Objective:

To evaluate the efficacy of acupuncture in improving reproductive outcomes for infertile women with diminished ovarian reserve (DOR) undergoing IVF/ICSI, particularly in the context of existing treatment challenges.

Key Findings:

• Acupuncture increased clinical pregnancy rate by 25% (RD = 0.25, 95% CI: 0.18 to 0.32; p < 0.00001).
• Live birth rate improved by 22% (RD = 0.22, 95% CI: 0.05 to 0.40; p = 0.01).
• Embryo implantation rate increased by 30% (RD = 0.30, 95% CI: 0.20 to 0.41; p < 0.00001).
• Acupuncture improved the number of oocytes retrieved (MD = 1.72, 95% CI: 1.03 to 2.41; p < 0.00001) and the number of optimal embryos (MD = 1.50, 95% CI: 1.42 to 1.58; p < 0.00001).
• E2 levels on the day of hCG trigger were significantly higher (MD = 318.48, 95% CI: 137.16 to 499.80; p = 0.0006).

Interpretation:

Acupuncture may be a beneficial intervention for improving clinical outcomes in women with DOR undergoing IVF/ICSI, although further rigorous RCTs are needed for confirmation of these findings.

Limitations:

• Evidence certainty for all assessed outcomes ranged from very low to moderate, indicating a need for caution in interpretation.
• Findings from previous studies on acupuncture's efficacy have been inconsistent, and potential biases in the included studies should be considered.

Conclusion:

Acupuncture shows potential in enhancing IVF/ICSI outcomes for women with DOR, warranting further investigation through well-designed RCTs to substantiate these findings.

Sources:

• Systematic Review Registration