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Pregnancy Benefit of Acupuncture on in vitro Fertilization: A Systematic Review and Meta-Analysis

  • Evidence-Based Integrative Medicine
  • Published:
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Abstract

Background

Currently, more and more infertility couples are opting for combined acupuncture to improve success rate of in vitro fertilization (IVF). However, evidence from acupuncture for improving IVF pregnancy outcomes remains a matter of debate.

Objective

To quantitatively summarized the evidence of the efficacy of acupuncture among women undergoing IVF by means of systematic review and meta-analysis.

Methods

Four English (PubMed, Web of Science, EMBASE, and Cochrane Register of Controlled Clinical Trials) and Four Chinese databases (Wanfang Databases, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and SinoMed) were searched from database inception until July 2, 2023. Randomized controlled trials (RCTs) that evaluated the acupuncture’s effects for women undergoing IVF were included. The subgroup analysis was conducted with respect to the age of participants, different acupuncture types, type of control, acupuncture timing, geographical origin of the study, whether or not repeated IVF failure, and acupuncture sessions. Sensitivity analyses were predefifined to explore the robustness of results. The primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR), and the secondary outcomes were ongoing pregnancy rate and miscarriage rate. Random effects model with I2 statistics were used to quantify heterogeneity. Publication bias was estimated by funnel plots and Egger’s tests.

Results

A total of 58 eligible RCTs representing 10,968 women undergoing IVF for pregnant success were identifified. Pooled CPR and LBR showed a signifificant difference between acupuncture and control groups [69 comparisons, relative risk (RR) 1.19, 95% confifidence intervals (CI) 1.12 to 1.25, I2=0], extremely low evidence; 23 comparisons, RR 1.11, 95%CI 1.02 to 1.21, I2=14.6, low evidence, respectively). Only transcutaneous electrical acupoint stimulation showed a positive effect on both CPR (16 comparisons, RR 1.17, 95%CI 1.06 to 1.29; I2=0, moderate evidence) and LBR (9 comparisons, RR 1.20, 95%CI 1.04 to 1.37; I2=8.5, extremely low evidence). Heterogeneity across studies was found and no studies were graded as high-quality evidence.

Conclusion

Results showed that the convincing evidence levels on the associations between acupuncture and IVF pregnant outcomes were relatively low, and the varied methodological design and heterogeneity might inflfluence the fifindings. (Registration No. PROSPERO CRD42021232430)

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Availability of Data and Materials

The datasets for this study can be requested from the Corresponding author at yanshiyan@bucm.edu.cn.

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Acknowledgments

We thank Ph.D Myeong Soo Lee (Korea Institute of Oriental Medicine) for polishing the article.

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Authors and Affiliations

  1. College of Preschool Education, Beijing Youth Politics College, Beijing, 100102, China

    Hao-ran Zhang

  2. School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China

    Cheng Zhang, Pei-hong Ma, Cheng-yi Sun, Chong-yang Sun, Zhen-qing Pu, Yu-han Lin, Cun-zhi Liu & Shi-yan Yan

  3. School of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China

    Xiao-yu Liu

  4. China Academy of Chinese Medical Sciences, Beijing, 100091, China

    Bao-yan Liu

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Contributions

Zhang HR and Zhang C contributed equally to this work. Zhang HR, Liu CZ, Yan SY, and Liu BY conceived the study and wrote the protocol. Zhang HR, Zhang C and Yan SY performed the literature search and drafted the manuscript. Liu XY, Pu ZQ and Lin YH participated in the data extraction. Ma PH assessed the quality of the studies. Sun CYa and Sun CYb made the assessment of the risks of bias. Zhang HR, Zhang C and Yan SY performed the whole statistical analysis. All authors revised the manuscript and approved the final version for publication. Yan SY is the guarantor for this work and accepts full responsibility for the conduct of the study, had access to the data, and controlled the decision to publish. The corresponding authors (Yan SY, Liu BY and Liu CZ) attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

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Correspondence to Shi-yan Yan.

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Conflict of Interest The authors declared that there were no competing interests.

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Supported by the National Science Fund for Distinguished Young Scholars (No. 81825024)

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Zhang, Hr., Zhang, C., Ma, Ph. et al. Pregnancy Benefit of Acupuncture on in vitro Fertilization: A Systematic Review and Meta-Analysis. Chin. J. Integr. Med. 29, 1021–1032 (2023). https://doi.org/10.1007/s11655-023-3748-3

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