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Effects of acupuncture on pregnancy outcomes in women undergoing in vitro fertilization: an updated systematic review and meta-analysis

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Abstract

Purpose

To evaluate the effects of acupuncture on IVF-ET outcomes.

Methods

Digital databases, including Pubmed, Embase, the Cochrane Library, the Web of Science and ScienceDirect, were searched from their inception to July 2022. The MeSH terms we used included: acupuncture, in vitro fertilization, assisted reproductive technology and randomized controlled trial. The reference lists of relevant documents were also searched. The biases of included studies were assessed by the Cochrane Handbook 5.3. The major outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). The pregnancy outcomes reported in these trials were pooled and expressed as risk ratios (RR) with 95% confidence interval (CI) in the Review Manager 5.4 meta-analysis software. Heterogeneity of the therapeutic effect was evaluated with a forest plot analysis. Publication bias was assessed by a funnel plot analysis.

Results

Twenty-five trials (a total of 4757 participants) were included in this review. There were no significant publication biases for most of the comparisons among these studies. The pooled CPR (25 trials) of all the acupuncture groups (43.6%) was significantly higher than that of all the control groups (33.2%, P < 0.00001), and the pooled LBR (11 trials) of all the acupuncture groups (38.0%) was significantly higher than that of all the control groups (28.7%, P < 0.00001). Different acupuncture methods (manual acupuncture, electrical acupuncture and transcutaneous acupoint electrical stimulation), acupuncture time (before or during the time of controlled ovarian hyperstimulation and around the time of embryo transfer), and acupuncture courses (at least 4 sessions and less than 4 sessions) have respectively positive effects on IVF outcomes.

Conclusion

Acupuncture can significantly improve CPR and LBR among women undergoing IVF. Placebo acupuncture can be a relatively ideal control measure.

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Data availability

The data underlying this article are available in the article and in its online supplementary material.

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Funding

This study was supported by grants from National Natural Science Foundation of China (No. 81202757, No. 81874388).

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Authors and Affiliations

  1. Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, People’s Republic of China

    Menghao Xu, Mengdi Zhu & Cuihong Zheng

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Contributions

CZ contributed to the project conception and design. Material preparation, data collection and analysis were performed by MX and MZ. The first draft of the manuscript was written by MX and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Cuihong Zheng.

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Supplementary Information

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404_2023_7142_MOESM1_ESM.pdf

Supplementary file1 Supplementary Fig. 1: Comparisons of LBR by Different Types of Control; Supplementary Fig. 2: Comparisons of LBR by Different Acupuncture Methods; Supplementary Fig. 3: Comparisons of LBR by Different Acupuncture Time; Supplementary Fig. 4: Comparisons of LBR by Different Acupuncture Courses; Supplementary Fig. 5: Different Acupuncture Methods vs Blank control; Supplementary Fig. 6: Different Acupuncture Methods vs Placebo Acupuncture; Supplementary Fig. 7: Comparisons by Different Control-Before or during the time of COH; Supplementary Fig. 8: Comparisons by Different Control-Around the time of ET; Supplementary Fig. 9: Comparisons by Different Acupuncture Methods-At least 4 sessions; Supplementary Fig. 10: Comparisons by Acupuncture Methods-Less than 4 sessions; Supplementary Fig. 11: Funnel plot analysis. (PDF 1262 KB)

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Xu, M., Zhu, M. & Zheng, C. Effects of acupuncture on pregnancy outcomes in women undergoing in vitro fertilization: an updated systematic review and meta-analysis. Arch Gynecol Obstet 309, 775–788 (2024). https://doi.org/10.1007/s00404-023-07142-1

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