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acupuncture:evaluation:gyneco-obstetrique:09. fecondation in vitro [29 Sep 2024 15:33] Nguyen Johan [1.2. Special Acupuncture Techniques] |
acupuncture:evaluation:gyneco-obstetrique:09. fecondation in vitro [04 Jun 2025 18:05] (Version actuelle) Nguyen Johan [1.1.1. Fu 2025] |
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| ===== Systematic Reviews and Meta-Analysis===== | ===== Systematic Reviews and Meta-Analysis===== | ||
| - | | ☆☆☆ | Evidence for effectiveness and a specific effect of acupuncture | | + | |
| - | | ☆☆ | Evidence for effectiveness of acupuncture | | + | |
| - | | ☆ |Limited evidence for effectiveness of acupuncture | | + | |
| - | | Ø |No evidence or insufficient evidence | | + | |
| ==== Generic Acupuncture ==== | ==== Generic Acupuncture ==== | ||
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| + | === Fu 2025 === | ||
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| + | Fu QW, Zhu SM, Chen J, Liu YQ, Liang CH, Song LJ, Zhuang J, Tan X, Liu LZ, Luo L, Yin HY, Yeung WF, Chen SC, Liu WT, Zhang QX, Tang Y. Acupuncture for women undergoing in vitro fertilization: An updated systematic review and meta-analysis with trial sequential analysis. Int J Nurs Stud. 2025 Apr 24;168:105097. https://doi.org/10.1016/j.ijnurstu.2025.105097 | ||
| + | ^Backgound| In vitro fertilization (IVF) is a widely utilized assisted reproductive technology, but its success rates remain suboptimal due to various physiological and psychological factors. Acupuncture, as a complementary therapy, has been proposed to improve reproductive outcomes and alleviate associated pain and anxiety.| | ||
| + | ^Objective| To evaluate the effectiveness and safety of acupuncture as an adjunctive treatment for women undergoing IVF, focusing on reproductive outcomes, pain reduction, and anxiety alleviation.| | ||
| + | ^Methods| Five English databases were searched up to June 20th, 2024. Manual acupuncture or electro-acupuncture was used solely as a complementary adjuvant in the experimental groups, and control interventions were sham acupuncture or blank (wait-list) control. Systematic reviews and meta-analyses were conducted based on the Cochrane systematic review method, and trial sequential analyses were performed. Meta-influence analyses, meta-regression and subgroup-analyses were performed for exploration of heterogeneity and related variables. Egger's together with trim and fill tests were conducted for evaluation of publication bias. The quality of the results was assessed, and correlation coefficient and cluster analyses were also performed.| | ||
| + | ^Results| Finally, 42 trials identified from** 37 published articles, involving 7400 participants**, were included, representing diverse populations worldwide. Compared to sham acupuncture and blank controls, acupuncture significantly (P < 0.05) improved biochemical pregnancy rate (RR = 1.28, 95 % CI: 1.04-1.57) and clinical pregnancy rates (RR = 1.19, 95 % CI: 1.06-1.34). Additionally, acupuncture was associated with better pain management during surgery and reduced anxiety levels. Acupuncture-specific adverse events were reported in eight of 42 trials, primarily mild to moderate local reactions. However, a significantly higher early miscarriage rate was observed in the acupuncture groups (RR = 1.51, 95 % CI: 1.10-2.08).| | ||
| + | ^Conclusions| Acupuncture may improve certain reproductive outcomes and alleviate pain and anxiety in women undergoing IVF. However, the potential risk of early miscarriage warrants caution, and further rigorous trials are needed to confirm these findings.| | ||
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| + | === Liu 2025 === | ||
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| + | Liu KX, Wu YY, Zhang M, Jia M, Wang D, Zhang CX, Guan YC, Tian PL. Effectiveness of non-pharmacological interventions on pregnancy rates in infertile individuals undergoing IVF/ICSI: a systematic review and network meta-analysis. Arch Public Health. 2025 Apr 22;83(1):110. https://doi.org/10.1186/s13690-025-01571-x | ||
| + | ^Aim|To assess the impact of various non-pharmacological interventions on the likelihood of achieving pregnancy in individuals undergoing IVF/ICSI.| | ||
| + | ^Backgound| Despite significant advancements in assisted reproductive technology, the strategic utilization of non-pharmacological interventions to enhance clinical outcomes continues to pose a significant challenge in the field of reproductive medicine.| | ||
| + | ^Methods| Relevant studies published in English or Chinese were comprehensively selected from databases including CNKI, Wanfang Data, VIP Database, PubMed, Web of Science, and Embase up to December 2023. Studies that examined various non-pharmacological interventions during IVF/ICSI treatment, and reported subsequent pregnancy outcomes, were included. The control group received standard treatment. Study quality was assessed based on the methodology and criteria outlined in the Cochrane Collaboration Handbook. This review protocol was registered with PROSPERO (CRD42023414729).| | ||
| + | ^Results| Out of the initial 28,688 studies identified, 43 trials involving 5,779 women were included. When compared to the control treatment, cognitive-behavioral therapy, **acupuncture**, lifestyle intervention, health education, and music therapy were associated with a significantly increased likelihood of clinical pregnancy (OR 1.44, 95% CI 1.21 to 1.72; 1.89, 1.46 to 2.43; 1.75, 1.18 to 2.57; 2.10, 1.57 to 2.80; 1.52, 1.08 to 2.13, respectively). Among the non-pharmacological treatments studied, cognitive-behavioral therapy and lifestyle intervention were associated with the highest number of oocytes retrieved (OR 0.31, 95% CI 0.11 to 0.86; 0.15, 95% CI 0.04 to 0.58, compared to controls). No significant differences were observed among non-pharmacological interventions and the control group. Cognitive-behavioral therapy and health education led to the highest rate of high-quality embryos (OR 0.41, 95% CI 0.20 to 0.84; 0.52, 95% CI 0.28 to 0.97, compared to controls).| | ||
| + | ^Conclusions| Non-pharmacological treatments such as cognitive-behavioral therapy, health education, lifestyle intervention, **acupuncture**, and music therapy showed trends suggesting better clinical outcomes in terms of pregnancy achievement compared to the control group. More high-level RCT studies are clearly necessary for future meta-analyses to better guide clinical practice.| | ||
| + | ^Implications for nursing and/or health policy|Policymakers should promote non-pharmacological programs for infertile population and develop standard guidelines. This will ensure that non-pharmacological interventions are implemented responsibly, protecting patient rights and enhancing healthcare outcomes.| | ||
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| + | === Wang 2024 === | ||
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| + | Wang X, Xu HM, Wang QL, Zhu XY, Zeng YM, Huang L, Feng X, Chen S. The Timing and Dose Effect of Acupuncture on Pregnancy Outcomes for Infertile Women Undergoing In Vitro Fertilization and Embryo Transfer: A Systematic Review and Meta-Analysis. J Integr Complement Med. 2024 Nov;30(11):1031-1046. https://doi.org/10.1089/jicm.2023.0478 | ||
| + | ^Backgound| Women undergoing in vitro fertilization and embryo transfer (IVF-ET) often utilize acupuncture to enhance pregnancy outcomes. Yet, the optimal timing for acupuncture sessions and the relationship between dosage and effect remain uncertain. | | ||
| + | ^Objectives| To investigate the impact of the timing and dosage of acupuncture on pregnancy outcomes, drawing on existing research. | | ||
| + | ^Methods| A comprehensive search of eight databases was conducted from their inception to January 14th, 2023, without restrictions on language. Only randomized controlled trials comparing acupuncture with either sham acupuncture or no adjuvant treatment were selected for inclusion. This meta-analysis assessed the efficacy of acupuncture in IVF-ET, analyzing the influence of varied timing and dosage on pregnancy outcomes. Subgroup analyses were undertaken to address any heterogeneity across the studies. | | ||
| + | ^Results| A total of **38 RCTs involving 5,991 participants** were analyzed. In infertile women undergoing IVF fresh cycles, acupuncture performed during controlled ovarian hyperstimulation (COH) significantly increased the clinical pregnancy rate (CPR) (relative risk [RR] = 1.33, 95% confidence interval [CI]: 1.07-1.65, p = 0.01), whereas acupuncture administered either before COH or on the day of ET did not demonstrate reproductive benefits. Regarding frozen cycles, acupuncture before freeze-thaw embryo transfer (FET) significantly enhanced the CPR (RR = 1.71, 95% CI: 1.36-2.16, p < 0.00001) and live birth rate (LBR) (RR = 2.40, 95% CI: 1.20-4.79, p = 0.01). Improvements in CPR were observed across all dosage groups, but only the high-dosage group showed a significant increase in LBR (RR = 1.75, 95% CI: 1.05-2.92, p = 0.03). | | ||
| + | ^Conclusions| Timing and dosage of acupuncture are crucial factors affecting pregnancy outcomes in IVF-ET. For women undergoing IVF fresh cycles, acupuncture during COH yielded more significant reproductive benefits. In addition, acupuncture before freeze-thaw embryo transfer (FET) was associated with improved pregnancy outcomes in frozen cycles. Furthermore, higher dosages of acupuncture were linked to more favorable outcomes.| | ||
| === Xu 2024 === | === Xu 2024 === | ||
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| === Comparison of Acupuncture techniques === | === Comparison of Acupuncture techniques === | ||
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| + | == Bin 2025 == | ||
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| + | Bin C, Zhong H, Zhang S, Luo Y, Su J, Li M, Wei S. Effects of acupuncture-related therapies on pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer: a Bayesian network meta-analysis. J Assist Reprod Genet. 2025 May 9. https://doi.org/10.1007/s10815-025-03489-3 | ||
| + | ^Backgound| This network meta-analysis aimed to assess the efficacy of different acupuncture-related therapies in improving pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer (IVF-ET).| | ||
| + | ^Methods| Randomized controlled trials (RCTs) examining acupuncture-related therapies as adjuncts to IVF-ET were systematically searched in eight databases from inception until January 15, 2025. Dichotomous outcomes concerning efficacy were evaluated as odds risk (OR) and continuous data as mean difference (MD) and 95% credible intervals (CrI) utilizing R 4.1.2 and Stata 16.1.| | ||
| + | ^Results| Through a comprehensive literature search, we ultimately identified **96 RCTs that involved 14,736 participants** and 15 interventions in this systematic analysis. Based on the clinical pregnancy rate outcome, warm acupuncture for three menstrual cycles before oocyte retrieval (WA-TTP, OR 3.56, 95% CrI 2.05 to 6.25, low certainty, SUCRA = 89.54%), acupuncture combined with moxibustion for three menstrual cycles before oocyte retrieval (AC + M-TTP, OR 3.31, 95% CrI 1.05 to 11.77, low certainty, SUCRA = 78.70%), and acupuncture for one menstrual cycle before oocyte retrieval (AC-OTP, OR 2.69, 95% CrI 1.76 to 4.09, moderate certainty, SUCRA = 77.98%) demonstrated potential superiority compared to false acupuncture or no treatment (F/N). Significant subgroup differences between clinical pregnancy rates were observed by subgroup analysis.| | ||
| + | ^Conclusion| Acupuncture-related therapies can potentially enhance clinical pregnancy rates among women undergoing IVF-ET, with WA-TTP, AC + M-TTP, and AC-OTP demonstrating potential superiority. AC-TTP demonstrated a greater efficacy in improving live birth rates, increasing endometrial thickness, and reducing pulsation index. Our findings emphasize that acupuncture-related therapies with a limited number of sessions before or after embryo transfer show minimal clinical benefit except auricular acupressure.| | ||
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| == Luo 2024 == | == Luo 2024 == | ||
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| === Polycystic Ovarian Syndrome === | === Polycystic Ovarian Syndrome === | ||
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| + | == Li 2024 == | ||
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| + | Li YT, Li CL, Yang H, Huang L, Liu JJ, Zheng XY, Tao XY, Yu Z, Liang FR, Tian XP, Yang J. Correlation between acupuncture dose and pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization-embryo transfer: a systematic review. BMC Complement Med Ther. 2024 Nov 26;24(1):407. https://doi.org/10.1186/s12906-024-04695-9 | ||
| + | ^Backgound| Increasing studies focused on the efficacy of acupuncture on pregnancy outcomes in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization-embryo transfer (IVF-ET). However, debatable conclusions have been drawn from different randomized controlled trials (RCTs), which might be related to different doses of acupuncture.| | ||
| + | ^Objective| To evaluate whether acupuncture has a dose-dependent effect on pregnancy outcomes in patients with PCOS undergoing IVF-ET in systematically reviewing.| | ||
| + | ^Methods| Seven electronic databases were searched from inception to October 10th, 2024. The Cochrane Collaboration's tool ROB 2.0 (ROB 2.0) provided an assessment for the risk of bias. The acupuncture dose was extracted, then categorized into high, medium, and low dose according to the scoring system results, the evidence was assessed by Slavin's qualitative best-evidence synthesis approach in a rigours methodological way. Clinical pregnancy rate (CPR) was regarded as the primary outcome.| | ||
| + | ^Results| A total of **953 subjects** met the eligibility criteria in **12 RCTs** were included, among which two studies were low dose, four were medium dose, and six were high dose. The overall quality of included studies was low, 50.00% (6/12) studies were low risk, 16.67% (2/12) studies were some concerns, and 33.33% (4/12) studies were high risk. Comparing the results, the consistent high-dose result among high-quality trials provides strong evidence for a positive correlation between high-dose acupuncture and pregnancy outcomes.| | ||
| + | ^Conclusion| A trend indicates that higher acupuncture doses yield better outcomes for PCOS patients undergoing IVF-ET. Further confirmation through direct comparisons of different doses was needed| | ||
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| == Yin 2020 ☆☆ == | == Yin 2020 ☆☆ == | ||
