Li Menglin, Liu Yunyun, Wang Haoran, Zheng Shuzhen, Deng Yinhe, Li Yuemei
Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
Evid Based Complement Alternat Med. 2021 Feb 2;2021:6661235. doi: 10.1155/2021/6661235. eCollection 2021.
To systematically evaluate the efficacy and safety of acupuncture for patients with recurrent implantation failure (RIF) undergoing in vitro fertilization-embryo transfer (IVF-ET) and hopefully provide reliable guidance for clinicians and patients.
Through searching domestic and foreign medical journals, the literature of randomized controlled trials (RCTs) of acupuncture for RIF undergoing IVF-ET was collected. RevMan 5.3 software was used for meta-analysis and Cochrane's risk of bias assessment tool was used to evaluate the quality of the included studies.
Seven documents meeting the criteria were finally included. The results showed that the intervention group contributes more in outcomes including clinical pregnancy rate (RR = 1.90, 95% CI (1.51, 2.40), < 0.05), biochemical pregnancy rate (RR = 1.59, 95% CI (1.27, 1.99), < 0.05), embryo implantation rate (RR = 1.89, 95% CI (1.47, 2.45), < 0.05), and endometrial thickness (MD = 1.11, 95% CI (0.59, 1.63), < 0.05) when compared with the control group, and the difference is statistically significant. In terms of the number of embryo transfers and the type of endometrium, the difference between the acupuncture group and the control group was not statistically significant.
Acupuncture therapy on patients with RIF can improve the pregnancy outcome of patients. It is a relatively effective treatment with satisfactory safety and suitable for clinical application. However, as the quality of the included studies is not good enough, the conclusion of this meta-analysis should be treated with caution. More double-blind RCTs equipped with high quality and large samples are expected for the improvement of the level of evidence.
系统评价针刺对体外受精-胚胎移植（IVF-ET）反复种植失败（RIF）患者的疗效和安全性，以期为临床医生和患者提供可靠指导。
通过检索国内外医学期刊，收集针刺治疗IVF-ET反复种植失败的随机对照试验（RCT）文献。采用RevMan 5.3软件进行Meta分析，并用Cochrane偏倚风险评估工具评价纳入研究的质量。
最终纳入7篇符合标准的文献。结果显示，与对照组相比，干预组在临床妊娠率（RR = 1.90，95%CI（1.51，2.40），P < 0.05）、生化妊娠率（RR = 1.59，95%CI（1.27，1.99），P < 0.05）、胚胎着床率（RR = 1.89，95%CI（1.47，2.45），P < 0.05）及子宫内膜厚度（MD = 1.11，95%CI（0.59，1.63），P < 0.05）等结局方面贡献更大，差异有统计学意义。在胚胎移植次数及子宫内膜类型方面，针刺组与对照组差异无统计学意义。
针刺治疗RIF患者可改善患者妊娠结局，是一种安全性满意且相对有效的治疗方法，适合临床应用。但由于纳入研究质量不够理想，本Meta分析结论应谨慎对待。期待开展更多高质量、大样本的双盲RCT以提高证据水平。
