Effects of Acupuncture on Endometrium and Pregnancy Outcomes in Patients with Polycystic Ovarian Syndrome Undergoing in vitro Fertilization-Embryo Transfer: A Randomized Clinical Trial

Wu, Jiaman; Yan, Ning; Ye, Yang-Yang; Liu, Yu-Lei; Meng, Tao; Hu, Shan; Zhuo, Yuanyuan

doi:10.1007/s11655-022-3498-z

Cited by 11 publications

(8 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many studies have confirmed that Acupuncture & Moxibustion plays an active role in promoting follicular development (7,8) and improving pregnancy outcomes (9,10). Acupuncture & Moxibustion, as an alternative therapy, has gradually been used for PCOS treatment.…”

Section: Discussionmentioning

confidence: 99%

“…It has attracted much attention in the reproductive field in recent years. Many studies have confirmed that Acupuncture & Moxibustion plays a positive role in promoting follicular development (7,8), improving pregnancy outcomes (9,10) and other links, and can make up for the lack of clinical treatment of Clomiphene (11)(12)(13)(14). However, studies have reported that Acupuncture & Moxibustion has no effect on the improvement of PCOS live birth rate (15), and there is no systematic evaluation of the controversial effect.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Meta analysis of ovulation induction effect and pregnancy outcome of acupuncture & moxibustion combined with clomiphene in patients with polycystic ovary syndrome

Yang,

Sun

et al. 2023

Front. Endocrinol.

View full text Add to dashboard Cite

ObjectiveUsing Mesh Meta Analysis to evaluate the efficacy of Acupuncture & Moxibustion, Clomiphene, Acupuncture & Moxibustion combined with Clomiphene for treating Polycystic Ovary Syndrome (PCOS), in order to provide evidence-based medical evidence for whether to recommend Acupuncture & Moxibustion or Combine western medicine to treat PCOS.MethodsEight databases including The Cochrane Library, Pubmed, Embase, Web of Science, CNKI, Wanfang Date, VIP and CBM were searched by computer. The included research period is from the establishment of the database to May 2023, which concerned with randomized controlled trials involving Acupuncture & Moxibustion, Clomiphene, Acupuncture & Moxibustion combined with Clomiphene on ovulation induction and pregnancy outcome in patients with PCOS. The duration of the research paper is from 2016 to 2023.The inclusion criteria refer to the Rotterdam standards issued by the European Center for Human Reproduction and Embryology and the American Society of Reproductive Medicine in January 2003, or the Expert Consensus on the Diagnosis and Treatment of Polycystic Ovarian Syndrome by the Endocrinology Group of the Obstetrics and Gynecology Branch of the Chinese Medical Association. Simultaneously exclude related diseases, repetitive literature, as well as literature with incomplete abstract information and no original data provided. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias included in the study, using Stata17.0 software for a mesh meta-analysis.ResultsSix randomized controlled trials were included, covering 1410 PCOS patients. Three interventions included Acupuncture & Moxibustion, Clomiphene, Acupuncture & Moxibustion combined with Clomiphene. Mesh Meta Analysis showed that in terms of improving ovulation rate, there was no statistical difference between Acupuncture & Moxibustion (A), Clomiphene (B), Clomiphene combined with Acupuncture & Moxibustion (C) (P>0.05).Acupuncture & Moxibustion (A) versus Clomiphene (B) [MD=0.15,95% CI (-0.51,0.80)], Acupuncture & Moxibustion (A) versus Clomiphene combined with Acupuncture & Moxibustion (C) [MD=1.60,95% CI (0.97,2.23)], Clomiphene (B) versus Clomiphene combined with Acupuncture & Moxibustion (C) [MD=1.45,95% CI (0.91,1.99)]. In terms of pregnancy outcome, the difference between the three intervention methods was statistically significant (P<0.05). Acupuncture & Moxibustion (A) versus Clomiphene (B) [MD=-0.80,95% CI (-1.84,0.23)], Acupuncture & Moxibustion (A) versus Clomiphene combined with Acupuncture & Moxibustion (C) [MD=0.29,95% CI (-0.73,1.30)], and Clomiphene (B) versus Clomiphene combined with Acupuncture & Moxibustion (C) [MD=1.09,95% CI (0.39,1.79)], The order of pregnancy rate from high to low is Acupuncture & Moxibustion combined with Clomiphene (C), Acupuncture & Moxibustion (A), Clomiphene (C).In terms of influencing endometrial thickness, the difference between the three intervention methods was statistically significant (P<0.05). Acupuncture & Moxibustion (A) versus Clomiphene (B) [MD=-0.84,95% CI (-1.87,0.19)], Acupuncture & Moxibustion (A) versus Acupuncture & Moxibustion combined with Clomiphene (C) [MD=0.26,95% CI (-1.01,1.53)], Clomiphene (B) versus Acupuncture & Moxibustion combined with Clomiphene (C) [MD=1.10,95% CI (0.36,1.84)], Acupuncture & Moxibustion combined with Clomiphene (C) has the best effect on improving endometrial thickness. In subgroup analysis, the effect of Acupuncture & Moxibustion treatment frequency on ovulation rate and pregnancy rate was not statistically significant. The combination of Acupuncture & Moxibustion, Electroacupuncture and warm Acupuncture & Moxibustion has no effect on the pregnancy rate, but the combination of Electroacupuncture and Clomiphene has the best effect on improving the ovulation rate. In the observation of adverse reactions, compared with clomiphene alone, Acupuncture & Moxibustion combined with Clomiphene can reduce the occurrence of Luteinized Unruptured Follicle Syndrome (LUFS) and Ovarian Hyperstimulation Syndrome (OHSS), and reduce the occurrence of physical adverse reactions such as nausea, vomiting, headache and dermatitis.ConclusionAcupuncture & Moxibustion is effective in improving the ovulation promoting effect and pregnancy outcome of PCOS patients. The ovulation promoting effect of Acupuncture & Moxibustion or combined with Clomiphene is similar to that of Clomiphene alone, but Acupuncture & Moxibustion combined with Clomiphene has more advantages in improving the pregnancy rate of PCOS, and it also can reduce the adverse reactions of Clomiphene alone. Acupuncture & Moxibustion can be used as a recommended treatment for PCOS. More cases should also be included in the subgroup analysis to study the impact of Acupuncture & Moxibustion programs on clinical efficacy and further optimize the Acupuncture & Moxibustion treatment program.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier (CRD42023433057).

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Meta analysis of ovulation induction effect and pregnancy outcome of acupuncture & moxibustion combined with clomiphene in patients with polycystic ovary syndrome

Yang,

Sun

et al. 2023

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…All studies only used particular time points in the IVF-ET process as the beginning and end, such as the down-regulation day, human chorionic gonadotropin (HCG) day, so the total number of treatments seemed very vague due to the variability of IVF-ET protocols between patients. One study 27 receiving acupuncture intervention within the menstrual cycle, two studies 22,23 having three menstrual cycles of acupuncture before starting IVF-ET, six studies 18,19,25,28, 29 24 getting treatment procedures in the menstrual cycle before and also during controlled ovulation hyperstimulation (COH) until the day of human chorionic gonadotrophin (HCG), two studies 20,21 having acupuncture therapy within the COH cycle until the day of egg retrieval, and only one study 26 performed a total of ve acupuncture sessions separately at the start of down-regulation, the start of stimulation, two days before oocyte retrieval, before and after embryo transfer (ET) day. All the characteristics we summarized in Supplementary Table S2.…”

Section: The Timing Of Treatmentsmentioning

confidence: 99%

Correlation between acupuncture dose and pregnancy outcomes in women with Polycystic ovary syndrome undergoing in vitro fertilization-embryo transfer: a systematic review

Li,

Yang,

Huang

et al. 2023

Preprint

View full text Add to dashboard Cite

Background More and more studies focused on the efficacy of acupuncture on pregnancy outcomes in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization-embryo transfer (IVF-ET). However, the current relevant randomized controlled trials (RCTs) drew different conclusions, which may be related to different doses of acupuncture. Objective To systematically review RCTs to determine whether acupuncture has a dose-dependent effect on pregnancy outcomes in patients with PCOS undergoing IVF-ET. Methods Seven electronic databases were searched from inception to February 16th, 2023. The acupuncture dose of eligible studies was extracted, then categorized into high, medium, and low dose according to the results of the scoring system. Clinical pregnancy rate (CPR) was regarded as the primary outcome. Finally, the dose-dependent relationship of acupuncture in improving pregnancy outcomes in PCOS patients undergoing IVF-ET was analyzed. Results A total of 953 subjects met the eligibility criteria in 12 RCTs were included. Among them were two studies for low dose, four studies for medium dose, and six studies for high dose. It showed that there were six RCTs in the high-dose group [100.00%] (6/6) reported positive in CPR, no RCT in the medium-dose group [0.00%] (0/4), and one RCT in the low-dose group [50.00%] (1/2). The quality of studies was low, 50.00% (6/12) studies were assessed as low risk, 16.66% (2/12) studies were some concerns, and 33.33% (4/12) studies were high risk. Conclusion It suggests a trend that higher acupuncture doses showed better outcomes in PCOS patients undergoing IVF-ET. However, no existing clinical evidence has directly compared the efficacy of different acupuncture doses. In the future, direct evidence from high-quality studies will be supposed. Trial registration The systematic review has been registered on PROSPERO (https://www.crd.york.ac.uk/prospero/), and the registration number is CRD42023400187.

show abstract

“…[6] Previous clinical trials conducted across various countries suggest a potential benefit of acupuncture in enhancing reproductive function. [7][8][9][10] However, these acupuncture trials lack sufficient evidence to determine the efficacy of acupuncture in treating ovulation disorders in women with PCOS. [11] Additionally, female infertility in PCOS is negatively affected by factors such as being overweight, hyperandrogenism, and increased serum luteinizing hormone (LH) levels.…”

Section: Introductionmentioning

confidence: 99%

Establishment and validation of a nomogram model for predicting ovulation in the PCOS women

Ge,

Chang,

Wang

et al. 2024

Medicine

View full text Add to dashboard Cite

Background: The mechanisms underlying ovulatory dysfunction in PCOS remain debatable. This study aimed to identify the factors affecting ovulation among PCOS patients based on a large sample-sized randomized control trial. Methods: Data were obtained from a multi-centered randomized clinical trial, the PCOSAct, which was conducted between 2011 and 2015. Univariate and multivariate analysis using binary logistic regression were used to construct a prediction model and nomogram. The accuracy of the model was assessed using receiver operating characteristic (ROC) curves and calibration curves. Results: The predictive variables included in the training dataset model were luteinizing hormone (LH), free testosterone, body mass index (BMI), period times per year, and clomiphene treatment. The ROC curve for the model in the training dataset was 0.81 (95% CI [0.77, 0.85]), while in the validation dataset, it was 0.7801 (95% CI [0.72, 0.84]). The model showed good discrimination in both the training and validation datasets. Decision curve analysis demonstrated that the nomogram designed for ovulation had clinical utility and superior discriminative ability for predicting ovulation. Conclusions: The nomogram composed of LH, free testosterone, BMI, period times per year and the application of clomiphene may predict the ovulation among PCOS patients.

show abstract

Effects of Acupuncture on Endometrium and Pregnancy Outcomes in Patients with Polycystic Ovarian Syndrome Undergoing in vitro Fertilization-Embryo Transfer: A Randomized Clinical Trial

Cited by 11 publications

References 31 publications

Meta analysis of ovulation induction effect and pregnancy outcome of acupuncture & moxibustion combined with clomiphene in patients with polycystic ovary syndrome

Meta analysis of ovulation induction effect and pregnancy outcome of acupuncture & moxibustion combined with clomiphene in patients with polycystic ovary syndrome

Correlation between acupuncture dose and pregnancy outcomes in women with Polycystic ovary syndrome undergoing in vitro fertilization-embryo transfer: a systematic review

Establishment and validation of a nomogram model for predicting ovulation in the PCOS women

Contact Info

Product

Resources

About