Embryo Transfer Acupuncture | Paulus Protocol


In 2002 Wolfgang Paulus (et al) published research that looked into the effects of acupuncture when given before and after Embryo Transfer.


Paulus Protocol


What was the research?

The research involved 160 women that were assigned randomly into an acupuncture (n=80) group and a control (n=80) group. The results were statistically significant (could not have been caused by chance) and showed that implantation rates could be increased by as much as 60% with acupuncture either side of embryo transfer (ET).

Further studies

Since 2002 there have a number of other research projects that have explored the use of the Paulus protocol. Most were attempts to explore if it was possible to improve implantation rates further and to observe acupuncture’s benefits on other aspects of fertility and pregnancy. Some of the most relevant are:

Quintero et al (2004) used the similar principles to Paulus but chose different points and used them 48 hrs after day 3 ET’s to see what the effects would be on implanation rates if used closer to the time of implantation. Once again they discovered that implantation rates were increased by about 60%.

Westergaard et al (2006) tried to see if a further acupuncture sessions around the time of implantation would increase pregnancy rates further. They did this by using acupuncture again 2 days after the post ET treatment. They found that it had similar results but that it didn’t add any further benefit.

Magarelli P. and Cridennda D. (2005) studied the effects of the Paulus protocol on live birth rates reported that miscarriage rates were almost halved when the protocol was used 24 hrs before ET.

What does all this mean?

The research shows that acupuncture is beneficial around ET. According to Chinese medicine this is about helping relax mind and body, and increasing blood flow to the uterus. Western medicine understands it as increasing beta-endorphins which in turn reduce the ‘sympathetic outflow’.

In layman’s terms – it reduces the level of stress hormones and increases blood flow
around the time that an embryo is trying to implant.

If you haven’t had much acupuncture before your ET then I suggest both a pre and post ET acupuncture treatment. If you have been having weekly treatment up to Egg Collection (EC) then it may be that you only need one. I am very happy to discuss this with you if you are unsure.

So when should I have my pre and post ET acupuncture?

Due to the nature of embryo transfer dates it can be difficult to schedule appointments in advance but there is room for flexibility. Research suggests that pre-ET acupuncture can be at any stage within the 24 hrs before ET and the post-ET acupuncture as much as 48 hrs afterwards (for ET on days 2 or 3).

Blastocyst (ET on day 5) acupuncture, however, should be on the same day, as a blastocyst will begin the implant soon after it is transferred.

It is my opinion that you are better off having one well-timed session than two poorly timed or stressful ones.

Can it help with my IUI or frozen embryo transfer (FET)?

The principles with IUI and FET are exactly the same as for IVF. Helping to relax your mind and body, and increasing blood flow to the uterus will increase the likelihood of a successful outcome.

Do I need any other treatment after this?

We suggest treatment to support your Luteal Phase on day 9,10 or 11 day after EC, which is considered day 0. This increases blood flow to the uterus and reduces the effect that stress and cramping can have at this stage.

How do I book this?

Once you start having scans we will get a sense of when your ET or IUI is likely to be and we can start looking at appointments for you. The day after EC the clinic will let you know when your ET will be. As soon as you know this, you can get yourself booked in.

If for any reason, we can’t fit you in, we will give you contact details for colleagues that also do pre and post ET treatments. They have a lot of experience and we will make sure that you are well looked after.

Click here for details about how to book appointments.

Click here for details about fees. 


For more details on our Fertility work see the fertility section of our website.


Rick Mudie

Rick Mudie

Rick is a Course Co-ordinator and Clinical Supervisor International College of Oriental Medicine (ICOM). He has degrees in Oriental Medicine from Brighton University and Social Sciences from Edinburgh University.

He has clinics in Brighton and Lewes, in East Sussex, and practices five-element 'Stems and Branches' and Traditional Chinese Medicine (TCM) acupuncture, with a strong emphasis on channel palpation.

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