Acupuncture for Poor Ovarian Response: A Randomized Controlled Trial

Abstract

Acupuncture is believed to improve ovarian reserve and reproductive outcomes in women undergoing in vitro fertilization (IVF). This study was conducted to evaluate the effect of network-optimized acupuncture followed by IVF on the oocyte yield in women showing a poor ovarian response. This study was an exploratory randomized controlled trial conducted from June 2017 to January 2020 at the Pusan National University Hospital. Women diagnosed with poor ovarian response were enrolled and randomly divided into two groups: IVF alone and Ac + IVF groups (16 acupuncture sessions before IVF treatment). Eight acupoints with high degree centrality and betweenness centrality were selected using network analysis. Among the participants, compared with the IVF treatment alone, the acupuncture + IVF treatment significantly increased the number of retrieved mature oocytes in women aged more than 37 years and in those undergoing more than one controlled ovarian hyperstimulation cycle. The negative correlation between the number of retrieved mature oocytes and consecutive controlled ovarian hyperstimulation cycles was not observed in the Ac + IVF group irrespective of the maternal age. These findings suggest that physicians can consider acupuncture for the treatment of women with poor ovarian response and aged > 37 years or undergoing multiple IVF cycles.

Systematic review of acupuncture to improve ovarian function in women with poor ovarian response

“…A total of 516 participants were enrolled in this review, with sample sizes ranging from 23 to 109 for each study. Six ( 40 , 41 , 43 – 45 , 47 ) studies were conducted in China and only the other study was conducted ( 42 ) in South Korea. In two studies ( 40 , 45 ) were master’s theses, one study ( 47 ) was a doctoral dissertation, and the remaining four ( 41 – 44 ) were journal articles.…”

“…In two studies ( 40 , 45 ) were master’s theses, one study ( 47 ) was a doctoral dissertation, and the remaining four ( 41 – 44 ) were journal articles. Besides, among these seven articles, six studies ( 40 , 41 , 43 – 45 , 47 ) were published in Chinese, and the other one ( 42 ) was published in English. Diagnostic criteria for POR are clear in all seven articles, one article ( 44 ) utilized the POR diagnostic of Poseidon, and three articles ( 42 , 45 , 47 ) utilized the POR diagnostic consensus developed by the European Society of Human Reproduction and Embryology (ESHRE) in Bologna, and the clear POR diagnostic consensus of the other three articles ( 40 , 41 , 43 ) was also given.…”

“…As for acupuncture manipulation, manual acupuncture ( 42 , 44 , 45 , 47 ), electroacupuncture ( 41 ), and TEAS ( 40 , 43 ) were involved. In addition, the outcomes of the included studies varied, including CPR ( 40 , 41 ), fertilization rate ( 40 – 45 , 47 ), the number of oocytes retrieved per woman ( 40 – 45 , 47 ), high-quality embryo rate ( 40 , 41 , 43 – 45 , 47 ), implantation rate ( 40 , 41 ), the thickness of endometrium ( 40 , 41 , 44 ), cycle cancellation rate ( 40 , 41 , 43 , 47 ), FSH ( 40 , 43 , 45 , 47 ), LH ( 40 , 41 , 43 , 45 , 47 ), E 2 ( 40 , 41 , 45 ), AFC ( 40 , 42 , 43 ), AMH ( 42 ), dose of Gn ( 40 , 44 , 47 ), duration of Gn ( 40 , 44 , 47 ), miscarriage ( 41 ), etc.…”

“…The quality of the included studies was generally low or very low. Five studies ( 41 , 42 , 44 , 45 , 47 ) identified random methods, and another two studies ( 40 , 43 ) did not mention a specific randomization scheme. Besides, two studies ( 42 , 45 ) applied allocation concealment.…”

“…Five studies ( 41 , 42 , 44 , 45 , 47 ) identified random methods, and another two studies ( 40 , 43 ) did not mention a specific randomization scheme. Besides, two studies ( 42 , 45 ) applied allocation concealment. None of the studies mentioned the blinding of participants or investigators.…”