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| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
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acupuncture:evaluation:gyneco-obstetrique:03. syndrome des ovaires polykystiques [14 Apr 2025 18:09] Nguyen Johan |
acupuncture:evaluation:gyneco-obstetrique:03. syndrome des ovaires polykystiques [29 Oct 2025 14:13] (Version actuelle) Nguyen Johan |
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| ===== Systematic Reviews and Meta-Analysis===== | ===== Systematic Reviews and Meta-Analysis===== | ||
| - | + | ==== Generic Acupuncture ==== | |
| - | ==== Jin 2025 (network meta-analysis) ==== | + | === Jin 2025 (network meta-analysis) === |
| Jin Q, Xu G, Ying Y, Liu L, Zheng H, Xu S, Yin P, Chen Y. Effects of non-pharmacological interventions on biochemical hyperandrogenism in women with polycystic ovary syndrome: a systematic review and network meta-analysis. J Ovarian Res. 2025 Jan 20;18(1):8. https://doi.org/10.1186/s13048-025-01595-5 | Jin Q, Xu G, Ying Y, Liu L, Zheng H, Xu S, Yin P, Chen Y. Effects of non-pharmacological interventions on biochemical hyperandrogenism in women with polycystic ovary syndrome: a systematic review and network meta-analysis. J Ovarian Res. 2025 Jan 20;18(1):8. https://doi.org/10.1186/s13048-025-01595-5 | ||
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| + | === Zhang 2025 === | ||
| + | Zhang GS, Lim ECN, Cheng NCL, Lim CED. Acupuncture for polycystic ovary syndrome. Cochrane Database Syst Rev. 2025 Oct 28;10:CD007689. https://doi.org/10.1002/14651858.CD007689.pub5 | ||
| - | + | ^Background| Polycystic ovary syndrome (PCOS) is characterised by oligo-amenorrhoea, infertility, and hirsutism. Treatments include pharmacological agents, lifestyle modifications, and surgery. During ovulation in healthy women, the concentration of beta-endorphin, a neuropeptide involved in pain and hormonal regulation, is higher in follicular fluid than in plasma. Acupuncture may improve ovulatory function by stimulating beta-endorphin production, which is hypothesised to enhance gonadotropin-releasing hormone (GnRH) secretion. This is an update of a review first published in 2011 and last updated in 2019.| | |
| - | + | ^Objective| To assess the benefits and harms of acupuncture in managing fertility and symptoms in oligo/anovulatory women with polycystic ovary syndrome.| | |
| - | + | ^Methods| Search methods: We searched the Cochrane Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, Embase, PsycINFO, AMED, and three Chinese databases (CNKI, CBM, and VIP). We also reviewed trial registries and reference lists for related papers. The searches in CENTRAL, MEDLINE, Embase, PsycINFO, and CNKI are current to December 2024, the VIP search to November 2024, and the CBM search to November 2015. We also performed reference checking, citation searching, and contacted study authors to identify additional studies. Eligibility criteria: We included randomised controlled trials (RCTs) on the efficacy of acupuncture for oligo/anovulatory women with PCOS. Outcomes: Critical outcomes were live birth rate, multiple pregnancy rate, and ovulation rate. Important outcomes were clinical pregnancy rate, restored regular menstrual period, miscarriage rate, and adverse events. Risk of bias: We used the original Cochrane risk of bias tool (RoB 1). Synthesis methods: Two authors independently selected studies, extracted data, and assessed risk of bias. We calculated risk ratios (RRs), mean differences (MDs), and standardised mean differences (SMDs) with 95% confidence intervals (CIs). Certainty of evidence was evaluated using GRADE. Skewed data and small-study effects were considered, and unreliable results interpreted cautiously.| | |
| - | ==== Generic Acupuncture ==== | + | ^Results| **Nine RCTs (one added in this update) with 1606 women** were included: acupuncture versus sham acupuncture (3 RCTs), low-frequency electroacupuncture versus exercise/no intervention (1 RCT), acupuncture versus relaxation (1 RCT), acupuncture versus clomiphene (1 RCT), and acupuncture versus Diane-35 (3 RCTs). Evidence remains uncertain regarding fertility and symptom control. Compared with sham acupuncture, acupuncture may result in little to no difference in live birth (RR 0.97, 95% CI 0.76-1.23), multiple pregnancy (RR 0.89, 95% CI 0.33-2.45), ovulation (SMD 0.02, 95% CI -0.15-0.19), clinical pregnancy (RR 1.07, 95% CI 0.85-1.35), and miscarriage (RR 1.10, 95% CI 0.77-1.56). Acupuncture may reduce mean days between menstrual periods at 12 weeks (MD -312.09 days, 95% CI -344.59--279.59; very low-certainty) and is probably associated with more adverse events (RR 1.16, 95% CI 1.02-1.31). Other comparisons (electroacupuncture, relaxation, clomiphene, Diane-35) yielded very low-certainty evidence with inconsistent outcomes.| |
| + | ^Conclusion| No clear evidence of a difference between acupuncture and sham acupuncture in live birth, multiple pregnancy, ovulation, clinical pregnancy, miscarriage, or restored menstrual periods. Acupuncture is probably associated with more adverse events. The limited number and quality of RCTs mean that the effectiveness of acupuncture for PCOS remains uncertain.| | ||
| === Li 2022 ☆☆=== | === Li 2022 ☆☆=== | ||
