TCM Gynaecology
Fù Kē 婦科
A clinical reference for menstruation, discharge, pregnancy, postpartum, infertility, menopause and uterine masses — organised around the Kidney–Tiān Guǐ–Chōng–Rèn–Uterus axis, with classical formulas and their source texts.
The four pillars of TCM gynaecology
Every menstrual, obstetric and reproductive pattern in Chinese medicine is read against these four structures.
Tiān Guǐ 天癸
The reproductive essence that arrives around age 14 (2×7) in women and departs around 49 (7×7). Governed by Kidney Jīng; without it there is no menstruation, no ovulation, no conception.
Sù Wèn 素問, Chapter 1 — Shàng Gǔ Tiān Zhēn Lùn 上古天真論
Chōng Mài 衝脈 — Sea of Blood
The Chong vessel houses menstrual and reproductive Blood. When Chong is full, menses arrive on time; when empty or stagnant, cycles fail, spotting, or infertility follows.
Líng Shū 靈樞, Chapter 65 — Wǔ Yīn Wǔ Wèi 五音五味
Rèn Mài 任脈 — Conception Vessel
Rules the uterus (Bāo Gōng 胞宮), yīn fluids, pregnancy and fetal nourishment. Ren opens and Chong descends → menses. Ren must be secured to hold a pregnancy.
Sù Wèn Chapter 1; Nán Jīng 難經 Difficulty 27–29
Liver–Spleen–Kidney axis
Liver stores and moves Blood; Spleen makes and holds Blood; Kidney stores Jīng and roots Tian Gui. Gynaecological disease almost always traces back to one or more of these three.
Fù Rén Dà Quán Liáng Fāng 婦人大全良方 (Chen Zi-Ming, 1237)
Menstrual disorders — Yuè Jīng Bìng 月經病
The core of Fù Kē. Differentiate by timing, quantity, colour, quality, and associated symptoms — then trace back to Kidney, Liver, Spleen and the Chōng-Rèn.
Early menses (Yuè Jīng Xiān Qī 月經先期)
- •Blood Heat (Xuè Rè 血熱) — bright red, heavy, red tongue, rapid pulse
- •Qi Deficiency (Qì Xū 氣虛) failing to hold Blood — pale, thin, fatigue
- •Liver Depression transforming Fire — clots, breast distension, wiry-rapid pulse
Classical formulas: Qīng Jīng Sǎn 清經散 (Fù Qīng Zhǔ Nǚ Kē 傅青主女科); Bǔ Zhōng Yì Qì Tāng 補中益氣湯 (Pí Wèi Lùn 脾胃論)
Delayed menses (Yuè Jīng Hòu Qī 月經後期)
- •Blood Deficiency — scanty pale flow, dizziness, dry skin
- •Kidney Deficiency — long cycles, low back soreness, thin pulse in chi position
- •Blood Cold (Xuè Hán) — dark clotted flow, cold abdomen relieved by warmth
- •Qi Stagnation with Blood Stasis — distending pain, purple clots
Classical formulas: Dà Yíng Jiān 大營煎 (Jǐng Yuè Quán Shū 景岳全書); Wēn Jīng Tāng 溫經湯 (Jīn Guì Yào Lüè 金匱要略, Ch. 22)
Irregular menses (Yuè Jīng Xiān Hòu Wú Dìng Qī 月經先後無定期)
- •Liver Qi Stagnation — mood swings, breast tenderness, wiry pulse
- •Kidney Deficiency (Yin or Yang) — long-standing irregularity from menarche
Classical formulas: Xiāo Yáo Sǎn 逍遙散 (Tài Píng Huì Mín Hé Jì Jú Fāng 太平惠民和劑局方); Gù Yīn Jiān 固陰煎 (Jǐng Yuè Quán Shū)
Heavy menses / flooding (Bēng Lòu 崩漏)
- •Spleen Qi failing to control Blood — pale, exhausted, incessant trickling
- •Blood Heat forcing Blood out of the vessels — bright red gushing, thirst
- •Blood Stasis obstructing the Chōng-Rèn — dark clots then flooding
Classical formulas: Gù Běn Zhǐ Bēng Tāng 固本止崩湯 (Fù Qīng Zhǔ Nǚ Kē); Qīng Rè Gù Jīng Tāng 清熱固經湯; Táo Hóng Sì Wù Tāng 桃紅四物湯
Amenorrhoea (Bì Jīng 閉經)
- •Deficiency type — Kidney Jing/Blood empty, no material to make menses
- •Excess type — Blood stasis, phlegm-damp, or Qi stagnation blocking the uterus
Classical formulas: Guī Shèn Wán 歸腎丸 (Jǐng Yuè Quán Shū); Cāng Fù Dǎo Tán Wán 蒼附導痰丸; Xuè Fǔ Zhú Yū Tāng 血府逐瘀湯 (Yī Lín Gǎi Cuò 醫林改錯)
Painful menses (Tòng Jīng 痛經, dysmenorrhoea)
- •Qi Stagnation & Blood Stasis — pre-menstrual distending stabbing pain, better after clots pass
- •Cold-Damp obstructing the uterus — pain relieved by heat, dark thin flow
- •Damp-Heat pouring down — burning pain, thick discharge, red tongue
- •Qi & Blood Deficiency — dull ache after menses, relieved by pressure
- •Liver-Kidney Deficiency — chronic dull ache, low back soreness
Classical formulas: Gé Xià Zhú Yū Tāng 膈下逐瘀湯 (Yī Lín Gǎi Cuò); Shào Fù Zhú Yū Tāng 少腹逐瘀湯; Wēn Jīng Tāng 溫經湯 (Jīn Guì Yào Lüè)
PMS (Jīng Xíng Qián Hòu Zhū Zhèng 經行前後諸症)
- •Liver Qi Stagnation with Spleen deficiency — irritability, bloating, breast pain
- •Liver-Kidney Yin Deficiency with Yang rising — headaches, insomnia, night sweats
- •Phlegm-Damp — cyclical acne, oedema, heaviness
Classical formulas: Dān Zhī Xiāo Yáo Sǎn 丹梔逍遙散; Yī Guàn Jiān 一貫煎 (Xù Míng Yī Lèi Àn 續名醫類案)
Leukorrhea & pelvic infection — Dài Xià Bìng 帶下病
All discharge is a Dampness problem at root — the differentiation is which organ generated it and whether Heat, Cold or Toxin has joined.
Spleen Qi Deficiency (Pí Xū Dài Xià)
White, thin, copious, no odour, worse with fatigue. Pale tongue, weak pulse.
Wán Dài Tāng 完帶湯 (Fù Qīng Zhǔ Nǚ Kē)
Kidney Yang Deficiency
Clear watery persistent leukorrhea, cold low back, frequent pale urine.
Nèi Bǔ Wán 內補丸 (Fù Rén Dà Quán Liáng Fāng)
Damp-Heat pouring down (Shī Rè Xià Zhù)
Yellow or green thick discharge, foul odour, itch, red tongue with greasy yellow coat.
Zhǐ Dài Fāng 止帶方; Yì Yǐ Fù Zǐ Bài Jiàng Sǎn 薏苡附子敗醬散 (Jīn Guì Yào Lüè) for pelvic pus
Damp-Toxin (Shī Dú) — commonly BV, trichomonas, chronic PID
Purulent, blood-streaked, foul discharge; lower abdominal pain, fever.
Wǔ Wèi Xiāo Dú Yǐn 五味消毒飲 modified; Huáng Bǎi + Kǔ Shēn 苦參 washes
Pregnancy — Rèn Shēn Bìng 妊娠病
Treatment during pregnancy must safeguard the fetus first. Use only pregnancy-safe herbs and avoid strong descending / Blood-moving / warm-acrid substances unless clearly indicated and dosed with care.
Refer, do not manage alone: heavy bleeding, severe abdominal pain, fever > 38°C, suspected ectopic, blood-pressure spike, decreased fetal movement, or any red-flag obstetric sign requires immediate biomedical assessment.
Morning sickness (Rèn Shēn È Zǔ 妊娠惡阻)
Stomach Qi rebelling upward, worsened by Chōng qi ascending. Differentiate Stomach Deficiency-Cold, Stomach Heat, Liver-Stomach disharmony, Phlegm-Damp.
Xiāng Shā Liù Jūn Zǐ Tāng 香砂六君子湯; Sū Yè Huáng Lián Tāng 蘇葉黃連湯 (Wēn Rè Jīng Wěi 溫熱經緯)
Threatened miscarriage (Tāi Dòng Bù Ān 胎動不安) & habitual miscarriage (Huá Tāi 滑胎)
Kidney deficiency failing to secure the fetus is the primary axis. Also Qi-Blood deficiency, Blood Heat, or trauma/Blood stasis.
Shòu Tāi Wán 壽胎丸 (Yī Xué Zhōng Zhōng Cān Xī Lù 醫學衷中參西錄, Zhang Xichun); Tài Shān Pán Shí Sǎn 泰山磐石散
Ectopic pregnancy (Yì Wèi Rèn Shēn) — TCM adjunct only
Emergency Western referral. TCM used adjunctively in stable, unruptured cases follows the Shan-xi protocol: resolve Blood stasis, transform mass.
Gōng Wài Yùn I & II 宫外孕 I, II 方 (methotrexate adjunct only, hospital setting).
Gestational hypertension / pre-eclampsia (Zǐ Xián 子癇, Zǐ Yūn 子暈)
Liver Yang Rising on a background of Yin-Blood deficiency; internal Wind risk.
Qǐ Jú Dì Huáng Wán 杞菊地黃丸; Líng Jiǎo Gōu Téng Tāng 羚角鉤藤湯 (Tōng Sú Shāng Hán Lùn 通俗傷寒論)
Postpartum — Chǎn Hòu Bìng 產後病
Postpartum women are simultaneously Blood-empty and Blood-stasis prone. The classical injunction: "warm without generating heat, disperse without breaking, tonify without stagnating."
Postpartum abdominal pain (Chǎn Hòu Fù Tòng)
Pattern: Blood stasis in the uterus; or Blood-Qi deficiency with Cold.
Shēng Huà Tāng 生化湯 (Fù Qīng Zhǔ Nǚ Kē) — the classical postpartum formula.
Retained lochia (È Lù Bù Jué 惡露不絕)
Pattern: Qi deficiency, Blood Heat, or Blood stasis.
Shēng Huà Tāng modified; Bǎo Yīn Jiān 保陰煎 for Heat pattern.
Postpartum fever (Chǎn Hòu Fā Rè)
Pattern: Rule out puerperal sepsis first. TCM patterns: infection/toxin, Blood stasis, deficiency, or externally contracted.
Wǔ Wèi Xiāo Dú Yǐn 五味消毒飲; Xiǎo Chái Hú Tāng 小柴胡湯 (Shāng Hán Lùn line 96) for Shaoyang pattern.
Insufficient lactation (Quē Rǔ 缺乳)
Pattern: Qi & Blood deficiency (no milk to give) vs Liver Qi Stagnation (milk exists but does not flow).
Tōng Rǔ Dān 通乳丹 (Fù Qīng Zhǔ Nǚ Kē); Xià Rǔ Yǒng Quán Sǎn 下乳湧泉散
Postpartum depression (Chǎn Hòu Yù Zhèng)
Pattern: Heart-Spleen deficiency; Liver Qi Stagnation; Blood deficiency failing to nourish Shen.
Guī Pí Tāng 歸脾湯 (Jì Shēng Fāng 濟生方); Gān Mài Dà Zǎo Tāng 甘麥大棗湯 (Jīn Guì Yào Lüè).
Infertility, menopause & pelvic masses
Infertility (Bù Yùn 不孕)
Kidney deficiency is the root; Liver Qi stagnation, Blood stasis, Phlegm-Damp (classic PCOS picture) and Uterine Cold are common branches. Formulas: Yù Lín Zhū 毓麟珠 (Jǐng Yuè Quán Shū), Kāi Yù Zhǒng Yù Tāng 開鬱種玉湯 (Fù Qīng Zhǔ Nǚ Kē), Cāng Fù Dǎo Tán Wán for phlegm-damp PCOS, Shào Fù Zhú Yū Tāng for endometriosis-related infertility.
Perimenopause & menopause (Jué Jīng Qián Hòu Zhū Zhèng 絕經前後諸症)
Kidney Yin and Yang decline together, often with Yin deficiency predominant → hot flushes, night sweats, insomnia, palpitations, mood lability. Formulas: Zuǒ Guī Wán 左歸丸 & Yòu Guī Wán 右歸丸 (Jǐng Yuè Quán Shū), Èr Xiān Tāng 二仙湯 (a modern classic bridging Yin & Yang Xu), Gān Mài Dà Zǎo Tāng for tearfulness.
Uterine masses (Zhēng Jiǎ 癥瘕) — fibroids, endometriosis, ovarian cysts
Zhēng (fixed) vs Jiǎ (moving) — Qi/Blood/Phlegm/Cold accumulating in the Bao Gong. Formulas: Guì Zhī Fú Líng Wán 桂枝茯苓丸 (Jīn Guì Yào Lüè, Ch. 22) — the seminal formula; Dà Huáng Zhè Chóng Wán 大黃蟅蟲丸 for dense stasis; Cāng Fù Dǎo Tán Wán for phlegm-cyst PCOS morphology.
Chronic PID (Pén Qiāng Yán) & pelvic pain
Damp-Heat lingering with Blood stasis is the dominant pattern in chronic disease. Formula backbone: Yì Yǐ Fù Zǐ Bài Jiàng Sǎn 薏苡附子敗醬散 (Jīn Guì Yào Lüè) combined with Xuè Fǔ Zhú Yū Tāng. External retention enemas with Hóng Téng 紅藤 and Bài Jiàng Cǎo 敗醬草 are widely used in China.
IVF & ART support — integrative TCM alongside assisted reproduction
Chinese medicine sits alongside IVF, not against it. The goal is better egg quality, a receptive endometrium, a calmer nervous system and a secured Rèn Mài through the two-week wait — timed carefully around stimulation, retrieval and transfer so nothing interferes with the reproductive endocrinologist's protocol.
Collaborative care model: herbs typically pause once ovarian stimulation begins; acupuncture continues throughout. Always tell the IVF clinic what you're using, and stop any Blood-moving formula at least two weeks before stimulation starts.
Pick the pattern that best matches your presentation — the recommended treatment plan and FAQ answers below will update to that pattern's strategy, formulas, points and timing.
Recommended TCM treatment
Kidney Yin deficiency (Shèn Yīn Xū 腎陰虛)
Signs: Short luteal phase, thin endometrium (<7 mm), high FSH, low AMH, poor egg quality, night sweats, dry vagina, red tongue with little coat, thin-rapid pulse.
Strategy: Nourish Kidney Yin and Blood, build the endometrium and fluids of the follicle.
Formulas: Zuǒ Guī Wán 左歸丸 (Jǐng Yuè Quán Shū); Liù Wèi Dì Huáng Wán 六味地黃丸; Èr Zhì Wán 二至丸.
Points: KI-3, KI-6, SP-6, REN-4, BL-23, BL-52, SP-10.
FAQ tailored to this pattern
How long before IVF should I start treatment?
Yin deficiency is slow to rebuild — allow a full 90-day folliculogenesis window, ideally 3–4 months. Weekly acupuncture plus Zuǒ Guī Wán / Èr Zhì Wán through the follicular phase, and stop moving herbs 2 weeks before stimulation.
What lifestyle changes matter most for my pattern?
Protect Yin — bed before 11pm, cut caffeine and alcohol, avoid saunas and hot yoga, eat cooling nourishing foods (black sesame, goji, mulberry, bone broth). CoQ10 300–600 mg and vitamin D help follicular fluid quality.
Which points will be prioritised on transfer day?
KI-3, KI-6 and SP-6 to nourish Yin and thicken lining pre-transfer; ST-36 and REN-4 (needled only, no moxa) after transfer. No strong LI-4 or lower-abdomen stimulation from transfer day onward.
The evidence base
Click any study for the full citation, trial design, key numbers and honest caveats.
Pattern differentiation for IVF candidates
Kidney Yin deficiency (Shèn Yīn Xū 腎陰虛)
Signs: Short luteal phase, thin endometrium (<7 mm), high FSH, low AMH, poor egg quality, night sweats, dry vagina, red tongue with little coat, thin-rapid pulse.
Strategy: Nourish Kidney Yin and Blood, build the endometrium and fluids of the follicle.
Formulas: Zuǒ Guī Wán 左歸丸 (Jǐng Yuè Quán Shū); Liù Wèi Dì Huáng Wán 六味地黃丸; Èr Zhì Wán 二至丸.
Points: KI-3, KI-6, SP-6, REN-4, BL-23, BL-52, SP-10.
Kidney Yang deficiency (Shèn Yáng Xū 腎陽虛)
Signs: Cold uterus, low basal body temperature, weak ovulation, low progesterone in the luteal phase, low libido, cold limbs, loose stool, pale tongue with white coat, deep-weak pulse.
Strategy: Warm Kidney Yang and Ming-Mén, warm the uterus, support implantation.
Formulas: Yòu Guī Wán 右歸丸; Wēn Bāo Yǐn 溫胞飲 (Fù Qīng Zhǔ Nǚ Kē); Jīn Guì Shèn Qì Wán 金匱腎氣丸.
Points: REN-4 + REN-6 with moxa, BL-23, KI-3, KI-7, ST-29, Zǐ Gōng — moxa lower abdomen in pre-transfer window.
Liver Qi stagnation (Gān Yù 肝鬱)
Signs: Classic IVF-stress presentation — irritability, breast tenderness, cycle irregularity, poor response despite reasonable reserve, wiry pulse. Common in high-achieving women in prolonged treatment.
Strategy: Course Liver Qi, harmonise Chōng-Rèn, calm Shén.
Formulas: Xiāo Yáo Sǎn 逍遙散 (Tài Píng Huì Mín Hé Jì Jú Fāng); Chái Hú Shū Gān Sǎn 柴胡疏肝散; add Suān Zǎo Rén Tāng for sleep.
Points: LR-3 + LI-4 (Four Gates), PC-6, HT-7, Yìn Táng, GB-34, SP-6.
Blood stasis (Xuè Yū 血瘀)
Signs: Endometriosis, adenomyosis, prior pelvic surgery, dark clotted menses, fixed stabbing pain, purple tongue with sublingual varicosities. Major driver of implantation failure.
Strategy: Invigorate Blood, resolve stasis in the Bāo Gōng — best worked in the follicular phase, eased right down after ovulation.
Formulas: Guì Zhī Fú Líng Wán 桂枝茯苓丸 (Jīn Guì Yào Lüè); Shào Fù Zhú Yū Tāng 少腹逐瘀湯 (Yī Lín Gǎi Cuò); Xuè Fǔ Zhú Yū Tāng.
Points: SP-10, SP-8, LR-3, BL-32, ST-29, Zǐ Gōng — with electroacupuncture at 2 Hz for perfusion.
Phlegm-Damp (Tán Shī 痰濕) — PCOS phenotype
Signs: Anovulation, elevated LH:FSH, insulin resistance, higher BMI, oily skin/acne, thick greasy tongue coat, slippery pulse. Common cause of OHSS risk in IVF stimulation.
Strategy: Transform phlegm, dry damp, restore ovulation and endometrial receptivity.
Formulas: Cāng Fù Dǎo Tán Wán 蒼附導痰丸; Èr Chén Tāng 二陳湯 + Cāng Zhú, Xiāng Fù; Guì Zhī Fú Líng Wán when cysts co-exist.
Points: ST-40, SP-9, REN-9, ST-29, SP-6, Zǐ Gōng — combined with dietary carbohydrate reform and inositol.
Heart–Kidney disharmony (Xīn Shèn Bù Jiāo 心腎不交)
Signs: The picture after multiple failed cycles: insomnia, anxiety, palpitations, mid-cycle spotting, red tongue tip, thin-rapid pulse. Directly suppresses hypothalamic-pituitary-ovarian rhythm.
Strategy: Descend Heart Fire, tonify Kidney Yin, re-establish the Water-Fire axis.
Formulas: Tiān Wáng Bǔ Xīn Dān 天王補心丹; Huáng Lián Ē Jiāo Tāng 黃連阿膠湯 (Shāng Hán Lùn); Gān Mài Dà Zǎo Tāng for tearfulness.
Points: HT-7, KI-6, KI-3, PC-6, REN-15, Yìn Táng, Ān Mián.
IVF acupuncture point grid by pattern
Working point lists for each of the six IVF patterns above, with the indication for every point and a short note on how the prescription is put together. Use these as a starting frame — always adjust for cycle phase, stimulation day and the reproductive endocrinologist's timeline.
Kidney Yin deficiency (Shèn Yīn Xū 腎陰虛)
How points are selected: Pick Kidney Yin source and river points to nourish Jīng, add Chōng-Rèn openers to thicken the endometrium, and finish with Blood-building points in the follicular phase. Even, quiet needle technique — no strong reduction. 20–25 minutes, retained.
- KI-3 Tài Xī 太溪 — Kidney Yuán-source, foundational Yin tonic — thickens follicular fluid and endometrium.
- KI-6 Zhào Hǎi 照海 — Opens Yīn Qiāo Mài, nourishes Kidney Yin and uterine lining, quiets Shén at night.
- SP-6 Sān Yīn Jiāo 三陰交 — Meeting of the three Yin — nourishes Blood and Yin, regulates the cycle. Stop from day of transfer.
- REN-4 Guān Yuán 關元 — Front-Mù of Small Intestine, gathers Yuán Qi to the uterus. Needle only — no moxa in Yin Xū heat picture.
- BL-23 Shèn Shū 腎俞 — Back-Shū of Kidney — direct tonification of Kidney Jīng.
- BL-52 Zhì Shì 志室 — Outer Bladder line — strengthens Kidney will and reproductive vitality.
- SP-10 Xuè Hǎi 血海 — Sea of Blood — builds endometrial thickness in the follicular phase.
Cautions: No moxa on the abdomen (aggravates Yin Xū heat). Skip KI-2 and any Fire-reducing points once stimulation starts.
Kidney Yang deficiency (Shèn Yáng Xū 腎陽虛)
How points are selected: Warm the Ming-Mén and lower burner with moxa on Rèn Mài and Bladder-line Shū points. Use tonification technique and long retention. Ideal in the luteal phase and pre-treatment window — stop all abdominal moxa from the day of embryo transfer.
- REN-4 + REN-6 (moxa) — Warms Kidney Yang and Ming-Mén, secures Uterus and lower burner.
- BL-23 Shèn Shū 腎俞 — Direct Kidney Yang tonification via the back-Shū — moxa cone or stick.
- KI-3 Tài Xī 太溪 — Anchors both Yin and Yang of the Kidneys — the pairing point for Yang tonics.
- KI-7 Fù Liū 復溜 — Metal point of Kidney channel — warms Yang, regulates fluid metabolism, supports implantation.
- ST-29 Guī Lái 歸來 — Local uterine point — 'return' the menses and warm the Bāo Gōng.
- Zǐ Gōng 子宮 (extra) — Bilateral extra point over the uterus — direct effect on ovarian and endometrial perfusion.
- GV-4 Mìng Mén 命門 — Root of Ming-Mén fire — moxa in pre-treatment window.
Cautions: No moxa on the abdomen once stimulation begins; keep BL-23 warmth only via wheat pack from transfer day onward.
Liver Qi stagnation (Gān Yù 肝鬱)
How points are selected: Free the Liver, calm Shén and open the Chōng-Rèn. Distal points first, then a small number of local uterine points. Even technique with brief manipulation — avoid heavy reduction, which drops already-taxed Qi in stimulation cycles.
- LR-3 Tài Chōng 太衝 + LI-4 Hé Gǔ 合谷 — Four Gates — moves Qi and Blood, releases held tension across the whole body.
- PC-6 Nèi Guān 內關 — Opens the Yīn Wéi Mài, regulates Heart and chest Qi, eases breast tenderness.
- HT-7 Shén Mén 神門 — Quiets the Shén, useful for cycle anxiety and sleep.
- Yìn Táng 印堂 (extra) — Calms Shén, anchors the mind on the table — routine pre-transfer point.
- GB-34 Yáng Líng Quán 陽陵泉 — He-sea of Gallbladder — softens tendon-vessel tension driven by Liver Qi bind.
- SP-6 Sān Yīn Jiāo 三陰交 — Regulates the three Yin and menses — before transfer only, then avoided.
- GB-41 + SJ-5 — Dài Mài opener pair — useful for lateral pelvic tension and mid-cycle irritability.
Cautions: Drop LI-4 from the day of embryo transfer. Avoid strong SP-6 reduction from transfer day forward.
Blood stasis (Xuè Yū 血瘀)
How points are selected: Move Blood in the Bāo Gōng during the follicular phase with electroacupuncture at 2 Hz across paired lower-abdomen points, then switch to gentle tonification from ovulation. All Blood-moving work stops from the day of embryo transfer.
- SP-10 Xuè Hǎi 血海 — Sea of Blood — invigorates and cools stagnant Blood.
- SP-8 Dì Jī 地機 — Xì-cleft of Spleen — strong Blood-moving point for dysmenorrhoea and endometriosis. Follicular phase only.
- LR-3 Tài Chōng 太衝 — Regulates Liver Blood, releases pelvic congestion.
- BL-32 Cì Liáo 次髎 — Sacral foramen point — pelvic perfusion, especially useful with adenomyosis.
- ST-29 Guī Lái 歸來 — Local uterine point paired with Zǐ Gōng for electroacupuncture at 2 Hz.
- Zǐ Gōng 子宮 (extra) — Direct uterine effect — the paired point for peri-follicular electroacupuncture.
- REN-6 Qì Hǎi 氣海 — Sea of Qi — moves Qi to break Blood stasis in the lower burner.
Cautions: Electroacupuncture across the abdomen must be off by transfer day and stays off through pregnancy. Skip SP-8 and BL-32 once implantation window opens.
Phlegm-Damp (Tán Shī 痰濕) — PCOS phenotype
How points are selected: Transform Phlegm and drain Damp from the middle and lower burner, then support ovulation with local uterine points. Twice-weekly through stimulation to lower OHSS risk. Combine with inositol, low-GI diet and resistance training.
- ST-40 Fēng Lóng 豐隆 — Master point for phlegm — the anchor point of any Tán Shī prescription.
- SP-9 Yīn Líng Quán 陰陵泉 — He-sea of Spleen — drains Damp from the lower burner.
- REN-9 Shuǐ Fēn 水分 — Regulates fluid metabolism, useful when abdominal Damp is heavy.
- ST-36 Zú Sān Lǐ 足三里 — Strengthens Spleen Qi so it stops generating Phlegm at source.
- ST-29 Guī Lái 歸來 — Local uterine point — restores ovulation in anovulatory PCOS.
- SP-6 Sān Yīn Jiāo 三陰交 — Regulates the three Yin, supports insulin sensitivity via Spleen and Kidney.
- Zǐ Gōng 子宮 (extra) — Ovarian perfusion — helpful pre-trigger to encourage even follicular development.
Cautions: Watch for early OHSS after retrieval — bloating, rapid weight gain, breathlessness go straight to the fertility clinic.
Heart–Kidney disharmony (Xīn Shèn Bù Jiāo 心腎不交)
How points are selected: Descend Heart Fire and lift Kidney Water to re-establish the Shào Yīn axis. Use light, quiet needling with long retention and low room lighting. Add an extra session 2–3 days after transfer for nervous-system support.
- HT-7 Shén Mén 神門 — Yuán-source of Heart — descends Fire, quiets Shén, treats palpitations and insomnia.
- KI-6 Zhào Hǎi 照海 — Opens Yīn Qiāo Mài, lifts Kidney Yin to meet Heart Fire.
- KI-3 Tài Xī 太溪 — Anchors the Kidney foundation of the axis.
- PC-6 Nèi Guān 內關 — Opens Yīn Wéi Mài — settles the chest and calms cycle-grief anxiety.
- REN-15 Jiū Wěi 鳩尾 — Luo of Rèn Mài, powerful Shén-quieting point for post-failed-cycle presentations.
- Yìn Táng 印堂 (extra) — Anchors the mind on the table — routine for the two-week wait.
- Ān Mián 安眠 (extra) — 'Peaceful sleep' — nightly self-massage or press-tacks between sessions.
Cautions: Avoid strong stimulation of any point — this pattern is exhausted, not excess. No electroacupuncture.
Cycle-by-cycle protocol
Pre-treatment (3–6 months out)
Goal: Optimise egg quality (folliculogenesis takes ~90 days), regulate the cycle, treat any underlying pattern. This is where TCM does the most work.
Weekly acupuncture. Individualised herbs by phase — Yin/Blood tonics follicular, Yang/Kidney tonics luteal, moving formulas at menses. Address diet, sleep, alcohol, caffeine. CoQ10, methylated folate, vitamin D, omega-3 as adjuncts. Cease all Blood-moving herbs 2 weeks before stimulation starts.
Ovarian stimulation (Days 1–12 of the IVF cycle)
Goal: Support multi-follicular development, protect the endometrium, reduce injection-site bruising and OHSS risk.
2 sessions per week. Points: KI-3, SP-6, ST-29, Zǐ Gōng, REN-4 (needled only, no moxa now), plus SP-10/LR-3 for stagnation and PC-6/HT-7 for stress. Herbs paused during stimulation in most Australian clinics to avoid pharmacokinetic uncertainty — acupuncture and lifestyle continue.
Egg retrieval & the transfer window
Goal: Reduce uterine contractility, warm the uterus, prime endometrial receptivity, calm the sympathetic surge.
Paulus protocol: 25 minutes before and 25 minutes after embryo transfer. Pre-transfer points — PC-6, SP-8, LR-3, GV-20, ST-29. Post-transfer — ST-36, SP-6 (light stimulation), KI-3, REN-4 with soft moxa if allowed. Warm the lower abdomen, avoid strong Blood-moving herbs, no aggressive needling of SP-6 or LI-4 from transfer day onward.
Two-week wait (luteal support)
Goal: Support progesterone action, secure the Rèn Mài, quiet Shén, prevent early miscarriage.
1–2 gentle sessions. Points: REN-4, REN-6, KI-3, KI-9 (Zhú Bīn — the pregnancy 'guest'), ST-36, BL-23, Yìn Táng. Avoid SP-6, LI-4, BL-60, BL-67, GB-21, ST-30, LR-3 strongly needled, and any lower-abdomen or lumbosacral electroacupuncture. Shòu Tāi Wán 壽胎丸 (Yī Xué Zhōng Zhōng Cān Xī Lù) if the practitioner is confident and the fertility specialist is aware.
Early pregnancy confirmed
Goal: Prevent threatened miscarriage, manage nausea, support rising HCG, continue Rèn Mài security to 12 weeks.
Weekly acupuncture through the first trimester. PC-6 + ST-36 for nausea, KI-9 for fetal calming, REN-4 with moxa cone (not stick) if cold-Xu picture. Shòu Tāi Wán or Bǎo Chǎn Wú Yōu Fāng for recurrent pregnancy loss history, in collaboration with the obstetric team.
Failed cycle — recovery
Goal: Clear residual medication effects, restore ovulation, process grief, prepare for the next cycle.
Full course of moving formulas early (Xuè Fǔ Zhú Yū Tāng, Shào Fù Zhú Yū Tāng) then rebuild with Kidney tonics. Gān Mài Dà Zǎo Tāng and PC-6 + HT-7 + Yìn Táng for the grief. Minimum one natural cycle before returning to stimulation is standard.
Interactive IVF protocol timeline
A stage-by-stage walkthrough of a full integrative IVF cycle. Tick the checklist as you go — progress is saved to this device so you can pick up between visits.
Step 1 of 6 · 3–6 months out
Pre-treatment
Build the terrain — egg quality, endometrial receptivity, cycle rhythm and nervous-system baseline before the clinic clock starts.
Watch-outs for this stage
- • This is where TCM does the heaviest lifting — don't skip the runway to save time.
- • Address weight, thyroid and iron before stimulation, not during.
Safety, contraindications & collaboration
- Always coordinate with the reproductive endocrinologist. Herbs can interact with gonadotropins, GnRH analogues and progesterone support — most Australian IVF units prefer herbs paused from stimulation onward.
- TGA-restricted herbs (Ephedra, Aconite, Xì Xīn full dose) are never appropriate in fertility or pregnancy protocols.
- Electroacupuncture around the abdomen is avoided from embryo transfer onward and throughout pregnancy.
- Contraindicated pregnancy points (SP-6, LI-4, BL-60, BL-67, GB-21, lower abdomen and lumbosacral strong needling) apply from the day of transfer, not from the positive test.
- Any bleeding, severe cramping, positive HCG that stops rising, or suspected ectopic must be referred to the IVF clinic immediately — do not attempt to hold with acupuncture alone.
The gynaecology point toolkit
The workhorse points across almost every Fù Kē protocol. Combine root (Kidney/Liver/Spleen shu-points, REN-4, KI-3) with branch (SP-6, SP-10, BL-32, LR-3, Zǐ Gōng).
SP-6 Sān Yīn Jiāo 三陰交
Meeting of the 3 leg Yin — regulates menses, tonifies Blood, moves Blood stasis. Contraindicated in pregnancy.
SP-10 Xuè Hǎi 血海
Sea of Blood — cools Blood, resolves stasis, regulates menstruation.
SP-8 Dì Jī 地機
Xi-cleft of Spleen — powerful for acute dysmenorrhoea.
LR-3 Tài Chōng 太衝
Moves Liver Qi, subdues rising Yang — PMS, irregular cycles, breast distension.
REN-4 Guān Yuán 關元
Tonifies Kidney and Original Qi, warms the uterus. Front-mu of Small Intestine, meeting of the 3 leg Yin with Ren. Contraindicated for needling in pregnancy — moxa allowed.
REN-3 Zhōng Jí 中極
Front-mu of Bladder — regulates lower jiao, treats leukorrhea and dysuria.
REN-6 Qì Hǎi 氣海
Sea of Qi — tonifies Yuan Qi, moves lower jiao stagnation.
ST-29 Guī Lái 歸來
Uterine descent / prolapse, amenorrhoea, dysmenorrhoea — literally 'return'.
ST-30 Qì Chōng 氣衝
Meeting point with Chōng vessel — regulates the Sea of Blood.
KI-3 Tài Xī 太谿
Yuan-source of Kidney — foundation for infertility, menopause, chronic gynae disease.
KI-13 Qì Xué 氣穴
Meeting of Kidney and Chōng — infertility, irregular menses.
BL-32 Cì Liáo 次髎
Second sacral foramen — the single most-used sacral point in menstrual disorders and labour analgesia.
BL-23 Shèn Shū 腎俞 & BL-52 Zhì Shì 志室
Back-shu of Kidney — chronic gynae deficiency patterns, lumbar pain in pregnancy.
GB-26 Dài Mài 帶脈
Confluent point of the Girdle vessel — the classical point for leukorrhea (Dài Xià).
Zǐ Gōng Xué 子宮穴 (Extra)
3 cun lateral to Ren-3 — the 'Uterus point'; infertility, prolapse, dysmenorrhoea.
PC-6 Nèi Guān 內關
Confluent of Yīn Wéi Mài — the primary point for morning sickness, paired with ST-36.
The gynaecology canon
Every pattern and formula on this page can be traced back to one of these source texts.
Sù Wèn 素問, Chapter 1 (Shàng Gǔ Tiān Zhēn Lùn)
The 7×7 female life-cycle: menarche, fertility, menopause, keyed to Tiān Guǐ and the Chōng-Rèn.
Jīn Guì Yào Lüè 金匱要略, Chapters 20–22 (Zhang Zhongjing)
The first systematic gynae text: pregnancy, postpartum and miscellaneous women's diseases. Home of Guì Zhī Fú Líng Wán and Wēn Jīng Tāng.
Fù Rén Dà Quán Liáng Fāng 婦人大全良方 (Chen Zi-Ming, 1237)
24 volumes, the first free-standing gynaecology compendium in East Asia.
Jǐng Yuè Quán Shū 景岳全書, Fù Rén Guī 婦人規 (Zhang Jing-Yue, Ming)
Emphasis on Kidney and Ming-Men fire in women's disease; source of Zuǒ Guī / Yòu Guī and Dà Yíng Jiān.
Fù Qīng Zhǔ Nǚ Kē 傅青主女科 (Fu Shan, Qing)
The most clinically influential gynae text of the Qing dynasty. Source of Wán Dài Tāng, Shēng Huà Tāng, Qīng Jīng Sǎn, Kāi Yù Zhǒng Yù Tāng, Tōng Rǔ Dān.
Yī Xué Zhōng Zhōng Cān Xī Lù 醫學衷中參西錄 (Zhang Xichun, early 20th c.)
Bridged classical and biomedical thinking; source of Shòu Tāi Wán for habitual miscarriage.
Turn a gynaecology case into a full treatment plan
Enter any Western gynae diagnosis — endometriosis, PCOS, dysmenorrhoea, unexplained infertility, perimenopausal insomnia — and get pattern differentiation, acupuncture protocol, herbal formula and evidence in one click.