During an IVF cycle there is a lot of emphasis on improving egg and sperm quality, but what about the health and receptivity of the womb? This is an equally important factor, as the thickness and quality of the endometrial lining is essential for the success of an IVF cycle and the ability to carry a baby to term.


What is a thin lining?

The endometrium is the inner layer or lining of the uterus. It it is this layer that is shed during menstruation each month and it thickens in preparation for the implantation of a fertilised embryo. The hormone oestrogen is responsible for creating a thick, rich and healthy uterine lining. If oestrogen levels are low and blood flow to the pelvic cavity is poor, then the lining of the uterus can be thin.

Pulsatility Index and Blood Flow to the Uterus

So for any woman undergoing IVF, good blood flow to the pelvic region is essential and there is a very precise technique that predicts both uterine blood flow and also the success of an embryo transfer.

A transvaginal ultrasound can be used to measures the pulsatility index in the uterine arteries, which is the blood flow to this area. A higher index indicates greater restriction of blood flow to the uterus. The pulsatility index has been used in many studies to assess endometrial receptivity (1,2).  Many studies also indicate that a higher index (greater restriction of blood flow) has been associated with a decreased pregnancy rate following embryo transfer. One study showed that a pulsatility index of 3.0 or more at the time of embryo transfer could actually predict 35% of failed pregnancies.

Can Electroacupuncture Increase IVF Success?

Acupuncture has been shown to increase blood flow to the womb lining and increase vascularization of the lining also. Electroacupuncture, which involves gentle electrical stimulation of acupuncture points, has been shown to reduce blood flow impedance to the uterine arteries. In one study, a group of women undergoing IVF received a series of 8 acupuncture treatments over the course of 4 weeks. In these women, a statistically significant drop in the pulsatility index was measured by the end of the 8th treatment.  This benefit could still be measured 10-14 days after the treatment period had ended. Following the acupuncture treatments, the pulsatility index fell within the range for optimal uterine receptivity of 2.0 – 2.99, for the majority of the women in this study.


At Shen we use an evidence-based protocol by Stener-Victorin (3), to improve lining quality, thickness and blood flow, thus enhancing implantation and reducing miscarriage rates. A series of 8 electroacupuncture treatments is recommended to increase uterine artery blood flow and promote endometrial receptivity in women undergoing IVF.


  1. Steer, C.V., Campbell, S., Tan, S.L. et al. The use of transvaginal colour flow imaging after in vitro fertilisation to identify optimum uterine conditions before embryo transfer. Fertil. Steril. 1992; 57, 372-376.
  2. Steer, C.V., Tan, S.L., Mason, B.A. and Campbell, S. Vaginal color Doppler assessment of uterine artery impedance correlates with immunohistochemical markers of endometrial receptivity required for the implantation of an embryo. Fertil., Steril. 1995; 61, 101-108.
  3. Stener-Victorin, E., Waldenström, U., Andersson, S.A. and Wikland M. Reduction of blood flow impedance in the uterine arteries of infertile women with electro- acupuncture. Hum Reprod. 1996;11, 1314-1317.