Abstract Background:
The influence of acupuncture on female fertility is of interest to people in clinical practice and acupuncture researchers. Despite developing research in the field, there is a marked absence of research defining an adequate treatment to support and treat women experiencing delays in conceiving.

Objectives:
The aims of this study were to develop a consensus among acupuncture fertility specialists on what is adequate acupuncture treatment to promote female fertility in the periconception period; to examine what acupuncturists do in a consultation; to examine their actions and their exchanges with their patients; and to finalize an acupuncture intervention for a clinical trial of fertility problems.

Design and subjects:
An online consensus-building technique was used among acupuncturists who are recognized experts in the field of women's reproductive health. The 10 subjects were selected on the basis of their published work with respect to treating female fertility problems or on the recommendation of researchers who had published articles in this discipline. All 10 subjects currently, or until recently, treated (some exclusively) women facing fertility problems using acupuncture as one of the modalities to address these problems.

Results:
Although the participants were relatively diverse, a consensus emerged regarding the best way to provide acupuncture to women with fertility problems. Along the way, a rich vein of qualitative data emerged about the way in which acupuncture is applied. These data included, for example, the high value placed on differential diagnosis and the importance of the practitioner-patient relationship for the therapeutic outcome.

Conclusions:
Consensus building among experts provides a transparent method of protocol development suited to acupuncture research that will then hold relevance to clinical practice.