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.
Arch Gynecol Obstet. 2024 Mar;309(3):775-788. doi: 10.1007/s00404-023-07142-1. Epub 2023 Jul 12.
To evaluate the effects of acupuncture on IVF-ET outcomes.
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.
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.
Acupuncture can significantly improve CPR and LBR among women undergoing IVF. Placebo acupuncture can be a relatively ideal control measure.
评估针灸对体外受精-胚胎移植（IVF-ET）结局的影响。
检索 Pubmed、Embase、Cochrane 图书馆、Web of Science 和 ScienceDirect 等数字数据库，检索时间从建库至 2022 年 7 月。我们使用的 MeSH 术语包括：针灸、体外受精、辅助生殖技术和随机对照试验。还检索了相关文献的参考文献列表。使用 Cochrane 手册 5.3 评估纳入研究的偏倚。主要结局是临床妊娠率（CPR）和活产率（LBR）。使用 Review Manager 5.4 荟萃分析软件，对这些试验中报告的妊娠结局进行合并，并以风险比（RR）和 95%置信区间（CI）表示。使用森林图分析评估治疗效果的异质性。通过漏斗图分析评估发表偏倚。
本综述纳入了 25 项试验（共 4757 名参与者）。大多数比较中，研究之间没有显著的发表偏倚。所有针灸组（43.6%）的总体 CPR（25 项试验）明显高于所有对照组（33.2%，P<0.00001），所有针灸组（38.0%）的总体 LBR（11 项试验）明显高于所有对照组（28.7%，P<0.00001）。不同的针灸方法（手动针灸、电针和经皮穴位电刺激）、针灸时间（在控制性卵巢过度刺激期间或之前以及胚胎移植前后）和针灸疗程（至少 4 次和少于 4 次）分别对 IVF 结局有积极影响。
针灸可显著提高接受 IVF 治疗的女性的 CPR 和 LBR。安慰剂针灸可能是一种相对理想的对照措施。
