Acupuncture for women undergoing in vitro fertilization: An updated systematic review and meta-analysis with trial sequential analysis

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2025-04-24 DOI:10.1016/j.ijnurstu.2025.105097

Qin-Wei Fu , Shao-Mi Zhu , Ji Chen , Yong-Qin Liu , Chang-Hao Liang , Lin-Jiang Song , Jing Zhuang , Xin Tan , Li-Zhou Liu , Ling Luo , Hai-Yan Yin , Wing-Fai Yeung , Shu-Cheng Chen , Wei-Ting Liu , Qin-Xiu Zhang , Yong Tang

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引用次数: 0

Abstract

Background

In vitro fertilization (IVF) is a widely utilized assisted reproductive technology, but its success rates remain suboptimal due to various physiological and psychological factors. Acupuncture, as a complementary therapy, has been proposed to improve reproductive outcomes and alleviate associated pain and anxiety.

Objective

To evaluate the effectiveness and safety of acupuncture as an adjunctive treatment for women undergoing IVF, focusing on reproductive outcomes, pain reduction, and anxiety alleviation.

Methods

Five English databases were searched up to June 20th, 2024. Manual acupuncture or electro-acupuncture was used solely as a complementary adjuvant in the experimental groups, and control interventions were sham acupuncture or blank (wait-list) control. Systematic reviews and meta-analyses were conducted based on the Cochrane systematic review method, and trial sequential analyses were performed. Meta-influence analyses, meta-regression and subgroup-analyses were performed for exploration of heterogeneity and related variables. Egger’s together with trim and fill tests were conducted for evaluation of publication bias. The quality of the results was assessed, and correlation coefficient and cluster analyses were also performed.

Results

Finally, 42 trials identified from 37 published articles, involving 7400 participants, were included, representing diverse populations worldwide. Compared to sham acupuncture and blank controls, acupuncture significantly (P < 0.05) improved biochemical pregnancy rate (RR = 1.28, 95 % CI: 1.04-1.57) and clinical pregnancy rates (RR = 1.19, 95 % CI: 1.06-1.34). Additionally, acupuncture was associated with better pain management during surgery and reduced anxiety levels. Acupuncture-specific adverse events were reported in eight of 42 trials, primarily mild to moderate local reactions. However, a significantly higher early miscarriage rate was observed in the acupuncture groups (RR = 1.51, 95 % CI: 1.10-2.08).

Conclusions

Acupuncture may improve certain reproductive outcomes and alleviate pain and anxiety in women undergoing IVF. However, the potential risk of early miscarriage warrants caution, and further rigorous trials are needed to confirm these findings.

Registration

PROSPERO registration number CRD42020206012.

查看原文本刊更多论文

针灸治疗妇女体外受精：一项最新的系统综述和荟萃分析与试验序列分析

体外受精（IVF）是一种应用广泛的辅助生殖技术，但由于各种生理和心理因素，其成功率仍不理想。针灸，作为一种辅助疗法，已被提出改善生殖结果和减轻相关的疼痛和焦虑。目的评价针刺作为IVF辅助治疗的有效性和安全性，重点关注生殖结局、疼痛减轻和焦虑缓解。方法检索截至2024年6月20日的5个英文数据库。实验组单独使用手针刺或电针作为辅助治疗，对照组采用假针刺或空白（等候名单）对照。采用Cochrane系统评价方法进行系统评价和meta分析，并进行试验序贯分析。采用元影响分析、元回归分析和亚组分析探讨异质性和相关变量。采用Egger’s、trim和fill检验评价发表偏倚。评价结果的质量，并进行相关系数分析和聚类分析。最后，从37篇已发表的文章中确定了42项试验，涉及7400名参与者，代表了全球不同的人群。与假针刺和空白对照相比，针刺显著(P <；0.05)提高生化妊娠率（RR = 1.28, 95% CI: 1.04 ~ 1.57）和临床妊娠率（RR = 1.19, 95% CI: 1.06 ~ 1.34）。此外，针灸与手术期间更好的疼痛管理和降低焦虑水平有关。42项试验中有8项报告了针灸特异性不良事件，主要是轻度至中度局部反应。针刺组早期流产率明显高于对照组（RR = 1.51, 95% CI: 1.10 ~ 2.08）。结论针刺可改善体外受精妇女的某些生殖结局，减轻疼痛和焦虑。然而，早期流产的潜在风险值得谨慎，需要进一步严格的试验来证实这些发现。普洛斯彼罗注册号CRD42020206012。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).