Infertility: Evaluation and Initial Management

Koroma, Lucy; Stewart, Leslye

doi:10.1111/j.1542-2011.2012.00241.x

Cited by 7 publications

(3 citation statements)

References 52 publications

(124 reference statements)

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“…Among couples who are trying to conceive at reproductive age in China, 25% may encounter infertility (4). According to the report, female factors account for 40% of overall infertility (5). In vitro fertilization and embryo transfer (IVF-ET) is an effective treatment method for subfertility couples (6,7).…”

Section: Introductionmentioning

confidence: 99%

An Overview of Systematic Reviews of Acupuncture for Infertile Women Undergoing in vitro Fertilization and Embryo Transfer

Wang

Wei

et al. 2021

Front. Public Health

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Background: Currently, more and more subfertility couples are opting for combined acupuncture to improve the success rate of in vitro fertilization and embryo transfer (IVF-ET). However, the efficacy and safety of acupuncture in IVF-ET is still highly controversial.Objectives: The purpose of this overview is to summarize evidence of essential outcomes of systematic reviews (SRs) of acupuncture in IVF-ET and evaluate their methodological quality.Methods: We conducted a comprehensive literature search for relevant SRs in eight databases from inception to July 31, 2020, without language restriction. We evaluated the methodological quality of the included SRs by using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), which was the latest available assessment tool. The Risk of Bias in Systematic Review (ROBIS) tool was used to assess the risk of bias in SRs. We assessed the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) score to determine the strength of evidence. We excluded the overlapping randomized controlled trials (RCTs) and performed a re-meta-analysis of the primary RCTs.Results: This review included 312 original RCT studies and 65,388 participants. By using AMSTAR-2, we found that the methodological quality of 16 SRs was critically low, because they had more than one critical weakness. Our reviews showed that although the GRADE for quality of evidence profile was suboptimal, acupuncture seemed to be beneficial in increasing the pregnancy rate. Our re-meta-analysis suggested that acupuncture was superior to sham acupuncture in improving the clinical pregnancy rate (CPR) of IVF-ET with substantial heterogeneity (RR = 1.31, 95% CI: 1.13–1.52, p = 0.0004, I2 = 66%). No statistical difference was observed regarding the outcomes of live birth rate (LBR), ongoing pregnancy rate (OPR), biochemical pregnancy rate (BPR), and miscarriage rate (MR) between two groups. When compared with no adjunctive treatment groups, acupuncture improved CPR (RR = 1. 25, 95% CI: 1.11–1.42, p = 0.0003) and OPR (RR = 1. 38, 95% CI: 1.04–1.83, p = 0.03). Acupuncture was more superior than no adjunctive treatment in reducing MR (OR = 1.42, 95% CI: 1.03–1.95, p = 0.03) and BPR (RR = 1.19, 95% CI: 1.02–1.37, p = 0.02).Conclusions: Although the evidence of acupuncture in IVF-ET is insufficient, acupuncture appears to be beneficial to increase the clinical pregnancy rate in women undergoing IVF-ET. However, there are severe heterogeneity and methodological quality defects, which limit the reliability of results. Further, high-quality primary studies are still needed.

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Section: Introductionmentioning

confidence: 99%

An Overview of Systematic Reviews of Acupuncture for Infertile Women Undergoing in vitro Fertilization and Embryo Transfer

Wang

Wei

et al. 2021

Front. Public Health

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“…This series has addressed mainstays of gynecologic care, such as sexually transmitted infections (STIs) 1,2 and contraception, 3,4 as well as more complex conditions, including polycystic ovary syndrome 5 and breast cancer 6,7 . Two of the articles in this issue address topics that have been frequently requested in the Journal's reader surveys: hormone therapy 8 and infertility 9 . Overall, the series recognizes that midwives provide a broad scope of gynecologic care.…”

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confidence: 99%

“…6,7 Two of the articles in this issue address topics that have been frequently requested in the Journal's reader surveys: hormone therapy 8 and infertility. 9 Overall, the series recognizes that midwives provide a broad scope of gynecologic care.…”

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confidence: 99%