Background: The evidence of acupuncture for in vitro fertilization (IVF) remains debatable. Objectives: To evaluate the efficacy of acupuncture on embryo transfer in women undergoing IVF. Search Strategy: PubMed, MEDLINE, Web of Science, EMBASE, CENTRAL, Wanfang, Chinese National Knowledge Infrastructure, VIP were searched up to 6 September 2021. Selection Criteria: Randomized controlled trials (RCTs) of acupuncture evaluating IVF’s effects were included. Data Collection and Analysis: Clinical pregnancy rate (CPR) and live birth rate (LBR) were quantitatively summarized by the random-effect model. Variations in pooled estimates were examined by subgroup analyses and I2 was measured to quantify statistical heterogeneity. Main Results: Forty-nine eligible RCTs representing 9422 women undergoing IVF for pregnant success were identified. Pooled CPR and LBR showed a significant difference between acupuncture and control groups (odds ratio [OR]=1.65, 95% confidence interval [CI]: 1.45 to 1.88; OR=1.34, 95% CI: 1.08 to 1.66). Subgroup analysis showed a benefit of traditional acupuncture for women aged < 35 years (CPR: OR=1.57, 95% CI: 1.23 to 2.03; LBR: OR=1.34, 95% CI:1.23 to 1.48), treatment with  3 sessions (CPR: OR=2.37, 95% CI: 1.46 to 3.85; LBR: OR=1.99, 95% CI:1.52 to 2.60), and lower baseline control group rates of CPR (CPR: OR=2.14, 95% CI: 1.22 to 2.13; LBR: OR=2.23, 95% CI:1.07 to 4.62). Heterogeneity across studies were found (CPR: I2=47.4, p <0.001; LBR: I2=62.9, p <0.001). Conclusions: Although benefits of acupuncture in CPR and LBR among IVF women existed, no robust associations were found and which might be limited by the heterogeneity of current evidence

Background: This study reviewed published evidence of the efficacy of acupuncture among women undergoing in vitro fertilization (IVF). Methods: The database included PubMed, MEDLINE, Web of Science, EMBASE, CENTRAL, Wanfang, CNKI, VIP were searched up to May 24, 2022. The primary outcomes for clinical pregnancy rate (CPR) and live birth rate (LBR) were quantitatively summarized by the random-effect model with I2 statistics to quantify heterogeneity. Results: Forty-nine eligible randomized clinical trials (RCTs)representing 9422 women undergoing IVF for pregnant success were identified. The results indicated that pooled CPR and LBR showed a significant difference between acupuncture and control groups [53 trials, odds ratio (OR)1.68, 95% confidence intervals (CI) 1.47 to 1.92, I2=47.4], extremely low evidence; 20 trials, OR1.37, 95%CI 1.11 to 1.69, I2=62.6, low evidence, respectively). Only transcutaneous electrical acupoint stimulation (TEAS) was found to be a positive effect on both CPR (10 trials, OR1.73, 95%CI 1.35 to 2.23; I2=28.1, moderate evidence) and LBR (7 trials, OR 1.74, 95%CI 1.23 to 2.46; I2=47.6, extremely low evidence). Heterogeneity across studies was found and no studies were graded as high quality of evidence. Conclusions: Our results showed that the association between acupuncture use and IVF pregnant outcomes were not supported by robust evidence and the varied methodological design and heterogeneity might influence the findings in a relevant way.Registration: PROSPERO CRD42021232430.