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Xu M, Zhu M, Zheng C. Effects of acupuncture on pregnancy outcomes in women undergoing in vitro fertilization: an updated systematic review and meta-analysis. Arch Gynecol Obstet 2024; 309:775-788. [PMID: 37436463 DOI: 10.1007/s00404-023-07142-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/03/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE To evaluate the effects of acupuncture on IVF-ET outcomes. METHODS Digital databases, including Pubmed, Embase, the Cochrane Library, the Web of Science and ScienceDirect, were searched from their inception to July 2022. The MeSH terms we used included: acupuncture, in vitro fertilization, assisted reproductive technology and randomized controlled trial. The reference lists of relevant documents were also searched. The biases of included studies were assessed by the Cochrane Handbook 5.3. The major outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). The pregnancy outcomes reported in these trials were pooled and expressed as risk ratios (RR) with 95% confidence interval (CI) in the Review Manager 5.4 meta-analysis software. Heterogeneity of the therapeutic effect was evaluated with a forest plot analysis. Publication bias was assessed by a funnel plot analysis. RESULTS Twenty-five trials (a total of 4757 participants) were included in this review. There were no significant publication biases for most of the comparisons among these studies. The pooled CPR (25 trials) of all the acupuncture groups (43.6%) was significantly higher than that of all the control groups (33.2%, P < 0.00001), and the pooled LBR (11 trials) of all the acupuncture groups (38.0%) was significantly higher than that of all the control groups (28.7%, P < 0.00001). Different acupuncture methods (manual acupuncture, electrical acupuncture and transcutaneous acupoint electrical stimulation), acupuncture time (before or during the time of controlled ovarian hyperstimulation and around the time of embryo transfer), and acupuncture courses (at least 4 sessions and less than 4 sessions) have respectively positive effects on IVF outcomes. CONCLUSION Acupuncture can significantly improve CPR and LBR among women undergoing IVF. Placebo acupuncture can be a relatively ideal control measure.
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Affiliation(s)
- Menghao Xu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China
| | - Mengdi Zhu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China
| | - Cuihong Zheng
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China.
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Zhang HR, Zhang C, Ma PH, Sun CY, Sun CY, Liu XY, Pu ZQ, Lin YH, Liu BY, Liu CZ, Yan SY. Pregnancy Benefit of Acupuncture on in vitro Fertilization: A Systematic Review and Meta-Analysis. Chin J Integr Med 2023; 29:1021-1032. [PMID: 37815728 DOI: 10.1007/s11655-023-3748-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Currently, more and more infertility couples are opting for combined acupuncture to improve success rate of in vitro fertilization (IVF). However, evidence from acupuncture for improving IVF pregnancy outcomes remains a matter of debate. OBJECTIVE To quantitatively summarized the evidence of the efficacy of acupuncture among women undergoing IVF by means of systematic review and meta-analysis. METHODS Four English (PubMed, Web of Science, EMBASE, and Cochrane Register of Controlled Clinical Trials) and Four Chinese databases (Wanfang Databases, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and SinoMed) were searched from database inception until July 2, 2023. Randomized controlled trials (RCTs) that evaluated the acupuncture's effects for women undergoing IVF were included. The subgroup analysis was conducted with respect to the age of participants, different acupuncture types, type of control, acupuncture timing, geographical origin of the study, whether or not repeated IVF failure, and acupuncture sessions. Sensitivity analyses were predefifined to explore the robustness of results. The primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR), and the secondary outcomes were ongoing pregnancy rate and miscarriage rate. Random effects model with I2 statistics were used to quantify heterogeneity. Publication bias was estimated by funnel plots and Egger's tests. RESULTS A total of 58 eligible RCTs representing 10,968 women undergoing IVF for pregnant success were identifified. Pooled CPR and LBR showed a signifificant difference between acupuncture and control groups [69 comparisons, relative risk (RR) 1.19, 95% confifidence intervals (CI) 1.12 to 1.25, I2=0], extremely low evidence; 23 comparisons, RR 1.11, 95%CI 1.02 to 1.21, I2=14.6, low evidence, respectively). Only transcutaneous electrical acupoint stimulation showed a positive effect on both CPR (16 comparisons, RR 1.17, 95%CI 1.06 to 1.29; I2=0, moderate evidence) and LBR (9 comparisons, RR 1.20, 95%CI 1.04 to 1.37; I2=8.5, extremely low evidence). Heterogeneity across studies was found and no studies were graded as high-quality evidence. CONCLUSION Results showed that the convincing evidence levels on the associations between acupuncture and IVF pregnant outcomes were relatively low, and the varied methodological design and heterogeneity might inflfluence the fifindings. (Registration No. PROSPERO CRD42021232430).
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Affiliation(s)
- Hao-Ran Zhang
- College of Preschool Education, Beijing Youth Politics College, Beijing, 100102, China
| | - Cheng Zhang
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Pei-Hong Ma
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Cheng-Yi Sun
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Chong-Yang Sun
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Xiao-Yu Liu
- School of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Zhen-Qing Pu
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yu-Han Lin
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Bao-Yan Liu
- China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Cun-Zhi Liu
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Shi-Yan Yan
- School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China.
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Hwang SI, Yoon YJ, Sung SH, Cho SJ, Park JK. Acupuncture Treatment for Emotional Problems in Women with Infertility: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:2704. [PMID: 37893778 PMCID: PMC10606758 DOI: 10.3390/healthcare11202704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
This systematic review and meta-analysis aimed to evaluate the efficacy and safety of acupuncture in treating emotional problems in women with infertility. We searched for randomized controlled trials using acupuncture treatment for emotional problems in women with infertility using 11 databases from their inception to 30 June 2023. The control intervention included no treatment, sham acupuncture treatment, and conventional treatment. The primary outcome was emotion-related rating scales, and the secondary outcomes were total effectiveness rate, quality of life, clinical pregnancy rate, and adverse events. Twelve randomized controlled trials involving 1930 participants were included. A meta-analysis of these studies indicated that, as compared to the control treatment, acupuncture significantly improved the State-Trait Anxiety Inventory, Self-rating Anxiety Scale, Amsterdam Preoperative Anxiety and Information Scale, and Self-rating Depression Scale scores, which were the primary emotion-related outcomes. Furthermore, the meta-analysis demonstrated that acupuncture treatment had a significant effect on the clinical pregnancy rate, which was the secondary outcome. No adverse events were reported in any of the studies. Our findings demonstrate the potential of acupuncture for treating emotional problems in women with infertility. However, well-designed and high-quality randomized clinical trials are required to confirm the effectiveness and safety of acupuncture treatment. The protocol of the current study was registered in PROSPERO (registration number: CRD42020166119).
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Affiliation(s)
- Su-In Hwang
- Department of Korean Medicine, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea;
| | - Young-Jin Yoon
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea;
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital, Yangsan 50612, Republic of Korea
| | - Soo-Hyun Sung
- Department of Policy Development, National Institute of Korean Medicine Development, Seoul 04554, Republic of Korea;
| | - Su-Jin Cho
- Research Institute of Nursing Science, Pusan National University, Yangsan 50612, Republic of Korea;
| | - Jang-Kyung Park
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea;
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital, Yangsan 50612, Republic of Korea
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YIN YL, LI HX, LIANG SJ, XIA YB, SHEN J, SHEN MH. Regularities of acupoint selection in adjuvant interventions with acupuncture-moxibustion for in vitro fertilization-embryo transfer based on complex network technology 基于复杂网络技术探讨针灸辅助体外受精-胚胎移植选穴规律. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2022. [DOI: 10.1016/j.wjam.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Zhou X, Li X, Ding H, Lu Y. Acupuncture effects on in-vitro fertilization pregnancy outcomes: A meta-analysis. Complement Ther Clin Pract 2021; 46:101525. [PMID: 34979465 DOI: 10.1016/j.ctcp.2021.101525] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/22/2021] [Accepted: 12/26/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The effects of acupuncture on in-vitro fertilization outcomes remain controversial. This study aimed to perform a meta-analysis to assess the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls on improving pregnancy outcomes in women undergoing in-vitro fertilization. METHODS A systematic literature search up to January 2021 was performed and 29 studies included 6623 individuals undergoing in-vitro fertilization at the baseline of the study; 3091 of them were using acupuncture as an adjuvant therapy to embryo transfer, 1559 of them were using sham-controls, and 1441 of them were using no adjuvant therapy controls. They reported a comparison between the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls on improving pregnancy outcomes in women undergoing in-vitro fertilization. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated assessing the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls using the dichotomous method with a random or fixed-effect model. RESULTS Significantly higher outcomes with acupuncture were observed in biochemical pregnancy (OR, 1.98; 95% CI, 1.55-2.53, p < 0.001); clinical pregnancy (OR, 1.70; 95% CI, 1.46-1.98, p < 0.001); ongoing pregnancy (OR, 1.78; 95% CI, 1.41-2.26, p < 0.001); and live birth (OR, 1.58; 95% CI, 1.15-2.18, p = 0.005) compared to no adjuvant therapy controls. However, no significant difference were found between acupuncture and no adjuvant therapy controls in miscarriage (OR, 0.96; 95% CI, 0.48-1.92, p = 0.91). No significant difference was observed with acupuncture in biochemical pregnancy (OR, 1.16; 95% CI, 0.65-2.08, p = 0.62); clinical pregnancy (OR, 1.13; 95% CI, 0.83-1.54, p = 0.43); ongoing pregnancy (OR, 1.04; 95% CI, 0.66-1.62, p = 0.87); live birth (OR, 1.02; 95% CI, 0.73-1.42, p = 0.90), and miscarriage (OR, 1.16; 95% CI, 0.86-1.55, p = 0.34) compared to sham-controls. CONCLUSIONS Using acupuncture as an adjuvant therapy to embryo transfer may improve the biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth outcomes compared to no adjuvant therapy controls. However, no significant difference was found between acupuncture as an adjuvant therapy to embryo transfer and sham-controls in any of the measured outcomes. This relationship forces us to recommend the use of acupuncture as adjuvant therapy in women undergoing in-vitro fertilization and inquire further studies comparing acupuncture and sham-controls to reach the best procedure.
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Affiliation(s)
- Xue Zhou
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China
| | - Xiuling Li
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China
| | - Hui Ding
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China
| | - Ying Lu
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China.
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Xiu WC, Gang WJ, Jiao RM, Shi LJ, Yang JW, Jing XH, Shi XS. Effect of Acupuncture on Outcomes of In Vitro Fertilisation: A Scoping Review. Chin J Integr Med 2021; 28:472-480. [PMID: 34897592 DOI: 10.1007/s11655-021-3459-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To identify, examine and summarize the available evidence on the effectiveness and safety of acupuncture for in vitro fertilisation (IVF) outcomes. METHODS Eight electronic databases, including PubMed, EMBASE, Cochrane Database of Systematic Review, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Database and VIP Database, were searched, supplemented by manual searches. Two researchers independently conducted the literature screening, data extraction, and methodological quality assessments. A narrative description was provided to show the general information and specific characteristics of the included studies. A bubble plot was used to visually display the overall effects of acupuncture on IVF outcomes. RESULTS Eighty-two studies were identified, including 64 primary studies and 18 systematic reviews. Transcutaneous electrical acupoint stimulation, electric acupuncture and manual acupuncture were applied in most studies and compared with no acupuncture, sham acupuncture and placebo acupuncture control groups. Sixty-three (98.4%) primary studies reported clinical pregnancy rate, and positive effects of acupuncture were found in 34 studies (54.0%). Live birth rate was reported in only 18 (28.1%) primary studies, of which 10 (55.6%) showed positive results. In addition, only 8 and 2 systematic reviews showed that acupuncture could increase clinical pregnancy events and live birth events, respectively. However, none of these reviews was of high methodological quality. CONCLUSIONS Available evidence suggests that acupuncture therapy could improve clinical pregnancy rates. However, whether acupuncture could increase live birth events was difficult to determine based on the few studies that have reported this outcome indicator. Furthermore, the methodological quality of most systematic reviews was assessed as critically low or low. Studies with a rigorous design and standardized implementation should be performed to refine the available evidence.
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Affiliation(s)
- Wen-Cui Xiu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Wei-Juan Gang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Rui-Min Jiao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Lan-Jun Shi
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Ji-Wei Yang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Xiang-Hong Jing
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Xiao-Shuang Shi
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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Hwang SI, Sung SH, Yoon YJ, Park JK. Acupuncture treatment for emotional problems in infertile women: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e26306. [PMID: 34115040 PMCID: PMC8202593 DOI: 10.1097/md.0000000000026306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Infertility causes emotional and psychological problems, including anxiety, depression, low self-efficacy, and chronic mental stress in women. These emotional problems can negatively affect fertility treatment. Numerous studies have reported the clinical therapeutic effects of acupuncture on emotional problems; however, the efficacy and safety of acupuncture treatment for emotional problems in infertile women remain unclear. This protocol aims to evaluate the efficacy and safety of acupuncture for treating emotional problems in infertile women. METHODS We will search the following databases from their inception to April 30, 2021: MEDLINE, EMBASE, Cochrane Library, Korean Medical Databases (KoreaMed, Korean studies Information Service System, Korean Traditional Knowledge Portal, Oriental Medicine Advanced Searching Integrated System, Research Information Sharing Service, and National Digital Science Library), and Chinese databases (CNKI and Wan Fang Database). We will include randomized controlled trials on acupuncture for emotional problems in infertile women. There will be no restrictions regarding language or publication date. The primary outcome will be assessed using an emotion-related assessment scale. The risk of bias of the included studies will be measured using the Cochrane risk of bias assessment tool. For meta-analysis, RevMan Version 5.4 software will be used to combine the relative risks for dichotomous outcomes, as well as the mean differences or standardized mean differences for continuous outcomes, with both having 95% confidence intervals. RESULTS Based on current evidence, this study will assess the effectiveness and safety of acupuncture for emotional problems in infertile women. CONCLUSION This study will provide evidence for evaluating the acupuncture efficacy for infertile women with emotional problems. REGISTRATION NUMBER INPLASY202150082.
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Affiliation(s)
- Su-In Hwang
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital
| | - Soo-Hyun Sung
- Department of Policy Development, National Development Institute of Korean Medicine
| | - Young-Jin Yoon
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital
- Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan, South Korea
| | - Jang-Kyung Park
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital
- Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan, South Korea
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Wang X, Wang Y, Wei S, He B, Cao Y, Zhang N, Li M. An Overview of Systematic Reviews of Acupuncture for Infertile Women Undergoing in vitro Fertilization and Embryo Transfer. Front Public Health 2021; 9:651811. [PMID: 33959581 PMCID: PMC8096176 DOI: 10.3389/fpubh.2021.651811] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/19/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Currently, more and more subfertility couples are opting for combined acupuncture to improve the success rate of in vitro fertilization and embryo transfer (IVF-ET). However, the efficacy and safety of acupuncture in IVF-ET is still highly controversial. Objectives: The purpose of this overview is to summarize evidence of essential outcomes of systematic reviews (SRs) of acupuncture in IVF-ET and evaluate their methodological quality. Methods: We conducted a comprehensive literature search for relevant SRs in eight databases from inception to July 31, 2020, without language restriction. We evaluated the methodological quality of the included SRs by using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), which was the latest available assessment tool. The Risk of Bias in Systematic Review (ROBIS) tool was used to assess the risk of bias in SRs. We assessed the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) score to determine the strength of evidence. We excluded the overlapping randomized controlled trials (RCTs) and performed a re-meta-analysis of the primary RCTs. Results: This review included 312 original RCT studies and 65,388 participants. By using AMSTAR-2, we found that the methodological quality of 16 SRs was critically low, because they had more than one critical weakness. Our reviews showed that although the GRADE for quality of evidence profile was suboptimal, acupuncture seemed to be beneficial in increasing the pregnancy rate. Our re-meta-analysis suggested that acupuncture was superior to sham acupuncture in improving the clinical pregnancy rate (CPR) of IVF-ET with substantial heterogeneity (RR = 1.31, 95% CI: 1.13–1.52, p = 0.0004, I2 = 66%). No statistical difference was observed regarding the outcomes of live birth rate (LBR), ongoing pregnancy rate (OPR), biochemical pregnancy rate (BPR), and miscarriage rate (MR) between two groups. When compared with no adjunctive treatment groups, acupuncture improved CPR (RR = 1. 25, 95% CI: 1.11–1.42, p = 0.0003) and OPR (RR = 1. 38, 95% CI: 1.04–1.83, p = 0.03). Acupuncture was more superior than no adjunctive treatment in reducing MR (OR = 1.42, 95% CI: 1.03–1.95, p = 0.03) and BPR (RR = 1.19, 95% CI: 1.02–1.37, p = 0.02). Conclusions: Although the evidence of acupuncture in IVF-ET is insufficient, acupuncture appears to be beneficial to increase the clinical pregnancy rate in women undergoing IVF-ET. However, there are severe heterogeneity and methodological quality defects, which limit the reliability of results. Further, high-quality primary studies are still needed.
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Affiliation(s)
- Xia Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yan Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shaobin Wei
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Bisong He
- Department of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yihong Cao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Nannan Zhang
- Department of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Maoya Li
- Department of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Effects of acupuncture on the relief of anxiety and/or depression during in vitro fertilization: A systematic review and meta-analysis. Eur J Integr Med 2021. [DOI: 10.1016/j.eujim.2021.101287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Coyle ME, Stupans I, Abdel-Nour K, Ali H, Kotlyarsky M, Lie P, Tekin S, Thrimawithana T. Acupuncture versus placebo acupuncture for in vitro fertilisation: a systematic review and meta-analysis. Acupunct Med 2021; 39:20-29. [PMID: 33040570 DOI: 10.1177/0964528420958711] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the efficacy of acupuncture compared to placebo acupuncture for women undergoing in vitro fertilisation (IVF) in a systematic review and meta-analysis. METHODS A search was conducted in seven English-language biomedical databases from their inception to 3 April 2019 to identify studies evaluating acupuncture as an adjunct to IVF treatment. Randomised controlled trials (RCTs) that compared acupuncture with placebo acupuncture using a non-invasive placebo acupuncture device in women undergoing a fresh or frozen IVF cycle were eligible, as were studies that tested placebo acupuncture as the intervention. Outcomes were clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, live birth rate and adverse events. RESULTS Eight RCTs involving 3607 women were included. Studies were judged to be low risk for most of the risk of bias domains. Acupuncture around the time of embryo transfer was not significantly different to placebo acupuncture in terms of the clinical pregnancy rate (6 RCTs, 2473 women, risk ratio (RR) = 0.99 (95% confidence interval (CI) = 0.88, 1.11), I2 = 51%, moderate certainty evidence), ongoing pregnancy rate (4 RCTs, 1459 women, RR = 0.88 (95% CI = 0.75, 1.02), I2 = 50%, moderate certainty evidence), miscarriage rate (4 RCTs, 502 women, RR = 1.23 (95% CI = 0.89, 1.71), I2 = 30%, high certainty evidence) or live birth rate (4 RCTs, 1835 women, RR = 0.87 (95% CI = 0.75, 1.01), I2 = 0%, high certainty evidence). Outcomes with placebo acupuncture were not significantly different to usual care. Adverse events relating to acupuncture, such as discomfort and bruising, were mild to moderate. CONCLUSION Acupuncture administered around the time of embryo transfer did not have a statistically significant effect on IVF outcomes compared with placebo acupuncture.
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Affiliation(s)
- Meaghan E Coyle
- China-Australia International Research Centre for Chinese Medicine & School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Ieva Stupans
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Katherine Abdel-Nour
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Hiba Ali
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Michelle Kotlyarsky
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Phillip Lie
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Sinan Tekin
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Thilini Thrimawithana
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
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Chronopoulou E, Seifalian A, Stephenson J, Serhal P, Saab W, Seshadri S. Preconceptual care for couples seeking fertility treatment, an evidence-based approach. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.xfnr.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Xing L, Xu J, Zhang Q, Li L, Li Y, Zhuang H, Yuan Z, Zhao R, Ma Y. Pregnancy outcome treated with stage-by-stage acupuncture and moxibustion therapy based on the chong channel being sea of blood theory in repeated IVF-ET failure patients: A randomized controlled trial. Medicine (Baltimore) 2020; 99:e23234. [PMID: 33217839 PMCID: PMC7676521 DOI: 10.1097/md.0000000000023234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Acupuncture and moxibustion has become a commonly used adjuvant treatment method to improve the success rate of in vitro fertilization-embryo transfer (IVF-ET). However, There is still insufficient evidence that acupuncture treatment can improve the local microenvironment of endometrium, the endometrial receptivity, and the pregnancy outcome of patients, which is worthy of further study. METHOD/DESIGN To investigate the effect of Stage by Stage Acupuncture and Moxibustion Therapy on endometrial receptivity and Pregnancy Outcome based on the theory of "Chong channel being sea of blood," we will conduct a multicenter randomized controlled trial. Inclusion criteria are as follows: infertile women under 45 years of age who received IVF-ET or Intracytoplasmic sperm injection cycles. The study will only be applied to women who have failed repeated implantation, that is, women who have failed 3 or more embryo transplants in the past (existing frozen embryos do not require the retrieval of eggs). Those who are not prepared to receive IVF-ET or are at risk of pregnancy, have a serious medical condition, or are egg donors will be excluded. Subjects will be randomly assigned to either the acupuncture group (IVF-ET plus stage-by-stage acupuncture and moxibustion therapy based on the "Chong channel being sea of blood" theory) or the control group (IVF-ET only). The trial required a total sample size of 246 women to compare endometrial receptivity between the 2 groups. The acupuncture group will receive acupuncture and moxibustion treatment 3 times a week starting from the third day of menstruation in the ovary stimulation cycle. One menstrual cycle was one course of treatment, and a total of 3 menstrual cycles were treated. The main outcome indicator was clinical pregnancy rate. Secondary outcome indicators were the three-dimensional volume blood flow parameters (vascularization index, flow index, and vascularization flow index) of the endometrium, endometrial thickness, endometrial volume, uterine artery PI, RI, and S/D during the "implantation window period" (20-24 days after menstruation in the ovary stimulation cycle). DISCUSSION This study will provide important evidence for the use of Stage by Stage Acupuncture and Moxibustion Therapy Based on the "Chong Channel Being Sea of Blood" Theory in IVF. TRIAL REGISTRATION http://www.chictr.org.cn/edit.aspx?pid=28811&htm=4 ID: ChiCTR1800017191 (07/17/2018).
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Affiliation(s)
- Liwei Xing
- Yunnan University of Traditional Chinese Medicine
| | - Jinlong Xu
- Yunnan University of Traditional Chinese Medicine
| | | | - Li Li
- Yunnan University of Traditional Chinese Medicine
| | | | - Haina Zhuang
- Yunnan University of Traditional Chinese Medicine
| | - Zhuojun Yuan
- Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan province, China
| | - Rong Zhao
- Yunnan University of Traditional Chinese Medicine
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13
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Lee JW, Hyun MK, Kim HJ, Kim DI. Acupuncture and herbal medicine for female infertility: an overview of systematic reviews. Integr Med Res 2020; 10:100694. [PMID: 33665092 PMCID: PMC7903059 DOI: 10.1016/j.imr.2020.100694] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/29/2022] Open
Abstract
Background Acupuncture and herbal medicine have been used as additional treatments for infertility or as an adjuvant treatment of assisted reproductive technology (ART) in infertility. Many systematic reviews (SRs) and meta-analyses (MA) have been published. This paper reviews the SRs and MA of acupuncture and herbal medicine on infertility to provide evidence for clinical decision making. Methods A comprehensive literature search of SRs and MA for the effects of acupuncture and herbal medicine on infertility was conducted using nine databases. Two independent reviewers extracted the data of the selected SR and MA and evaluated their methodological quality using the ‘Assessment of multiple systematic reviews 2 (AMSTAR2)’. Results Twenty-one studies were included in this analysis. Eight studies were published in China, and three studies each were published in the USA, UK, and Australia. Conflicting evidence on the efficacy of acupuncture for infertile women has been reported. Herbal medicine for infertile women undergoing ART, women with anovulation, and women with polycystic ovary syndrome helped improve the clinical pregnancy rate. The methodological quality of SRs and MAs evaluated by AMSTAR 2 was low or very low because the protocol or list of excluded studies were omitted. Conclusion Herbal medicine tended to be effective in infertility, but acupuncture had low evidence of an effect on infertility. The methodological quality of the published SRs and MAs was underestimated because AMSTAR2 is a more rigorous assessment tool than the previous version.
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Affiliation(s)
- Jang Won Lee
- Department of Preventive Medicine, Dongguk University Graduate School of Korean Medicine, Seoul, Republic of Korea.,Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Min Kyung Hyun
- Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Hye Jin Kim
- College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Dong-Il Kim
- Department of Korean Obstetrics and Gynecology, Dongguk University Ilsan Oriental Hospital, Goyang, Republic of Korea
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14
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Wei W, Liu LY, Chen L, Su MH, Hong XJ. Acupuncture for "poor ovarian response" of women to controlled ovarian hyperstimulation: A protocol for meta-analysis and systematic review. Medicine (Baltimore) 2020; 99:e22868. [PMID: 33126333 PMCID: PMC7598851 DOI: 10.1097/md.0000000000022868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Poor ovarian response (POR) is a high-incidence disease of women, which cause in vitro fertilization failure. Various treatment options have been proposed for women with POR to improve their ovarian response, but with little effect. In recent years, there is a wide range of applications of acupuncture in the process of in vitro fertilization. The meta-analysis and systematic review are designed to analyze whether acupuncture is effective for patients with POR. METHODS The following databases will be searched from inception to March 2020: Electronic databases consist of MEDLINE, EMBASE, Allied and Complementary Medicine Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, the Chinese Scientific Journal Database, and Wanfang Database. Other literature resources will also be searched including clinical trial registries, key journals, and meeting records. The results of randomized controlled trials of acupuncture therapy on POR, which are published in Chinese or English, will be embedded. The primary outcome is the clinical pregnancy rate. Data identification, data selection, data extraction, and assessment of bias risk will be completed independently by 2 or more reviewers. STATA/IC 16 will be used to perform the meta-analysis. We will use the Grading of Recommendations Assessment, Development, and Evaluation system to evaluate the quality of our evidence. A systematic narrative synthesis will be provided if the quantitative analysis is not available. DISCUSSION This study will provide the first meta-analysis and systematic review to evaluate the efficacy of acupuncture in treating POR. This protocol provides details to guide this study. CONCLUSIONS From this review may benefit POR patients or clinical decision-makers. PROSPERO REGISTRATION NUMBER PROSPERO CRD42020169560.
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15
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Lorenzon AR, Garcia D, Silva L, Oliveira CAD, Chehin MB, Marinho RM, Caetano JPJ, Vassena R, Motta ELAD. Research priorities in infertility and assisted reproductive technology treatments - a James Lind Alliance priority setting partnership with brazilian patients. JBRA Assist Reprod 2020; 24:265-272. [PMID: 32157860 PMCID: PMC7365546 DOI: 10.5935/1518-0557.20190077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To identify the main research interests of Brazilian patients in the field of infertility and assisted reproductive technology (ART) treatments. METHODS This prospective multicenter cross-sectional study was carried out in Brazil. Patients attending five fertility centers from the Huntington Group between October and December 2018 were invited to join the study, which consisted of answering an anonymous survey online. Two hundred and twenty-seven patients signed the informed consent form and were emailed the survey link. The survey was designed based on the James Lind Alliance Priority Setting Partnership protocol. In the area of infertility, patients were probed on issues such as somatic and psychological effects of treatment, prevention, assisted reproductive technology (medications and procedures), success rates, risks, and emotional aspects. RESULTS The response rate (RR) was 47.58% (108 patients; 88 women - RR 51.46% and 20 men - RR 35.71%). Patient mean age was 36.5 years (SD 4.6). The top ten research priorities listed were 1) short- and long-term side effects of treatment; 2) how to cope with infertility; 3) risks associated with ART; 4) success rates in ART; 5) impact of diet on ART and fertility; 6) healthy habits; 7) alternative therapies; 8) impact of exercise on fertility and ART success; 9) oocyte quality and ovarian reserve; and 10) genetic or inherited causes of infertility. CONCLUSION To better cater to the needs of patients and develop patient-centered care in the field of infertility and ART treatment, clinicians, healthcare providers, and the scientific community must identify patient concerns and priorities and make efforts to address them.
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Affiliation(s)
| | | | - Leticia Silva
- Huntington Medicina Reprodutiva, São Paulo, SP, Brazil
| | | | | | | | | | | | - Eduardo Leme Alves da Motta
- Huntington Medicina Reprodutiva, São Paulo, SP, Brazil.,Departamento de Ginecologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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16
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Jang S, Kim KH, Jun JH, You S. Acupuncture for in vitro fertilization in women with poor ovarian response: a systematic review. Integr Med Res 2020; 9:100395. [PMID: 32322482 PMCID: PMC7160570 DOI: 10.1016/j.imr.2020.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 12/04/2022] Open
Abstract
Background Poor ovarian response (POR) is one reason for infertility. In vitro fertilization (IVF) is frequently used to help achieve pregnancy, and performing acupuncture before IVF may promote ovulation and reduce egg retrieval pain. The purpose of this systematic review was to evaluate the effectiveness of acupuncture on clinical pregnancy rates (CPR) after IVF in women with POR. Methods Eight electronic databases were searched in January 2020, and reference lists of retrieved articles and previous review articles were hand-searched. Randomized controlled trials (RCTs) using any type of acupuncture for women with POR undergoing IVF were considered. Risk of bias was assessed using the Cochrane risk of bias standards. Results Three RCTs were included in this review. CPR and the number of retrieved oocytes were measured in two studies, while the values of anti-Mullerian hormone (AMH) and antral follicle count (AFC) were only reported in one study. In two studies, CPR was higher in the intervention group than the control group [37.8 % vs 24.3 %]. We did not conduct a meta-analysis, as there was a high level of heterogeneity in interventions among the included trials. Conclusions This study suggests that acupuncture may improve CPR, AMH, AFC and the number of retrieved oocytes in women with POR undergoing IVF. However it is difficult to conclude that acupuncture is more effective than conventional treatment. Additionally, more clinical trials are needed to evaluate the effectiveness of acupuncture on CPR and other outcomes of POR. Study registration PROSPERO CRD42018087813; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018087813
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Affiliation(s)
- Soobin Jang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Kyeong Han Kim
- Department of Preventive Medicine, College of Korean Medicine, Woosuk University, Jeonju, Republic of Korea
| | - Ji Hee Jun
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sooseong You
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Corresponding author at: Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea.
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17
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Djaali W, Abdurrohim K, Helianthi DR. Management of Acupuncture as Adjuvant Therapy for In Vitro Fertilization. Med Acupunct 2019; 31:361-365. [PMID: 31871523 DOI: 10.1089/acu.2019.1394] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
One treatment option for couples with infertility that enables the highest success rate is in vitro fertilization (IVF). With this technique, various causes of infertility can be overcome, whether they are caused by anatomical abnormalities in women or abnormalities of sexual dysfunction in men. Acupuncture, a nonpharmacologic therapy with minimal side-effects, according to various studies is be beneficial for increasing the success of IVF. There are several mechanisms of acupuncture related to this, such as: (1) modulating neuroendocrine factors; (2) increasing blood flow to the uterus and ovaries; (3) modulating immune factors; and (4) reducing stress, anxiety, and depression. Because acupuncture does not have bad side-effects, it is an adjuvant therapy that can be performed at each stage of the IVF procedure to increase the chances of successful IVF.
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Affiliation(s)
- Wahyuningsih Djaali
- Faculty of Sport Science, Universitas Negeri Jakarta, Jakarta, Indonesia.,Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Kemas Abdurrohim
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Dwi Rachma Helianthi
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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18
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Kusuma AC, Oktari N, Mihardja H, Srilestari A, Simadibrata CL, Hestiantoro A, Wiweko B, Muna N. Electroacupuncture Enhances Number of Mature Oocytes and Fertility Rates for In Vitro Fertilization. Med Acupunct 2019; 31:289-297. [PMID: 31624528 DOI: 10.1089/acu.2019.1368] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective: The increasing prevalence of infertility every year is in line with the increasing need for in vitro fertilization (IVF) programs. Failure of oocyte maturation is an obstacle that often causes low success in IVF. According to several studies, controlled ovarian stimulation (COS) has been reported to increase the risk of granulosa-cell apoptosis associated with inhibition of oocyte maturation. This study was conducted to determine the effect of electroacupuncture (EA) on oocyte maturation; rate of fertilization; granulosa-cell apoptosis; and levels of growth-differentiation factor 9 (GDF9) and bone-morphogenetic protein 15 (BMP15) an IVF program. Materials and Methods: A randomized controlled trial was conducted with 24 subjects who were in the IVF program. Subjects were randomly allocated into verum-EA (n = 12) and sham-EA groups (n = 12). Microscopic assessment of oocyte maturation and rate of fertilization was performed by embryologists, and examinations of granulosa-cell apoptosis index (Bax/Bcl-2 ratio), GDF9, and BMP15 were performed, using real-time quantitative polymerase chain reaction and messenger-RNA techniques. Results: There were significant differences in oocyte maturation (P = 0.02) and fertilization rates (P = 0.03) between the verum-EA and sham-EA groups. There were differences in granulosa-cell apoptosis index between the verum-EA and sham-EA groups (P < 0.001). There were significant differences in Bax-protein expression (P = 0.04) and Bcl-2 (P = 0.03) granulosa cells between the verum-EA and sham-EA groups. There was no significant difference in GDF9 levels (P = 0.34) and BMP15 (p = 0.47) between the verum-EA and sham-EA groups. Conclusions: EA can enhance oocyte maturation and fertilization rate, and reduce the granulosa-cell apoptosis index in an IVF program.
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Affiliation(s)
- Ayu Cintani Kusuma
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nadia Oktari
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Hasan Mihardja
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Adiningsih Srilestari
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Christina L Simadibrata
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Andon Hestiantoro
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Budi Wiweko
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Naylah Muna
- Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute, Universitas Indonesia, Jakarta, Indonesia
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Ma R, Song J, Si J, Liu Y, Li X, Cheng R, Hu Z, Xia T, Zhai J. Acupuncture for diminished ovarian reserve: Protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e16852. [PMID: 31441859 PMCID: PMC6716689 DOI: 10.1097/md.0000000000016852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The choice of treatments for diminished ovarian reserve (DOR) still remains a challenging clinical problem in reproductive medicine. Acupuncture could be beneficial for patients with DOR. This study aims to systematically investigate the efficacy and safety of the acupuncture for women with DOR. METHODS We will search electronic databases including PubMed (1946 to present), EMBASE (1974 to present), Cochrane Central Register of Controlled Trials (CENTRAL, all years), Web of Science (1900 to present), Chinese Biomedical Literatures Database (CBM, 1978 to present), China National Knowledge Infrastructure (CNKI, 1979 to present), WANFANG Data (from 2000 to present) to identify potentially eligible studies. Only randomized controlled trials (RCTs) will be included. Experimental interventions include traditional or contemporary acupuncture. Control interventions include no treatment, sham acupuncture, placebo acupuncture, or another active therapy. The primary outcomes include ongoing pregnancy rate and serum anti-Müllerian hormone level. A meta-analysis will be used to estimate a pooled intervention effect if possible. RESULTS The results will be published in a peer-reviewed journal. CONCLUSION The findings will provide further evidence for the management of DOR. PROSPERO REGISTRATION NUMBER CRD42018114385.
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Affiliation(s)
- Ruihong Ma
- Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
| | - Jiayi Song
- Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
| | - Jinhua Si
- Library, Tianjin University of Traditional Chinese Medicine
| | - Yan Liu
- Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
| | - Xinyun Li
- Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
| | - Rui Cheng
- Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
| | - Zuxian Hu
- Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
| | - Tian Xia
- Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
| | - Jingbo Zhai
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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20
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Gu YE, Zhang X, Zhang Q, Dai MC, Wu Y, Zhou Y, Qu F. The effects of acupuncture on pregnancy outcomes of in vitro fertilization with embryo transfer: An interdisciplinary systematic review. J Gynecol Obstet Hum Reprod 2019; 48:677-684. [PMID: 31276842 DOI: 10.1016/j.jogoh.2019.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/25/2019] [Accepted: 07/01/2019] [Indexed: 12/14/2022]
Abstract
The present systematic review is designed to summarize the evidence concerning the effect of acupuncture on pregnancy outcomes in vitro fertilization with embryo transfer (IVF-ET). We searched MEDLINE, the Wanfang Database, the China Academic Journal Electronic Full-text Database in the China National Knowledge Infrastructure, and the Index to Chinese Periodical Literature. Randomized controlled trials with intervention groups using acupuncture and control groups consisting of no acupuncture or sham (placebo) acupuncture in IVF-ET treatment were selected. Study characteristics were examined from these studies and an intention-to-treat approach was used to extract outcome data from each study. In total, 31 articles including 4450 women passed our selection criteria. The legitimacy, characteristics, and IVF outcomes of the included trials were summarized. Additional Traditional Chinese Medicine (TCM) theory-based, standardized, large-size, randomized, and multicenter trials are necessary prior to any conclusions being drawn on whether TCM can improve IVF outcomes.
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Affiliation(s)
- Ying-Er Gu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xian Zhang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qing Zhang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Min-Chen Dai
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yan Wu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yong Zhou
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fan Qu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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21
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Acupuncture Enhances Chances of Pregnancy in Unexplained Infertile Patients Who Undergo A Blastocyst Transfer in A Fresh-Cycle. Chin J Integr Med 2019; 25:298-302. [PMID: 31236890 DOI: 10.1007/s11655-018-2918-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2017] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To analyze the effects of acupuncture on in vitro fertilization patients with unexplained infertility. METHODS We retrospectively analyzed the charts of a total of 302 cycles performed in 273 patients attending Assisted Reproductive Technology (ART) Centre from August 2013 to August 2016. During the study period, embryo transfer with acupuncture (Acupuncture group, 46 cases) and without acupuncture (Control group, 42 cases) were applied. Prior to embryo transfer, the following points were used in the acupuncture group: Neiguan (CX 6), Diji (SP 8), Taichong (Liv 3), Baihui (Gv 20), and Guilai (S 29). These sessions were carried out two times before and after embryo transfer in a single day. In addition, auricular acupuncture was also performed at ear points, including ear point 55 (Shenmen), ear point 58 (Zhigong), ear point 22 (Neifenmi) and ear point 34 (Naodian). The biochemical pregnancy rate and clinical pregnancy rate after transplantation were compared between two groups. RESULTS The clinical pregnancy rate in the acupuncture group was higher than that in the control group [60.9% (28/46) vs. 33.3% (14/42), respectively, P<0.05]. Likewise, the live birth rate in the acupuncture group was also higher than that in the control group [71.7% (33/46) vs. 31.0% (12/42), P<0.01). CONCLUSION Administration of acupuncture on the day of embryo transfer dramatically improved fertility results in women who underwent in vitro fertilization/intra-cytoplasm sperm injection for reproduction.
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22
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Effects of Electroacupuncture on Expression of PI3K/Akt/Foxo3a in Granulosa Cells from Women with Shen (Kidney) Deficiency Syndrome Undergoing in vitro Fertilization-Embryo Transfer. Chin J Integr Med 2019; 25:252-258. [PMID: 31236889 DOI: 10.1007/s11655-019-2948-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To observe the effects of electroacupuncture (EA) on reproductive outcomes in women with Shen (Kidndy) deficiency syndrome after in vitro fertilization-embryo transfer (IVF-ET), and explore the underlying molecular mechanism. METHODS Sixty-six infertile patients with Shen deficiency syndrome undergoing IVF-ET were divided into EA or control groups according to a random table, 33 cases in each group. Before undergoing IVF, patients in the EA and control groups received EA therapy and placebo needle puncture, respectively, for 3 menstrual cycles. Shen deficiency syndrome scores were assessed. Other outcome measures included the number of retrieved oocytes and fertilization, high-quality embryo and clinical pregnancy rates. Follicular fluid was collected on the day of oocyte retrieval, and granulosa cell expression of phosphatidylinositide 3-kinases (PI3K), serine-threonine kinase (Akt) and forkhead box O3 (Foxo3a) mRNA were measured by reverse transcribed and quantitative real-time polymerase chain reaction. RESULTS Syndrome scores for pre- versus post-treatments decreased significantly (16.53±1.75 to 8.67±1.61) in the EA group (P<0.05), but showed no significant change in the control group (17.18±1.58 to 14.74±1.58). A significant difference in score change was found between the EA and control groups (P<0.05). High-quality embryo and clinical pregnancy rates were both increased in the EA group compared with the control group [69.15% (195/282) vs. 60.27% (176/292) and 66.67% (22/33) vs. 42.42% (14/33), respectively, P<0.05]. The fertilization rate was equivalent in EA and control groups. No difference was found in the number of retrieved oocytes between the two groups. Granulosa cell expression levels of PI3K and Akt mRNA were significantly increased in the EA group compared with the control group, while the expression of Foxo3a was reduced (all P<0.05). CONCLUSIONS For infertile patients with Shen deficiency syndrome undergoing IVF, EA for tonifying Shen as an adjunct treatment may alleviate clinical symptoms and improve the high-quality embryo rate. The EA-induced mechanism may involve regulation of PI3K/Akt/Foxo3a expression in granulosa cells to improve the developmental microenvironment of oocytes and inhibit granulosa cell apoptosis, possibly contributing to the improved clinical pregnancy rate (Registration No. ChiCTR 1800016217).
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Xie ZY, Peng ZH, Yao B, Chen L, Mu YY, Cheng J, Li Q, Luo X, Yang PY, Xia YB. The effects of acupuncture on pregnancy outcomes of in vitro fertilization: a systematic review and meta-analysis. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:131. [PMID: 31200701 PMCID: PMC6570865 DOI: 10.1186/s12906-019-2523-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 05/15/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND The effects of acupuncture on in vitro fertilization (IVF) outcomes remain controversial. And the variation in participant, interventions, outcomes studied, and trial design may relate to the efficacy of adjuvant acupuncture. METHODS We searched digital databases for relevant studies, including Embase, PubMed, Cochrane Library and some Chinese databases up to December 2018, for randomized controlled trials (RCTs) evaluating the effects of acupuncture on women undergoing IVF. We included studies with intervention groups using needling, and control groups consisting of no acupuncture or sham (placebo) acupuncture. Primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Meta-regression and subgroup analysis were conducted on the basis of eight pre-specified covariates to investigate the variances of the effects of adjuvant acupuncture on pregnancy rates and the sources of heterogeneity. RESULTS Twenty-seven studies with 6116 participants were included. The pooled clinical pregnancy rate (CPR) from all of acupuncture groups was significantly greater than that of control groups (RR 1.21, 95% CI: 1.07-1.38), whereas the pooled live birth rate (LBR) was not. Meta-regression subgroup analysis showed a more significant benefit of acupuncture for repeated IVF cycle proportion (number of women with a history of prior unsuccessful IVF attempt divided by number of women included in each trial) ≥ 50% group (CPR: RR 1.60, 95% CI: 1.28-2.00; LBR: RR 1.42, 95% CI: 1.05-1.92), and this covariate explained most of the heterogeneity (CPR and LBR: adjusted R2 = 100 and 87.90%). Similar results were found between CPR and number of acupuncture treatments (CPR: p = 0.002, adjusted R2 = 51.90%), but not LBR. CONCLUSIONS Our analysis finds a benefit of acupuncture for IVF outcomes in women with a history of unsuccessful IVF attempt, and number of acupuncture treatments is a potential influential factor. Given the poor reporting and methodological flaws of existing studies, studies with larger scales and better methodologies are needed to verify these findings.
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Affiliation(s)
- Zheng-yun Xie
- Nanjing Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhi-hang Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Bing Yao
- Center of Reproductive Medicine, Nanjing Jinling Hospital, Nanjing University School of Medical, Nanjing, China
| | - Li Chen
- Center of Reproductive Medicine, Nanjing Jinling Hospital, Nanjing University School of Medical, Nanjing, China
| | - Yan-yun Mu
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Cheng
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qian Li
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xi Luo
- Changzheng Hospital of the Second Military Medical University, Nanjing branch, Nanjing, China
| | - Peng-yan Yang
- Nanjing Jiangning Hospital of Traditional Chinese Medicine, Nanjing, China
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Gao L, Xiao Z, Jia C, Wang W. A comparison of the efficacy of Chinese herbal medicines in the treatment of primary dysmenorrhea: A network meta-analysis protocol. Medicine (Baltimore) 2019; 98:e15100. [PMID: 30946372 PMCID: PMC6455849 DOI: 10.1097/md.0000000000015100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Chinese herbal medicines (CHM) have been commonly used in the treatment of primary dysmenorrhea in East Asia. Several systematic reviews have been conducted to assess the clinical efficacy of CHM in the treatment of primary dysmenorrhea. However, their comparative efficacy is still unclear. Therefore, the purpose of this study is to conduct a network meta-analysis (NMA) to systematically compare the advantages of different CHM in the treatment of primary dysmenorrhea. METHODS AND ANALYSIS The following electronic databases will be searched in this study: Web of Science, PubMed, Cochrane Library, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wan-fang Database. Search terms include (Chinese herbal medicine or Chinese patent medicine or medicinal plants or phytotherapy or traditional medicine or Chinese herbal drugs or plant extracts or herbal medicine or herbal extract or herb or traditional Chinese medicine) and (primary dysmenorrhea or dysmenorrhea or painful menstruation) and (randomized controlled trial). The language will be limited to Chinese and English, and the search date will be up to May 2019. The included studies must be randomized controlled trials (RCTs) with patients diagnosed with primary dysmenorrhea. CHM must be used as interventions in the experimental group. While in the control group, studies that used a different herbal medicine, nonsteroidal anti-inflammatory drugs (NSAIDs), or placebo will be included. The primary outcomes include clinical efficacy and visual analog scale (VAS), and the secondary outcomes include adverse events and quality of life. Four reviewers will independently extract the data and assess the qualities of the studies. Statistical analysis will be conducted with R package for each outcome. ETHICS AND DISSEMINATION Ethical approval is not required as this NMA is based on published studies. The completed NMA will be published in a peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER PROSPERO CRD42018095254.
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Kirca N, Pasinlioglu T. The effect of yoga on stress level in infertile women. Perspect Psychiatr Care 2019; 55:319-327. [PMID: 30657179 DOI: 10.1111/ppc.12352] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/11/2018] [Accepted: 01/06/2019] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The aim of the present study was to examine the effects of planned yoga practices on stress levels in infertile women. DESIGN AND METHODS This randomized controlled study included 128 volunteer women who were registered at a private in vitro fertilization (IVF) clinic and received infertility treatment. The patients in the experimental group took part in the yoga program twice a week for 6 weeks. A personal information form and The Copenhagen Multi-center Psychosocial Infertility (COMPI) Fertility Problem Stress Scale were used to collect data. FINDINGS The differences between the mean scores of the control and experimental groups on the COMPI Fertility Problem Stress Scale at pre- and posttests were statistically significant (P < 0.05). PRACTICE IMPLICATIONS Because yoga practices may be effective in reducing stress in infertile women, these applications can be performed before treatment. It may reduce patients' stress and increase the success of the treatment. These findings indicate that yoga could reduce stress levels in infertile women.
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Affiliation(s)
- Nurcan Kirca
- Department of Obstetrics & Gynecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Turkan Pasinlioglu
- Department of Obstetrics & Gynecological Nursing, Faculty of Health Sciences, Sanko University, Gaziantep, Turkey
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Smith CA, Armour M, Shewamene Z, Tan HY, Norman RJ, Johnson NP. Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis. Reprod Biomed Online 2019; 38:364-379. [PMID: 30658892 DOI: 10.1016/j.rbmo.2018.12.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 09/05/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
Abstract
This was a systematic review and meta-analysis to examine the efficacy, effectiveness and safety of acupuncture as an adjunct to embryo transfer compared with controls to improve reproductive outcomes. The primary outcome was clinical pregnancy. Twenty trials and 5130 women were included in the review. The meta-analysis found increased pregnancies (risk ratio [RR] 1.32, 95% confidence interval [CI] 1.07-1.62, 12 trials, 2230 women), live births (RR 1.30, 95% CI 1.00-1.68, 9 trials, 1980 women) and reduced miscarriage (RR 1.43, 95% CI 1.03-1.98, 10 trials, 2042 women) when acupuncture was compared with no adjunctive control. There was significant heterogeneity, but no significant differences between acupuncture and sham controls. Acupuncture may have a significant effect on clinical pregnancy rates, independent of comparator group, when used in women who have had multiple previous IVF cycles, or where there was a low baseline pregnancy rate. The findings suggest acupuncture may be effective when compared with no adjunctive treatment with increased clinical pregnancies, but is not an efficacious treatment when compared with sham controls, although non-specific effects may be active in both acupuncture and sham controls. Future research examining the effects of acupuncture for women with poorer IVF outcomes is warranted.
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Affiliation(s)
- Caroline A Smith
- NICM Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia.
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia
| | - Zewdneh Shewamene
- NICM Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia
| | - Hsiewe Ying Tan
- School of Science and Health, Western Sydney University, Penrith NSW 2751, Australia
| | - Robert J Norman
- Robinson Research Institute, University of Adelaide and Fertility SA, Adelaide SA 5000, Australia
| | - Neil P Johnson
- Robinson Research Institute, University of Adelaide and Fertility SA, Adelaide SA 5000, Australia; Repromed Auckland, 105 Remuera Road, Auckland 1050, New Zealand
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Schwarze JE, Ceroni JP, Ortega-Hrepich C, Villa S, Crosby J, Pommer R. Does acupuncture the day of embryo transfer affect the clinical pregnancy rate? Systematic review and meta-analysis. JBRA Assist Reprod 2018; 22:363-368. [PMID: 30132627 PMCID: PMC6210608 DOI: 10.5935/1518-0557.20180057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The effects of acupuncture on IVF outcomes is still unknown. We carried out a
systematic review and meta-analysis of RCT to determine whether acupuncture
performed at the time of ET improves outcomes. We searched Medline and Embase
from January 1990 to June 2017, for the following terms): (acupuncture;
acupuncture therapy) and (reproductive techniques, assisted; in
vitro fertilization; embryo transfer). We selected RCT that
compared acupuncture with sham acupuncture or no treatment. We included only
trials in which acupuncture involved the insertion of needles into traditional
meridian points. We evaluated the methodological quality of the trials using the
Cochrane risk of bias tool. The measure of treatment effect was the pooled odds
ratio of achieving a clinical pregnancy, ongoing pregnancy, or live birth for
women in the acupuncture group compared with women in the control group. For
pooled data, summary test statistics were calculated using the Mantel-Haenszel
method, using the Rev-Man software, version 5.1. We analyzed six studies,
including 2,376. In all trials, there were no significant differences between
the groups concerning the mean numbers of embryos transferred, the mean age of
the women undergoing the procedure, diagnose and use of ICSI. Acupuncture
performed the day of ET was associated with a reduced risk of clinical pregnancy
(0.87, 95% confidence interval 0.77 to 0.98). The pooled rate difference was
-0.06 (-0.12 to -0.01) for clinical pregnancy. None of the trials reported
significant adverse effects of acupuncture.
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Affiliation(s)
- Juan-Enrique Schwarze
- Unidad de Medicina Reproductiva Clinica Las Condes, Santiago, Chile.,Departamento OB/GIN, Universidad de Santiago, Santiago, Chile
| | | | | | - Sonia Villa
- Unidad de Medicina Reproductiva Clinica Monteblanco, Santiago, Chile
| | - Javier Crosby
- Unidad de Medicina Reproductiva Clinica Las Condes, Santiago, Chile
| | - Ricardo Pommer
- Unidad de Medicina Reproductiva Clinica Monteblanco, Santiago, Chile
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Chen CY, Lin XX, Wang X. Efficacy of Non-Invasive Auricular Acupressure for Treating Constipation in Leukemia Patients Undergoing Chemotherapy: A Systematic Review. Complement Med Res 2018; 25:406-412. [DOI: 10.1159/000491693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: The aim of this systematic review was to evaluate the available evidence from randomized controlled trials (RCTs) of auricular acupressure (AA) therapy for preventing constipation in leukemia patients undergoing chemotherapy. Methods: We searched 5 English databases and 4 Chinese databases, from their inception until August 2017. Quantitative syntheses of RCTs were conducted using RevMan 5.3 software. Study selection, data extraction, and validation were performed independently by 2 reviewers. Cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials. Results: Five RCTs met the inclusion criteria, and most were of low methodological quality. All RCTs compared AA + routine care with routine care alone. Our analysis found that complementary effects of AA can improve the scores of the Bristol Stool Form (BSF), the Constipation Assessment Scale (CAS), and the Patient Assessment of Constipation-Quality of Life (PAC-QOL). However, the same positive results were not found in terms of the Fatigue Severity Scale (FSS), the EuroQoL 5-domain (EQ-5D), and the Hospital Anxiety Depression Scale (HADS). Conclusions: Overall, as a potential safety therapy, AA may be recommended in addition to routine care including use of laxatives to prevent constipation in leukemia patients undergoing chemotherapy. In the future, more rigorous RCTs must be conducted to overcome the limitations of our existing data and to confirm the effect and safety of AA for managing constipation in leukemia patients undergoing chemotherapy.
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Zheng SH, Yan M, Field T, Xu X. Beneficial effects of auricular acupressure on preventing constipation in breast cancer patients undergoing chemotherapy: evidence from systematic review and meta-analysis. FRONTIERS OF NURSING 2018. [DOI: 10.1515/fon-2018-0030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objective
To evaluate the available evidence from randomized controlled trials (RCTs) of auricular acupressure (AA) therapy for preventing constipation in breast cancer patients undergoing chemotherapy.
Methods
The following databases were searched from their inception until August 2017: Ovid Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and Allied and Alternative Medieine (AMED). We also searched four Chinese databases: Chinese BioMedical Database (CBM), China National Knowledge Infrastructure (CNKI), WANFANG Data, and Chinese VIP Database. Only the RCTs related to the effects of AA therapy on preventing constipation in breast cancer patients undergoing chemotherapy were included in this study. Quantitative syntheses of data from RCTs were conducted using RevMan 5.3 software. Study selection, data extraction, and validation were performed independently by two authors. Cochrane criteria for risk of bias were used to assess the methodological quality of the trials.
Results
Four RCTs met the inclusion criteria, and most were of low methodological quality. Study participants in the AA plus routine care group showed significantly greater improvements in the response rate (risk ratio [RR] = 1.27, 95% confidence interval [CI] [1.14,1.42], P < 0.01) with low heterogeneity χ2 = 2.31, P = 0.31, l2 = 14%). In addition, when compared with routine care alone, one RCT suggested favorable statistically significant effects of AA plus routine care on Constipation Assessment Scale (CAS; mean difference [MD] = -5.07,95% CI [-6.86, -3.28], P < 0.01). Furthermore, when compared with routine care alone, one RCT suggested positive statistically significant effects of AA plus routine care on Patient Assessment of Constipation-Quality of Life (PAC-QOL; MD = -1.26,95% CI [-1.59, -0.93], P < 0.01).
Conclusions
Overall, as a potential safety therapy, only weak evidence can support the hypothesis that AA can effectively prevent constipation in breast cancer patients undergoing chemotherapy.
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Affiliation(s)
- Su-Hua Zheng
- Department of Oncology, Changzhou No. 2 People's Hospital , Affiliated to Nanjing Medical University , Changzhou , Jiangsu 213003 , China
| | - Min Yan
- School of Nursing , Changzhou University , Changzhou , Jiangsu 213003 , China
| | - Tiffany Field
- School of Nursing , Louisiana State University , Lafayette , LA 70803 , USA
| | - Xiao Xu
- School of Nursing , Changzhou University , Changzhou , Jiangsu 213003 , China
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Effects of Acupuncture on the Outcomes of Assisted Reproductive Technology: An Overview of Systematic Reviews. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:7352735. [PMID: 30327681 PMCID: PMC6171206 DOI: 10.1155/2018/7352735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/29/2018] [Indexed: 12/14/2022]
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.
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Wang X, Lin H, Chen M, Wang J, Jin Y. Effect of acupuncture on in vitro fertilization: An updated systematic review and data mining protocol. Medicine (Baltimore) 2018; 97:e10998. [PMID: 29901590 PMCID: PMC6025581 DOI: 10.1097/md.0000000000010998] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Although many patients try to seek acupuncture to improve in vitro fertilization (IVF) outcomes, evidence regarding its efficacy and acupoints characters are lacking. The aim of this protocol is to evaluate the effectiveness and safety, as well as the acupoints characteristics of acupuncture in the treatment of female undergoing IVF, by conducting a systematic review and data mining. METHODS The following 6 databases will be searched from their inception to April 30, 2018: PubMed, Chinese National Knowledge Infrastructure, Wanfang, VIP database, Embase, and Cochrane Library. The randomized controlled trials (RCTs) or case-control studies of acupuncture that assess clinical effects and side effects in female undergoing IVF are included. The primary outcome measures will be number of oocytes retrieved, fertilization rate, oocyte cleavage rate, high-quality embryos rate, ovarian hyperstimulation syndrome (OHHS) incidence rate, clinical pregnancy rate (CPR), biochemical pregnancy rate (BPR), implantation rate, and cycle cancellation rate. Two reviewers will independently undertake data extraction and quality assessments. Data will be synthesized by RevMan V.5.3 software. Acupoints characteristics will be excavated using Traditional Chinese Medicine inheritance support system (TCMISS). Reporting bias will be assessed by Funnel plots, Begg test, and Egger test. RESULTS This review will assess the clinical efficacy and safety, as well as the acupoints characteristics of acupuncture on IVF. CONCLUSION These findings will summarize the current evidence of acupuncture on IVF outcomes and may provide guidance for clinicians and infertile women to select acupuncture for IVF.
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Affiliation(s)
- Xiaotong Wang
- Shenzhen Bao’an Traditional Chinese Medicine Hospital Group, Guangzhou University of Chinese Medicine, Shenzhen
| | | | - Mingzhu Chen
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Jian Wang
- Shenzhen Bao’an Traditional Chinese Medicine Hospital Group, Guangzhou University of Chinese Medicine, Shenzhen
| | - Yuanlin Jin
- Shenzhen Bao’an Traditional Chinese Medicine Hospital Group, Guangzhou University of Chinese Medicine, Shenzhen
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Gay C, Cros A, Berbis J, Bretelle F, Perrin J, Courbiere B. Evaluation of "Energy Resonance by Cutaneous Stimulation" Among Women Treated by In Vitro Fertilization. J Altern Complement Med 2018; 24:578-583. [PMID: 29641245 DOI: 10.1089/acm.2017.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Pregnancy rate in in vitro fertilization (IVF) depends on many factors, such as the characteristics of the couple and the clinicobiological parameters. Interest in alternative and complementary medicine (ACM) for IVF is discussed because of the lack of scientific evidence. Energy resonance by cutaneous stimulation (ERCS), an acupuncture-like technique, consists of skin stimulation to transmit vibratory messages. The aim of this study was to evaluate the effect of ERCS on live birth rates (LBRs) in IVF. DESIGN A prospective observation study was performed in the Unit of Assisted Reproductive Technologies of a University Teaching Hospital. Every woman who agreed to participate in this study and received a fresh embryo transfer (ET) after IVF or Intracytoplasmic Sperm Injection (ICSI) was included. Patients randomly underwent an ERCS session on the day of ET according to the schedule of the midwife performing this technique. The control group consisted of women undergoing ET under usual conditions. The main outcome measure was the LBR per transfer. RESULTS Three-hundred-eighteen women were included, 120 in the ERCS + ET group and 198 in the ET without ERCS group. None of the women dropped out. The clinical characteristics in both groups were comparable. There was a significant difference in the clinical pregnancy rates, 31.7% in the ERCS group versus 21.7% in the No ERCS group (p = 0.037). The LBR in the ERCS group was nearly significantly higher, 29.2% versus 20.7% in the No ERCS group (p = 0,059). CONCLUSIONS Women undergoing ERCS on the day of ET had a significantly higher IVF pregnancy rate. However, this methodology made not possible to draw conclusions about the mechanisms that induced the increase of IVF LBRs: placebo effect, "cocooning," or ERCS self-effect? Further well-conducted studies are strongly needed to assess ERCS efficacy.
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Affiliation(s)
- Camille Gay
- 1 Department of Gynecology-Obstetric and Reproductive Medicine , AP-HM, Hôpital La Conception-Hôpital Nord, Marseille, France
| | - Anne Cros
- 1 Department of Gynecology-Obstetric and Reproductive Medicine , AP-HM, Hôpital La Conception-Hôpital Nord, Marseille, France
| | - Julie Berbis
- 2 EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix Marseille University , Marseille, France
| | - Florence Bretelle
- 1 Department of Gynecology-Obstetric and Reproductive Medicine , AP-HM, Hôpital La Conception-Hôpital Nord, Marseille, France .,3 Aix Marseille University, CNRS UMR 7278, Inserm U1095 , Marseille, France
| | - Jeanne Perrin
- 1 Department of Gynecology-Obstetric and Reproductive Medicine , AP-HM, Hôpital La Conception-Hôpital Nord, Marseille, France .,4 Aix Marseille University, CNRS, IRD, Avignon University , IMBE UMR 7263, Marseille, France
| | - Blandine Courbiere
- 1 Department of Gynecology-Obstetric and Reproductive Medicine , AP-HM, Hôpital La Conception-Hôpital Nord, Marseille, France .,4 Aix Marseille University, CNRS, IRD, Avignon University , IMBE UMR 7263, Marseille, France
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Jing X, Liu J, Wang C, Ji M, Chen X, Mei Y, Zhu QR. Auricular acupressure is an alternative in treating constipation in leukemia patients undergoing chemotherapy: A systematic review and meta-analysis. Complement Ther Clin Pract 2018; 31:282-289. [PMID: 29705469 DOI: 10.1016/j.ctcp.2018.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/16/2018] [Accepted: 03/13/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Auricular acupressure (AA) therapy has been widely used in Eastern Asia and Europe to prevent constipation in leukemia patients undergoing chemotherapy. The aim of this systematic review was to review data from randomized controlled trials (RCTs) of auricular acupressure therapy for preventing constipation in leukemia patients undergoing chemotherapy. METHODS Databases that were searched from their inception until August 2017 included: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, as well as four Chinese databases [Chinese BioMedical Database, China National Knowledge Infrastructure, Wan-Fang Data, and the Chinese WeiPu Database]. In this systematic review, only RCTs that were related to the effects of auricular acupressure therapy on preventing constipation in leukemia patients undergoing chemotherapy were included. Study selection, data extraction, and validation were performed independently by two reviewers. Quantitative analyses of RCTs were performed using RevMan 5.3 software, and cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials. RESULTS A total of 5 RCTs met the inclusion criteria, and most were of low methodological quality. Participants in the AA plus routine care group showed significantly greater improvements in the Bristol Stool Form (BSF) [MD = 0.55, 95% CI (0.39, 0.71), p < 0.01] with low heterogeneity (Chi2 = 5.01, p = 0.29, I2 = 20%). Moreover, when compared with routine care alone, meta-analysis of three RCTs indicated favorable statistically significant effects of AA plus routine care on the Constipation Assessment Scale (CAS) [MD = -1.51, 95% CI (-1.89, -1.14), p < 0.01] with low heterogeneity (Chi2 = 1.63, p = 0.44, I2 = 0%). Furthermore, when compared with routine care alone, meta-analysis of two RCTs demonstrated statistically significant effects of AA plus routine care on the Patient Assessment of Constipation-Quality Of Life (PAC-QOL) [MD = -1.28, 95% CI (-1.44, -1.13), p < 0.01], with low heterogeneity (Chi2 = 0.19, p = 0.67, I2 = 0%). CONCLUSION Taken together, as a potential safety therapy, only weak evidence supported the hypothesis that AA effectively prevented constipation in leukemia patients undergoing chemotherapy.
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Affiliation(s)
- Xueming Jing
- Department of hepatology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jiao Liu
- Department of infectious diseases, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Chuanlin Wang
- Department of infectious diseases, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ming Ji
- Department of infectious diseases, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xing Chen
- Department of infectious diseases, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yihan Mei
- Department of Medicine, The Capital University of Medical Sciences, Beijing, China
| | - Qi Rong Zhu
- Department of hepatology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
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LoGiudice JA, Massaro J. The impact of complementary therapies on psychosocial factors in women undergoing in vitro fertilization (IVF): A systematic literature review. Appl Nurs Res 2017; 39:220-228. [PMID: 29422163 DOI: 10.1016/j.apnr.2017.11.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 11/19/2017] [Indexed: 12/16/2022]
Abstract
AIM This review evaluates the impact of complementary therapies on psychosocial factors in women undergoing IVF. BACKGROUND According to the CDC, nearly 7% of married women in the United States face infertility. Approximately 1.5% of all infants born in the U.S. annually are conceived through assisted reproductive technologies (ART), such as IVF. Women undergoing ART report distress, anxiety, and depression related to their treatment. Stress has been cited as the top reason why women terminate treatment. Complementary therapies, such as mind-body techniques, have been associated with decreasing stress and anxiety. METHODS CINAHL and PubMED databases were searched for studies 1) published from January 2010 to 2017, 2) written in English, 3) that examined the effect of an complementary therapy on the psychological well-being of women undergoing, or about to be undergoing a cycle of IVF. RESULTS The search revealed 11 studies published between 2010 and 2015 from a variety of countries. The most common research design was a randomized controlled trial (n=7). The psychosocial factor most frequently measured was anxiety (n=8). The forms of complementary therapy varied, with the most common being Hatha yoga, cognitive behavioral interventions, and mind-body therapies (n=2 each). CONCLUSIONS Utilizing complementary therapies appears to be a positive way to decrease women's anxiety, depression, distress, and stress, and to increase fertility quality of life. This review informs providers that incorporating complementary therapies into the plan of care can lead to improved psychosocial health outcomes for women undergoing IVF.
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Affiliation(s)
| | - Jenna Massaro
- 1073 North Benson Rd., Fairfield, CT 06824, United States.
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Effects of auricular acupressure therapy for preventing constipation in leukemia patients undergoing chemotherapy: Protocol for a systematic review. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Arhin SK, Zhao Y, Lu X, Chetry M, Lu J. Effect of micronutrient supplementation on IVF outcomes: a systematic review of the literature. Reprod Biomed Online 2017; 35:715-722. [PMID: 28919239 DOI: 10.1016/j.rbmo.2017.08.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/06/2017] [Accepted: 08/08/2017] [Indexed: 11/17/2022]
Abstract
There is accumulating evidence on the importance of micronutrients in improving fertility in couples undergoing IVF therapy. Despite this, studies reporting the relevant clinical outcomes of IVF, such as pregnancy and live birth rates, are very scarce. This review aimed to systematically summarize clinical evidence on the effect of micronutrients on primary outcome parameters of IVF treatment. The literature was searched up to February 2017 through Embase and PubMed databases for relevant studies. The quality of eligible studies was assessed with the Downs and Black checklist. A total of five studies qualified for inclusion. These studies reported outcomes on 467 participants administered micronutrient supplements alone or combined with other nutrients as part of IVF therapy. There was significant heterogeneity among the interventions and study designs. However, all the studies reported a positive impact of micronutrient supplementation on clinical outcomes of IVF therapy in terms of pregnancy rate and/or live birth rate. Within the limits of this review, micronutrients appear to influence positive outcomes in couples undergoing fertility treatment. Larger clinical studies are needed to strengthen these findings so that the benefit of micronutrients can be extended to subjects undergoing IVF therapy.
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Affiliation(s)
- Samuel Kofi Arhin
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 32500, China
| | - Yu Zhao
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 32500, China
| | - XiaoSheng Lu
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 32500, China
| | - Mandika Chetry
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 32500, China
| | - JieQiang Lu
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 32500, China.
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Gao L, Jia C, Zhang H, Ma C. Wenjing decoction (herbal medicine) for the treatment of primary dysmenorrhea: a systematic review and meta-analysis. Arch Gynecol Obstet 2017; 296:679-689. [PMID: 28791471 DOI: 10.1007/s00404-017-4485-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 08/03/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Wenjing decoction is a well-accepted traditional Chinese medicine for the treatment of primary dysmenorrhea in East Asia, but its clinical effectiveness and risk have not been adequately assessed. In this paper, we conducted a systematic review and meta-analysis to evaluate the efficacy of Wenjing decoction for the treatment of primary dysmenorrhea. METHODS Eight databases were used in our research: the Cochrane Library, the Web of Science, PubMed, EMBASE, the Chinese Biomedical Literature Database (CBM), the Chinese National Knowledge Infrastructure (CNKI), the Chinese Scientific Journal Database, and the Wan-fang Database. The following search terms were used: (Wenjing decoction OR Wenjing formula OR Wenjing tang) AND (primary dysmenorrhea OR dysmenorrhea OR painful menstruation) AND (randomized controlled trial). No language limitation was used. RESULTS A total of 18 studies, including 1736 patients, were included in the meta-analysis. Wenjing decoction was shown to be significantly better than nonsteroidal anti-inflammatory drugs for the improvement of primary dysmenorrhea according to the clinical effective rate (RR 1.41, 95% CI 1.24-1.61), the visual analogue scale (MD -1.77, 95% CI -2.69 to -0.84), and the pain scale for dysmenorrhea (MD -1.81, 95% CI -2.41 to -1.22). CONCLUSIONS The results supported the clinical use of Wenjing decoction for the treatment of primary dysmenorrhea. However, the quality of the evidence for this finding was low due to a high risk of bias in the included studies. Therefore, well-designed randomized controlled trials are still needed to further evaluate the efficacy of Wenjing decoction for the treatment of primary dysmenorrhea.
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Affiliation(s)
- Li Gao
- School of Preclinical Medicine, Beijing University of Chinese Medicine, No. 11 North 3rd Ring East Road, Chaoyang District, Beijing, 100029, China
| | - Chunhua Jia
- School of Preclinical Medicine, Beijing University of Chinese Medicine, No. 11 North 3rd Ring East Road, Chaoyang District, Beijing, 100029, China.
| | - Heng Zhang
- School of Preclinical Medicine, Beijing University of Chinese Medicine, No. 11 North 3rd Ring East Road, Chaoyang District, Beijing, 100029, China
| | - Cuilan Ma
- School of Preclinical Medicine, Beijing University of Chinese Medicine, No. 11 North 3rd Ring East Road, Chaoyang District, Beijing, 100029, China
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