针灸相关疗法对体外受精和胚胎移植妇女妊娠结局的影响:贝叶斯网络荟萃分析。

IF 2.7 3区 医学 Q2 GENETICS & HEREDITY
Chengli Bin, Hanzhi Zhong, Shipeng Zhang, Yiping Luo, Jiali Su, Maoya Li, Shaobin Wei
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引用次数: 0

摘要

背景:本网络荟萃分析旨在评估不同针灸相关疗法在改善体外受精和胚胎移植(IVF-ET)妇女妊娠结局方面的疗效。方法:系统检索8个数据库中从建立到2025年1月15日,研究针灸相关疗法作为IVF-ET辅助疗法的随机对照试验(rct)。使用R 4.1.2和Stata 16.1,用比值风险(OR)评价有关疗效的二分类结果,用平均差(MD)和95%可信区间(CrI)评价连续数据。结果:通过全面的文献检索,我们最终确定了96项随机对照试验,涉及14,736名参与者和15项干预措施。根据临床妊娠率结局,温针刺取卵前3个月经周期(WA-TTP, OR 3.56, 95% CrI 2.05 ~ 6.25,低确定性,SUCRA = 89.54%)、针刺结合艾灸取卵前3个月经周期(AC + M-TTP, OR 3.31, 95% CrI 1.05 ~ 11.77,低确定性,SUCRA = 78.70%)、针刺取卵前1个月经周期(AC- otp, OR 2.69, 95% CrI 1.76 ~ 4.09,中等确定性)、针刺取卵前1个月经周期(AC- otp, OR 2.69, 95% CrI 1.76 ~ 4.09,中等确定性)。supra = 77.98%)显示出与假针灸或不治疗相比的潜在优势(F/N)。亚组分析两组临床妊娠率差异有统计学意义。结论:针灸相关疗法可提高IVF-ET患者的临床妊娠率,其中WA-TTP、AC + M-TTP和AC- otp具有潜在优势。AC-TTP在提高活产率、增加子宫内膜厚度和降低搏动指数方面表现出更大的功效。我们的研究结果强调,在胚胎移植之前或之后进行有限次数的针灸相关治疗,除了耳穴按摩外,临床疗效微乎其微。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of acupuncture-related therapies on pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer: a Bayesian network meta-analysis.

Background: This network meta-analysis aimed to assess the efficacy of different acupuncture-related therapies in improving pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer (IVF-ET).

Methods: Randomized controlled trials (RCTs) examining acupuncture-related therapies as adjuncts to IVF-ET were systematically searched in eight databases from inception until January 15, 2025. Dichotomous outcomes concerning efficacy were evaluated as odds risk (OR) and continuous data as mean difference (MD) and 95% credible intervals (CrI) utilizing R 4.1.2 and Stata 16.1.

Results: Through a comprehensive literature search, we ultimately identified 96 RCTs that involved 14,736 participants and 15 interventions in this systematic analysis. Based on the clinical pregnancy rate outcome, warm acupuncture for three menstrual cycles before oocyte retrieval (WA-TTP, OR 3.56, 95% CrI 2.05 to 6.25, low certainty, SUCRA = 89.54%), acupuncture combined with moxibustion for three menstrual cycles before oocyte retrieval (AC + M-TTP, OR 3.31, 95% CrI 1.05 to 11.77, low certainty, SUCRA = 78.70%), and acupuncture for one menstrual cycle before oocyte retrieval (AC-OTP, OR 2.69, 95% CrI 1.76 to 4.09, moderate certainty, SUCRA = 77.98%) demonstrated potential superiority compared to false acupuncture or no treatment (F/N). Significant subgroup differences between clinical pregnancy rates were observed by subgroup analysis.

Conclusion: Acupuncture-related therapies can potentially enhance clinical pregnancy rates among women undergoing IVF-ET, with WA-TTP, AC + M-TTP, and AC-OTP demonstrating potential superiority. AC-TTP demonstrated a greater efficacy in improving live birth rates, increasing endometrial thickness, and reducing pulsation index. Our findings emphasize that acupuncture-related therapies with a limited number of sessions before or after embryo transfer show minimal clinical benefit except auricular acupressure.

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来源期刊
CiteScore
5.70
自引率
9.70%
发文量
286
审稿时长
1 months
期刊介绍: The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.
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