针灸对体外受精与胚胎移植妊娠结局影响的Meta分析

A Meta-Analysis of the Effect of Acupuncture on Pregnancy Outcomes of in Vitro Fertilization and Embryo Transfer

目的系统评价针灸对体外受精与胚胎移植妊娠结局的影响。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库及PubMed、Web of Science、Cochrane Library和Embase数据库,全面搜索针灸辅助体外受精与胚胎移植的RCTs,检索时限为建库至2023年12月31日。由2名研究员独立筛选文献、提取资料、分析文献;采用Cochrane偏倚风险评估工具对纳入文献进行质量评估,统计分析软件Stata16.0对数据进行Meta分析。结果最终纳入28篇文献,共1315例患者。Meta分析结果显示:针灸辅助在IVF-ET的临床妊娠率、着床率、持续妊娠率、活产率、植入率、生化妊娠率等方面优于单纯性IVF-ET,在自然流产率方面二者疗效相当。结论当前有限证据表明,针灸能够改善体外受精-胚胎移植的妊娠结局,但所纳入的研究数量和质量都有限,所以还需要更高质量的RCTs进行验证,为针灸在辅助生殖领域的应用提供更可靠的循证证据。

Objective To systematically evaluate the effect of acupuncture and moxibustion on pregnancy outcomes in vitro insemination and embryo transfer(IVF-ET).Methods Randomized controlled trials(RCTs)on acupuncture-assisted in vitro fertilization and embryo transfer were searched through CNKI,Wanfang,VIP,CBM and PubMed,Web of Science,Cochrane Library and Embase.The search period is up to December 31,2022.After literature screening,data extraction,and integration,Cochrane bias risk assessment tool was used to evaluate the quality of the included literature,and statistical analysis software Stata 16.0 was used to perform meta-analysis of the data.Results 28 literatures with a total of 1315 patients were included.The results of meta-analysis showed that acupuncture and moxibustion assisted IVF-ET was superior to simple IVF-ET in terms of clinical pregnancy rate,implantation rate,ongoing pregnancy rate,live birth rate,implantation rate and biochemical pregnancy rate,and the two had similar efficacy in spontaneous abortion rate.Conclusion Currently,there is limited evidence that acupuncture can improve the pregnancy outcome of in vitro insemination and embryo transfer,but the number and quality of included studies are limited,so higher quality RCTs need to be validated to provide more reliable evidence-based evidence for the application of acupuncture in the field of assisted reproduction.