Different acupuncture methods on pregnancy outcome of <i>in vitro</i> fertilization-embryo transfer: a network meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Yu , FAN Huaying , WU Tianyu ,  CHEN Jiao

School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P. R. China;

Corresponding?author：

CHEN Jiao, Email: chenjiao@cdutcm.edu.cn

Keywords：

In vitro fertilization-embryo transfer; Acupuncture and moxibustion; Network meta-analysis; Clinical pregnancy rate; Live birth rate

DOI：

10.7507/1672-2531.202305077

Video：

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Objective To analyze the efficacy and safety of different acupuncture methods on outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods The PubMed, EMbase, Cochrane Library, CNKI, VIP, WanFang Data and CBM databases were searched to collect randomized controlled trials (RCTs) related to the objectives of the study from the inception to April 16, 2023. After two investigators independently screened the literature, extracted the data and evaluated the risk of bias of the included studies, a network meta-analysis was performed using Stata 16.0 software. Results There were 62 trials total with 9844 patients, involving 7 interventions. Network meta-findings analysis revealed the following: ① Clinical pregnancy rate (CPR): needle warming > auricular acupressure > transcutaneous electrical acupoint stimulation (TEAS) > electroacupuncture > acupuncture > sham acupuncture > no adjunctive treatment; ② Live birth rate (LBR): electroacupuncture > auricular acupressure > TEAS > acupuncture > sham acupuncture > no adjunctive treatment. Conclusion ?Needle warming assisted IVF-ET is superior to other acupuncture therapies in improving CPR, especially during the promotion period of excretion, and the selection of Zusanli, Guanyuan and uterine acupoints for 3-month cycles may have the best effect. And for the LBR, the effect of electroacupuncture is better than that of other therapies. Besides, auricular acupressure may have good therapeutic potential. Due to the limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.

Citation： LIU Yu, FAN Huaying, WU Tianyu, CHEN Jiao. Different acupuncture methods on pregnancy outcome of in vitro fertilization-embryo transfer: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2023, 23(9): 1017-1025. doi: 10.7507/1672-2531.202305077 Copy

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2. Buckett W, Sierra S. The management of unexplained infertility: an evidence-based guideline from the Canadian Fertility and Andrology Society. Reprod Biomed Online, 2019, 39(4): 633-640.
3. European IVF-monitoring Consortium (EIM), European Society of Human Reproduction and Embryology (ESHRE), Calhaz-Jorge C, et al. Assisted reproductive technology in Europe, 2013: results generated from European registers by ESHRE. Hum Reprod, 2017, 32(10): 1957-1973.
4. Gunby J, Bissonnette F, Librach C, et al. Assisted reproductive technologies (ART) in Canada: 2007 results from the Canadian ART Register. Fertil Steril, 2011, 95(2): 542-547.
5. Shen C, Wu M, Shu D, et al. The role of acupuncture in in vitro fertilization: a systematic review and meta-analysis. Gynecol Obstet Invest, 2015, 79(1): 1-12.
6. Zhang X, Lee MS, Smith CA, et al. Effects of acupuncture during in vitro fertilization or intracytoplasmic sperm injection: an updated systematic review and meta-analysis. Eur J Integr Med, 2018, 23: 14-25.
7. Smith CA, Armour M, Shewamene Z, et al. Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis. Reprod Biomed Online, 2019, 38(3): 364-379.
8. Wang X, Wang Y, Wei S, et al. An overview of systematic reviews of acupuncture for infertile women undergoing in vitro fertilization and embryo transfer. Front Public Health, 2021, 9: 651811.
9. Elsevier. Choriogonadotropin alpha administration is associated with an increased clinical pregnancy rate among infertile couples undergoing controlled ovarian hyperstimulation with intrauterine insemination. Fertil Steril, 2016, 105(2): e39-e40.
10. Sterne JAC, Savovi? J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ, 2019, 366: l4898.
11. Paulus WE, Zhang M, Strehler E, et al. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertil Steril, 2002, 77(4): 721-724.
12. Smith C, Coyle M, Norman RJ. Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer. Fertil Steril, 2006, 85(5): 1352-1358.
13. Westergaard LG, Mao Q, Krogslund M, et al. Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertil Steril, 2006, 85(5): 1341-1346.
14. 崔薇, 孫偉, 劉莉莉, 等. 電針干預對體外受精-胚胎移植患者的作用研究. 中國婦幼保健, 2007, 22(24): 3403-3405.
15. 陳軍, 劉莉莉, 崔薇, 等. 電針干預對卵巢低反應患者體外受精胚胎移植的影響. 中國針灸, 2009, 29(10): 775-779.
16. So EW, Ng EH, Wong YY, et al. A randomized double blind comparison of real and placebo acupuncture in IVF treatment. Hum Reprod, 2009, 24(2): 341-348.
17. Domar AD, Meshay I, Kelliher J, et al. The impact of acupuncture on in vitro fertilization outcome. Fertil Steril, 2009, 91(3): 723-726.
18. Magarelli PC, Cridennda DK, Cohen M. Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization-embryo transfer treatment. Fertil Steril, 2009, 92(6): 1870-1879.
19. So EW, Ng EH, Wong YY, et al. Acupuncture for frozen-thawed embryo transfer cycles: a double-blind randomized controlled trial. Reprod Biomed Online, 2010, 20(6): 814-821.
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Chinese Journal of Evidence-Based Medicine

Different acupuncture methods on pregnancy outcome of in vitro fertilization-embryo transfer: a network meta-analysis

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