Acupuncture combined with metformin versus metformin alone to improve pregnancy rate in polycystic ovary syndrome: A systematic review and meta-analysis

Abstract

ObjectiveThe aim of this study was to evaluate the comparison between acupuncture combined with metformin versus metformin alone in improving the pregnancy rate of people with polycystic ovary syndrome (PCOS).MethodsA literature search of eight databases resulted in nine randomized controlled trials (RCTs) that assessed the effect of acupuncture combined with metformin on pregnancy rate in PCOS patients compared with metformin alone. Subsequently, data extraction and analysis were conducted to evaluate the quality and risk of bias of the methodological design of the study, and meta-analysis was conducted on the RCT data.ResultsNine RCTs and 1,159 women were included. Acupuncture can improve pregnancy rate. It was analyzed according to the diagnostic criteria of PCOS [Z = 2.72, p = 0.007, relative risk (RR) 1.31, 95% CI 1.08 to 1.60, p = 0.15, I2 = 41%]. Analysis was performed according to different diagnostic criteria of pregnancy (Z = 3.22, p = 0.001, RR 1.35, 95% CI 1.13 to 1.63, p = 0.12, I2 = 42%). Acupuncture can improve ovulation rate. Subgroup analysis was performed according to the number of ovulation patients (Z = 2.67, p = 0.008, RR 1.31, 95% CI 1.07 to 1.59, p = 0.04, I2 = 63%) and ovulation cycle (Z = 3.57; p = 0.0004, RR 1.18, 95% CI 1.08 to 1.29, p = 0.57, I2 = 0%). Statistical analysis also showed that acupuncture combined with metformin could improve homeostatic model assessment of insulin resistance (HOMA-IR) [mean difference (MD) −0.68, 95% CI −1.01 to −0.35, p = 0.003, I2 = 83%].ConclusionsBased on the results of this study, compared with metformin alone, acupuncture combined with metformin has a positive effect on pregnancy rate, ovulation rate, and insulin resistance in PCOS. However, due to the limitations regarding the number and quality of the included studies, the above conclusions need to be verified by further high-quality studies.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#myprospero.

Trends in acupuncture for infertility: a scoping review with bibliometric and visual analysis

“…Among the seven included meta-analyses, acupuncture for infertility caused by PCOS, ovulation dysfunction, and anovulatory have been published in the recent 4 years (21)(22)(23)(24); the details about the seven included meta-analyses are provided in Supplementary Table S5. Except for LUFS, the number of RCTs for male infertility and female infertility caused by other diseases were less than three; therefore, we only conducted meta-analysis of acupuncture for LUFS infertility.…”

Cancer risk in polycystic ovary syndrome patients: Common treatments and future perspectives

“…Remarkably, this treatment has shown no detrimental impact on the rate of ovulation or the likelihood of a successful live birth (Wu et al, 2020). The combination of acupuncture and metformin has demonstrated efficacy in enhancing the ovulation rate and improving the homeostatic model assessment of insulin resistance in women afflicted with PCOS as compared to the use of metformin alone (Chen et al, 2022).…”

Underlying mechanisms of acupuncture therapy on polycystic ovary syndrome: Evidences from animal and clinical studies

“…Interestingly, this systematic review suggested that acupuncture could promote the recovery of menstrual cycles as well as downregulate the levels of LH and testosterone in PCOS patients. A recent systematic review showed that acupuncture combined with metformin improved pregnancy rate, ovulation rate, and insulin resistance in PCOS patients compared to using metformin alone ( 97 ). Another study found that acupuncture combined with moxibustion improved pregnancy, ovulation, and miscarriage rates, as well as the levels of some sex hormones and metabolic indicators ( 98 ).…”