An Overview of Systematic Reviews of Acupuncture for Infertile Women Undergoing in vitro Fertilization and Embryo Transfer

Wang, Xia; Wang, Yan; Wei, S.; He, Bisong; Cao, Yihong; Zhang, Nannan; Li, Maoya

doi:10.3389/fpubh.2021.651811

Cited by 19 publications

(7 citation statements)

References 38 publications

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“…We employed Medical Subject Heading terms and relevant keywords for the search. The retrieval formula was as follows: (Title/Abstract): female infertility/sterility, assisted reproduction, embryo transfer, in vitro fertilization, polycystic ovary syndrome, acupuncture, pharmacopuncture, electroacupuncture, and needle; we also searched for previous systematic reviews on this topic and reviewed their reference lists [ 20 – 23 ]. In addition, we searched Google Scholar for book publications relevant to infertility and acupuncture and then checked the reference lists for relevant articles; the search strategy was developed after consultation with an experienced medical research professor.…”

Section: Methodsmentioning

confidence: 99%

Acupuncture as Treatment for Female Infertility: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Quan

Lin

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. The effects of acupuncture on female infertility remain controversial. Also, the variation in the participant, interventions, outcomes studied, and trial design may relate to the efficacy of adjuvant acupuncture. The aim of the study is to systematically evaluate the efficacy and safety of acupuncture for female with infertility and hopefully provide reliable guidance for clinicians and patients. Methods. We searched digital databases for relevant studies, including EMBASE, PubMed, Cochrane Library, and Web of Science, and the Cochrane Library up to April 2021, for randomized controlled trials (RCTs) evaluating the effects of acupuncture on women undergoing IVF and other treatment. We included studies with intervention groups using acupuncture and control groups consisting of no acupuncture or sham (placebo) acupuncture. Primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Meta-regression and subgroup analysis were conducted on the basis of ten prespecified covariates to investigate the variances of the effects of adjuvant acupuncture on pregnancy rates and the sources of heterogeneity. Results: Twenty-seven studies with 7676 participants were included. The results showed that the intervention group contributes more in outcomes including live birth rate (RR = 1.34; 95% CI (1.07, 1.67); P < 0.05 ), clinical pregnancy rate (RR = 1.43; 95% CI (1.21, 1.69); P < 0.05 ), biochemical pregnancy rate (RR = 1.42; 95% CI (1.05, 1.91); P < 0.05 ), ongoing pregnancy rate (RR = 1.25; 95% CI (0.88, 1.79); P < 0.05 ), adverse events (RR = 1.65; 95% CI (1.15, 2.36); P < 0.05 ), and implantation rate (MD = 1.19; 95% CI (1.07, 1.33); P < 0.05 ) when compared with the control group, and the difference is statistically significant. In terms of the number of oocytes retrieved, good-quality embryo rate, miscarriages, and ectopic pregnancy rate, the difference between the acupuncture group and the control group was not statistically significant. Conclusions: Our analysis finds a benefit of acupuncture for outcomes in women with infertility, and the number of acupuncture treatments is a potential influential factor. Given the poor reporting and methodological flaws of existing studies, studies with larger scales and better methodologies are needed to verify these findings. More double-blind RCTs equipped with high quality and large samples are expected for the improvement of the level of evidence.

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Section: Methodsmentioning

confidence: 99%

Acupuncture as Treatment for Female Infertility: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Quan

Lin

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…For gray literature retrieval, only 4.55% (n=1) of the SRs/MAs searched the gray literature database [11], and (n=6) searched the clinical trial platform [11,[27][28][29]43]. Winters et al [97] proposed three methods to control the publication bias, namely, (1) registering before the start of the trial, (2) using a funnel to evaluate the publication bias intuitively, and (3) using comprehensive retrieval strategy multiple gray literature Unpublished studies may signi cantly change the clinical effect of SRs/MAs, and more comprehensive literature retrieval strategies be developed in the The AMSTAR 2 and have used in combination in diverse elds such as heart failure [98], dyslipidemia [99], infertility [100], and psoriasis [101]. It has been con rmed that there is a strong use of AMSTAR 2 and ROBIS tools for evaluation and the methodological quality [102,103].…”

Section: Discussionmentioning

confidence: 99%

Methodological Quality and Risk of Bias of Systematic Reviews and Meta-Analyses on Stem Cells for Knee Osteoarthritis: A Cross-Sectional Survey

Liu

Chen

et al. 2022

Stem Cells and Development

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Background: Clinical guidelines need high-quality studies to support clinical decision-making, in which the evidence often was collected from systematic reviews (SRs) and/or meta-analyses (MAs). At present, the methodological quality and risk of bias (RoB) of SRs/MAs on stem cell therapy for the treatment of knee osteoarthritis (KOA) has been poorly investigated. This study aims to strictly evaluate the methodological quality and RoB in SRs/MAs of stem cell therapy for KOA.Methods: Four electronic databases (PubMed, Embase, Cochrane Library, and Web of Science databases) were searched, from inception to October 5th, 2021. SRs/MAs involving RCTs or cohort studies on stem cell therapy for the treatment of KOA were included. The methodological quality and RoB were assessed using AMSTAR 2 and ROBIS tool respectively.Results: In total, 22 SRs/MAs were included. According to the results obtained by AMSTAR 2 tool, all SRs/MAs were rated as "Critically low". Main methodological weaknesses were as follows: eight items accounted for more than 50% of "No", including Items 2 Protocol registration (81.82%), Item 7 Study exclusion and justi cation (86.36%) and Item 15 Investigation and discussion of publication bias (63.64%) were critical items. ROBIS-based RoB assessment showed that all the SRs/MAs were rated as "High". Conclusions:The overall methodological quality of the SRs/MAs concerning the application of stem cell therapy in treating KOA is "Critically low", while the RoB is high. It is di cult to provide effective evidence for the formulation of guidelines for KOA treatment. We suggest that the relevant methodological quality assessment should be carried out in the future before the SRs/MAs are used as clinical evidence.

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“…The quality assessment of the overview mainly followed the Cochrane Handbook and the methods of relevant studies (39)(40)(41)(42)(43). The quality assessment mainly contained four aspects: methodological quality, risk of bias, reporting quality, and evidence quality.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…Nearly 21% of patients undergoing KOA even suffer from a series of psychological problems such as depression and anxiety (5). The global prevalence of KOA has reached 22.9% in patients aged 40 or older, which represents tremendous personal and societal burdens (6,7). The increased disease burden has not only strained severely the healthcare institution but has also affected the medical expenditure of patients (8).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of manual therapy for knee osteoarthritis: An overview of systematic reviews and meta-analyses

Feng

Wang

Jin

et al. 2023

Front. Public Health

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BackgroundManual therapy has been used as an alternative approach to treat knee osteoarthritis (KOA) for many years. Numerous systematic reviews (SRs) or meta-analyses (MAs) were published to evaluate its effectiveness and safety. Nevertheless, the conclusions of SRs/MAs are inconsistent, and the uneven quality needs to be critically appraised.ObjectivesTo conduct a comprehensive overview of the effectiveness and safety of manual therapy for KOA and the quality of relevant SRs/MAs, thus providing critical evidence and valuable direction for future researchers to promote the generation of advanced evidence.MethodsThe pre-defined search strategies were applied to eight electronic databases from inception to September 2022. Suitable SRs/MAs were included in accordance with the inclusion and exclusion criteria. The methodological quality, risk of bias, reporting quality, and evidence quality were assessed by two independent reviewers who used respectively the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Version (PRISMA 2020), and Grades of Recommendations, Assessment, Development and Evaluation (GRADE) based on the method of narrative synthesis. We excluded the overlapping randomized controlled trials (RCTs) and performed a re-meta-analysis of the total effective rate.ResultsA total of eleven relevant SRs/MAs were included: nine SRs/MAs were rated critically low quality, and two were rated low quality by AMSTAR-2. According to ROBIS, all SRs/MAs were rated low risk in Phase 1 (assessing relevance) and Domain 1 (study eligibility criteria) of Phase 2. Three SRs/MAs (27.27%) were rated low risk in Domain 2 (identification and selection of studies). Ten SRs/MAs (90.91%) were rated low risk in Domain 3 (data collection and study appraisal). Five SRs/MAs (45.45%) were rated low risk in Domain 4 (synthesis and findings). And five SRs/MAs (45.45%) were rated low risk in Phase 3 (risk of bias in the review). By PRISMA 2020, there were some reporting deficiencies in the aspects of abstract (2/11, 18.18%), search strategy (0/11, 0%), preprocessing of merging data (0/11, 0%), heterogeneity exploration (6/11, 54.55%), sensitivity analysis (4/11, 36.36%), publication bias (5/11, 45.45%), evidence quality (3/11, 27.27%), the list of excluded references (3/11, 27.27%), protocol and registration (1/11, 9.09%), funding (1/11, 9.09%), conflict of interest (3/11, 27.27%), and approach to relevant information (0/11, 0%). In GRADE, the evidence quality was defined as moderate quality (8 items, 21.05%), low quality (16 items, 42.11%), and critically low quality (14 items, 36.84%). Among the downgraded factors, risk of bias, inconsistency, imprecision, and publication bias were the main factors. A re-meta-analysis revealed that manual therapy can increase the total effective rate in KOA patients (risk ratio = 1.15, 95% confidence interval [1.12, 1.18], p < 0.00001; I2 = 0, p = 0.84). There are four reviews that narratively report adverse effects, and no severe adverse reactions occurred in the manual therapy group.ConclusionsManual therapy may be clinically effective and safe for patients with KOA. However, this conclusion must be interpreted with caution because of the generally unsatisfactory study quality and inconsistent conclusions of the included SRs/MAs. Further rigorous and normative SRs/MAs are expected to be carried out to provide robust evidence for definitive conclusions.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier: CRD42022364672.

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An Overview of Systematic Reviews of Acupuncture for Infertile Women Undergoing in vitro Fertilization and Embryo Transfer

Cited by 19 publications

References 38 publications

Acupuncture as Treatment for Female Infertility: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Acupuncture as Treatment for Female Infertility: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Methodological Quality and Risk of Bias of Systematic Reviews and Meta-Analyses on Stem Cells for Knee Osteoarthritis: A Cross-Sectional Survey

Effectiveness and safety of manual therapy for knee osteoarthritis: An overview of systematic reviews and meta-analyses

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