Intervention Review

Acupuncture and assisted conception

  1. Ying C Cheong1,*,
  2. Ernest Hung Yu Ng2,
  3. William L Ledger3

Editorial Group: Cochrane Menstrual Disorders and Subfertility Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 13 OCT 2007

DOI: 10.1002/14651858.CD006920.pub2

Database Title

Additional Information

How to Cite

Cheong YC, Hung Yu Ng E, Ledger WL. Acupuncture and assisted conception. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD006920. DOI: 10.1002/14651858.CD006920.pub2.

Author Information

  1. 1

    University of Southampton, Obstetrics and Gynaecology, Southampton, UK

  2. 2

    University of Hong Kong, Queen Mary Hospital, Department of Obstetrics and Gynaecology, Hong Kong, Hong Kong, Hong Kong

  3. 3

    University of New South Wales, School of Women's & Children's Health, Randwick, NSW, Australia

*Ying C Cheong, Obstetrics and Gynaecology, University of Southampton, Level F, Princess Anne Hospital, Coxford Road, Southampton, SO16 5YA, UK. yingcheong@hotmail.com. Y.Cheong@soton.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Acupuncture has recently been studied in assisted reproductive treatment (ART) although its role in reproductive medicine is still debated.

Objectives

To determine the effectiveness of acupuncture in the outcomes of ART.

Search methods

All reports which describe randomised controlled trials of acupuncture in assisted conception were obtained through searches of the Menstrual Disorders and Subfertility Group Specialised Register, CENTRAL, Ovid MEDLINE (1996 to August 2007), EMBASE (1980 to August 2007), CINAHL (Cumulative Index to Nursing & Allied Health Literature) (1982 to August 2007), AMED, National Research Register, Clinical Trials register (www.clinicaltrials.gov), and the Chinese database of clinical trials.

Selection criteria

Randomised controlled trials of acupuncture for couples who were undergoing ART comparing acupuncture treatment alone or acupuncture with concurrent ART versus no treatment, placebo or sham acupuncture plus ART for the treatment of primary and secondary infertility. Women with medical illness deemed contraindications for ART or acupuncture were excluded.

Data collection and analysis

Sixteen randomised controlled trials were identified that involved acupuncture and assisted conception. Thirteen trials were included in the review and three were excluded. Quality assessment and data extraction were performed independently by two review authors. Meta-analysis was performed using odds ratio (OR) for dichotomous outcomes. The outcome measures were live birth rate, clinical ongoing pregnancy rate, miscarriage rate, and any reported side effects of treatment.

Main results

There is evidence of benefit when acupuncture is performed on the day of embryo transfer (ET) on the live birth rate (OR 1.86, 95% CI 1.29 to 2.77) but not when it is performed two to three days after ET (OR 1.79, 95% CI 0.93 to 3.44). There is no evidence of benefit on pregnancy outcomes when acupuncture is performed around the time of oocyte retrieval.

Authors' conclusions

Acupuncture performed on the day of ET shows a beneficial effect on the live birth rate; however, with the present evidence this could be attributed to placebo effect and the small number of women included in the trials. Acupuncture should not be offered during the luteal phase in routine clinical practice until further evidence is available from sufficiently powered RCTs.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Acupuncture and assisted conception

The data from this meta-analysis suggests that acupuncture does increase the live birth rate with in vitro fertilisation (IVF) treatment when performed around the time of embryo transfer. However, this could be attributed to placebo effect and the small number of trials included in the review. Larger studies are necessary to confirm the results. Acupuncture may have potential harmful effects in early pregnancy and hence clinicians should be cautious when giving advice regarding the use of acupuncture in early pregnancy.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

針刺與輔助受孕

近來針刺已經被研究用來輔助生殖 (assisted reproductive treatment, ART) ，但其角色在生殖醫學上仍受到爭論

目標

來決定針刺對ART結果的有效性。

搜尋策略

所有描述用針刺來輔助受孕的隨機對照試驗的研究報告，都是經由搜尋以下資料庫：Menstrual Disorders and Subfertility Group Specialised Register, CENTRAL, Ovid MEDLINE (1996 to August 2007), EMBASE (1980 to August 2007), CINAHL (Cumulative Index to Nursing & Allied Health Literature) (1982 to August 2007), AMED, National Research Register, Clinical Trials register (www.clinicaltrials.gov), 與中國臨床試驗資料庫.

選擇標準

運用針刺的隨機對照實驗來比較:受試者接受ART與單獨使用針刺治療，或針刺合併ART組與安慰劑組、偽針刺合併ART組對於治療原發性或次發性不孕的效果。婦女有內科疾病被評定為不適合ART或是針刺者，則與以排除。

資料收集與分析

找到16個針刺與輔助受孕相關的隨機對照試驗，其中13個試驗被納入本文獻回顧，3個被排除。品質的評估與資料的選取由兩位複審作者個別執行。執行統合分析時二分結果是以odds ratio (OR) 來表示。結果檢測包括:活產率、臨床懷孕率、流產率、及治療副作用的報告。

主要結論

有證據顯示，在胚胎植入(embryo transfer, ET)當天施行針刺有助於活產率 (OR 1.89, 95% CI 1.29 to 2.77) ，但並不是在植入後兩至三天 (OR 1.79, 95% CI 0.93 to 3.44) 。沒有證據顯示於取卵時給予針刺治療有助於懷孕的結果。

作者結論

在胚胎植入的當天施行針刺，顯示對於活產率有助益的效果; 然而，依目前的證據這可能歸因於安慰劑效應，而且試驗的婦女數量太少。在臨床常規試驗中，針刺不可用於黃體期，除非有足夠充分的隨機對照試驗 (RCTs) 進一步的證據顯示可以使用

翻譯人

本摘要由高雄醫學大學附設醫院林宏隆翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

針刺與輔助受孕：從本統合分析的資料建議在胚胎植入當天施行針刺，有助於提高體外受孕 (in vitro fertilization, IVF) 治療的活產率。然而,這有可能歸因於安慰的效果，而且分析的試驗數太少，因此需要更大的研究來確定此結果。由於針刺對於懷孕早期有潛在的傷害，因此建議臨床醫師對於懷孕早期使用針刺應該要十分小心。

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