Review Article

Effectiveness of Acupuncture for Primary Ovarian Insufficiency: A Systematic Review and Meta-Analysis

Table 1

The characteristics of the included studies.

Author/yearSample size (Mean age, range)Diagnostic criteriaInterventionTreatment session/periodAcupointsComparisonOutcome measuresOutcome assessment

Dong et al., 2013 [19, 22]60
Acupuncture: NR, 24–36
Control: NR, 23–36
Age <40, amenorrhea ≥6 months, FSH ≥40 U/L, and E2 <73 pmol/LAcupuncture and HRTUp to 6 sessions over 6 months (15 treatments/session)CV6, CV4, SP6, BL7, SP10, LI4, LR3, KI3, BL23, BL15, BL20HRTFSH, E2, Kupperman index, recovery of menstruationAfter treatment (6 months)

Wang et al., 2011 [18]40
Acupuncture: 35.4, 26–44
Control: 34.9, 24–43
Age <40, amenorrhea ≥6 months, FSH >40 mIU/mL, LH >40 mIU/mL, and E2 <30 pg/mLAcupuncture and CHMUp to 6 sessions over 3 months (10 treatments/session)BL20, BL21, BL18, BL23, CV4, CV2, SP10, Ex-CA1, SP6CHME2, FSH, LH, menopausal symptomsAfter treatment (3 months)

Fu, 2012 [14]23
Acupuncture: NR, 25–40
Control: NR, 25–40
Age <40, amenorrhea ≥6 months, FSH >40 IU/L, LH >30 IU/L, and E2 <25 ng/mLEA and placebo CHM20 treatments over 3 months (4/week for first 2 weeks; 2/week for 3-4 weeks; weekly for 5–12 weeks)Bilateral ST25 and BL33HRT and placebo CHM E2, FSH, LH, recovery of menstruation After treatment (3 months)

Sha et al., 1998 [17]168
(35.5, 26–40)
Prolactin normal, FSH >40 µg/LAcupunctureaUp to 6 sessions (1 session: 20 treatments)CV4, CV3, KI12, Ex-CA1, BL23
SP6, SP9, BL18, HT6, KI7 added in some cases
BL19, GV4, BL32, SP8 added in some cases
Clomiphene and estrogenE2, FSH, LHAfter treatment (6, 7, and 9 months)

Yang et al., 2008 [16]60
(35.5, 28–40)
Age <40, amenorrhea ≥4 months, FSH >40 U/L, LH ≥normal, and E2 <73.2 pmol/LAcupuncture
A group: liver-kidney yin deficiency pattern identification of TCM
B group: spleen-kidney yang deficiency pattern
90 treatmentsA group: CV4, ST30, Ex-CA1, CV3, SP6, ST36, SP10, LR3, KI3
B group: BL17, BL18, BL19, BL23, BL26, BL32
HRTE2, FSH, LH, recovery of menstruationAfter treatment (3 months)

Li et al., 2014 [20]65
(NR, 18–40)
Age <40, amenorrhea ≥6 months, FSH >40 IU/L, E2 <100 pmol/L, and menopausal symptomsAcupoint catgut implantation and HRTOnce/2-3 weeks for 6 monthsMajor points:
(1) PC6, ST36
(2) CV4, SP6
Selected points: BL23, BL19, CV6, BL21, Ex-CA1, GV4, CV7, CV3, BL26, BL32, ST40
HRTKupperman index, FSH, E2After treatment (6 months) and follow-up at 12 months about symptoms

Liu et al., 2008 [21]132
(NR)
Age <40, amenorrhea ≥4 months, FSH >40 IU/L, and E2 <73.2 pmol/LAcupoint catgut implantationTotal 8 treatments over 6 monthsBL18, BL20, BL23, LR14, LR13, GB25HRTFSH, E2, recovery of menstruationAfter treatment (6 months) and follow-up at 12 months about symptoms

Jia and Duan, 2011 [15]23
Acupuncture: NR, 33–40
Control: NR, 32–38
Age <40, amenorrhea, hypergonadotropic hypogonadism ≥6 monthsEA and HRTOnce daily but stopped after recovery of menstruationAuricular points (Shenmen, internal genitalia, endocrine, pituitary)
CV6, CV4, ST30, BL18, BL23, LI4, SP10, ST30, ST36, SP6
HRTE2, FSH, LH, recovery of menstruationAfter treatment (6 months)

CHM: Chinese herbal medicine; EA: electroacupuncture; E2: serum estradiol; FSH: follicle-stimulating hormone; HRT: hormone replacement therapy; LH: luteinizing hormone; TCM: traditional Chinese medicine; NR: not reported.
aWarm needling and cupping added in some cases.