much everything. Which… of course it can.

And aside from the impressive science, here’s one last fact about acupuncture during pregnancy. Obstetrics & gynecology are the oldest specialties in TCM (traditional Chinese medicine) and the first book about treating pregnant people were from 1500 BC! Infertility treatments can be dated as far back as 476 BC!

So back to the question.

Lest you think I’m shirking the question — “WHEN should I come in for acupuncture Nicole?” Let’s talk brass tacks.

There are LOADS of studies on protocols and treatment strategies for specific concerns and nuances that we could get into. Here’s my video about the IVF specific protocols.

And there are even more specific studies on what to do if you’re a poor responder in IVF, have PCOS with blood sugar concerns, endometriosis, are doing an embryo transfer, are dealing with male factor infertility, etc.

I’m happy to explain / discuss it all with you. But here’s the thing I really really want you to take away.

ALL of these benefits, all the positive ripples, all the amazing physiological changes — be they from a general '“come in when you can” point-of-view or a specific “protocol mindset.” They can all be COMPLETELY UNDONE by you walking back out my door and into the real world and going right back into fight-or-flight mode.

Good acupuncture is amazing! But it’s even better if you also have life skills, reframes, and more tools in your toolbox to sustain and maintain that reset.

This is why I spend more time per visit and between visits communicating, educating, empowering and informing you. This is why I create TONS of on-demand online fertility and pregnancy education! I want you to see me and to use acupuncture to hit the reset and get you to a blissful baseline then ALSO send you out into the world feeling more capable and skillful so you can maintain and even add onto the good we’re doing. Not undoing, offsetting, and shifting back to stressed and overwhelmed.

And here’s a BIG thing when it comes to “when should I come in for acupuncture Nicole??” Sometimes adding acupuncture visits, missing more work and cramming in more appointments, spending more money, etc. can PUT you into fight-or-flight. And that’s never gonna register like you want it to.

So you MUST find the sweet spot. I know lots of acupuncture and even fertility clinics say do X number of visits before your transfer or see us two times a week for the best results. I’m sorry, but that’s BS — go ahead, ask me how I really feel. No one knows YOU better than YOU. I get the best results and I rarely see women more than once a week. Especially with some education and when you feel empowered and know how to feel better here and now. And especially when you drop the desperate for a magic fix (that doesn’t exist) mindset. Once a week is plenty, and it might make sense for you to do even less than weekly based on your unique needs.

I hope you leave with the take-a-way that there’s always good we can do with acupuncture (wherever you are in your cycle or pregnancy). But it’ll do the most good when it actually feels good and fits right here and now. Not when it’s forced and desperate.

So, come in during times when you know you’re going to need and want some extra TLC. When you need an ear to listen. When you know you’ve got something specific that you want to trouble shoot and could use a little support or a reset. Come in as regularly as actually fits your whole life and serves your big picture. And trust that that’s exactly the right number of visits or times to come in.

But, Nicole.

I know you’ll have read all this (thanks for reading!) and I’ll have given this long, big picture answer, and some people will still say, “But are there times you think are most important Nicole?” So if you’re doing fertility treatments and you need a little more guidance, and acupuncture feels doable and appealing, here’s some times you might consider booking a visit — so long as it doesn’t stress you out.

• Once a week, or every-other-week, during active ART cycle times (stimming, prepping for FET) — if we do electro-stim it lasts 10 - 14 days which covers circulation nicely

• Between egg retrieval and FRESH transfer only if you have OHSS worries or high IVF anxiety

• Once during the 3 - 5 days prior to IUI or transfer — this is our one last hurrah for aggressive blood circulation treatments

• 1 - 2 treatments, preferably at your IVF clinic, the day of embryo transfer (you bet I have a whole ‘nother post just on that)

• Once during the 9-14 day wait, preferably in the final few days prior to your pregnancy test day — That’s when you’re likely going to start to panic and we can hit the reset and get you through those last days of waiting in a much more sane and supported way

• Once every 1 - 2 weeks through the first trimester for placental support + anxiety reduction. Possibly with a specific aim at getting something a few days before the 6 - 7 week heartbeat ultrasound if you’re doing one of those — ditto for freak-outs here

• Space out or stop for 2nd trimester unless there are specific concerns

• Resume weekly or every-other week for the final 6 - 8 weeks of pregnancy to gear up for childbirth, recovery, and lactation

• As needed for WHOLE YOU support after birth and beyond — once I’m on your team I’m always happy to support you!

There you have it! We can do a TON of amazing stuff for your body and mind at ANY time. There’s no such thing as a one-size-fits-all acupuncture protocol that’s best for everyone. To get all the best benefits do what makes sense for YOU! Factor in research and recommendations and science and studies, plus your real life concerns, finances, schedule, preferences and how acupuncture feels for you. If you find the balance and come in when acupuncture actually fits and feels right, you’ll get the MOST benefit for your buck.

I’m happy to chat more about any of your specific concerns, questions, etc at a visit. Just let me know what’s on your mind. I’m so happy and lucky to do this work — I know we will make your life better. Thanks for inviting me in!

Nicole Lange

LICENSED ACUPUNCTURIST
HOLISTIC FERTILITY EDUCATOR