Acupuncture may be an effective treatment option for infertility. Although there are several forms of acupuncture, there are no data that define which is the most suitable for infertility. The aim of this study was to conduct a network meta-analysis (NMA) to compare the effectiveness of various types of acupuncture used in the treatment of infertility.
Searches in seven databases were conducted and data from randomized controlled trials (RCTs) of acupuncture for infertility extracted and systematically reviewed. A measurement tool to assess systematic reviews 2 (AMSTAR2) was used to evaluate the quality of the systematic reviews(SRs). After conducting pairwise meta-analyses, NMA was used to compare the efficacy of the acupuncture treatment options. The risk of bias was assessed using the Cochrane risk of bias tool.
Twenty-four eligible RCTs (n=2095) were included in this review. The NMA data showed that warm acupuncture had the highest chances of increasing the rate of pregnancy (3 trials, 192 participants, RR=2.02,95%CI [(1.20,3.42)]) while acupuncture most positively affected the ovulation rate. On the other hand, a combination of acupuncture and moxibustion (1 trial, 62 participants, RR=1.89 (0.69, 3.09) had the most significant improvement in endometrial thickness and could reduce the rate of pregnancy loss.
Compared with western medicine, acupuncture significantly increased the pregnancy and ovulation rates, as well as reducing the rate of miscarriages among Chinese women with infertility. Our NMA data demonstrated that warm acupuncture appears more effective in increasing the pregnancy rate.
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