Acupuncture in Gynecology and Assisted Reproduction – A Short Evidence-Based Review

Acupuncture has become an increasingly relevant complementary therapy in modern gynecology and reproductive medicine, offering solid scientific support for various conditions affecting women's health. Traditionally used in Eastern medicine for thousands of years, acupuncture gained acceptance in the West through rigorous scientific studies that began in the late twentieth century. Technological advances in neuroimaging, Doppler ultrasound, and laser technologies have allowed a more objective understanding of the mechanisms of action of this ancient medical practice, promoting its integration into contemporary gynecologic care.

This editorial study, based on a scientific review presented at an international seminar in Slovenia in 2025, aimed to examine the current evidence on the use of acupuncture in gynecology and assisted reproduction. The analysis included a comprehensive review of the scientific literature, with special emphasis on a 2025 systematic meta-analysis on acupuncture in assisted reproductive technologies. The methodology involved evaluating studies on the physiologic mechanisms of acupuncture, its clinical applications in various gynecologic conditions, safety profile, and integration into modern medical practice. Researchers analyzed data from studies that used both traditional acupuncture techniques and modern methods such as laser acupuncture.

The results demonstrate that acupuncture acts through multiple well-documented physiologic mechanisms. From a neurologic standpoint, the technique promotes modulation of peripheral and central nerve pathways, including activation of pain inhibition systems. In the neuroendocrine aspect, modulation is observed of important hormones such as beta-endorphin and cortisol, with regulation of the hypothalamic-pituitary-gonadal axis. Doppler ultrasound studies have shown that acupuncture significantly improves uterine and ovarian blood flow.

In addition, research has revealed immunomodulatory effects, including reduction of pro-inflammatory cytokines in conditions such as polycystic ovary syndrome and endometriosis. In terms of specific applications, acupuncture has shown significant benefits for menstrual cramps through modulation of uterine blood flow and central pain pathways. For menopausal symptoms, evidence supports reductions in hot flashes, improved sleep, and quality of life. In assisted reproduction, which represents one of the most researched areas, acupuncture has been shown to reduce stress and sympathetic activity, improve endometrial receptivity, and potentially increase pregnancy rates.

The clinical implications are substantial for both patients and healthcare professionals. For women, acupuncture offers a safe and effective therapeutic option that can complement conventional treatments, providing symptom relief and psychological support during stressful procedures such as in vitro fertilization. The technique has demonstrated an excellent safety profile when performed by trained professionals, with rare, mild, and self-limited adverse events. An important finding is that the traditional concept of "forbidden points" during pregnancy is being reassessed: safety depends more on the application technique — depth, type of stimulus, duration — than on the specific points used.

For healthcare professionals, the integration of acupuncture represents an opportunity to offer more comprehensive and patient-centered care. Many fertility and women's health centers already incorporate acupuncture as part of integrative medicine models, recognizing its measurable physiologic effects beyond the psychological support it provides.

The study also highlights promising developments in the field, including the use of artificial intelligence and data mining to analyze large volumes of clinical studies and identify the most effective point combinations for specific conditions. For example, for diminished ovarian reserve, the most frequently identified points include Guanyuan, Sanyinjiao, and Zusanli, while for tubal infertility, combinations such as Sanyinjiao with Guanyuan have proven recurrent in the protocols analyzed.

Despite encouraging results, the study acknowledges important limitations. The evidence base, although extensive, is heterogeneous, with significant variations in methodologies, control conditions, and point selection across studies. Future research requires greater methodologic standardization and individualized protocols to optimize results. The need for interdisciplinary collaboration is emphasized, integrating neuroimaging, molecular biomarkers, and microcirculatory assessment for a better understanding of the mechanisms of action.

In conclusion, acupuncture emerges as a physiologically active complementary therapy, with robust scientific support and an excellent safety profile in gynecology and assisted reproduction. Its diverse applications, from menstrual regulation to fertility support, align well with modern integrative medicine strategies. Continued high-quality research will be essential to better define its role in evidence-based women's health care, promising significant benefits for women seeking safe and effective complementary therapeutic approaches.