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Meta-Analysis
. 2013 Jul 26;2013(7):CD006920.
doi: 10.1002/14651858.CD006920.pub3.

Acupuncture and assisted reproductive technology

Ying C Cheong  1 , Sarah Dix, Ernest Hung Yu Ng, William L Ledger, Cindy Farquhar
Affiliations
Meta-Analysis

Acupuncture and assisted reproductive technology

Ying C Cheong et al. Cochrane Database Syst Rev. .

Abstract

Background: Acupuncture is commonly undertaken during an assisted reproductive technology (ART) cycle although its role in improving live birth and pregnancy rates is unclear.

Objectives: To determine the effectiveness and safety of acupuncture as an adjunct to ART cycles for male and female subfertility.

Search methods: All reports which described randomised controlled trials of acupuncture in assisted conception were obtained through searches of the Menstrual Disorders and Subfertility Group Specialised Register, CENTRAL, Ovid MEDLINE, EMBASE, CINAHL (Cumulative Index to Nursing & Allied Health Literature), AMED , www.clinicaltrials.gov (all from inception to July 2013), National Research Register, and the Chinese clinical trial database (all to November 2012).

Selection criteria: Randomised controlled trials of acupuncture for couples who were undergoing ART, comparing acupuncture treatment alone or acupuncture with concurrent ART versus no treatment, placebo or sham acupuncture plus ART for the treatment of primary and secondary infertility. Women with medical illness that was deemed to contraindicate ART or acupuncture were excluded.

Data collection and analysis: Twenty randomised controlled trials were included in the review and nine were excluded. Study selection, quality assessment and data extraction were performed independently by two review authors. Meta-analysis was performed using odds ratio (OR) and 95% confidence intervals (CI). The outcome measures were live birth rate, clinical ongoing pregnancy rate, miscarriage rate, and any reported side effects of treatment. The quality of the evidence for the primary outcome (live birth) was rated using GRADE methods.

Main results: This updated meta-analysis showed no evidence of overall benefit of acupuncture for improving live birth rate (LBR) regardless of whether acupuncture was performed around the time of oocyte retrieval (OR 0.87, 95% CI 0.59 to 1.29, 2 studies, n = 464, I(2) = 0%, low quality evidence) or around the day of embryo transfer (ET) (OR 1.22, 95% CI 0.87 to 1.70, 8 studies, n = 2505, I(2) = 69%, low quality evidence). There was no evidence that acupuncture had any effect on pregnancy or miscarriage rates, or had significant side effects.

Authors' conclusions: There is no evidence that acupuncture improves live birth or pregnancy rates in assisted conception.

PubMed Disclaimer

Conflict of interest statement

Ernest Ng is an author for So 2009 and So 2010.

Figures

1
1
Study selection PRISMA flow diagram.
2
2
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
3
3
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
4
4
Forest plot of comparison: 1 Acupuncture around the time of oocyte retrieval versus control (sham, placebo, no acupuncture), outcome: 1.1 Live Birth Rate.
5
5
Forest plot of comparison: 1 Acupuncture around the time of oocyte retrieval versus control (sham, placebo, no acupuncture), outcome: 1.4 Miscarriage rate.
6
6
Forest plot of comparison: 2 Acupuncture on and around the day of ET versus control, outcome: 2.1 Live Birth.
7
7
Forest plot of comparison: 2 Acupuncture on and around the day of ET versus control, outcome: 2.4 Miscarriage.
1.1
1.1. Analysis
Comparison 1 Acupuncture around the time of oocyte retrieval versus control (sham, placebo, no acupuncture), Outcome 1 Live Birth Rate.
1.2
1.2. Analysis
Comparison 1 Acupuncture around the time of oocyte retrieval versus control (sham, placebo, no acupuncture), Outcome 2 Ongoing Pregnancy Rate.
1.3
1.3. Analysis
Comparison 1 Acupuncture around the time of oocyte retrieval versus control (sham, placebo, no acupuncture), Outcome 3 Clinical Pregnancy Rate.
1.4
1.4. Analysis
Comparison 1 Acupuncture around the time of oocyte retrieval versus control (sham, placebo, no acupuncture), Outcome 4 Miscarriage rate.
2.1
2.1. Analysis
Comparison 2 Acupuncture on and around the day of ET versus control, Outcome 1 Live Birth.
2.2
2.2. Analysis
Comparison 2 Acupuncture on and around the day of ET versus control, Outcome 2 Ongoing pregnancy.
2.3
2.3. Analysis
Comparison 2 Acupuncture on and around the day of ET versus control, Outcome 3 Clinical pregnancy.
2.4
2.4. Analysis
Comparison 2 Acupuncture on and around the day of ET versus control, Outcome 4 Miscarriage.
2.5
2.5. Analysis
Comparison 2 Acupuncture on and around the day of ET versus control, Outcome 5 Multiple gestation.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Andersen 2010 {published data only}
    1. Andersen D, Lossl K, Nyboe Andersen A, Furbringer J, Bach H, Simonsen J, et al. Acupuncture on the day of embryo transfer: a randomized controlled trial of 635 patients. Reproductive Biomedicine Online 2010;21(3):366‐72. - PubMed
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Humaidan 2004 {published data only}
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Westergaard 2006 {published data only}
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References to studies excluded from this review

Chen 2004 {published data only}
    1. Chen D, Shi XL, Cai MX. Clinical observation on treatment of functional anovulation by acupunctural prick. Zhongguo Zhong Xi Yi Jie He Za Zhi Zhongxiyi Jiehe Zazhi 2004;27(8):735‐7. - PubMed
Chen 2009 {published data only (unpublished sought but not used)}
    1. Chen J, Liu L, Cui W, Sun W. Effects of electro‐acupuncture on in vitro fertilization‐embryo transfer (IVF‐ET) of patients with poor ovarian response. Zhongguo Zhen Jiu 2009;29(10):775‐9. - PubMed
Chen 2012 {published data only}
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