Pregnancy benefit of acupuncture on in vitro fertilization: a systematic review and meta- analysis

Background: This study reviewed published evidence of the efficacy of acupuncture among women undergoing in vitro fertilization (IVF). Methods: : The database included PubMed, MEDLINE, Web of Science, EMBASE, CENTRAL, Wanfang, CNKI, VIP were searched up to May 24, 2022. The primary outcomes for clinical pregnancy rate (CPR) and live birth rate (LBR) were quantitatively summarized by the random-effect model with I 2 statistics to quantify heterogeneity. Results: : Forty-nine eligible randomized clinical trials (RCTs)representing 9422 women undergoing IVF for pregnant success were identified. The results indicated that pooled CPR and LBR showed a significant difference between acupuncture and control groups [53 trials, odds ratio (OR)1.68, 95% confidence intervals (CI) 1.47 to 1.92, I 2 =47.4], extremely low evidence; 20 trials, OR1.37, 95%CI 1.11 to 1.69, I 2 =62.6, low evidence, respectively). Only transcutaneous electrical acupoint stimulation (TEAS) was found to be a positive effect on both CPR (10 trials, OR1.73, 95%CI 1.35 to 2.23; I 2 =28.1, moderate evidence) and LBR (7 trials, OR 1.74, 95%CI 1.23 to 2.46; I 2 =47.6, extremely low evidence). Heterogeneity across studies was found and no studies were graded as high quality of evidence. Conclusions: : Our results showed that the association between acupuncture use and IVF pregnant outcomes were not supported by robust evidence and the varied methodological design and heterogeneity might influence the findings in a relevant way. Registration: PROSPERO CRD42021232430.