The Role of Acupuncture in Assisted Reproductive Technology

Table 3

Forest plots of IVF outcomes as compared by different acupuncture times and controls.

(i) Around ET: acupuncture versus all controls
CPR
Study or subgroup	Acupuncture		Control		Weight	Odds ratio M-H, random, 95% CI	Odds ratio M-H, random, 95% CI
	Events	Total	Events	Total
Paulus et al. [21]	34	80	21	80	5.9%	2.08 [1.07, 4.04]
Paulus et al. [22]	43	100	37	100	6.8%	1.28 [0.73, 2.26]
Smith et al. [23]	34	110	31	118	6.7%	1.26 [0.71, 2.23]
Westergaard et al. [24]	70	200	21	100	6.9%	2.03 [1.15, 3.55]
Dieterle et al. [25]	39	116	17	109	6.1%	2.74 [1.44, 5.22]
Benson et al. [26]	54	106	67	152	7.5%	1.32 [0.80, 2.17]
Craig et al. [27]	21	48	32	46	4.5%	0.34 [0.15, 0.79]
Fratterelli et al. [29]	213	402	278	598	10.2%	1.30 [1.01, 1.67]
Domar et al. [31]	24	78	23	68	5.6%	0.87 [0.43, 1.74]
So et al. [33]	72	185	91	185	8.4%	0.66 [0.44, 0.99]
So et al. [34]	41	113	50	113	7.1%	0.72 [0.42, 1.22]
Andersen et al. [35]	101	314	112	321	9.4%	0.88 [0.64, 1.23]
Madaschi et al. [36]	84	208	67	208	8.6%	1.43 [0.95, 2.13]
Moy et al. [38]	39	86	39	74	6.3%	0.74 [0.40, 1.39]
Total (95% CI)		2146		2272	100.0%	1.12 [0.89, 1.42]
Total events	869		886
Heterogeneity: Tau^2 = 0.12; Chi^2 = 39.14, df=13 (𝑃=0.0002); 𝐼^2=67%
Test for overall effect: 𝑍=1.00 (𝑃=0.32)
LBR
Study or subgroup	Acupuncture		Control		Weight	Odds ratio M-H, fixed, 95% CI	Odds ratio M-H, fixed, 95% CI
	Events	Total	Events	Total
Andersen et al. [35]	79	314	96	321	24.2%	0.79 [0.56, 1.12]
Fratterelli et al. [29]	163	402	224	598	36.4%	1.14 [0.88, 1.48]
Madaschi et al. [36]	70	208	57	208	12.9%	1.34 [0.88, 2.04]
So et al. [33]	55	185	71	185	17.0%	0.68 [0.44, 1.05]
So et al. [34]	33	113	40	113	9.6%	0.75 [0.43, 1.32]
Total (95% CI)		1222		1425	100.0%	0.97 [0.82, 1.14]
Total events	400		488
Heterogeneity: Chi^2 = 8.55, df = 4 (𝑃=0.07); 𝐼^2=53%
Test for overall effect: 𝑍=0.42 (𝑃=0.67)
(ii) Around ET: acupuncture versus sham acupuncture at acupoints.
The CPR and LBR results are identical to those in Table 2(ii)
(iii) Around ET: acupuncture versus sham acupuncture at non- or inappropriate acupoints.
The CPR result is identical to that in Table 2(iii)
(iv) Around ET: acupuncture versus non intervention or relaxation control
CPR
Study or subgroup	Acupuncture		Control		Weight	Odds ratio M-H, random, 95% CI	Odds ratio M-H, random, 95% CI
	Events	Total	Events	Total
Paulus et al. [21]	34	80	21	80	11.6%	2.08 [1.07, 4.04]
Westergaard et al. [24]	70	200	21	100	13.8%	2.03 [1.15, 3.55]
Benson et al. [26]	54	106	67	152	15.3%	1.32 [0.80, 2.17]
Craig et al. [27]	21	48	32	46	8.7%	0.34 [0.15, 0.79]
Fratterelli et al. [29]	213	402	278	598	21.8%	1.30 [1.01, 1.67]
Domar et al. [31]	24	78	23	68	11.1%	0.87 [0.43, 1.74]
Madaschi et al. [36]	84	208	67	208	17.8%	1.43 [0.95, 2.13]
Total (95% CI)		1122		1252	100.0%	1.27 [0.93, 1.72]
Total events	500		509
Heterogeneity: Tau^2 = 0.10; Chi^2 = 15.35, df = 6 (𝑃=0.02); 𝐼^2=61%
Test for overall effect: 𝑍=1.50 (𝑃=0.13)
LBR
Study or subgroup	Acupuncture		Control		Weight	Odds ratio M-H, random, 95% CI	Odds ratio M-H, random, 95% CI
	Events	Total	Events	Total
Fratterelli et al. [29]	163	402	224	598	73.9%	1.14 [0.88, 1.48]
Madaschi et al. [36]	70	208	57	208	26.1%	1.34 [0.88, 2.04]
Total (95% CI)		610		806	100.0%	1.19 [0.96, 1.49]
Total events	233		281
Heterogeneity: Chi^2 = 0.43, df = 1 (𝑃=0.51); 𝐼^2=0%
Test for overall effect: 𝑍=1.57 (𝑃=0.12)
(v) Around OA: acupuncture versus all controls
CPR
Study or subgroup	Acupuncture		Control		Weight	Odds ratio M-H, random, 95% CI	Odds ratio M-H, random, 95% CI
	Events	Total	Events	Total
Stener-Victorin et al. [3]	28	75	19	74	15.5%	1.72 [0.86, 3.48]
Stener-Victorin et al. [40]	43	136	49	138	43.0%	0.84 [0.51, 1.39]
Humaidan and Stener-Victorin [41]	46	100	50	100	34.9%	0.85 [0.49, 1.48]
Sator-Katzenschlager et al. [42]	30	64	7	30	6.5%	2.90 [1.09, 7.71]
Total (95% CI)		375		342	100.0%	1.12 [0.82, 1.52]
Total events	147		125
Heterogeneity: Chi^2 = 7.28, df = 3 (𝑃=0.06); 𝐼^2=59%
Test for overall effect: 𝑍=0.70 (𝑃=0.48)
LBR
Study or subgroup	Acupuncture		Control		Weight	Odds ratio M-H, random, 95% CI	Odds ratio M-H, random, 95% CI
	Events	Total	Events	Total
Stener-Victorin et al. [3]	25	75	13	67	100.0%	2.08 [0.96, 4.50]
Total (95% CI)		75		67	100.0%	2.08 [0.96, 4.50]
Total events	25		13
Heterogeneity: nonapplicable
Test for overall effect: 𝑍=1.85 (𝑃=0.06)
(vi) Around OA: acupuncture versus non intervention or relaxation control
CPR
Study or subgroup	Acupuncture		Control		Weight	Odds ratio M-H, random, 95% CI	Odds ratio M-H, random, 95% CI
	Events	Total	Events	Total
Stener-Victorin et al. [3]	28	75	19	74	16.6%	1.72 [0.86, 3.48]
Stener-Victorin et al. [40]	43	136	49	138	46.0%	0.84 [0.51, 1.39]
Humaidan and Stener-Victorin [41]	46	100	50	100	37.4%	0.85 [0.49, 1.48]
Total (95% CI)		311		312	100.0%	0.99 [0.71, 1.37]
Total events	117		118
Heterogeneity: Chi^2 = 3.10, df = 2 (𝑃=0.21); 𝐼^2=36%
Test for overall effect: 𝑍=0.05 (𝑃=0.96)
LBR identical to the above in (v)
(vii) Around OA: acupuncture versus adhesive tapes
identical to that in Table 2(vi)
(viii) Around COH: acupuncture versus all controls (=acupuncture versus non intervention or relaxation control)
CPR
Study or subgroup	Acupuncture		Control		Weight	Odds ratio M-H, fixed, 95% CI	Odds ratio M-H, fixed, 95% CI
	Events	Total	Events	Total
Cui et al. [28]	22	47	16	47	27.5%	1.71 [0.74, 3.92]
Chen et al. [30]	9	28	6	27	13.4%	1.66 [0.50, 5.53]
Ho et al. [32]	9	30	4	14	12.3%	1.07 [0.26, 4.34]
Cui et al. [39]	14	34	11	32	21.5%	1.34 [0.49, 3.63]
Arnoldi et al. [37]	22	102	10	102	25.3%	2.53 [1.13, 5.66]
Total (95% CI)		241		222	100.0%	1.75 [1.13, 2.71]
Total events	76		47
Heterogeneity: Chi^2 = 1.57, df = 4 (𝑃=0.81); 𝐼^2=0%
Test for overall effect: 𝑍=2.51 (𝑃=0.01)