Intervention Review

Acupuncture for polycystic ovarian syndrome

  1. Danforn CE Lim1,*,
  2. Wei Chen2,
  3. Lisa NC Cheng3,
  4. Charlie Changli Xue4,
  5. Felix WS Wong5,
  6. Anthony J O'Sullivan6,
  7. Jian Ping Liu7

Editorial Group: Cochrane Menstrual Disorders and Subfertility Group

Published Online: 10 AUG 2011

Assessed as up-to-date: 7 MAR 2011

DOI: 10.1002/14651858.CD007689.pub2

Database Title

Additional Information

How to Cite

Lim DCE, Chen W, Cheng LNC, Xue CC, Wong FWS, O'Sullivan AJ, Liu JP. Acupuncture for polycystic ovarian syndrome. Cochrane Database of Systematic Reviews 2011, Issue 8. Art. No.: CD007689. DOI: 10.1002/14651858.CD007689.pub2.

Author Information

  1. 1

    University of New South Wales, South Western Sydney Clinical School, Faculty of Medicine, BLAKEHURST, New South Wales, Australia

  2. 2

    Beijing University of Chinese Medicine, Centre For Evidence-Based Chinese Medicine, Beijing, China

  3. 3

    University of New South Wales, Faculty of Medicine, Sydney Children's Hospital, Randwick, NSW, Australia

  4. 4

    RMIT University, Traditional & Complementary Medicine Research Program, Health Innovations Research Institute and Discipline of Chinese Medicine, School of Health Sciences, Bundoora, Victoria, Australia

  5. 5

    School of Women's and Children's Health, Obstetrics & Gynaecology, Liverpool, New South Wales, Australia

  6. 6

    University of New South Wales, St George Clinical School, Kogarah, New South Wales, Australia

  7. 7

    Beijing University of Chinese Medicine, Centre for Evidence-Based Chinese Medicine, Beijing, China

*Danforn CE Lim, South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, PO BOX 3256, BLAKEHURST, New South Wales, 2221, Australia. celim@unswalumni.com. D.LIM@UNSW.EDU.AU.

Publication History

  1. Publication Status: New
  2. Published Online: 10 AUG 2011

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Abstract

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

Background

Polycystic ovarian syndrome (PCOS) is characterised by the clinical signs of oligo-amenorrhoea (infrequent or very light menstruation), infertility (failure to conceive), and hirsutism (excessive hair growth). Whilst Aleem 1987 revealed the presence of beta-endorphin in the follicular fluid of both normal and polycystic ovaries, Petraglia 1987 demonstrated that the beta-endorphin levels in ovarian follicular fluid of otherwise healthy women who were undergoing ovulation were much higher than the levels measured in plasma. Given that acupuncture has an impact on beta-endorphin production, which may affect gonadotropin-releasing hormone (GnRH) secretion, it is postulated that acupuncture may have a role in ovulation induction and fertility.

Objectives

To assess the efficacy and safety of acupuncture treatment for women with polycystic ovarian syndrome (PCOS).

Search methods

Relevant studies were identified from the Menstrual Disorders and Subfertility Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), Ovid MEDLINE® In-Process and other non-indexed citations, Ovid MEDLINE® Daily and Ovid MEDLINE(R), EMBASE, PsycINFO, AMED, Chinese National Knowledge Infrastructure (CNKI) (including the Chinese journal full-text database (CJFD)), Chinese BioMedical Literature Database (CBM), VIP database for Chinese Technical Periodicals, China's important Conference Papers Database, and the China dissertation database.

Selection criteria

Truly randomised controlled trials (RCTs) that studied the efficacy of acupuncture treatment for infertility in women with PCOS. We excluded quasi- or pseudo-RCTs.

Data collection and analysis

We aimed to extract data independently by three authors using a piloted data extraction form. Data on study characteristics including methods, participants, interventions, and outcomes would be extracted. Crossover trials were not included unless there were first-phase data provided. Non-randomised controlled studies have been excluded.

Main results

No truly randomised controlled trials of acupuncture for PCOS were found .

Authors' conclusions

The current conventional medical treatments for women with PCOS are prescription medications, surgery, and lifestyle changes. Associated problems with current western therapies are the cost, risk of multiple pregnancies, undesirable side effects, and inconsistent effectiveness. Non-randomised acupuncture studies in PCOS have suggested a low associated adverse events rate, no increased risk of multiple pregnancies, and that it is inexpensive. However, there no RCTs have been performed in this area thus far. Therefore, properly designed RCTs are required before a conclusive statement can be drawn to support the use of acupuncture in the management of PCOS.

 

Plain language summary

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

Acupuncture for polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) is characterised by the clinical signs of infrequent or very light menstruation, failure to conceive, and excessive hair growth. The current standard western medical treatments for women with PCOS are prescription medications, surgery and lifestyle changes, whether or not they want to become pregnant. However, problems associated with current western therapies are the cost, increased risk of multiple pregnancies, undesirable side effects and inconsistency in their effectiveness. On the other hand, various non-randomised studies of acupuncture in PCOS have suggested low rates of associated adverse events, no increased risk of multiple pregnancy and that it is comparatively inexpensive to administer. However, it should be emphasised that these conclusions are made based on the findings of non-randomised controlled studies alone and therefore may not reliably support the effectiveness and use of acupuncture in this area.

 

Resumen

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  3. Plain language summary
  4. Resumen

Antecedentes

Acupuntura para el síndrome del ovario poliquístico

El síndrome del ovario poliquístico (SOPQ) se caracteriza por signos clínicos de oligoamenorrea (menstruación poco frecuente o muy escasa), infertilidad (fracaso para concebir) e hirsutismo (crecimiento excesivo de vello). Aunque Aleem 1987 mostró la presencia de betaendorfina en el líquido folicular de los ovarios normales y poliquísticos, Petraglia 1987 demostró que los niveles de betaendorfina en el líquido folicular ovárico durante la ovulación en mujeres por otra parte sanas fueron mucho más elevados que los niveles medidos en plasma. Debido a que la acupuntura tiene una repercusión sobre la producción de betaendorfina que puede afectar la secreción de la hormona liberadora de gonadotropina (GnRH), se postula que la acupuntura puede tener una función en la inducción de la ovulación y la fertilidad.

Objetivos

Evaluar la eficacia y la seguridad del tratamiento con acupuntura en las mujeres con síndrome del ovario poliquístico (SOPQ).

Estrategia de búsqueda

Se identificaron estudios relevantes en el Registro Especializado de Ensayos Controlados del Grupo Cochrane de Trastornos Menstruales y Subfertilidad (Menstrual Disorders and Subfertility Group), Registro Cochrane Central de Ensayos Controlados (Cochrane Central Register of Controlled Trials, CENTRAL) (Cochrane Library), Ovid MEDLINE® InProcess and other nonindexed citations, Ovid MEDLINE® Daily y Ovid MEDLINE(R), EMBASE, PsycINFO, AMED, Chinese National Knowledge Infrastructure (CNKI) (incluyendo la Chinese journal fulltext database (CJFD)), en la Chinese BioMedical Literature Database (CBM), VIP database for Chinese Technical Periodicals, China's important Conference Papers Database, y en la China dissertation database.

Criterios de selección

Ensayos controlados con asignación aleatoria (ECAs) real que estudiaron la eficacia del tratamiento con acupuntura para la infertilidad en mujeres con SOPQ. Se excluyeron los ensayos controlados con asignaicón cuasialeatoria o pseudoaleatoria.

Obtención y análisis de los datos

Se planificó extraer los datos de forma independiente por tres revisores mediante un formulario piloto de extracción de datos. Se extrajeron datos sobre las características de los estudios que incluyeron los métodos, las participantes, las intervenciones y las medidas de resultado. Los ensayos cruzados (crossover) no se incluyeron a menos que se proporcionaran los datos de la primera fase. Se excluyeron los estudios controlados sin asignación aleatoria.

Resultados principales

No se encontraron ensayos controlados con asignación aleatoria real de acupuntura para el SOPQ.

Conclusiones de los autores

Los tratamientos médicos convencionales actuales para las mujeres con SOPQ incluyen la prescripción de fármacos, la cirugía y los cambios en el estilo de vida. Los problemas asociados con las terapias occidentales actuales son el coste, el riesgo de embarazos múltiples, los efectos secundarios indeseables y la efectividad inconsistente. Los estudios sin asignación aleatoria de acupuntura en el SOPQ han indicado una tasa baja de eventos adversos asociados, ningún aumento en el riesgo de embarazos múltiples y que es económica. Sin embargo, hasta el momento no se han realizado ECAs en esta área. Por lo tanto, se necesitan ECAs adecuadamente diseñados antes de establecer una afirmación concluyente para apoyar el uso de la acupuntura en el tratamiento del SOPQ.

Traducción

Traducción realizada por el Centro Cochrane Iberoamericano

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