Enhancing IVF Outcomes Through Integrative Care: The Role of Naturopathy & Acupuncture: Pilot Survey Results from IVF Patients and Specialists

FSANZ Conference September 2025

 

Pilot survey results from IVF patients and specialists

Presented at the FSANZ Conference September 2025

 

Introduction

IVF patients are driving a collaborative care model for IVF that includes integrative practitioners, seeking personalised support, greater agency, and improved wellbeing. Studies show most infertility †  patients use at least one integrative medicine modality to support conception (Sehgal et al., 2023) and incorporating complementary and alternative medicine (CAM) into IVF care plans can lead to improved psychosocial health outcomes (LoGiudice et al., 2018).

Focus groups in Melbourne found that women † using CAM to optimise conception valued enhanced communication between their CAM practitioners and fertility specialists (Rayner et al., 2009). Coordinated care between conventional and complementary specialists is essential for safe, informed, and effective IVF support (Sharifi et al., 2022).

Fertile Ground is a multidisciplinary complementary medicine practice operating independently from any single IVF provider, enabling collaboration with multiple clinics and specialists while maintaining neutrality, transparency, and trust with both patients and providers. Since 2001, Fertile Ground’s fertility-focused naturopaths, acupuncturists, counsellors, and massage therapists have provided individualised, whole systems care that complements IVF by addressing modifiable factors beyond the laboratory.

Each month, 120 – 150 new patients seek Fertile Ground support for preconception, IVF, pregnancy, and postpartum care – reflecting a growing demand for independent, integrative models that combine medical IVF expertise with whole-person care.

This collaborative approach enables recruitment of patients from multiple IVF clinics, capturing diverse perspectives and minimising institutional bias.

Within this context, we conducted a pilot study to explore the perceived benefits of collaborative care between IVF specialists and Fertile Ground naturopathic and acupuncture clinicians, to inform priorities for prospective evaluation of the role of collaborative care.

Objectives & Aims

• Assess patient-reported experiences and perceived benefits of collaborative care (naturopathy and acupuncture) during IVF. 
• Explore IVF specialists’ perceptions of benefits and challenges when their patients engage in collaborative care with Fertile Ground clinicians.
• Generate preliminary insights into whether collaborative care may contribute to improved health, wellbeing, and fertility outcomes.

Methodology

• Design: Exploratory pilot survey, July 2025
• Patients:
  • Online survey emailed to the full Fertile Ground database → 13,091 active emails
  • 33 responses reporting IVF treatment with collaborative care included in analysis
• IVF Specialists:
  • Survey emailed to 13 IVF specialists/clinics with existing collaborative relationships with Fertile Ground
  • 8 responses received
  • Purposive sampling approach used to capture perspectives
• Recruitment: Voluntary, self-selected participation; respondents could choose to be identified or remain anonymous
• Ethics: As an internal quality assurance project, ethics approval was not required, but national ethical guidelines including informed consent were followed
• Data Collection: Structured and open-ended questions on experiences, perceived benefits, and challenges
• Analysis: Descriptive statistics (quantitative) and thematic review (qualitative)

Limitations

• Small, exploratory pilot study – findings are hypothesis-generating rather than conclusive 
• Limited sample size
• Short timeline
• Voluntary participation, introducing potential self-selection bias
• Not everyone who received a survey responded  – 4283 opened emails, 421 clicks
• Response rate means that findings may not be generalisable
• Potential for positive responder bias. Interestingly no negative responses were received.
• Reliance on participant recollection introduces potential recall bias
  

Patient Responses: Quantitative Data

Improved subjective patient outcomes attributed to integrative care:

• “Going through IVF can be a mix of intense highs and lows, but having a small, caring team by your side… can make a huge difference. When you have these therapies and the thoughtful guidance that come with them, it’s not just about increasing your chances of a healthy pregnancy and birth. It’s about feeling held, supported, and understood every step of the way. Taking a whole-system approach to your care can also help you feel more in control, especially in a medical process where so much can feel out of your hands. It’s a way to remain connected with yourself, more in tune with your body, and to navigate the IVF journey with a greater sense of calm and confidence.” Jen
• “Embryo quality improved, successful implantation, pregnancy went smoothly.” Emma
• “My care team were really happy with the number of follicles stimulated – resulting in 14 eggs collected and 4 embryos created. I had a successful transfer. I feel collaborative care really helped achieve these outcomes. I didn’t undertake IVF without acupuncture so can’t compare in any other way.” Lisa
• “My naturopath and I were able to counteract a lot of the side effects of my fertility medications through the use of specific supplements. We were also able to add in supplements that supported all stages of conception and pregnancy to help ensure baby was well supported and healthy/thriving too…I attribute avoiding things like gestational diabetes (expected in my situation…) to excellent support and guidance from my Naturopath.” Nichola
• “Issues were looked over with a fine-tooth comb. A fertility specialist appointment can be minutes, whereas an initial consult with a naturopath can be 90 minutes – you feel so supported.” Kira
• “At the time of treatment, when I compared myself to others undergoing IVF, I felt that I was coping both physically and emotionally better due to the treatment of the Naturopath.” Heather
• “The Fertile Ground staff knew about the meds and treatment details from (my specialist) … meaning Fertile Ground could work with it and understand what I was going through and why. Integrated care like that doesn’t happen enough in healthcare.” Rachel
• “We did IVF over a 9-year period… it seemed hopeless…. It’s a testament to the naturopath that we ended up eventually having success with IVF, embryo quality improved. Furthermore my mental health and general health was supported. It allowed me to continue with IVF treatment.” Kira 
• “The emotional support of acupuncture on the day of embryo transfer helped – I stopped needing Valium prescribed by my fertility specialist on transfer day.” Kira
• “I strongly believe I wouldn’t have a baby (without naturopathy and acupuncture support and) …attribute both my IVF children to working with a senior naturopath with genuine IVF understanding.” Rachel
• “It made me feel less alone, and like someone was helping me look after my body and my peace of mind (IVF can make you feel very battered and physically wrung out, but I feel like this support was about helping me heal and focused on my care).” Kate
• “My hormone levels improved with Naturopathy supplements. This meant I could continue my IVF journey. The wholistic approach meant that I was treated for everything, not just what would traditionally be thought of as fertility issues. I lost my first son and I believe that the wholistic approach benefited my subsequent successful pregnancy.” Dianne

Fertility Specialist Responses: Quantitative Data

Observations of collaborative/integrative care from specialists during IVF:

• “The patients who engage integrative care have a greater understanding about the role that diet, nutrition and lifestyle can play in supporting general health and their reproductive outcomes. They are also more actively involved in their treatment plan…. Those that make changes often feel better about their general health and well-being.” Anon
• “Patients who have undergone acupuncture are calmer. Patients doing IVF often feel guilty that they are not pregnant, that a negative result is their ‘fault’ … patients seem better able to distance themselves from the outcome, either because they feel they have tried everything, or because the acupuncture actually changes something to make them feel better. Either way, in the end, being calmer and happier seems to improve the patient experience of treatment, and often the end result also.”  Victoria
• “Our patients have a lot going on. It is unrealistic and unreasonable to think we can manage every aspect of their case. It’s helpful to have a team ready to optimise and support your patients for better outcomes.” Linda 
• “Healthy lifestyle advice is always given but the collaborative practitioners are better at following up … then showing patients the evidence in terms of blood test results, seminograms, weight change etc how the lifestyle changes have positively affected those results.” Victoria

Experience collaborating with Fertile Ground practitioners:

• “Extremely positive… they build relationships for the long term and not just short-term goals.” Linda
• “Reassuring that I know those I work with “know their stuff”.”  Alice
• “Good communication between Fertile Ground and our clinic which is supportive of collaborative shared care.” Anon

Benefits and challenges of collaboration:

• “Working with the right practitioners… many practitioners who claim to be experts in fertility.” Anon
• “I only see benefits. There could be challenges on a financial level.” Victoria

Advice for those considering collaborative care during IVF:

• “I recommend this to my patients. I am aware that ART offers solutions to mechanistic problems – ovulation, tubal and sperm factors but does not deal with underlying health issues or other symptoms. I believe that integrative care considers patients more holistically, and addresses symptoms beyond infertility. I also believe that patients who engage integrative care feel more supported during their treatment.” ANON

Discussion

At Fertile Ground, we observe that collaborative, patient-centered care is reported by both patients and specialists to lead to improved patient outcomes. This approach allows patients to contribute and not just comply with medication. An individualised and nuanced, whole systems program empowers patients to persist and leads to better clinical outcomes.

Collaboration in Practice – Reported Areas of Benefit

While mechanisms underpinning naturopathy and acupuncture in IVF remain an active area of research, growing evidence across diet, lifestyle, supplementation, herbal medicine, and acupuncture suggests potential effects on oocyte and sperm quality, endometrial receptivity, stress regulation and metabolic health. 

IVF specialists and patients in our survey described collaborative care as supporting:

• Improved egg and sperm quality (patient-reported embryo quality, implantation, pregnancy outcomes; specialist observations of healthier patients and better treatment engagement).
• Targeted supplementation to improve outcomes, reduce medication side effects and support pregnancy/baby health.
• Optimised diet, nutrition, and lifestyle changes (weight, exercise, quitting smoking, reducing alcohol, caffeine and endocrine disrupting chemicals).
• Reduced stress, coping/resilience and sleep, with patients reporting greater calm and emotional stability; specialists observing calmer, more engaged patients.
• Enhanced continuity and persistence with IVF treatment, with patients and specialists highlighting greater resilience and ability to “stay the course.”

What does the current research say in support of these interventions?

A substantial body of evidence exists on the role of acupuncture, naturopathy, and lifestyle interventions in IVF outcomes and informs the treatments received at Fertile Ground as part of our collaborative care model. The following represents a brief snapshot of key findings, not an exhaustive review.

Acupuncture

• Associated with 28–32% higher clinical pregnancy, 42% higher ongoing pregnancy, and 30% higher live birth rates compared with no treatment, particularly in women † with prior failed cycles or at clinics with lower baseline success. Outcomes were most favourable with 3–12 treatments prior to embryo transfer day plus treatment before and after transfer, (Hullender Rubin, 2019).
• May improve IVF clinical pregnancy and live birth rates, but results remain inconsistent due to methodological limitations and variability in sham controls (Wang et al., 2021; Manheimer et al., 2008; Smith et al., 2019).
• Reduces IVF-related anxiety and improves emotional wellbeing, with fewer side effects than conventional care alone (Amorim et al., 2018; Hullender Rubin et al., 2022).
• May support male infertility, via neuroendocrine regulation, reduced inflammation, and improved semen quality (Feng et al., 2022).

Evidence for acupuncture in IVF is mixed, limited by small sample sizes, heterogeneity of protocols, and challenges finding an inert control. Nonetheless, biological plausibility, safety, and patient-reported benefits support its potential role as an adjunctive therapy.

Naturopathy (Diet, Lifestyle, Supplementation)

• Diet & Lifestyle: Healthy and Mediterranean diets are linked to improved oocyte quality, embryo yield, and IVF/live birth rates (Jahangirifar et al., 2019; Sun et al., 2019). Weight management, smoking cessation, and alcohol reduction are also well established for improving fertility outcomes (yourfertility.org.au., 2025).
• Environmental Factors: Reducing endocrine disruptor exposure is associated with improved fertilisation and embryo quality (Shen et al., 2024).
• Micronutrients & Supplements: Evidence suggests benefits for IVF outcomes from micronutrient and targeted supplementation (Arhin et al., 2017), including Omega-3s (Trop-Steionberg et al., 2024), Vitamin D (Iliuta et al., 2024; Jukic et al., 2019), CoQ10 (Lin et al., 2024), N-Acetyl Cysteine (Li et al., 2022), Myo-Inositol (Zheng et al., 2017), B12/5-MTHF (Cirillo et al., 2021), Iron (Tulenheimo-Silfvast et al., 2025), and Zinc (Garner et al., 2021).
• Male Fertility: Lifestyle and antioxidant therapy can reduce sperm DNA damage in men with failed IVF/ICSI (Humaidan et al., 2022) and enhance sperm quality and reproductive potential (Kaltasas et al., 2024).

Evidence for naturopathic approaches in IVF is mixed, with most studies focused on single factors, and limited by small samples, supplement quality and protocol variation. Whole-systems, multi-modal research is scarce, though practice and patient reports suggest cumulative “marginal gains” that support wellbeing and persistence.

Conclusion

This pilot study suggests that collaborative care combining naturopathy and acupuncture may offer measurable benefits for patients undergoing IVF. Further research is warranted to evaluate the impact of whole-systems, multi-modal, collaborative care models and mechanisms of actions on IVF, clinical pregnancy and live birth rates, as well as patient-centred outcomes.

Key Points for Clinical Relevance

Patient-Reported Perceived Benefits:

• Collaborative care supported embryo quality, implantation, and healthy pregnancies.
• Side effects of fertility medications were reduced, and targeted supplements supported conception, pregnancy, and baby’s health.
• Patients felt physically and emotionally stronger, coping better through IVF treatment.
• Confidence came from working with knowledgeable, fertility-focused integrative practitioners offering holistic support alongside IVF.

IVF Specialist Observations:

• Patients in integrative care report being more engaged, calmer, and having better overall wellbeing during IVF.
• Patients and IVF specialists reported a high degree of trust in practitioners at Fertile Ground for their expertise, evidence-based approach, and strong communication.
• Collaborative care has the potential to address health and lifestyle factors beyond the scope of IVF alone.
• Qualified, evidence-based practitioners can optimise outcomes while supporting emotional resilience.

Collaborative care integrating naturopathy and acupuncture may enhance patient experience, adherence, and biological readiness, potentially improving IVF outcomes.

† We acknowledge the diversity of people undergoing IVF/ART; terms such as “women” or “infertility patients” reflect study language, not all lived experiences.

Presenter contact information

For further information about our pilot study or Fertile Ground Health Group please contact:

Fertile Ground Health Group

P: 03 9419 9988

www.fertileground.com.au

 

Charmaine Dennis 

BHSc (Nat), PGCert (Repro Med)

Director | Naturopath

email:  charmaine@fertileground.com.au

 

Gina Fox

BHSc (Nat), MA (Repro Med)

Naturopath | Nutritionist

email:  gina@fertileground.com.au

 

Tina Jenkins

B.Nat), MA (Repro Med-with Excellence), B.A., Cert. Nat. Fert. Mgt., Grad Cert (Learning & Teaching)

Naturopath | Torrens University Clinical Supervisor (Naturopathy and Western Herbal Medicine)

email: tina@fertileground.com.au

 

Georgia Marrion

MHNut, BHSc (Comp Med), Adv Dip (Nat)

Naturopath | Nutritionist

email:  georgiamarrion@fertileground.com.au

 

Christina Tolstrup

BHSc (Chinese Med)

Acupuncturist  | Chinese Herbalist

email: christina@fertileground.com.au

Survey Results

• Online surveys created on Typeform.com 

Patient Responses:

• Emailed to the full Fertile Ground database → 13,091 active emails
• 4283 opened emails, 421 clicks to links
• 28 finalised survey responses reporting IVF treatment with collaborative care
• Summary document linked

Collaborative Care in IVF for FG Patients – FINAL SURVEY RESULTS SUMMARY

IVF Specialist Responses:

• Survey emailed to 13 IVF specialists/clinics with existing collaborative relationships with Fertile Ground
• 8 responses received
• Purposive sampling approach used to capture perspectives
• Summary document linked

Collaborative Care in IVF for IVF specialists – FINAL SURVEY RESULTS SUMMARY

 

References

Introduction – Collaborative Care Models

1. Sehgal S et al. Integrative medicine utilization among infertility patients. Reprod Biol Endocrinol. 2023;21(1):71.
2. LoGiudice JA, Massaro J. The impact of complementary therapies on psychosocial factors in women undergoing in vitro fertilization (IVF): a systematic literature review. Appl Nurs Res. 2018;39:220-228.
3. Rayner JA, McLachlan HL, Forster DA, Cramer R. Australian women’s use of complementary and alternative medicines to enhance fertility: exploring the experiences of women and practitioners. BMC Complement Altern Med. 2009;9:52.
4. Sharifi F, Roudsari RL. Complementary and alternative medicine use in infertility: a review of infertile women’s needs. J Educ Health Promot. 2022;11:195.

Discussion – Acupuncture in IVF

1. Hullender Rubin LE. Point of Influence: What is the Role of Acupuncture in In Vitro Fertilization Outcomes? Med Acupunct. 2019;31(6):329-333.
2. Manheimer E et al. Effects of acupuncture on rates of pregnancy and live birth among women undergoing IVF: systematic review and meta-analysis. BMJ. 2008;336:545-549. 
3. Smith CA et al. Acupuncture performed around embryo transfer: systematic review and meta-analysis. Reprod Biomed Online. 2019;38(3):364-379.
4. Wang X et al. Overview of systematic reviews of acupuncture for women undergoing IVF/ET. Front Public Health. 2021;9:651811.
5. Amorim D et al. Acupuncture and electroacupuncture for anxiety disorders: systematic review. Complement Ther Clin Pract. 2018;31:31-37.
6. Hullender Rubin LE et al. Acupuncture for IVF-related anxiety: systematic review and meta-analysis. Reprod Biomed Online. 2022;45(1):69-80.
7. Feng J et al. The efficacy and mechanism of acupuncture in the treatment of male infertility: review. Front Endocrinol. 2022;13:1009537.

Discussion – Naturopathy in IVF – Diet, Lifestyle, Supplements

1. Jahangirifar M et al. Dietary patterns and ART outcomes: a prospective cohort. Int J Fertil Steril. 2019:316-323.
2. Yourfertility.org.au. Lifestyle interventions for fertility. 2025.
3. Shen J et al. Exposure of women undergoing in vitro fertilisation to per- and polyfluoroalkyl substances: evidence on negative effects on fertilisation and high-quality embryos. Environ Pollut. 2024;359:124474.
4. Arhin SK et al. Effect of micronutrient supplementation on IVF outcomes: systematic review. Reprod Biomed Online. 2017;35(6):715-722.
5. Trop-Steionberg S et al. Omega-3 supplements or diets on fertility in women: meta-analysis. Heliyon. 2024;10(8):e29324.
6. liuta F et al. Women’s vitamin D levels and IVF results: systematic review and meta-analysis considering three categories of vitamin status (replete, insufficient and deficient). Hum Fertil. 2022;25(2):228-246.
7. Lin G et al. Clinical evidence of coenzyme Q10 pre-treatment for women with diminished ovarian reserve undergoing IVF/ICSO: a systematic review and meta-analysis. Ann Med. 2024;56(1):2389469.
8. Li X et al. N-acetylcysteine treatment in women with advanced age undergoing IVF/ICSI cycles: prospective study. Front Med. 2022;9:917146.
9. Zheng X et al. Inositol supplement improves clinical pregnancy rate in infertile women undergoing ovulation induction for ICSI or IVF-ET – A meta-analysis and systematic review. Medicine (Baltimore) 2017;96(49):e8842.
10. Cirillo M et al. 5-MTHF and Vitamin B12 supplementation is associated with clinical pregnancy and live birth in women undergoing assisted reproductive technology. Int J Environ Res Public Health. 2021;18(23):12280.
11. Tulenheimo-Silfvast A et al. Association between iron deficiency and fertility. Acta Obstet Gynecol Scand. 2025;104(4):738-745.
12. Garner TB et al. Role of zinc in female reproduction. Biol Reprod. 2021;104(5):976-994.
13. Humaidan P et al.  The combined effect of lifestyle intervention and antioxidant therapy on sperm DNA fragmentation and seminal oxidative stress in IVF patients: pilot study. Int Braz J Urol. 2022;48(1):131-156.
14. Kaltsas A et al. Lifestyle modifications and medicines for male infertility. Diseases. 2024;12(9):209.

Potential mechanisms supporting our clinical approach and outcomes  – A Whole-Systems Approach

Contact authors for further references supporting mechanisms of action. 

• Dietary Patterns (e.g. Mediterranean): May improve metabolic and hormonal regulation, reduce inflammation and oxidative stress, and support gamete and endometrial quality.
• Cellular Function & Methylation: May optimise mitochondrial activity and ATP production; protect DNA integrity via antioxidant effects; and support one-carbon metabolism (folate, B12, choline) for DNA synthesis, repair, and epigenetic programming.
• Blood Flow: May enhance autonomic regulation, vasodilation, and perfusion of ovaries and endometrium, supporting implantation parameters.
• Endometrial Receptivity: Potential improvements in endometrial thickness, vascularity, and receptivity markers.
• Neuroendocrine Modulation: Influencing hypothalamic-pituitary-gonadal signalling and neurotransmitter activity for coordinated reproductive function.
• Metabolic Support: May improve glucose regulation, insulin sensitivity, and nutrient utilisation relevant to folliculogenesis and embryogenesis.
• Anti-inflammatory & Antioxidant Actions: May reduce systemic and local inflammation, attenuate oxidative stress, and protect reproductive tissues.
• Detoxification & Environmental Load Reduction: Support for hepatic clearance pathways and minimisation of endocrine-disrupting chemical exposure.
• Stress Response: Downregulation of sympathetic activity, reduced cortisol, improved parasympathetic balance, and potential support for treatment adherence.
• Male Factor Support: May enhance testicular perfusion, optimise spermatogenesis, and improve sperm DNA integrity through antioxidant, endocrine, and environmental pathways.