Review Article

Effects of Acupuncture on the Outcomes of Assisted Reproductive Technology: An Overview of Systematic Reviews

Table 2

Level of evidence of the included studies (GRADE).
(a) Acupuncture around the time of oocyte retrieval or ET versus control (sham, placebo, no acupuncture)

StudyOutcomesNumber of participants(studies)Risk of bias InconsistencyIndirectnessImprecisionPublication-biasRelative effect (95% CI)Quality of the evidence (GRADE)

Junyong Jo 2017LBR66(1 RCT)not seriousnot seriousnot seriousseriousseriousRR 1.61(0.73,3.58)LOW
CPR430(4 RCTs)seriousnot seriousnot seriousseriousnot seriousRR 1.35(1.05,1.74)LOW
OPR164(2 RCTs)not seriousnot seriousnot seriousseriousseriousRR 1.99(1.06,3.74)LOW

Zheng CH 2012LBR1863(6 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 1.09(0.74,1.60)LOW
CPR5599(23 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 1.22(1.01,1.47)LOW

Fan Qu 2012LBR1990(6 RCTs)seriousvery seriousnot seriousnot seriousnot seriousRR 1.42(0.92,2.20)VERY LOW
CPR3713(17 RCTs)seriousseriousnot seriousnot seriousnot seriousRR 1.09(0.94,1.26)LOW
OPR2392(8 RCTs)seriousseriousnot seriousnot seriousnot seriousRR 1.20(0.93,1.56)LOW
MR373(5 RCTs)seriousnot seriousnot seriousseriousnot seriousRR 0.95(0.68,1.35)LOW

Eric M 2013LBP3075(12 RCTs)seriousseriousnot seriousnot seriousnot seriousRR 1.14(0.92,1.42)LOW
CPR4021(16 RCTs)seriousseriousnot seriousnot seriousnot seriousRR 1.12(0.96,1.31)LOW
OPC3005(11 RCTs)seriousseriousnot seriousnot seriousnot seriousRR 1.22(0.98,1.52)LOW
MR1070(12 RCTs)seriousnot seriousnot seriousnot seriousnot seriousRR 1.09(0.85,1.40)MODERATE

Qian Y 2017LBR2331(9 RCTs)seriousvery seriousnot seriousnot seriousnot seriousOR 1.17(0.80,1.72)VERY LOW
CPR6344(30 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 1.26(1.06,1.50)LOW
OPR3602(10 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 1.14(0.87,1.48)LOW

Yang HS 2017LBR1951(8 RCTs)seriousseriousnot seriousnot seriousnot seriousRR 1.18(0.89,1.58)LOW
CPR2773(17 RCTs)seriousseriousnot seriousnot seriousnot seriousRR 1.43(1.15,1.77)LOW

Yu J 2009LBR1333(6 RCTs)seriousvery seriousnot seriousnot seriousnot seriousRR 1.28(0.91,1.79)VERY LOW
CPR2103(11 RCTs)seriousseriousnot seriousnot seriousseriousRR 1.34(1.09,1.66)VERY LOW
OPR1333(6 RCTs)seriousvery seriousnot seriousnot seriousnot seriousRR 1.28(0.91,1.79)VERY LOW

(b) Acupuncture before oocyte retrieval and∖or on the time of oocyte retrieval versus control (sham, placebo, no acupuncture)

StudyOutcomesNumber of participants(studies)Risk of bias InconsistencyIndirectnessImprecisionPublication biasRelative effect (95% CI)Quality of the evidence (GRADE)

Cheong YC 2013LBR464(2 RCTs)seriousnot seriousnot seriousnot seriousseriousOR 0.87(0.59,1.29)LOW
OPR464(2 RCTs)seriousnot seriousnot seriousnot seriousseriousOR 0.86(0.58,1.26)LOW
CPR912(6 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 1.12(0.78,1.62)LOW
MR262(4 RCTs)seriousnot seriousnot seriousseriousnot seriousOR 0.79(0.42,1.47)LOW

Zheng CH 2012LBP142(1 RCT)seriousnot seriousnot seriousseriousseriousOR 2.08(0.96,4.50)VERY LOW
CPR699(4 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 1.12(0.82,1.52)LOW

Qian Y 2017CPR876(5 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 1.07(0.81,1.41)LOW

FU SJ 2016CPR835(7 RCTs)seriousnot seriousnot seriousnot seriousseriousOR 1.40(1.05,1.86)LOW
MR231(4 RCTs)seriousnot seriousnot seriousseriousnot seriousOR 0.69(0.26,1.86)LOW

(c) Acupuncture on and around the day of ET versus control (sham, placebo, no acupuncture)

StudyOutcomesNumber of participants(studies)Risk of bias InconsistencyIndirectnessImprecisionPublication biasRelative effect (95% CI)Quality of the evidence (GRADE)

Cheong YC 2013LBR2505(8 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 1.22(0.87,1.70)LOW
OPR2807(10 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 1.10(0.80,1.52)LOW
CPR3632(14 RCTs)seriousnot seriousnot seriousnot seriousseriousOR 1.11(0.87,1.42)LOW
MR616(6 RCTs)seriousnot seriousnot seriousnot seriousseriousOR 1.10(0.73,1.67)LOW

Zheng CH 2012LBP1647(4 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 0.87(0.70,1.07)LOW
CPR4418(14 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 1.12(0.89,1.42)LOW

Tarek ET 2009CPR1993(9 RCTs)seriousvery seriousnot seriousnot seriousnot seriousRR 1.16(0.92,1.48)VERY LOW

Shen CJ 2015CPR859(4 RCTs)seriousvery seriousnot seriousnot seriousseriousRR 1.39(0.90,2.13)VERY LOW

Qian Y 2017CPR4513(16 RCTs)seriousseriousnot seriousnot seriousnot seriousOR 1.19(0.95,1.50)LOW

FU SJ 2016LBR1756(7 RCTs)seriousvery seriousnot seriousnot seriousnot seriousRR 1.06(0.79,1.42)VERY LOW
CPR2668(10 RCTs)seriousvery seriousnot seriousnot seriousnot seriousRR 1.07(0.86,1.33)VERY LOW
OPR1729(5 RCTs)seriousseriousnot seriousnot seriousseriousRR 1.05(0.69,1.69)VERY LOW
MR772(6 RCTs)seriousnot seriousnot seriousnot seriousseriousRR 1.15(0.83,1.59)LOW