To evaluate acupuncture-related interventions in assisted reproductive technology (ART) and explore potential timing- and dose-response patterns, specifically focusing on clinical pregnancy, implantation, and live birth rates.
Approach:
Data Sources: PubMed, Embase, Web of Science, Scopus, the Cochrane Library, and Ovid MEDLINE were searched from inception to January 19, 2026.
Key Findings:
Acupuncture was associated with a higher clinical pregnancy rate (RR = 1.25; 95% CI, 1.14-1.37) and implantation rate (RR = 1.16; 95% CI, 1.02-1.31).
The effect of acupuncture on live birth was uncertain (RR = 1.14; 95% CI, 0.98-1.32).
Timing analyses suggested higher estimates for acupuncture during controlled ovarian hyperstimulation compared to embryo transfer alone.
Dose-response models indicated possible nonlinear associations between treatment sessions and reproductive outcomes.
Interpretation:
The certainty of evidence for all major outcomes was very low, and the findings regarding timing and dose-response patterns are exploratory and should be interpreted with caution.
Limitations:
Sparse data and clinical heterogeneity limited dose-response model estimates.
The findings should not be used as treatment-dose recommendations due to the low certainty of evidence.
Conclusion:
Acupuncture as an adjunct to ART may be associated with improved clinical pregnancy and implantation rates, but the certainty of evidence is very low, necessitating further well-designed trials to confirm these findings.
