Higher Expectancy of Acupuncture Treatment is Associated with Significant Higher Ovulation, Less Bruising and Lower Dropout in Infertile Women with PCOS Receiving Acupuncture

Object To study the expectancy of acupuncture treatment on fertility outcomes and adverse events in infertile women with polycystic ovary syndrome (PCOS) receiving acupuncture. Method: This analysis including 1000 infertile women with PCOS. Women with available expectancy of acupuncture treatment were included in analysis, of whom were subdivided into low and high expectancy groups. The anthropometric and endocrinal parameters, fertility outcomes as well as adverse events and dropout were compared. The risk of low expectancy of acupuncture treatment on ovulation and correspondent 95% confidence interval was computed by multivariable logistic regression model. The Kaplan Meier survival curve was employed to plot the time to ovulation and Cox regression model was used to compare the difference of time to ovulation between groups, adjusting by interventions. Results: 827 women were included in analysis, of whom 373 and 454 women were identified as low and high expectancy, respectively. Compared with low expectancy, women with high expectancy had higher BMI (24.56 vs 23.77 kg/m 2 , p = 0.03), shorter time to attempt to conception (22.97 vs. 25.00 months, p = 0.03), earlier menarche (13.61vs.13.68 years, p = 0.03) and lower estradiol (256.68 vs. 284.13 pmol/L, p = 0.03). There was not interaction between acupuncture treatment and expectancy of acupuncture treatment regarding ovulation (p = 0.07). High expectancy was associated with significant higher ovulation (adjusted odds ratio (OR) 2.33, 95% CI 1.31 to 4.16, p = 0.004) and lower dropout (adjusted OR 0.13, 95%CI 0.03 to 0.57) in women receiving control acupuncture, even after adjustment by BMI, estradiol, and clomiphene, while it was associated with significant less bruising (adjusted OR 0.28, 95%CI 0.13-0.61) and lower dropout (adjusted OR 0.42, 95%CI 0.18-0.96) in those receiving active acupuncture. High expectancy was associated with significant shorter time to ovulation (median 28 vs 49 days, P < 0.001) in women received control acupuncture, yet it was no longer significant after adjustment for clomiphene. Conclusion: High expectancy of acupuncture treatment was associated with significant higher ovulation, less bruising and lower dropout, but not other fertility outcome in infertile women with PCOS receiving acupuncture. Trial Registration ClinicalTrial.gov number: NCT01573858 and chictr.org.cn number: ChiCTR-TRC-12002081.