The Effect Of Acupuncture On Live Birth And Preganancy Outcomes In Infertility Treatment: Systematic Review
Abstract
Background: Although infertility treatment has achieved significant results with the development of technology, the tendency towards complementary/alternative treatments used together with infertility treatment is on the rise in order to increase the success result. Objectives: In this systematic review, it is aimed to systematically evaluate the results of research examining the effect of acupuncture application in infertility treatment on pregnancy and live birth outcomes. Methods: Cochrane, Science Direct and Pubmed databases were scanned between August 2023 and October 2023, without setting a starting year limit for this systematic review.Of the 847 published studies, 15 studies were included in the scope of the review. Results: Out of the 15 studies included in the systematic review; It was determined that acupuncture had a positive effect on live birth outcomes in 6 studies and did not have any effect on live birth outcomes in 8 studies.In one study, it was concluded that acupuncture was effective in women over the age of 35, although the live pregnancy rate of the women in the sample group was not affected.There are heterogeneities in studies such as applying acupuncture to different areas at different times, creating control groups that never applied acupuncture or applied placebo acupuncture (those applied to the same area as the real acupuncture group with a fake needle or those applied to places without an acupuncture zone). Conclusion: In the systematic review that examined 15 studies; the number of studies stating that acupuncture increases pregnancy and live birth rates and those concluding that it does not affect pregnancy and live birth rates are very close to each other. The inclusion of acupuncture in infertility treatment remains a controversial issue and randomized controlled trials with high levels of evidence are needed on this subject.
Keywords
References
- Andersen, D., Løssl, K., Andersen, A. N., Fürbringer, J., Bach, H., Simonsen, J., … Larsen, E. C. (2010). Acupuncture on the day of embryo transfer: a randomized controlled trial of 635 pati-ents. Reproductive Biomedicine Online, 21, 366-372.
- Andersonn, B. J. ve Rosenthal, L. (2006). Acupuncture and IVF controversies. Fertil Steril, 87, 1000.
- Çayır, Y., Gürsoy, P. G. (2018). In vitro fertilization and acupuncture. Konuralp Medical Jour-nal,10, 420-3.
- Domar, A. D., Meshay, I., Kelliher, J., Alper, M., Powers, R. D. (2009). The impact of acupuncture on in vitro fertilization outcome. Fertility and sterility, 91, 723-6.
- El‐Toukhy, T., Sunkara, S. K., Khairy, M., Dyer, R., Khalaf, Y., … Coomarasamy, A. (2008). A systematic review and meta‐analysis of acupuncture in in vitro fertilisation. BJOG: An International Journal of Obstetrics & Gynaecology, 115, 1203-1213.
- Feng, X., Zhu, N., Yang, S., Wang, L., Sun, W., Li, R., ... Han, J. (2022). Transcutaneous electrical acupoint stimulation improves endometrial receptivity resulting in improved IVF-ET pregnancy outco-mes in older women: a multicenter, randomized, controlled clinical trial. Reproductive Biology and En-docrinology, 20, 1-13.
- Guven, P. G., Cayir, Y. ve Borekci, B. (2020). Effectiveness of acupuncture on pregnancy success rates for women undergoing in vitro fertilization: A randomized controlled trial. Taiwanese Journal of Obstetrics and Gynecology, 59, 282-6.
- Hassanzadeh Bashtian, M., Latifnejad Roudsari, R. ve Sadeghi, R. (2017). Effects of acupuncture on anxiety in infertile women: a systematic review of the literature. Journal of Midwifery and Repro-ductive Health, 5, 842-8.
- Kırca, N. ve Çelik, A. S. (2018). Complementary and supportive care practices used by infertil women. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 21, 178-188.
- Li, J., Ng, E. H. Y., Stener-Victorin, E., Hu, Z., Wu, W., Lai, M., … Ma, H. (2016). Comparison of acupuncture pretreatment followed by letrozole versus letrozole alone on live birth in anovulatory infer-tile women with polycystic ovary syndrome: a study protocol for a randomised controlled trial. BMJ open, 6, 010955.
- Manheimer, E., Zhang, G., Udoff, L., Haramati, A., Langenberg, P., Berman, B. M., … Bouter, L. M. (2008). Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vit-ro fertilisation: systematic review and meta-analysis. BMJ, 336, 545-9.
- Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G. ve PRISMA Group. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med, 6, e1000097. doi:10.1371/journal.pmed1000097.
- Nahçivan, N. ve Seçginli, S. (2017). Sistematik Derlemeye Dahil Edilen Nicel Araştırmaların Me-todolojik Kalitesi Nasıl Değerlendirilir? Turkiye Klinikleri J Public Health Nurs-Special Topics, 3, 10-9.
- Nandi, A., Shah, A., Gudi, A. ve Homburg, R. (2014). Acupuncture in IVF: A review of current li-terature. Journal of Obstetrics and Gynaecology, 34, 555-561.
- Özcan, H.ve Beji, N. K. (2016). Complementary and alternative medicine applications in ınferti-lity. Okmeydanı Tıp Dergisi, 32, 36-44.
- Park, J. J., Kang, M., Shin, S., Choi, E., Kwon, S., Wee, H., … Kaptchuk, T. J. (2010). Unexplained infertility treated with acupuncture and herbal medicine in Korea. The Journal of Alternative and Comp-lementary Medicine, 16, 193-8.
- Qu, F., Wang, F. F., Wu, Y., Zhou, J., Robinson, N., Hardiman, P. J., ... Ye, Y. H. (2017). Transcu-taneous electrical Acupoint stimulation improves the outcomes of in vitro fertilization: a prospective, randomized and controlled study. Explore, 13, 306-12.
- Sela, K., Lehavi, O., Buchan, A., Kedar-Shalem, K., Yavetz, H. ve Lev-ari, S. (2011). Acupuncture and Chinese herbal treatment for women undergoing intrauterine insemination. European Journal of Integrative Medicine, 3, 77-81.
- Seto, M. T., Cheung, K. W., Lo, T. K. ve Ng, E.H. (2017). Pregnancy outcomes of women rando-mized to receive real versus placebo acupuncture on the day of fresh or frozen-thawed embryo trans-fer. European Journal of Obstetrics & Gynecology and Reproductive Biology, 218, 119-122.
- Shen, C., Wu, M., Shu, D., Zhao, X. ve Gao, Y. (2015). The role of acupuncture in in vitro fertili-zation: a systematic review and meta-analysis. Gynecologic and Obstetric Investigation, 79, 1-12.
- Shuai, Z., Li, X., Tang, X., Lian, F. ve Sun, Z. (2019). Transcutaneous electrical acupuncture point stimulation improves pregnancy outcomes in patients with recurrent implantation failure undergoing in vitro fertilisation and embryo transfer: a prospective, randomised trial. Acupuncture in Medicine, 37, 33-9.
- Smith, C. A., Lacey, S., Chapman, M., Ratcliffe, J., Norman, R. J., Johnson, N. P., … Fahey, P. (2018). Effect of acupuncture vs sham acupuncture on live births among women undergoing in vitro fer-tilization: a randomized clinical trial. Jama, 319, 1990-8.
- So, E. W. S., Ng, E. H. Y., Wong, Y. Y., Lau, E. Y. L., Yeung, W. S. B. ve Ho, P. C. (2008). A ran-domized double blind comparison of real and placebo acupuncture in IVF treatment. Human Reproduc-tion, 24, 341-8.
- So, E. W. S., Ng, E. H. Y., Wong, Y. Y., Yeung, W. S. B. ve Ho, P. C. (2010). Acupuncture for fro-zen–thawed embryo transfer cycles: a double-blind randomized controlled trial. Reproductive biomedi-cine online 20, 814-21.
- Wang, X., Lin, H., Chen, M., Wang, J. ve Jin, Y. (2018). Effect of acupuncture on in vitro fertili-zation: An updated systematic review and data mining protocol. Medicine, 97.
- Wu, X., Stener-Victorin, E., Liu, J., Wu, T., Ng, E., Legro, R. S., … Zhang, H. (2016). Acupunctu-re and clomiphene for infertility in the polycystic ovary syndrome: a multicentre rondomized controlled trial. Fertility and Sterility, 106, e375.
- Wu, X. K., Stener-Victorin, E., Kuang, H. Y., Ma, H. L., Gao, J. S., Xie, L. Z., … PCOSAct Study Group. (2017). Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndro-me: a randomized clinical trial. Jama, 317, 2502-14.
- Wu, J. M., Ning, Y., Ye, Y. Y., Liu, Y. L., Tang, M., Hu, S. ve Zhuo, Y. Y. (2022). Effects of acu-puncture on endometrium and pregnancy outcomes in patients with polycystic ovarian syndrome under-going in vitro fertilization-embryo transfer: a randomized clinical trial. Chinese Journal of Integrative Medicine, 28, 736-742.
- Xi, J., Chen, H., Peng, Z. H., Tang, Z. X., Song, X. ve Xia, Y. B. (2018). Effects of acupuncture on the outcomes of assisted reproductive technology: an overview of systematic reviews. Evidence-Based Complementary and Alternative Medicine, 1, 1-13.
- World Health Organization. (2019). Sexual and reproductive health. https://www.who.int/reproductivehealth/topics/infertility/definitions/en. Accessed April 15.
- Zhang, R., Feng, X.J., Guan, Q., Cui, W., Zheng, Y., Sun, W., … Han, J. S. (2011). Increase of success rate for women undergoing embryo transfer by transcutaneous electrical acupoint stimulation: a prospective randomized placebo-controlled study. Fertility and Sterility, 96, 912-6.
- Zheng, C. H, Huang, G. Y., Zhang, M. M. ve Wang W. (2012). Effects of acupuncture on preg-nancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis. Fertility and Sterility, 97, 599-611.
- Zheng, C. H., Zhang, M. M., Huang, G. Y. ve Wang, W. (2012). The role of acupuncture in assis-ted reproductive technology. Evidence-Based Complementary and Alternative Medicine, 84, 543924.
- Zhu, J., Arsovska, B. ve Kozovska, K. (2018). Acupuncture treatment for fertility. Open Access Macedonian Journal of Medical Sciences, 6, 1685-7.
Abstract
Giriş: İnfertilite tedavisi teknolojinin gelişmesiyle önemli sonuçlar elde etmiş olsa da, başarı sonucunu arttırmak adına infertilite tedavisi ile birlikte kullanılan tamamlayıcı/alternatif tedavilere yönelim artmaktadır. Amaç: Bu sistematik derlemede infertilite tedavisinde akupunktur uygulamasının, gebelik ve canlı doğum sonuçları üzerine etkisini inceleyen araştırma sonuçlarını sistematik olarak değerlendirmek amaçlanmıştır. Yöntem: Bu sistematik derleme başlangıç yıl sınırı yapılmadan Ağustos 2023- Ekim 2023 tarihleri arasında Cochrane, Science Direct ve Pubmed veri tabanları tarandı. Yayınlanan 847 çalışmadan 15 çalışma inceleme kapsamına alındı. Bulgular: Sistematik derlemeye dahil edilen 15 çalışmadan; 6 çalışmada akupunkturun canlı doğum sonucunu olumlu etkilediği 8 çalışmada ise etkilemediği belirlenmiştir. 1 çalışmada örneklem grubundaki kadınların canlı gebelik oranı etkilenmese de 35 yaş üstü kadınlarda akupunkturun etkili olduğu sonucu elde edilmiştir. Çalışmalarda akupunkturun farklı zamanlarda, farklı bölgelere uygulanması, kontrol gruplarında hiç akupunktur uygulanmayan veya plasebo akupunktur uygulanan (sahte iğne ile gerçek akupunktur grubu ile aynı bölgeye uygulananlar veya akupunktur bölgesi olmayan yerlere uygulananlar) grupların oluşturulması gibi heterojeniteler bulunmaktadır. Sonuç: 15 çalışmanın incelendiği sistematik derlemede; akupunkturun gebelik ve canlı doğum oranlarını arttırdığını belirten ve etkilemediği sonucuna ulaşan çalışma sayıları birbirine çok yakındır. Akupunktur uygulanmasının infertilite tedavisinde yer alması, tartışmalı bir konu olarak devamlılığını korumakta ve konu ile ilgili kanıt düzeyi yüksek randomize kontrollü çalışmalara ihtiyaç duyulmaktadır.
Keywords
References
- Andersen, D., Løssl, K., Andersen, A. N., Fürbringer, J., Bach, H., Simonsen, J., … Larsen, E. C. (2010). Acupuncture on the day of embryo transfer: a randomized controlled trial of 635 pati-ents. Reproductive Biomedicine Online, 21, 366-372.
- Andersonn, B. J. ve Rosenthal, L. (2006). Acupuncture and IVF controversies. Fertil Steril, 87, 1000.
- Çayır, Y., Gürsoy, P. G. (2018). In vitro fertilization and acupuncture. Konuralp Medical Jour-nal,10, 420-3.
- Domar, A. D., Meshay, I., Kelliher, J., Alper, M., Powers, R. D. (2009). The impact of acupuncture on in vitro fertilization outcome. Fertility and sterility, 91, 723-6.
- El‐Toukhy, T., Sunkara, S. K., Khairy, M., Dyer, R., Khalaf, Y., … Coomarasamy, A. (2008). A systematic review and meta‐analysis of acupuncture in in vitro fertilisation. BJOG: An International Journal of Obstetrics & Gynaecology, 115, 1203-1213.
- Feng, X., Zhu, N., Yang, S., Wang, L., Sun, W., Li, R., ... Han, J. (2022). Transcutaneous electrical acupoint stimulation improves endometrial receptivity resulting in improved IVF-ET pregnancy outco-mes in older women: a multicenter, randomized, controlled clinical trial. Reproductive Biology and En-docrinology, 20, 1-13.
- Guven, P. G., Cayir, Y. ve Borekci, B. (2020). Effectiveness of acupuncture on pregnancy success rates for women undergoing in vitro fertilization: A randomized controlled trial. Taiwanese Journal of Obstetrics and Gynecology, 59, 282-6.
- Hassanzadeh Bashtian, M., Latifnejad Roudsari, R. ve Sadeghi, R. (2017). Effects of acupuncture on anxiety in infertile women: a systematic review of the literature. Journal of Midwifery and Repro-ductive Health, 5, 842-8.
- Kırca, N. ve Çelik, A. S. (2018). Complementary and supportive care practices used by infertil women. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 21, 178-188.
- Li, J., Ng, E. H. Y., Stener-Victorin, E., Hu, Z., Wu, W., Lai, M., … Ma, H. (2016). Comparison of acupuncture pretreatment followed by letrozole versus letrozole alone on live birth in anovulatory infer-tile women with polycystic ovary syndrome: a study protocol for a randomised controlled trial. BMJ open, 6, 010955.
- Manheimer, E., Zhang, G., Udoff, L., Haramati, A., Langenberg, P., Berman, B. M., … Bouter, L. M. (2008). Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vit-ro fertilisation: systematic review and meta-analysis. BMJ, 336, 545-9.
- Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G. ve PRISMA Group. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med, 6, e1000097. doi:10.1371/journal.pmed1000097.
- Nahçivan, N. ve Seçginli, S. (2017). Sistematik Derlemeye Dahil Edilen Nicel Araştırmaların Me-todolojik Kalitesi Nasıl Değerlendirilir? Turkiye Klinikleri J Public Health Nurs-Special Topics, 3, 10-9.
- Nandi, A., Shah, A., Gudi, A. ve Homburg, R. (2014). Acupuncture in IVF: A review of current li-terature. Journal of Obstetrics and Gynaecology, 34, 555-561.
- Özcan, H.ve Beji, N. K. (2016). Complementary and alternative medicine applications in ınferti-lity. Okmeydanı Tıp Dergisi, 32, 36-44.
- Park, J. J., Kang, M., Shin, S., Choi, E., Kwon, S., Wee, H., … Kaptchuk, T. J. (2010). Unexplained infertility treated with acupuncture and herbal medicine in Korea. The Journal of Alternative and Comp-lementary Medicine, 16, 193-8.
- Qu, F., Wang, F. F., Wu, Y., Zhou, J., Robinson, N., Hardiman, P. J., ... Ye, Y. H. (2017). Transcu-taneous electrical Acupoint stimulation improves the outcomes of in vitro fertilization: a prospective, randomized and controlled study. Explore, 13, 306-12.
- Sela, K., Lehavi, O., Buchan, A., Kedar-Shalem, K., Yavetz, H. ve Lev-ari, S. (2011). Acupuncture and Chinese herbal treatment for women undergoing intrauterine insemination. European Journal of Integrative Medicine, 3, 77-81.
- Seto, M. T., Cheung, K. W., Lo, T. K. ve Ng, E.H. (2017). Pregnancy outcomes of women rando-mized to receive real versus placebo acupuncture on the day of fresh or frozen-thawed embryo trans-fer. European Journal of Obstetrics & Gynecology and Reproductive Biology, 218, 119-122.
- Shen, C., Wu, M., Shu, D., Zhao, X. ve Gao, Y. (2015). The role of acupuncture in in vitro fertili-zation: a systematic review and meta-analysis. Gynecologic and Obstetric Investigation, 79, 1-12.
- Shuai, Z., Li, X., Tang, X., Lian, F. ve Sun, Z. (2019). Transcutaneous electrical acupuncture point stimulation improves pregnancy outcomes in patients with recurrent implantation failure undergoing in vitro fertilisation and embryo transfer: a prospective, randomised trial. Acupuncture in Medicine, 37, 33-9.
- Smith, C. A., Lacey, S., Chapman, M., Ratcliffe, J., Norman, R. J., Johnson, N. P., … Fahey, P. (2018). Effect of acupuncture vs sham acupuncture on live births among women undergoing in vitro fer-tilization: a randomized clinical trial. Jama, 319, 1990-8.
- So, E. W. S., Ng, E. H. Y., Wong, Y. Y., Lau, E. Y. L., Yeung, W. S. B. ve Ho, P. C. (2008). A ran-domized double blind comparison of real and placebo acupuncture in IVF treatment. Human Reproduc-tion, 24, 341-8.
- So, E. W. S., Ng, E. H. Y., Wong, Y. Y., Yeung, W. S. B. ve Ho, P. C. (2010). Acupuncture for fro-zen–thawed embryo transfer cycles: a double-blind randomized controlled trial. Reproductive biomedi-cine online 20, 814-21.
- Wang, X., Lin, H., Chen, M., Wang, J. ve Jin, Y. (2018). Effect of acupuncture on in vitro fertili-zation: An updated systematic review and data mining protocol. Medicine, 97.
- Wu, X., Stener-Victorin, E., Liu, J., Wu, T., Ng, E., Legro, R. S., … Zhang, H. (2016). Acupunctu-re and clomiphene for infertility in the polycystic ovary syndrome: a multicentre rondomized controlled trial. Fertility and Sterility, 106, e375.
- Wu, X. K., Stener-Victorin, E., Kuang, H. Y., Ma, H. L., Gao, J. S., Xie, L. Z., … PCOSAct Study Group. (2017). Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndro-me: a randomized clinical trial. Jama, 317, 2502-14.
- Wu, J. M., Ning, Y., Ye, Y. Y., Liu, Y. L., Tang, M., Hu, S. ve Zhuo, Y. Y. (2022). Effects of acu-puncture on endometrium and pregnancy outcomes in patients with polycystic ovarian syndrome under-going in vitro fertilization-embryo transfer: a randomized clinical trial. Chinese Journal of Integrative Medicine, 28, 736-742.
- Xi, J., Chen, H., Peng, Z. H., Tang, Z. X., Song, X. ve Xia, Y. B. (2018). Effects of acupuncture on the outcomes of assisted reproductive technology: an overview of systematic reviews. Evidence-Based Complementary and Alternative Medicine, 1, 1-13.
- World Health Organization. (2019). Sexual and reproductive health. https://www.who.int/reproductivehealth/topics/infertility/definitions/en. Accessed April 15.
- Zhang, R., Feng, X.J., Guan, Q., Cui, W., Zheng, Y., Sun, W., … Han, J. S. (2011). Increase of success rate for women undergoing embryo transfer by transcutaneous electrical acupoint stimulation: a prospective randomized placebo-controlled study. Fertility and Sterility, 96, 912-6.
- Zheng, C. H, Huang, G. Y., Zhang, M. M. ve Wang W. (2012). Effects of acupuncture on preg-nancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis. Fertility and Sterility, 97, 599-611.
- Zheng, C. H., Zhang, M. M., Huang, G. Y. ve Wang, W. (2012). The role of acupuncture in assis-ted reproductive technology. Evidence-Based Complementary and Alternative Medicine, 84, 543924.
- Zhu, J., Arsovska, B. ve Kozovska, K. (2018). Acupuncture treatment for fertility. Open Access Macedonian Journal of Medical Sciences, 6, 1685-7.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Obstetrics and Gynocology Nursing |
| Journal Section | Reviews |
| Authors | |
| Early Pub Date | April 15, 2025 |
| Publication Date | |
| Submission Date | November 10, 2023 |
| Acceptance Date | February 26, 2025 |
| Published in Issue | Year 2025 Volume: 18 Issue: 2 |
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