The Role of Acupuncture in in vitro Fertilization_A Systematic Review and Meta-Analysis

The Role of Acupuncture in in vitro Fertilization_A Systematic Review and Meta-Analysis

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E-Mail [email protected] Review Gynecol Obstet Invest 2015;79:1–12 DOI: 10.1159/000362231 The Role of Acupuncture in in vitro Fertilization: A Systematic Review and Meta-Analysis Chunjuan Shen a Manxiang Wu b Defeng Shu a Xiaojie Zhao a Ying Gao a a Department of Obstetrics and Gynecology, and b Institute of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China at follicle phase and 25 min before and after ET (RR 1.56, 95% CI 1.04–2.33). Conclusion: Our study showed that acupunc- ture did not significantly improve the IVF clinical pregnancy rate when performed only at the time of ET, while we found pooled benefit of acupuncture for IVF when performed at fol- licle phase and 25 min before and after ET, as well as 30 min after ET and implantation phase. © 2014 S. Karger AG, Basel Introduction Over the past decade, much research has been devoted to increasing the in vitro fertilization (IVF) success rate, improving the quality of embryos, modulating the hor- mones, and managing the environment of the uterus. However, the pregnancy rate success remains low, so more and more couples affected by infertility try to seek other fertility cures. Acupuncture is an important part of tradi- tional Chinese medicine and dates back at least 3,000 years. In recent years, acupuncture is more and more popular in the management of subfertility, but its effectiveness has remained controversial [1]. Some studies showed that acu- puncture was significant in improving IVF outcomes [2– 4]. The specific rationales were displayed as follows. First, psychological and environmental factors among Chinese are associated with early pregnancy [5]. The acupuncture regimen may abate stress around embryo transfer (ET) Key Words Acupuncture · In vitro fertilization · Clinical pregnancy rate · Embryo transfer · Systematic review Abstract Background/Aims: In recent years, acupuncture has become more and more popular in the management of subfertility. The aim of this study was to evaluate the impact of acupunc- ture during in vitro fertilization (IVF) treatment on the out- comes of clinical pregnancy in published randomized stud- ies. Methods: This is a systematic review and meta-analysis. Data sources used were MEDLINE, Embase, Web of Knowl- edge and the Chinese Biomedical Database. Results: There was no statistically significant difference between the acu- puncture group and no acupuncture (intervention) controls around the time of embryo transfer (ET; risk ratio, RR, 1.24, 95% confidence interval, CI, 1.02–1.50) or in unblinded trials, trials blinded to physicians and double-blind trials (95% CI 1.26–1.88, 0.82–1.33 and 0.89–1.25, respectively). This was also the case when comparing acupuncture with sham acu- puncture controls around the time of ET (RR, 1.03, 95% CI 0.87–1.22) or when restricting to unblinded trials, trials blind- ed to physicians and double-blind trials (95% CI 0.80–2.02, 0.82–1.18 and 0.77–1.17, respectively). There was a statisti- cally significant difference when performed at 30 min after ET and implantation phase (RR 1.76, 95% CI 1.22–2.55). There
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