Purpose: Auricular acupressure was previously reported to relieve anxiety in the preoperative setting and improve functions of the endocrine system, which may have promises to improve the outcomes of in vitro fertilization.The study was to explore whether auricular acupressure can relieve anxiety during the period from trans-vaginal oocyte retrieval to the embryo transfer in in vitro fertilization treatment and whether auricular acupressure can improve the outcomes of in vitro fertilization.Methods: 305 infertile patients with tubal blockage who were referred for in vitro fertilization were included.The women were randomized into a control group with 102 cases, a Sham-auricular acupressure group with 102 cases and an auricular acupressure group with 101 cases.The anxiety levels were rated with Spielberger's State Trait Anxiety Inventory and the Amsterdam Preoperative Anxiety and Information Scale.Data of clinical pregnancy rate, implantation rate and live birth rate were obtained.The levels of neuropeptide Y and transforming growth factor alpha in the follicular fluids were detected with ELISA.Results: After treatment, in auricular acupressure group, the levels of state anxiety, preoperative anxiety and need-for-information were significantly lower, whereas clinical pregnancy rate, implantation rate, live birth rate and neuropeptide Y levels in the follicular fluids were markedly higher than Sham-auricular acupressure group and control group.No significant differences on transforming growth factor alpha levels in follicular fluids among the three groups.No side-effect was reported in all of the three groups during the treatment.Conclusions: Auricular acupressure could help to reduce anxiety levels associated with in vitro fertilization and improves the outcomes of in vitro fertilization partly through increasing the levels of neuropeptide Y in the follicular fluids.