The Dose-Related Efficacy of Acupuncture on Endometrial Receptivity in Infertile Women: A Systematic Review and Meta-Analysis

Frontiers in Public Health

Liying Liu¹  Han Yang¹  Siyi Yu¹  Jie Yang²  Xingyu Lv²  Fangge Wang²  Xiaoyan Zheng²  Hongmei Yang² 

[1] Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China;Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu Xi'nan Gynecological Hospital, Chengdu, China;

关键词: dose-related;    acupuncture;    endometrial receptivity;    meta-analysis;    heterogeneity analysis;   

DOI  :  10.3389/fpubh.2022.858587

来源: DOAJ

【 摘 要 】

BackgroundProgress has been achieved by using acupuncture widely for poor endometrial receptivity (PER). However, different acupuncture dosages may lead to controversy over efficacy.ObjectiveTo evaluate the evidence-based conclusions of dose-related acupuncture on infertile women with PER.MethodReferences were retrieved from nine databases from inception to 26 February 2022. This meta-analysis included randomized controlled trials (RCTs) that investigated the dose-related efficacy of acupuncture for PER with outcomes of endometrium receptivity (ER) parameters by transvaginal sonography (TVS) and the subsequent pregnancy outcomes in three acupuncture-dose groups: the high-dosage group (three menstrual cycles), the moderate-dosage group (one menstrual cycle), and the low-dosage group (two or four days). Since there remained sufficient heterogeneity among the three subsets, we prespecified seven subgroup variables (four clinical and three methodological) to investigate the heterogeneities.ResultsA total of 14 RCTs (1,564 women) of moderate or low overall quality were included. The results were different when the dosage of acupuncture was restricted. For the moderate or high-dosage group, CPR and part of ER parameters were improved in the acupuncture group (i.e., CPR: OR = 2.00, 95% CI [1.24, 3.22], p = 0.004, I2 = 0% in one menstrual cycle; OR = 2.49, 95%CI [1.67, 3.72], p < 0.05, I2 = 0% in three menstrual cycles). However, for the low-dosage group, no statistical difference was observed in CPR (OR = 0.07, 95% CI [−0.10, 0.23], p = 0.44, I2 = 82%) and a part of the ER parameters. In subgroup analysis, four subgroup variables (the routine treatment, risk of performance bias, duration of acupuncture treatment, and the age of participants) could explain some of the heterogeneities across all trials.ConclusionThe finding indicated that the trend of relatively more acupuncture dosage showed better effects for poor endometrial receptivity among PER women. It remains a potential heterogeneity in our studies. Further high-quality trials with a homogeneity trial design need to be conducted.

【 授权许可】

Unknown