Correlation between acupuncture dose and pregnancy outcomes in women with Polycystic ovary syndrome undergoing in vitro fertilization-embryo transfer: a systematic review

Abstract

Abstract Background More and more studies focused on the efficacy of acupuncture on pregnancy outcomes in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization-embryo transfer (IVF-ET). However, the current relevant randomized controlled trials (RCTs) drew different conclusions, which may be related to different doses of acupuncture. Objective To systematically review RCTs to determine whether acupuncture has a dose-dependent effect on pregnancy outcomes in patients with PCOS undergoing IVF-ET. Methods Seven electronic databases were searched from inception to February 16th, 2023. The acupuncture dose of eligible studies was extracted, then categorized into high, medium, and low dose according to the results of the scoring system. Clinical pregnancy rate (CPR) was regarded as the primary outcome. Finally, the dose-dependent relationship of acupuncture in improving pregnancy outcomes in PCOS patients undergoing IVF-ET was analyzed. Results A total of 953 subjects met the eligibility criteria in 12 RCTs were included. Among them were two studies for low dose, four studies for medium dose, and six studies for high dose. It showed that there were six RCTs in the high-dose group [100.00%] (6/6) reported positive in CPR, no RCT in the medium-dose group [0.00%] (0/4), and one RCT in the low-dose group [50.00%] (1/2). The quality of studies was low, 50.00% (6/12) studies were assessed as low risk, 16.66% (2/12) studies were some concerns, and 33.33% (4/12) studies were high risk. Conclusion It suggests a trend that higher acupuncture doses showed better outcomes in PCOS patients undergoing IVF-ET. However, no existing clinical evidence has directly compared the efficacy of different acupuncture doses. In the future, direct evidence from high-quality studies will be supposed. Trial registration The systematic review has been registered on PROSPERO (https://www.crd.york.ac.uk/prospero/), and the registration number is CRD42023400187.