CLEVELAND — A new study from University Hospitals Connor Whole Health and the UH Fertility Center has identified the kinds of patients most likely to use Whole Systems Traditional Chinese Medicine (WS-TCM) while undergoing in vitro fertilization. The analysis, published in F&S Reports, suggests that integrative fertility care is being sought disproportionately by women managing chronic pain, recurrent pregnancy loss, and repeated unsuccessful assisted reproductive technology cycles. The findings offer a detailed picture of how patients combine conventional reproductive medicine with acupuncture, lifestyle counseling, nutritional guidance, and Chinese herbal therapies during frozen embryo transfer treatment.
WS-TCM is broader than acupuncture alone. At University Hospitals, the approach combines licensed acupuncture, Chinese herbal medicine, lifestyle-oriented care, nutritional counseling, and individualized support within the fertility clinic itself. Practitioners work alongside reproductive endocrinologists, nurses, embryologists, and laboratory teams rather than operating as a separate service disconnected from fertility treatment. The model is designed to address physical symptoms, emotional stress, sleep, diet, and other factors that may influence a patient’s experience of fertility care. However, the new study examined utilization patterns, not whether WS-TCM improves pregnancy or live-birth rates.
The research team conducted a retrospective review of 799 women who underwent autologous frozen embryo transfers at University Hospitals between 2019 and spring 2024. In an autologous transfer, a patient’s own previously created embryo is thawed and transferred into the uterus after preparation of the endometrium. Frozen embryo transfer cycles have become an increasingly important part of modern IVF, making them a useful setting for studying how patients seek supportive therapies during treatment. The investigators reviewed demographic information, neighborhood-level socioeconomic indicators, reproductive histories, pain-related diagnoses, mental health conditions, and previous fertility treatment cycles.
After accounting for sociodemographic and clinical variables, the study found that women living in higher-income neighborhoods had greater odds of using WS-TCM during their fertility treatment. This pattern may reflect differences in healthcare access, insurance coverage, transportation, time flexibility, awareness of integrative services, or the ability to pay for treatments that may not be fully reimbursed. The finding does not mean that income determines whether a patient benefits from integrative care. Instead, it points to the possibility that economic and logistical barriers influence who can reach such services, even when those services are physically embedded within an academic medical center.
The strongest clinical associations involved recurrent pregnancy loss and chronic pain. Women with a history of recurrent pregnancy loss were more than twice as likely to use WS-TCM compared with women without that history. Recurrent pregnancy loss can involve multiple potential biological and psychological factors, including chromosomal abnormalities, uterine conditions, endocrine disorders, immune-related hypotheses, and unexplained causes. Repeated loss may also create substantial anxiety during subsequent IVF treatment. The study cannot establish that WS-TCM prevents miscarriage or changes the biological causes of pregnancy loss, but it indicates that patients confronting this history are more likely to seek a broader form of support during embryo transfer.
Pain-related diagnoses were also more common among WS-TCM users. These included migraine or headache disorders, musculoskeletal pain, and pelvic or genital pain. Chronic pain can complicate fertility care by affecting sleep, mobility, stress physiology, medication choices, and quality of life. Some patients may be searching for options that can be used alongside conventional treatment, particularly when they wish to reduce reliance on medications or when existing therapies have not provided adequate relief. Acupuncture is commonly used to manage certain pain conditions, although its effectiveness varies by diagnosis and individual response. The study identified an association between pain diagnoses and WS-TCM use; it did not test acupuncture as a treatment for those conditions.
Women who had undergone three or more previous assisted reproductive technology cycles were also significantly more likely to use WS-TCM. Repeated IVF treatment can be physically demanding, expensive, and emotionally exhausting, particularly when previous cycles have not resulted in an ongoing pregnancy. Patients with extensive treatment histories may be more likely to explore additional services, seek greater control over the treatment experience, or ask for help managing stress and symptoms between procedures. Their increased use of WS-TCM may therefore reflect both accumulated clinical complexity and a search for personalized support after conventional fertility treatment has produced limited results.
The analysis also found several factors associated with lower odds of WS-TCM utilization. Higher body mass index, the use of preimplantation genetic testing, a history of pelvic inflammatory disease, and high-risk pregnancy supervision were linked with reduced use. These associations may arise from differences in clinical circumstances, treatment priorities, referral patterns, safety considerations, or access to specialized services. For example, patients undergoing genetic testing may follow a more tightly structured laboratory and transfer pathway, while patients with high-risk reproductive histories may be referred toward other forms of medical management. Because the study was observational and based on existing clinical records, it cannot determine why these factors were associated with lower utilization.
The University Hospitals program was developed to integrate reproductive well-being into care across the fertility journey, including menstrual health, fertility treatment, pregnancy, postpartum recovery, and menopause. Christine Kaiser, the Connor Endowed Director of Reproductive Well-being and a licensed acupuncturist, said the findings highlight patients who may be facing additional challenges, particularly chronic pain and recurrent pregnancy loss. Kristi Artz, Vice President of Connor Whole Health, emphasized that understanding who uses integrative services may help clinicians identify barriers and expand access to patient-centered reproductive care. The research was led by Samuel Rodgers-Melnick and Lee Hullender Rubin, with collaborators from University Hospitals and the fertility research community.
Interest in integrative fertility care has grown as patients look for ways to manage stress, anxiety, pain, and overall well-being during IVF. Earlier research from the University Hospitals team described how WS-TCM is incorporated into the UH Fertility Center and reported improvements in patients’ pain, stress, and anxiety during the integrated care experience. The new study adds a utilization perspective, showing that WS-TCM is especially attractive to patients with complex reproductive and pain-related histories. The authors caution, however, that utilization data should not be interpreted as evidence that the therapies increase implantation, clinical pregnancy, or live birth. Future prospective studies will need to examine safety, treatment timing, patient-reported outcomes, cost, and reproductive endpoints while ensuring that acupuncture, herbs, and supplements are coordinated with standard fertility protocols.
Subject of Research: Factors associated with Whole Systems Traditional Chinese Medicine utilization among women undergoing frozen embryo transfer during IVF.
Article Title: Whole Systems Traditional Chinese Medicine Utilization Among Women Undergoing Frozen Embryo Transfers at an Academic Fertility Center
Web References: University Hospitals Connor Whole Health: https://www.uhhospitals.org/ConnorWholeHealth; UH Fertility Center: https://www.uhhospitals.org/services/obgyn-womens-health/conditions-and-treatments/fertility-and-reproductive-health; Article: https://www.sciencedirect.com/science/article/pii/S266633412600108X
References: Rodgers-Melnick SN, Hullender Rubin LE, Kim ST, Jones LD, Flyckt R, Kaiser C. “Whole Systems Traditional Chinese Medicine Utilization Among Women Undergoing Frozen Embryo Transfers at an Academic Fertility Center.” F&S Reports. 2026. doi:10.1016/j.xfre.2026.06.008
Image Credits: University Hospitals
Keywords: In vitro fertilization, IVF, frozen embryo transfer, acupuncture, Traditional Chinese medicine, integrative medicine, fertility treatment, recurrent pregnancy loss, chronic pain, reproductive health, assisted reproductive technology.
Tags: Chinese medicine in fertility treatmentcombining conventional and traditional Chinese medicine in IVFholistic approaches to fertility care including sleep and dietintegrative reproductive health practicesinterdisciplinary collaboration in integrative fertilitylifestyle counseling in assisted reproductive technologymanaging chronic pain and recurrent pregnancy loss with TCMpatient utilization patterns of Whole Systems TCM during fertility treatmentpersonalized fertility support with Chinese medicinerole of Chinese herbal medicine in fertility outcomestraditional Chinese medicine for IVF patientsuse of acupuncture and herbal therapies in fertility care
