Abstract
Objectives To conclude the evidence from systematic reviews (SRs) and meta-analyses assessing the effectiveness of acupuncture to treat couples with subfertility undergoing ART. Methods We searched the major databases from their inception to March 2018: PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chongqing VIP, and Sino-Med (the Chinese database). The primary outcomes of the overview were live birth and clinical pregnancy, and secondary outcomes were ongoing pregnancy, miscarriage, and adverse events. Study selection, quality assessment, and data extraction were performed independently by two review authors. Review methodological quality was assessed by using the AMSTAR tool, and the quality of the evidence was rated by GRADE methods. Results Eleven systematic reviews were included and published between 2009 and 2017. Our study showed that the acupuncture treatment seems to be a useful tool to improve the clinical pregnancy rate in patients who undergo assisted reproduction therapy. However, there was no evidence that acupuncture had any effect on live birth rate, ongoing pregnancy rates, or miscarriage regardless of whether acupuncture was performed around the time of oocyte retrieval or around the day of embryo transfer; this evidence is inconclusive because of the low quality of the included studies. Conclusions The evidence for acupuncture to treat couples with subfertility undergoing ART remains unclear. Further research is needed, with high-quality trials undertaken and reported.
Highlights
With rapid development of the economy, changes in lifestyles, and aggravation of environmental pollution, the incidence of infertility has gained increased worldwide attention
A total of 478 citations were acquired from the electronic search, and 76 duplicated articles were identified and excluded. 366 citations were excluded after screening the titles and abstracts for a variety of reasons, such as types of studies, interventions, and patients
Twenty-five publications were excluded for the following reasons: six [16,17,18,19,20,21] were not SRs, five [4, 10, 22,23,24] were narrative reviews, five [25,26,27,28,29] were early versions of an updated SR, one [30] could not get the full review, three [31,32,33] were not an acupuncture + assisted reproductive technology (ART) treatment, and five [34,35,36,37,38] were duplicate publications
Summary
With rapid development of the economy, changes in lifestyles, and aggravation of environmental pollution, the incidence of infertility has gained increased worldwide attention. In vitro fertilization has revolutionized the treatment of infertility. For many people, it provides the last possibility for pregnancy, and it is useful in almost all causes of sterility. It provides the last possibility for pregnancy, and it is useful in almost all causes of sterility These results are still modest and far from the expectations of couples since only 25% of patients deliver after an attempt and 40% to 50% after several attempts [2]. Because of expensive procedure, only some couples can afford only a limited number of treatments. Many patients have turned to complementary and alternative medical (CAM) treatments such as acupuncture to increase the success rate of assisted reproductive technology (ART) [3]
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