To systematically evaluate whether acupuncture improves clinical outcomes in infertile women with PCOS undergoing IVF or ICSI, particularly in light of inconsistent existing findings.
Key Findings:
Acupuncture therapy was associated with a 13% increase in clinical pregnancy rate (CPR) (RD = 0.13, 95% CI: 0.09 to 0.17; p < 0.00001).
There was a 15% increase in live birth rate (LBR) (RD = 0.15, 95% CI: 0.09 to 0.21; p < 0.00001).
Acupuncture resulted in an increased number of optimal embryos (MD = 0.42, 95% CI: 0.17 to 0.66; p = 0.0009) and higher E2 levels on the day of hCG (SMD = 0.30, 95% CI: 0.07 to 0.53; p = 0.010).
A reduced total gonadotropin dose (MD = -633.45, 95% CI: -1034.65 to -232.24; p = 0.002) and shorter duration of Gn use (MD = -0.74, 95% CI: -1.14 to -0.34; p = 0.0003) were observed in the acupuncture group.
No increased incidence of ovarian hyperstimulation syndrome (RD = -0.03, 95% CI: -0.07 to 0.01; p = 0.11) was noted with acupuncture.
Interpretation:
Evidence suggests that acupuncture may improve IVF/ICSI outcomes in women with PCOS, but findings should be interpreted with caution due to the very low to moderate certainty of evidence, which may limit clinical applicability.
Limitations:
Overall quality of evidence ranged from very low to moderate, which may affect the reliability of the findings.
Findings may not be generalizable due to variability in study designs and acupuncture protocols, which could influence outcomes.
Conclusion:
Further rigorous, multicenter studies with standardized designs and training protocols are warranted to confirm the efficacy of acupuncture in this population, emphasizing the need for reliable evidence.
