Insights & Discussion
Despite some indications of improved clinical pregnancy rates, the overall effectiveness of acupuncture as a treatment for couples with subfertility undergoing assisted reproduction therapy remains inconclusive and requires further high-quality research.
This abstract summarizes the findings of systematic reviews and meta-analyses assessing the effectiveness of acupuncture in treating couples with subfertility undergoing assisted reproduction therapy (ART). The review included eleven studies published between 2009 and 2017 and examined primary outcomes of live birth and clinical pregnancy, and secondary outcomes of ongoing pregnancy, miscarriage, and adverse events. The results suggest that acupuncture may improve the clinical pregnancy rate in ART patients. However, there was insufficient evidence to support its impact on live birth rate, ongoing pregnancy rates, or miscarriage, mainly due to the low quality of the included studies. The overall effectiveness of acupuncture in treating subfertility during ART remains uncertain, emphasizing the need for further high-quality research and well-reported trials.
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Acupuncture may have a significant effect on clinical pregnancy rates, independent of comparator group, when used in women who have had multiple previous IVF cycles, or where there was a low baseline pregnancy rate.
2019 Reproductive BioMedicine Online Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis Smith, C. A., Armour, M., Shewamene, Z., et al.
Systematic Review Embryo Transfer Female Fertility IVF
Evidence suggests acupuncture may be effective when compared with no adjunctive treatment, with increased clinical pregnancies and live births, but is not an efficacious treatment when compared with sham controls. Future research should focus on different dosing acupuncture regimens, and exploration of the components of acupuncture that are contributing to improved reproductive outcomes. Increased understanding of these components may have broader application to the care and treatment modalities provided to women undergoing IVF. Further exploration of the effects of acupuncture for women with poorer IVF outcomes is warranted.
Acupuncture improves the clinical pregnancy rate among women undergoing IVF and the IVF outcome results were significantly superior in the acupuncture group when acupuncture was conducted during controlled ovarian hyperstimulation.
2016 Archives of Gynecology and Obstetrics Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis Qian, Y., Xia, X.-R., Ochin, H., et al.
Systematic Review Female Fertility IVF
When the studies were restricted to Asian or non-Asian area patients, compared with traditional acupuncture and other methods, electrical acupuncture yielded better IVF outcomes. Optimal positive effects could be expected using acupuncture in IVF during controlled ovarian hyperstimulation, especially in Asian area. However, as a limitation of this review, most of the included studies did not mention the number of embryos transferred.
We found pooled benefit of acupuncture for IVF when performed at follicle phase and 25 min before and after embryo transfer, as well as 30 min after embryo transfer and implantation phase.
2015 Gynecologic and Obstetric Investigation The Role of Acupuncture in in vitro Fertilization: A Systematic Review and Meta-Analysis Shen C.,Wu M., Shu D., Zhao X. and Gao Y.
Systematic Review Embryo Transfer Female Fertility IVF
Our study showed that acupuncture increased pregnancy rates when performed at follicle phase and 25 min before and after ET or 30 min after ET and after the implantation phase in the IVF process. However, there was no statistically significant difference in women undergoing IVF between treatment performed only around the time of ET, follicle phase or implantation phase. The study of Zheng et al. also showed that the pooled CPR result around the time of ET showed no significant differences between all acupuncture groups and the control groups. However, the CPR result of acupuncture performed around the time of controlled ovarian hyperstimulation showed a significant difference. The potential impact of acupuncture in the treatment of female infertility on the hypothalamic-pituitary-ovarian axis and on the uterus was significant, but the specific mechanism was still unknown.
Despite its widespread use during assisted reproductive technology (ART) cycles, acupuncture does not appear to improve live birth or pregnancy rates in couples dealing with subfertility.
2013 Cochrane Database of Systematic Reviews Acupuncture and assisted reproductive technology Cheong YC, Dix S, Hung Yu Ng E, Ledger WL, Farquhar C
Systematic Review Female Fertility IVF
This passage discusses a meta-analysis that aimed to determine the effectiveness and safety of acupuncture as an adjunct to assisted reproductive technology (ART) cycles for couples dealing with subfertility. The review included 20 randomized controlled trials, analyzing the impact of acupuncture on live birth rate, ongoing pregnancy rate, miscarriage rate, and side effects. The findings indicate that acupuncture did not show any overall benefit in improving live birth or pregnancy rates during ART cycles, regardless of whether it was performed around oocyte retrieval or embryo transfer. Additionally, acupuncture did not have significant side effects. The authors conclude that there is no evidence supporting the use of acupuncture to enhance live birth or pregnancy rates in assisted conception.
The meta-analysis indicates that while adjuvant acupuncture does not show a pooled benefit for in vitro fertilization (IVF) across all trials, it appears to have a more significant effect in trials with lower baseline pregnancy rates, warranting further investigation and confirmation in additional studies.
2013 Human Reproduction Update The effects of acupuncture on rates of clinical pregnancy among women undergoing in vitro fertilization: a systematic review and meta-analysis Manheimer, E. ., van der Windt, D., Cheng, K., et al.
Systematic Review Female Fertility IVF
This passage presents a meta-analysis that aimed to assess the overall pooled effects of adjuvant acupuncture on in vitro fertilization (IVF) clinical pregnancy success rates, as well as identify factors that might explain the heterogeneity of results across trials. The analysis included 16 trials with 4021 participants and found no statistically significant difference between acupuncture and control groups when combining all trials or analyzing sham-controlled and no adjuvant treatment-controlled trials separately. However, the study identified baseline pregnancy rate as a significant effect modifier, with trials having lower control group pregnancy rates showing larger effects of adjuvant acupuncture. Overall, the meta-analysis did not find a pooled benefit of adjuvant acupuncture for IVF, but the potential benefit in trials with lower baseline pregnancy rates requires further exploration and confirmation in additional studies due to potential confounders and publication bias.
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