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Review
. 2023 Nov 12;43(11):1315-1323.
doi: 10.13703/j.0255-2930.20221124-k0006.

Acupuncture for in vitro fertilization-embryo transfer: an overview of systematic reviews

[Article in English, Chinese]
Xiang-Yu Hu  1 , Wen-Cui Xiu  2 , Lan-Jun Shi  2 , Rui-Min Jiao  2 , Zi-Yu Tian  2 , Xiao-Yi Hu  2 , Tian-Yu Ming  2 , Wei-Juan Gang  3 , Xiang-Hong Jing  2
Affiliations
Review

Acupuncture for in vitro fertilization-embryo transfer: an overview of systematic reviews

[Article in English, Chinese]
Xiang-Yu Hu et al. Zhongguo Zhen Jiu. .

Abstract
in English, Chinese

Objectives: To evaluate the report quality, methodological quality and evidence quality of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture for in vitro fertilization-embryo transfer (IVF-ET).

Methods: The SRs/MAs of acupuncture for IVF-ET were searched electronically from databases of CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Cochrane Library, from inception of each database to September 27th, 2022. Two reviewers independently screened the literature and extracted the data. Using PRISMA statement, the AMSTAR 2 scale and the GRADE system, the report quality, methodological quality and evidence quality of the included SRs/MAs were assessed.

Results: A total of 28 SRs/MAs were included, with PRISMA scores ranging from 8.5 points to 27 points. The problems of report quality focused on protocol and registration, retrieval, risk of bias in studies, additional analysis, limitations and funding. The methodological quality of included studies was generally low, reflecting on items 2, 3, 7, 10, 12 and 16. A total of 85 outcome indexes were included in the GRADE system for evidence grade evaluation. Most of the evidences were low or very low in quality. The reasons for the downgrade were related to study limitations, inconsistency, imprecision and publication bias.

Conclusions: Acupuncture therapy improves the outcomes of IVF-ET, but the methodological quality and evidence quality of related SRs/MAs are low. It is recommended to conduct more high-quality studies in the future to provide more reliable evidences.

目的: 对针灸辅助体外受精胚胎移植（IVF-ET）的系统评价（SR）/Meta分析（MA）进行报告质量、方法学质量和证据质量的再评价。方法: 计算机检索中国期刊全文数据库（CNKI）、万方数据知识服务平台（Wanfang）、维普中文期刊服务平台（VIP）、中国生物医学文献数据库（SinoMed）、PubMed、EMbase、Cochrane Library中针灸辅助IVF-ET的SR/MA。检索时限均为建库至2022年9月27日。由2名研究员独立筛选文献、提取资料后，采用PRISMA声明、AMSTAR 2量表和GRADE系统分别评价纳入SR/MA的报告质量、方法学质量和证据质量。结果: 共纳入28篇SR/MA，PRISMA评分在8.5～27分。报告质量问题主要表现在方案和注册、检索、研究偏倚、其他分析、局限性、资金支持等方面。纳入研究的方法学质量整体偏低，问题主要集中在条目2、3、7、10、12、16。共85个结局指标纳入GRADE系统进行证据等级评价，大部分证据质量为低或极低，降级的原因主要与研究的局限性、不一致性、不精确性和发表偏倚有关。结论: 针灸辅助IVF-ET治疗可以改善不孕患者的妊娠结局，但相关SR/MA的方法学质量和证据质量均较低，建议今后开展更多高质量的研究以提供更可靠的循证依据。.

Keywords: AMSTAR 2; GRADE; PRISMA; acupuncture; in vitro fertilization-embryo transfer (IVF-ET); overview of systematic review.

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