China-Australia International Research Centre for Chinese Medicine & School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia.
Pharmacy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia.
Acupunct Med. 2021 Feb;39(1):20-29. doi: 10.1177/0964528420958711. Epub 2020 Oct 10.
To evaluate the efficacy of acupuncture compared to placebo acupuncture for women undergoing in vitro fertilisation (IVF) in a systematic review and meta-analysis.
A search was conducted in seven English-language biomedical databases from their inception to 3 April 2019 to identify studies evaluating acupuncture as an adjunct to IVF treatment. Randomised controlled trials (RCTs) that compared acupuncture with placebo acupuncture using a non-invasive placebo acupuncture device in women undergoing a fresh or frozen IVF cycle were eligible, as were studies that tested placebo acupuncture as the intervention. Outcomes were clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, live birth rate and adverse events.
Eight RCTs involving 3607 women were included. Studies were judged to be low risk for most of the risk of bias domains. Acupuncture around the time of embryo transfer was not significantly different to placebo acupuncture in terms of the clinical pregnancy rate (6 RCTs, 2473 women, risk ratio (RR) = 0.99 (95% confidence interval (CI) = 0.88, 1.11), I = 51%, moderate certainty evidence), ongoing pregnancy rate (4 RCTs, 1459 women, RR = 0.88 (95% CI = 0.75, 1.02), I = 50%, moderate certainty evidence), miscarriage rate (4 RCTs, 502 women, RR = 1.23 (95% CI = 0.89, 1.71), I = 30%, high certainty evidence) or live birth rate (4 RCTs, 1835 women, RR = 0.87 (95% CI = 0.75, 1.01), I = 0%, high certainty evidence). Outcomes with placebo acupuncture were not significantly different to usual care. Adverse events relating to acupuncture, such as discomfort and bruising, were mild to moderate.
Acupuncture administered around the time of embryo transfer did not have a statistically significant effect on IVF outcomes compared with placebo acupuncture.
系统评价和荟萃分析评估针灸在体外受精（IVF）女性中的疗效，与安慰剂针灸比较。
从七个英语生物医学数据库中进行检索，从数据库建立到 2019 年 4 月 3 日，以确定评估针灸作为新鲜或冷冻 IVF 周期中辅助治疗的研究。符合条件的研究为随机对照试验（RCT），将针灸与使用非侵入性安慰剂针灸设备的安慰剂针灸进行比较，以及将安慰剂针灸作为干预措施的研究。结局为临床妊娠率、持续妊娠率、流产率、活产率和不良事件。
纳入 8 项 RCT，涉及 3607 名女性。大多数偏倚风险领域的研究被判定为低风险。胚胎移植时的针灸与安慰剂针灸在临床妊娠率（6 项 RCT，2473 名女性，风险比（RR）=0.99（95%置信区间（CI）=0.88，1.11），I²=51%，中等确定性证据）、持续妊娠率（4 项 RCT，1459 名女性，RR=0.88（95% CI=0.75，1.02），I²=50%，中等确定性证据）、流产率（4 项 RCT，502 名女性，RR=1.23（95% CI=0.89，1.71），I²=30%，高确定性证据）或活产率（4 项 RCT，1835 名女性，RR=0.87（95% CI=0.75，1.01），I²=0%，高确定性证据）方面无统计学差异。安慰剂针灸的结局与常规护理无显著差异。与针灸相关的不良事件，如不适和瘀伤，为轻度至中度。
胚胎移植时给予的针灸与安慰剂针灸相比，对 IVF 结局没有统计学上的显著影响。
