Fertility, IVF Support, and Recurrent Miscarriage

Fertility & Chinese Medicine

Fertility has been part of our practice from the beginning.

Adele chose to specialize in Chinese medical gynecology while she was still a student. After graduating in 1997, she went directly to Beijing, where she spent six months in the gynecology department at Xi Yuan Hospital, including clinical training with a physician specializing in infertility.

When she began practicing in New York in 1999, acupuncture for fertility was not yet widely known. Patients often had no idea that infertility was an established area of Chinese medical gynecology, and much of the early work involved simply explaining what Chinese medicine could contribute.

That changed considerably as acupuncture became more closely associated with IVF. But our approach has always been broader than IVF support. We treat fertility as part of gynecology — looking at the menstrual cycle, ovulation, underlying gynecological conditions, general health, and any medical fertility treatment already underway.

Some patients come to us when they have only recently begun trying to conceive. Others have endometriosis, adenomyosis, PCOS, diminished ovarian reserve, irregular ovulation, or a history of pregnancy loss. Many arrive somewhere in the middle of fertility treatment — preparing for an IUI or IVF cycle, between retrievals, approaching an embryo transfer, or using donor eggs.

Wherever you are in the process, we meet you there.

How we work

If you are trying to conceive without medical assistance, we usually begin with weekly acupuncture and, where appropriate, Chinese herbal medicine, and give the process three to six months.

The first objective is the menstrual cycle itself. We look at cycle length, ovulation, the luteal phase, cervical fluid, premenstrual symptoms, pain, spotting, and the character and amount of menstrual bleeding. Treatment changes through the follicular phase, ovulation, luteal phase, and menstruation rather than remaining the same throughout the month.

In our clinical experience, meaningful changes in the cycle are often apparent within the first three months, and among patients who go on to conceive naturally, many do so within the first six. That six-month point is therefore an important time to reassess. If pregnancy has not occurred, we want to ask why — whether additional testing is needed, something has been overlooked, or it is time to consider reproductive assistance rather than simply continuing indefinitely.

That timeline is not appropriate for everyone. Age, ovarian reserve, how long you have already been trying, endometriosis, tubal factors, previous pregnancy loss, male-factor infertility, and other findings all affect how much time it makes sense to spend trying naturally. For someone approaching 40, for example, we may recommend reproductive evaluation much earlier while treating concurrently.

If fertility treatment is already underway when you come to us, we simply begin wherever you are and adapt treatment accordingly.

Fertility is not only about fertility

One advantage of treating fertility within a broader gynecology practice is that we don’t separate conception from the rest of your health.

Painful periods matter. Heavy bleeding matters. A 35-day cycle is different from a 24-day cycle. Endometriosis matters. PCOS matters. So do chronic digestive problems, poor sleep, significant fatigue, and the effects of months or years of fertility treatment.

Sometimes the work is primarily reproductive. Sometimes the most useful thing we can do initially is address the condition making the reproductive process more difficult. Chinese medicine has always approached these things as connected.

Working with IVF and IUI

We regularly treat patients undergoing IUI, ovarian stimulation, egg retrieval, frozen embryo transfer, and donor-egg cycles.

Ideally, we like to begin two to three months before an IVF cycle. This gives us time to address symptoms or underlying gynecological conditions and establish treatment before the cycle begins. But if you are already in treatment, start where you are. You haven’t missed your opportunity because you didn’t begin acupuncture months earlier.

During stimulation, treatment can also be directed toward bloating, headaches, disrupted sleep, digestive changes, tension, and the considerable stress of the process itself.

Tell us your complete medication protocol and anything else you are taking. Chinese herbs are not automatically used during assisted reproduction; whether they are appropriate depends on your circumstances, medications, clinic protocol, and where you are in the cycle.

Acupuncture and embryo transfer

Acupuncture around embryo transfer has been studied extensively, beginning with early research that found improved pregnancy rates. Research since then has produced varying results, in part depending on how acupuncture and the comparison treatment are defined.

We do offer acupuncture on the day of embryo transfer when scheduling allows, and it is something we continue to consider a valuable part of fertility treatment. Treatment is timed around the transfer and adapted to the individual patient. It can also help make what is often an intensely stressful day feel calmer and more manageable.

Age, diminished ovarian reserve, and egg quality

Age and ovarian reserve change the fertility picture, but they do not tell the whole story.

When a patient has low AMH, diminished ovarian reserve, a history of poor response to stimulation, or concerns about egg or embryo quality, we generally want about three months before the next retrieval when time allows. We look at everything reasonably modifiable — diet, lifestyle, sleep, supplements, Chinese herbal medicine when appropriate, and weekly acupuncture — and build a treatment plan around the individual patient.

We cannot promise to improve egg quality, reverse ovarian aging, or raise ovarian reserve. What we can do is try to create the healthiest possible conditions during the months in which follicles are developing, while working realistically with the reproductive capacity that is there.

For patients with very low ovarian reserve or repeated disappointing retrievals, we may also suggest seeking an opinion from a fertility specialist or clinic experienced with different stimulation approaches, including mild or mini-IVF. For some patients, retrieving a small number of eggs at a time and, when possible, banking embryos over successive cycles may be an approach worth discussing.

Particularly in the late thirties and forties, complementary treatment should not become a reason to postpone appropriate reproductive care. Often the most sensible approach is to use the months available to improve everything we reasonably can while working with a reproductive specialist on the medical strategy.

Going the distance

We sometimes describe fertility treatment as the tortoise and the hare.

There are times when age or other factors mean we need to move quickly. But moving quickly is not the same as constantly changing course. Fertility treatment can easily become a roller coaster of new protocols, new doctors, new supplements, and new attempts without enough time to understand what is actually working.

When circumstances allow, we prefer a steadier approach: make a thoughtful plan, give it an appropriate amount of time, evaluate the results, and change course when there is a reason to.

For patients with diminished ovarian reserve or those banking embryos over multiple retrievals, this may mean accepting that the process is slow — sometimes one good embryo at a time. We are going the distance, step by step. That doesn’t mean continuing with something that isn’t working. It means knowing the difference between persistence and standing still.

Recurrent pregnancy loss

Recurrent pregnancy loss is an area we have worked with for many years, and we take it seriously.

If you have had three or more miscarriages without an identified cause, we generally recommend further specialist investigation. Adele has referred patients with unexplained recurrent loss to reproductive immunologists for many years, particularly when a standard fertility evaluation has not provided an explanation.

We can continue acupuncture during the investigation and, when appropriate, work alongside the treatment recommended by your reproductive specialists during a subsequent pregnancy.

We also understand that after repeated loss, trying to conceive again is no longer the same experience it once was. Having a place where the history is known and the fear surrounding another pregnancy does not need to be explained from the beginning each time matters too.

Male-factor fertility

Male-factor infertility can be an important part of the fertility picture, and semen analysis should not be an afterthought.

We treat male-factor fertility when appropriate, particularly when abnormalities in count, motility, or morphology have been identified. Because sperm development takes approximately three months, changes are generally assessed over months rather than weeks.

Our practice, however, is primarily focused on Chinese medical gynecology and female reproductive health. When male-factor infertility requires more extensive evaluation or treatment, we encourage appropriate specialist care alongside anything we do here.

Coming to see us

Your first visit takes ninety minutes and covers considerably more than your reproductive history. We will talk about your menstrual cycle in detail as well as sleep, digestion, energy, stress, temperature, exercise, medical history, and any gynecological symptoms or diagnoses.

Bring whatever fertility information you have — cycle tracking, laboratory results, AMH, ultrasound findings, operative reports, semen analysis, or your fertility clinic’s treatment protocol. You do not need to arrive with all of it.

At the beginning, we will talk frankly about what we think Chinese medicine can contribute, how often we recommend treatment, when medical evaluation should happen alongside it, and what is realistic given your particular circumstances.

Common questions

When should I start acupuncture before IVF?

If possible, we like to have two to three months before an IVF cycle. But if you have already started, start where you are.

Do you treat on the day of embryo transfer?

Yes, when scheduling allows. We can treat before or after transfer depending on timing.

Can I take Chinese herbs during IVF?

Sometimes, but not automatically. It depends on your diagnosis, medications, fertility clinic protocol, and where you are in the treatment cycle.

My AMH is low. Can acupuncture raise it?

We don’t promise to raise AMH, and we don’t use AMH alone to judge whether treatment is useful. We look at the larger fertility picture, including age, antral follicle count, cycle characteristics, previous response to stimulation, underlying gynecological conditions, and your reproductive plan.

Can acupuncture improve egg quality?

We don’t promise that acupuncture can improve egg quality. When egg or embryo quality is a concern, we concentrate on creating the healthiest conditions we reasonably can during the months before retrieval through acupuncture, diet, lifestyle, supplements, and Chinese herbs where appropriate.

I am in my 40s. Is acupuncture still worth doing?

It can still have a role, but time matters. We would not recommend spending months trying acupuncture alone when reproductive evaluation or treatment is indicated. Often the best approach is to pursue both simultaneously.

Do you treat endometriosis or PCOS when someone is trying to conceive?

Yes. This is one reason our background in gynecology matters. We don’t treat fertility as though the underlying gynecological condition stopped existing because pregnancy is the goal.

I’ve had several miscarriages. Can you treat me?

Yes, alongside appropriate medical investigation. If you have had three or more unexplained losses, we may also recommend consultation with a reproductive immunologist.

What about male infertility?

We treat male-factor fertility, although female reproductive health and gynecology make up the larger part of our fertility practice. We also encourage appropriate evaluation of an abnormal semen analysis.

Will you keep treating me once I am pregnant?

Yes. Some patients continue through the first trimester, while others continue longer depending on their history and symptoms. Pregnancy and postpartum care are established parts of our practice.