By Deanna Thomas BSc Hons, Lic.Ac, MBAcC, DipObsGyn | Fertility Support Trained | April 2026
A message came through from a client last week: a woman in her second IVF cycle, someone I've been working with for several months. She'd just spoken to her consultant, who mentioned that NICE's new fertility guideline explicitly lists acupuncture as an "unproven add-on." She wanted to know if she should stop coming.
She's not the first to ask. Since NICE published its updated guideline at the end of March 2026, I've had versions of the same question from women across Teesside: Does this mean acupuncture doesn't work? Does it mean I'm wasting money? Should I be worried that I've been doing this?
The short answer to all three is no. But the longer answer is worth taking time over, because "unproven add-on" is a specific regulatory phrase with a specific meaning — quite different from what many people assume. If you're using fertility acupuncture in Middlesbrough or anywhere else in Teesside alongside your IVF journey, here's what you actually need to know.
Key Takeaways
- NICE's "unproven IVF add-on" classification is about what the NHS will fund, not about whether acupuncture is safe or valuable to use.
- The evidence on acupuncture and IVF is genuinely mixed. Some studies show benefit, others don't, and that complexity deserves honest explanation, not spin.
- Where the evidence is most consistent is in the reduction of anxiety, stress, and pain during IVF cycles: outcomes that matter enormously, even if they are less visible than "success rates."
- A structured, consistent approach across your cycle may matter more than a single session around embryo transfer, supported by research on dose-dependence.
- The research that shows the most consistent benefit uses individualised treatment tailored to each person, not standardised protocols. That is how acupuncture is practised at this clinic.
- Any practitioner promising to "improve your IVF success rate" using acupuncture is making a claim the current evidence does not support. Transparency here is a form of care.
What NICE Actually Said, and What It Didn't
NICE, the National Institute for Health and Care Excellence, updated its fertility guideline in March 2026, replacing the previous version from 2013. Acupuncture is listed among what NICE calls "add-on treatments": therapies used alongside standard IVF that have not yet met NICE's threshold for routine NHS commissioning.
It's worth being precise about what changed, and what didn't. NICE has never recommended acupuncture for IVF. The 2013 guideline didn't either. What the 2026 update does is make the classification more explicit, using the specific "unproven add-on" language developed to address the growing market for IVF supplementary treatments. This isn't a reversal of a previous endorsement. It's a formalisation of a position NICE has always held.
NICE's role is to advise the NHS on what to fund based on consistent, reproducible evidence across diverse patient groups. The acupuncture evidence base does not yet meet that bar consistently — so this is a funding decision, not a safety decision, and not a verdict on whether acupuncture has value for any individual.
Worth knowingNICE guidance is not law. It tells NHS commissioners what to fund, not patients what to do. Women have always been free to choose acupuncture as private support alongside their NHS or private IVF treatment, and that remains true after this update.
What the guideline does call for — and I agree with this completely — is informed consent. Women considering any IVF add-on, including acupuncture, should have access to clear, balanced information about what the evidence shows and where the gaps are. That's not a threat to what we do here. It's the foundation of how we work.
The Evidence Landscape: What the Research Actually Shows
The reason NICE's classification is "unproven" rather than "disproven" is that the research is genuinely mixed, and that distinction matters.
In 2002, Paulus et al. published a prospective, randomised trial in Fertility and Sterility showing that acupuncture on the day of embryo transfer produced a clinical pregnancy rate of 42.5% compared with 26.3% in the control group. That finding was significant and sparked a wave of subsequent research. Some replicated it. Others didn't. As more trials were completed, two systematic reviews of 14 and 16 trials respectively concluded that two to three standardised sessions around embryo transfer did not reliably improve clinical pregnancy rates.
There is a critical detail in that failure to replicate that tends to get lost in the headlines. Almost all of those trials used identical, standardised protocols: the same points for every patient, regardless of diagnosis, history, or TCM pattern. That is not how acupuncture is practised clinically. It's the equivalent of prescribing the same drug to every patient regardless of what they have.
The largest current synthesis comes from a 2025 systematic review of 39 trials involving 7,188 women undergoing IVF. It found measurable improvements in clinical pregnancy rates and significant reductions in anxiety, pain, and stress. Those wellbeing outcomes matter considerably, even if they are less headline-grabbing than live birth figures.
The same review found something that warrants honest discussion: a higher early miscarriage rate in the acupuncture group. But this finding deserves careful interpretation. Women receiving acupuncture had more practitioner contact, meaning early losses were more likely to be detected and recorded — the loss may not have happened more often, it may have been noticed more often. The review also found higher clinical pregnancy rates, and more pregnancies means more opportunities for early loss. Most importantly, both individual studies most relevant to this question found the opposite signal: Phillippi et al. 2022 found 42% fewer biochemical pregnancies in the acupuncture group, and Hullender Rubin 2015 found the same. I'm not dismissing the finding. I'm giving you the context to evaluate it properly.
"The evidence is genuinely complex. That complexity deserves honest explanation — not reassuring spin in one direction, and not dismissal in the other."
What Acupuncture Can Legitimately Offer During IVF
Working with women across Teesside through their fertility journeys, I've seen up close what IVF actually does to a person. The monitoring appointments. The two-week wait. The emotional whiplash of results. The way hope and fear can sit in the same breath. One client told me, halfway through her second cycle, that the sessions had become the one hour where she could stop being a medical project and just be a body again. That experience is what I think the research on anxiety and nervous system regulation is actually measuring, even when it struggles to quantify it.
The most consistently supported role for acupuncture is reducing the physiological and psychological burden of the process. Chronic stress activates the HPA axis in a sustained way that directly suppresses the HPG axis — the hormonal pathway governing reproduction. The body under prolonged threat prioritises survival over reproduction. Acupuncture's documented role in activating the parasympathetic nervous system creates a physiological environment more conducive to the hormonal conditions IVF requires. That is a plausible, honest mechanism. It doesn't make acupuncture a guaranteed intervention. It makes it a sensible one.
Consistent, considered support across your cycle, at our acupuncture clinic in Middlesbrough.
Our acupuncture support for fertility is built around this understanding. Structured, consistent, and grounded in what the evidence allows us to say honestly.
Why Individualised, Consistent Support Outperforms a Single Standardised Session
Two studies help explain why the earlier RCT data produced such mixed results, and what the research looks like when acupuncture is delivered the way it actually works in practice.
The first, published in Fertility and Sterility in October 2022 (Phillippi, Kamel, Hullender Rubin et al.), was a retrospective cohort study of 2,330 women undergoing frozen embryo transfer at a private fertility centre in Chicago. Rather than using a standardised protocol, 579 patients received individualised acupuncture with points selected specifically to each patient's TCM pattern, diagnosis, and medical history. The acupuncture group was on paper the harder cohort: older, with more diagnoses of diminished ovarian reserve, ovulatory infertility, and unexplained infertility.
Study finding — Phillippi, Kamel, Hullender Rubin et al., Fertility & Sterility, 2022Despite the more complex patient profile, individualised transfer-day acupuncture was associated with 55% more live births (47.8% vs 37.1%, OR 1.55, p<0.00001) and 42% fewer biochemical pregnancies compared with frozen embryo transfer alone. The authors note this was a retrospective cohort study; the groups were not identical at baseline and these findings should be interpreted with particular caution pending prospective confirmation.
The distinction matters: a standardised protocol cannot account for whether a woman has diminished ovarian reserve or PCOS, a history of recurrent implantation failure, anxiety or thyroid disease. Individualised acupuncture does — and that may explain much of the heterogeneity in the evidence base.
The second study (Hullender Rubin et al., Reproductive BioMedicine Online, 2015) reviewed 1,231 IVF patient records across three groups: IVF alone; IVF with two standardised sessions on embryo transfer day; and IVF alongside a structured whole-systems TCM programme averaging 12 sessions across the cycle.
Study finding — Hullender Rubin et al., Reprod Biomed Online, 2015The structured whole-systems group had a live birth rate of 61.3%, compared with 48.2% for IVF alone and 50.8% for those who received standardised acupuncture only on transfer day. The standardised transfer-day group showed no statistically significant advantage over standard IVF care. The multi-session structured approach did, with an adjusted odds ratio of 2.09 compared with IVF alone (95% CI: 1.36–3.21). These results should be interpreted cautiously as retrospective cohort data.
Both studies point to the same conclusion: individualisation and consistency matter more than the standardised model. In the UK, acupuncturists always work independently from IVF clinics, which makes the whole-cycle preparation approach not just a preference but the appropriate clinical structure. Every session at this clinic is built around your individual picture: your diagnosis, your TCM pattern, your cycle history, what your body is showing on the day. Care that is specifically yours.
From a TCM perspectiveIn traditional Chinese medicine, IVF preparation is about creating conditions for Kidney Jing to be well-supported, the uterus to be well-nourished, and the Shen (the spirit) to be calm and resourced. This framework, translated into the language of nervous system regulation and hormonal environment, describes something that evidence-based research is beginning to map in increasing detail.
Why Honest Framing Is Itself a Form of Care
Women going through IVF are already overwhelmed. The last thing they need is a practitioner who adds to that load with promises the evidence can't support. Some websites make strong claims — that acupuncture improves egg quality, increases IVF success rates, or decreases the risk of miscarriage — that go beyond what the evidence can honestly support, particularly in light of NICE's 2026 update.
The approach here is different. Working with women navigating fertility treatment since 2021, the most meaningful thing I can offer is not a promise. It's a clear-eyed, warm, evidence-informed companion through a genuinely hard process — someone who tells you what we know, what we don't, and what the realistic range of what acupuncture might offer you looks like, so you can make a decision that's genuinely yours.
"I cannot recommend Deanna highly enough. I began seeing her for acupuncture to support me through the IVF process, and from the very start she was exceptional. She is not only highly knowledgeable, but compassionate and genuinely committed to her clients' wellbeing. Deanna went out of her way to ensure I could attend appointments at the times I needed... I am so grateful for her support and would wholeheartedly recommend her to anyone, particularly those navigating fertility treatments."
Lucy R. — Google Review ★★★★★
That's what the Roots to Transfer™ programme is built around. We start before your cycle begins, working on nervous system regulation and whatever your TCM pattern is presenting — because no two women present the same way. Sessions adjust as you move through stimulation, retrieval, and transfer, timed to the physiological demands of each phase. And through the two-week wait, you have somewhere to bring all of it. Not a therapist. Not a friend who doesn't understand. A practitioner who knows exactly where you are and holds it with you.
Frequently Asked Questions
Does the new NICE guideline mean I should stop using acupuncture during IVF?
No. The NICE guideline tells NHS commissioners what to fund — it does not advise patients to stop anything. It means the NHS will not routinely pay for acupuncture as part of an IVF cycle, which has always been the case. Whether acupuncture is right for your circumstances is a conversation to have with your practitioner.
What does "unproven IVF add-on" actually mean?
"Unproven add-on" is NICE's term for treatments that don't yet have sufficient high-quality evidence to recommend as standard NHS care. It does not mean dangerous, banned, or without any evidence. It means the evidence base is heterogeneous and NICE requires a more consistent standard of proof before recommending commissioning. This distinction matters.
What can acupuncture legitimately offer during an IVF cycle?
The area where evidence is most consistent is the reduction of anxiety, stress, and pain. A 2025 systematic review of 39 trials involving 7,188 women found acupuncture significantly reduced anxiety and pain scores during IVF cycles, alongside improvements in clinical pregnancy rates. Nervous system support is where the evidence base is clearest, and it matters because the toll of an IVF cycle is significant and real.
How is your approach different from clinics that promise acupuncture will improve IVF success rates?
We don't make outcome promises. What we offer is structured, evidence-informed support: nervous system regulation, stress reduction, and consistent individualised care across your cycle. You deserve to know what the evidence shows and where it has gaps, so you can make a genuinely informed decision. That transparency is not a weakness. It's what real clinical care looks like.
Why does individualised treatment matter more than a standard protocol?
A 2022 study (Phillippi et al., Fertility & Sterility) found that individualised transfer-day acupuncture in 2,330 FET patients was associated with 55% more live births than FET alone, even though the acupuncture group had more complex diagnoses. A 2015 study found that a standardised two-session protocol produced no significant benefit over IVF alone, while a structured 12-session whole-systems programme did. Individualisation and consistency appear to be what matters.
Final Thoughts
If you're preparing for an IVF cycle and the NICE guideline update has left you feeling unsure, that's completely understandable. You're being asked to make decisions where the information is genuinely complex and the stakes feel enormous.
What I hope this post offers is a clearer map: what "unproven add-on" actually means, what the evidence does and doesn't show, and what we can genuinely offer as support. Our fertility acupuncture clinic in Teesside is built on the belief that women navigating fertility treatment deserve practitioners who tell the truth, even when it's complicated. Especially then.
If you'd like to talk through whether acupuncture support might be right for you, you're very welcome to reach out. No pressure, no promises. Just an honest conversation when you're ready.
With warmth,
Deanna
You deserve support that holds the whole picture
If you're in Middlesbrough, Stockton, Yarm, or the wider Teesside area, an initial consultation is a quiet, no-obligation place to start. At that first appointment we take a full picture of where you are — your cycle history, your diagnosis, your TCM pattern — and talk through honestly whether acupuncture could be useful for you specifically.
Book an Initial Consultation No pressure. Come as you are, wherever you are in the process.
Deanna Thomas BSc Hons, Lic.Ac, MBAcC, DipObsGyn
Specialist women's health acupuncturist | Fertility Support Trained | Middlesbrough
Multi-award-winning clinic | 800+ five-star reviews on Fresha | Serving Middlesbrough, Stockton-on-Tees, Yarm & Teesside since 2021