Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis

Smith, Caroline; Armour, Mike; Shewamene, Zewdneh; Tan, Hsiewe Ying; Norman, Robert J.; Johnson, Neil

doi:10.1016/j.rbmo.2018.12.038

Cited by 34 publications

(37 citation statements)

References 62 publications

(104 reference statements)

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“…A systematic review of complementary therapies (mainly acupuncture, mind-body and cognitive techniques) showed the effectiveness of these techniques on decreasing anxiety in women under IVF, indicating they might help women to cope with distress (LoGiudice and Massaro 2018). However, reproductive outcomes after acupuncture were found to be increased when compared with no adjunctive controls, but no significant differences were identified when compared to sham controls (Smith, Armour et al 2019).…”

Section: Discussionmentioning

confidence: 78%

Identification of Research Priorities in Infertility and Assisted Reproduction: An International, Multicenter Study in Partnership with Patients

García¹,

Lidenberg²,

Hagström-Toft³

et al. 2019

Preprint

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STUDY QUESTION: Which are the main research interests among patients of assisted reproductive technologies (ART)?SUMMARY ANSWER: Patients identified as research priorities that deserve further investigation: success rates and risks of ART, side-effects of treatments, resources to cope with infertility, effectiveness of alternative therapies, lifestyle habits to protect fertility, oocyte quality and ovarian reserve, and causes of genetic or hereditary infertility.WHAT IS KNOWN ALREADY: The involvement of patients and caregivers in setting research agendas in medicine has gathered significant momentum in the last decade. Patients’ involvement in setting research priorities offers several benefits: improved patient knowledge and awareness of their condition; greater understanding of the medical professionals of the impact of the condition on patients’ quality of life; reduced costs associated with redundant research activities. This is may be also applicable to research in infertility and ART, where patients’ interests have never been explored before.STUDY DESIGN, SIZE, DURATION: This is a cross-sectional study that consists of an anonymous online survey, which was sent up to three times to 2112 patients from 11 fertility centers in 5 countries between January-December 2018. The study design was based on the James Lind Alliance priority setting partnership model, which comprises the identification of patients groups, the exploration of the research agenda, the analysis of collected data and identification of priorities.PARTICIPANTS/MATERIALS, SETTING, METHODS: Overall, 2112 patients were contacted, and 945 surveys were answered (RR: 44.7%). Patients were asked to identify research questions relevant to them in the areas of infertility causes and prevention, fertility treatments (medication and ART), and the emotional aspects of infertility. Answers were categorized in topics and ranked by frequency. A long list of the top-30 research topics was extracted from the aggregate results, from which, a short list of the top-10 research topics was created. At the end, 10 research questions related to each of the 10 research topics were constructed, based on the answers given by patients.MAIN RESULTS AND THE ROLE OF CHANCE: Female (845, 89.4%) and male (100, 10.6%) patients were included. The mean age of patients was 37.8 (SD 1.74). Most of the patients did not have children at the time of the survey (523, 59%), while 51 (5.7%) were pregnant. Sixty (6.3%) patients did not start treatment, 579 (61.3%) were performing a treatment with their own gametes and 304 (32.2%) were treated through gamete donation. Patients were mainly interested in the effectiveness of ART -especially per clinical profile-, side effects of drugs, protection of fertility and prevention of infertility –especially through diet and exercise-, and psychological aspects of the infertility journey. The top-10 research questions (and weight) obtained were: 1) What are the side-effects of ART treatments? (41.6%); 2) What are the most effective methods to cope with infertility from the psychological point of view? (37.2%); 3) What effects could diet have on fertility? (25.9%); 4) What are ART success rates per clinical profile? (25.9%); 5) Are there habits and lifestyle factors that could prevent infertility? (20.0%); 6) What are the long-term risks associated to ART? (18.5%); 7) Are alternative therapies such as acupuncture, yoga, and meditation effective to treat/prevent infertility? (18.5%); 8) What is the impact of exercise on fertility? (15.4%); 9) How does oocytes quantity and quality affect fertility? (9.5%); 10) What are the genetic patterns or hereditary conditions causing/related to infertility? (9.5%).LIMITATIONS, REASONS FOR CAUTION: Although all respondents had attended a fertility center, not all of them were diagnosed as infertile (i.e. single women) and had started treatment at the time of response, while a few were pregnant; their priorities for research might have been influenced by their infertility journey. Also, all participants attended private fertility centers: areas of interest may be different in public settings.WIDER IMPLICATIONS FOR THE FINDINGS: Researchers and clinicians should keep in mind that, in addition to improvement of treatments’ success rates and side-effects, patients greatly value research on causes, prevention and emotional aspects of infertility. As their views might differ from those of medical professionals, patients’ voices should be incorporated in setting infertility research priorities.

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Section: Discussionmentioning

confidence: 78%

Identification of Research Priorities in Infertility and Assisted Reproduction: An International, Multicenter Study in Partnership with Patients

García¹,

Lidenberg²,

Hagström-Toft³

et al. 2019

Preprint

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“…CPR is an intrauterine gestational sac and/or fetal heart motion confirmed by ultrasound (US). Overall, there was no difference when acupuncture was compared in a systematic review to a sham controls to improve CPR, but verum acupuncture increased CPR by 28% 19 -32%, 18 compared to no treatment. When acupuncture was compared to all control groups in another systematic review by Xie et al, 19 acupuncture increased pregnancy rates by 21%.…”

Section: Overview Of Recent Ivf Meta-analysesmentioning

confidence: 94%

“…19 Ongoing pregnancy rate (OPR) is an intrauterine pregnancy beyond 12 weeks and confirmed by US. Acupuncture increased OPR by 42% in Smith et al's analysis, 18 and Xie et al 19 did not assess OPR.…”

Section: Overview Of Recent Ivf Meta-analysesmentioning

confidence: 95%

“…When acupuncture was compared with a sham control, the impact of acupuncture was equivocal on this outcome. When acupuncture was compared with no treatment, Smith et al 18 found that acupuncture increased LBR by 30%, and Xie et al's 19 analysis found no significant difference among groups, but the LBR was trending toward significance.…”

Section: Overview Of Recent Ivf Meta-analysesmentioning

confidence: 99%

“…As of this writing, 2 rigorous systematic reviews and metaanalyses were published in 2019 that looked specifically at acupuncture as an adjuvant to IVF. 18,19 See Table 1. In these meta-analyses, acupuncture was compared with sham, no treatment, and all comparators.…”

Section: Overview Of Recent Ivf Meta-analysesmentioning

confidence: 99%

See 2 more Smart Citations

Point of Influence: What is the Role of Acupuncture inIn VitroFertilization Outcomes?

Rubin

2019

Medical Acupuncture

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Augmenting in vitro fertilization (IVF) with acupuncture is a popular adjuvant therapy in the United States, but its influence on IVF birth outcomes remains controversial. Recent meta-analyses found acupuncture is effective to increase the risk of live births by 30% when acupuncture was compared with no treatment in nine trials of 1,980 women. The efficacy of acupuncture is unclear, however, and confounded by the need for an adequate, inert control. Acupuncture does not increase the risk of miscarriage. Additionally, acupuncture was 42% more effective to increase live births when women had previously failed a cycle, and baseline pregnancy rate continues to mediate acupuncture's effects. The characteristics of treatment more favorable to improving birth outcomes included more treatments, timing treatments in the period before and on the day of embryo transfer (ET), and using a modified Paulus protocol on the day of ET. These findings should inform the dosage, timing, and components of acupuncture therapy and type of comparator in future trials investigating the effects of acupuncture on IVF outcomes.

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Effect of Acupuncture on Outcomes of in vitro Fertilisation: A Scoping Review

Xiu

Gang

Jiao

et al. 2021

Chin. J. Integr. Med.

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Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis

Abstract: and leads the Healthy Women research theme and a team of postdoctoral researchers and higher degree candidates. Caroline is a clinical researcher with extensive experience with the conduct of multicentre randomized controlled trials and systematic reviews.

Cited by 34 publications

References 62 publications

Identification of Research Priorities in Infertility and Assisted Reproduction: An International, Multicenter Study in Partnership with Patients

Identification of Research Priorities in Infertility and Assisted Reproduction: An International, Multicenter Study in Partnership with Patients

Point of Influence: What is the Role of Acupuncture inIn VitroFertilization Outcomes?

Effect of Acupuncture on Outcomes of in vitro Fertilisation: A Scoping Review

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