Effects of acupuncture on the pregnancy outcomes of frozen-thawed embryo transfer: A systematic review and meta-analysis

Abstract

BackgroundAcupuncture is increasingly used as adjuvant therapy for infertile women undergoing frozen-thawed embryo transfer (FET); however, its effects and safety are highly controversial. This study aimed to evaluate the pooled effects of adjuvant acupuncture on FET pregnancy outcomes.MethodsWe considered only randomized controlled trials (RCTs) that compared acupuncture with sham acupuncture or no adjuvant treatment during FET and the primary outcome was clinical pregnancy rate. Two authors separately selected studies, extracted data, and performed a risk of bias assessment. Pooled data were expressed as risk ratio (RR) or mean difference (MD), with a 95% confidence interval (CI). In addition, we conducted subgroup and sensitivity analyses to investigate the sources of heterogeneity, and we also constructed funnel plots to assess the likelihood of publication bias. Finally, Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) was applied to evaluate the quality of evidence.ResultsA total of 14 RCTs with a total of 1,130 participants were included in the study. We found significant effects of acupuncture adjuvant to FET on the outcomes of clinical pregnancy rate (RR = 1.54, 95% CI [1.28, 1.85], I2 = 34%; 14 trials), biochemical pregnancy rate (RR = 1.51, 95% CI [1.21, 1.89]; 5 trials), endometrial thickness (MD = 0.97, 95% CI [0.43, 1.51]; 12 trials), and endometrial pattern (RR = 1.41, 95% CI [1.13, 1.75]; 7 trials). For live birth rate (RR = 1.48, 95% CI [0.90, 2.43], 4 trials), there were no statistical effectiveness. For subgroup analyses, most variables had tolerable heterogeneity (I2 = 0%) except for trials that were sham-controlled, performed acupuncture only after FET, or <5 times, which appeared to interpret most of the heterogeneity. Additionally, the quality of evidence of all outcomes in this review ranged from low to moderate.ConclusionAcupuncture could be instrumental in the pregnancy outcomes of FET, and has very few risks of severe adverse events; however, the quality of evidence is unsatisfactory. Further research with rigorous methodological quality should be considered, and the protocols of acupuncture also need more investigations (e.g., appropriate control groups, sessions, and times).

A Data Mining Study for Analysis of Acupoint Selection and Combinations in Acupuncture Treatment of Carpal Tunnel Syndrome

“…[37][38][39][40] Acupuncture is a mild treatment with relatively fewer adverse reactions and costs. 41 Although acupuncture is associated with adverse effects such as hypodermal haemorrhage, in contrast to the gastrointestinal adverse effects associated with NSAIDs, acupuncture may be an alternate approach for patients who cannot endure the harmful effects on the digestive system. 42 Acupuncture exerts its analgesic properties through the regulation of affective and cognitive processing regions of the brain, as well as by stimulating endorphins, serotonin, and acetylcholine.…”

Acupuncture management in the field of assisted reproductive technology

“…However, in two other systematic evaluations, acupuncture was found to improve clinical pregnancy during IVF [30,31]. Another study confirmed that acupuncture before or during FET helped improve patients' biochemical pregnancy, and clinical pregnancy outcomes and the risk of serious adverse events is very low [32]. However, no significant improvement of acupuncture for live birth during FET was reported.…”

THE USE OF COMPLEMENTARY PRACTICES BY PATIENTS UNDERGOING MEDICALLY ASSISTED REPRODUCTION: The place of Chinese medicine and related practices

“…Several systematic reviews and meta-analyses have attempted to synthesize the available data. While some failed to show any benefit (25,26), most of the recent ones, have reported a positive an impact of acupuncture on fertility and IVF outcomes (27)(28)(29)(30).…”