A literature review from the USA provides an overview of the use of acupuncture as an adjunctive therapy for in vitro fertilisation (IVF). The authors used biomedical and acupuncture databases cross-referenced with published data, personal libraries and Chinese medicine textbooks. They concluded that limited but supportive evidence from clinical trials and case series suggests that acupuncture may improve the success rate of IVF and the quality of life of patients undergoing the process. They urged caution in interpreting study results, due to design limitations, and commented that the acupuncture described was often not consistent with traditional Chinese medical principles. Acupuncture was judged to be a safe adjunctive therapy. The reviewed literature suggested four possible mechanisms by which acupuncture could improve IVF outcomes: modulation of neuroendocrine factors: improvement of blood flow to the uterus; modulation of cytokines; and reduction of stress, anxiety and depression.  The need for more high-quality studies was noted.  (In vitro fertilization and acupuncture: clinical efficacy and mechanistic basis.  Altern Ther Health Med. 2007 May- Jun:13(3):38-48).