Effects of Acupuncture on the Outcomes of Assisted Reproductive Technology: An Overview of Systematic Reviews

Abstract

Objectives To conclude the evidence from systematic reviews (SRs) and meta-analyses assessing the effectiveness of acupuncture to treat couples with subfertility undergoing ART. Methods We searched the major databases from their inception to March 2018: PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chongqing VIP, and Sino-Med (the Chinese database). The primary outcomes of the overview were live birth and clinical pregnancy, and secondary outcomes were ongoing pregnancy, miscarriage, and adverse events. Study selection, quality assessment, and data extraction were performed independently by two review authors. Review methodological quality was assessed by using the AMSTAR tool, and the quality of the evidence was rated by GRADE methods. Results Eleven systematic reviews were included and published between 2009 and 2017. Our study showed that the acupuncture treatment seems to be a useful tool to improve the clinical pregnancy rate in patients who undergo assisted reproduction therapy. However, there was no evidence that acupuncture had any effect on live birth rate, ongoing pregnancy rates, or miscarriage regardless of whether acupuncture was performed around the time of oocyte retrieval or around the day of embryo transfer; this evidence is inconclusive because of the low quality of the included studies. Conclusions The evidence for acupuncture to treat couples with subfertility undergoing ART remains unclear. Further research is needed, with high-quality trials undertaken and reported.

Management of Male Infertility with Coexisting Sexual Dysfunction: A Consensus Statement and Clinical Recommendations from the Asia-Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men’s Health and Aging (ASMHA)

“…While a significant proportion of these potency-inducing supplements such as animal products and herbal plants may have similar phosphodiesterase type 5 inhibitor (PDE5i) substrates, there is no strong scientific evidence supporting their use in males with ED and MI [ 77 ]. The data for Chinese herbal medications, acupuncture, mind-body practice, and faith-based healing are sparse or inconclusive regarding positive effects on male fertility [ 80 81 82 ]. These confounding data can be partially attributed to the unproven large commercial amounts of supplements advertised to improve sperm quality, the difficulty in controlling various modifiable factors, generally sub-optimal quality, and the heterogeneous nature of the evidence as well as the question of whether any of these therapies translates in improving the chances of conception and live births or increasing miscarriage risk.…”

Acupuncture and Chinese Herbal Medicine Effects on Assisted Reproductive Technology: Six Cases and Their Clinical Significance

“…Another systematic review had a similar result with a series of clinical trials that included a total 44,619 participants (of whom 6344 participants received acupuncture treatment) in 210 primary studies in 2018 on acupuncture-assisted IVF. 9 However, the reported cases did not indicate if the inclusion criteria allowed conditions specifically requiring IVF, such as tubal blockage.…”

Do acupuncture trials have lower risk of bias over the last five decades? A methodological study of 4 715 randomized controlled trials

“…Due to the lack of high-quality evidence from systematic reviews (SRs) on acupuncture, the recommendations for acupuncture in the guidelines are not high in strength [2]. Several studies have shown that a high risk of bias (RoB) was the main reason for rating down the quality of evidence [3][4][5], and the conclusion cannot be trusted if randomized controlled trials (RCTs) were rated as high RoB [6]. Additionally, one methodological study has shown that supplementary information from trialists can significantly increase the rate of trials at low RoB rather than high RoB by reducing the rate of unclear RoB [7].…”