Introduction

Can combining Western medicine and Traditional Chinese Medicine boost fertility? A new 2025 meta-analysis suggests yes—especially for women with polycystic ovary syndrome (PCOS) who struggle with ovulation and pregnancy.
A systematic review published in the Journal of Manipulative and Physiological Therapeutics analyzed data from 15 randomized controlled trials (RCTs) involving 1,311 women receiving ovulation treatment with letrozole either alone or paired with acupuncture.¹

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What the Study Found

Letrozole is one of the most widely used ovulation induction medications.² The meta-analysis found that adding acupuncture to letrozole creates a synergistic effect, significantly improving pregnancy outcomes.

Women who received acupuncture + letrozole experienced:

• Higher pregnancy rates (RR = 1.84; 95% CI 1.59–2.13; p < 0.001)¹
• Improved ovulation rates (RR = 1.30; 95% CI 1.18–1.43; p < 0.001)¹
• Increase in endometrial thickness (MD = 1.05 mm; p < 0.00001)¹
• Reduced miscarriage rate (RR = 0.20; 95% CI 0.08–0.51; p < 0.001)¹
• Improved hormone profiles, including:
  • Lower LH levels (MD = –2.10; p < 0.001)¹
  • Reduced total testosterone (notably greater effect after >3 cycles)¹
  • Improved estradiol (E2) (MD = 8.34; p < 0.001)¹
• Reduction in ovarian volume, indicating metabolic and structural benefit¹

Authors concluded that acupuncture “may significantly improve clinical efficacy and pregnancy outcomes” when combined with letrozole, while still acknowledging limitations in study quality and publication bias.¹

Reference: PMID 41269185 – “Meta-analysis of the effects of acupuncture combined with letrozole on ovulation induction and pregnancy outcomes in patients with polycystic ovary syndrome.”¹

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How TCM Understands PCOS

In Traditional Chinese Medicine theory, PCOS is often associated with Liver qi stagnation, Spleen deficiency with dampness/phlegm, and Kidney essence insufficiency affecting the menstrual cycle and ovulation.³ ⁴
Because the Chong and Ren vessels govern reproductive cycles, acupuncture influences hormonal rhythm and ovarian function by:

• Regulating Liver qi to promote follicular development
• Strengthening the Spleen to reduce phlegm-damp accumulation associated with ovarian cysts and weight gain
• Nourishing the Kidneys to support ovulation and reproductive vitality
• Harmonizing Chong and Ren channels, improving menstrual regularity and fertility³–⁶

Thus, acupuncture offers a functional and regulatory role that complements letrozole, which induces ovulation but does not directly modulate endocrine balance or endometrial receptivity.²

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Why This Study Matters

Infertility treatment success is not based on ovulation alone. Implantation, miscarriage risk, metabolic regulation, and emotional stress all influence pregnancy outcomes.⁷ Acupuncture is known to modulate stress response, endocrine function, and pelvic circulation⁸—suggesting a plausible mechanism for the improved clinical outcomes observed in the meta-analysis.

Rather than forcing a choice between Western pharmacology and Chinese medicine, an integrative model may offer the most comprehensive care for PCOS.

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What Patients Should Know

For women with PCOS undergoing fertility treatment:

• Acupuncture is not a replacement for ovulation medication
• Benefits are greater over several menstrual cycles¹
• Treatment should follow individual TCM pattern diagnosis
• Best results occur with combined lifestyle and metabolic support³ ⁷

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Balanced Perspective

While the findings are promising, the review noted:

• Evidence quality ranged from low to moderate¹
• Most studies were conducted in China¹
• Few trials fully described acupuncture methods¹

Thus, acupuncture + letrozole should be described as an evidence-supported adjunct, not a miracle cure.

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Conclusion

Acupuncture combined with letrozole may significantly improve fertility outcomes for women with PCOS. This research supports what many patients experience clinically: when holistic reproductive regulation is paired with pharmacologic ovulation induction, the result is not simply more follicles—but a higher likelihood of pregnancy.

For those trying to conceive with PCOS, an integrative path may be the future of reproductive medicine.

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References

1. He Y, Chen X, Lin J, et al. Meta-analysis of the effects of acupuncture combined with letrozole on ovulation induction and pregnancy outcomes in patients with PCOS. J Manipulative Physiol Ther. 2025. PMID: 41269185.
2. Casper RF. Letrozole versus clomiphene citrate: Which is better? Fertil Steril. 2009;92(3):858-859.
3. Maciocia G. Obstetrics and Gynecology in Chinese Medicine. 2nd ed. 2011.
4. Flaws B. The Infertility Cure. Blue Poppy Press; 1997.
5. Cheng XN. Chinese Acupuncture and Moxibustion. Foreign Languages Press; 1999.
6. Wang Y, et al. Evidence-based analysis of acupuncture regulating Chong and Ren. J Tradit Chin Med. 2018;38(4).
7. Palomba S, et al. PCOS and fertility outcomes. Endocr Rev. 2007;28(6):801-834.
8. Stener-Victorin E, et al. Ovarian blood flow and neuroendocrine effects of acupuncture. Hum Reprod. 2009;24(2):543-550.