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Table 1 Characteristics of the studies included in this review

From: The effects of acupuncture on pregnancy outcomes of in vitro fertilization: a systematic review and meta-analysis

Study Country Main objective Acupuncture location No. randomised Acupuncture sessions Acupuncture type De qi sensation Controla IVF outcomes
Andersen 2010 [65] Denmark IVF outcome On-site 635 Two sessions: (1) 30 m before ET; (2) immediately after ET (n = 314) MA Yes The Streitberger placebo needlesb placed on the same acupoints which the true acupuncture used (n = 321) BPR、CPR、OPR、LBR、MR、IR
Arnoldi 2010 [18] Italy IVF outcome On-site 204 Three sessions: (1) d 5 of ovarian stimulation; (2) 30 m before ET; (3) immediately after ET (n = 102) MA Yes No adjuvant treatment (n = 102) CPR、LBR、MR、IR
Craig 2014 [59] USA IVF outcome Off-site 113 Two sessions: (1) within 1–2 h before ET; (2) within 1–2 h after ET (n = 57) MA Yes No adjuvant treatment (n = 56) BPR、CPR、LBR、MR
Dieterle 2006 [15] Germany IVF outcome On-site 225 Two sessions: (1) immediately after ET; (2) 3 days after ET (n = 116) MA Yes Needles inserted in real acupoints which were designed not to influence fertility (n = 109) BPR、CPR、OPR、LBR、MR、IR
Domar 2009 [29] USA IVF outcome On-site 150 Two sessions: (1) 25 m before ET; (2) immediately after ET (n = 78)d MA Unclear No adjuvant treatment (n = 68)d BPR、CPR
Feliciani 2011 [62] Italy IVF outcome On-site 46 Three sessions: (1) 5–7d before OA; (2) 2–3 d before OA; (3) within 1 h after ET (n = 23) MA Yes No adjuvant treatment (n = 23) CPR、OPR、LBR、MR、IR
Gillerman 2016 [58] UK IVF outcome On-site 127 Three sessions: (1) between days 6 and 8 of ovarian stimulation; (2) before egg retrieval; (3) before and after embryo transfer (n = 67) MA Yes No adjuvant treatment (n = 60) CPR
Ho 2009 [17] Taiwan IVF outcome On-site 56 Four sessions: twice a week for 2 weeks, from d2 to the day before oocyte retrieval (n = 30) EA Yes No adjuvant treatment (n = 26)j CPR
Humaidan 2004 [69] Denmark Pain-relieving effect On-site 200 One session: a few minutes before OA and terminated directly after OA (n = 75) EA No Alfentanil + PCB (n = 100) BPR、CPR
Villahermosa 2012 [20] Brazil anxiety-relieving efffects On-site 43 Four sessions: once a week over a 4-week period, comprised the whole IVF process from induction of ovulation to the result of β-human chorionic gonadotrophin, the last treatment was given after embryo transfer (n = 22) MA Yes Needles inserted in the sites which close to but not on (n = 21) CPR
Villahermosa 2013 [21] Brazil IVF outcome On-site 84 Four sessions: (1)D1 (first day of ovulation induction); (2)D7 (seventh day of ovulation induction); (3)on the day before the day of ovarian puncture; (4)on the day after the day of embryo transfer (n = 28) MA Yes Needles inserted in the arm and thigh, which are known not to correspond with classically described acupuncture points (n = 46) BPR、CPR
Madaschi 2010 [64] Brazil IVF outcome On-site 455g Two sessions: (1) 25 m before ET; (2) immediately after ET (n = 230) MA Yes No adjuvant treatment (n = 225) CPR、LBR、MR、IR
Morin 2017 [59] USA IVF outcome On-site 424 Two sessions: (1) 25 m before ET; (2) after ET (n = 210)e MA Unclear No adjuvant treatment (n = 210)f BPR、CPR、OPR、LBR、MR、IR
Moy 2011 [61] USA IVF outcome On-site 161 Two sessions: (1) 25 m before ET; (2) immediately after ET (n = 87) MA Yes Needles inserted in the sites which close to, but not on, the real acupoints (n = 74) BPR、CPR
Omodei 2010 [19] Italy IVF outcome On-site 168h Two sessions: (1) 25 m before ET; (2) immediately after ET (n = 44)h MA Unclear No adjuvant treatment (n = 124)h CPR、OPR、LBR、MR
Paulus 2002 [14] Germany IVF outcome On-site 160 Two sessions: (1) 25 m before ET; (2) immediately after ET (n = 80) MA Yes No adjuvant treatment (n = 80) CPR、OPR、LBR、MR
Paulus 2003 [71] Germany IVF outcome On-site 200 Two sessions: (1) 25 m before ET; (2) immediately after ET (n = 100) MA Yes The Streitberger placebo needlesb placed on the same acupoints which the true acupuncture used (n = 100) CPR、OPR、LBR、MR
Peyvandi 2016 [22] Iran IVF and FET outcomes On-site 164 Three sessions: (1)oocyte puncture day; (2)2 days after puncture; (3)one cycle before embryo transfer (n = 82) EA No No adjuvant treatment (n = 82) BPR、CPR、OPR
Rashidi 2013 [60] Iran IVF outcome On-site 62 Five sessions: (1)30 m on the 21st day of the previous cycle (start of downregulation); (2) the first day of stimulation; (3)2 days before OPU; (4) 30 m before ET; (5) immediately after ET (n = 31) EA Yes No adjuvant treatment (n = 31) BPR、CPR、OPR
Sator-K 2006 [68] Australia Pain-relieving effect On-site 94 One session:30 m before OA and lasted until 1 h after OA (n = 64)i EA/MA No PCA + an adhesive tape over the whole ear connected to the P-Stim™ without electrical stimulation (n = 30) CPR
Smith 2006 [67] Australia IVF outcome On-site 228 Three sessions: (1) d9 of stimulating injections; (2)25 m before ET; (3) immediately after ET (n = 110) MA Yes The Streitberger placebo needlesb placed close to but not on the real acupuncture points (n = 118) CPR、OPR
Smith 2018 [56] Australia and New Zealand IVF outcome On-site at the IVF centers or nearby 848 Three sessions: (1) between d6 and d8 of ovarian stimulation; (2) 1 h before ET; (3) immediately after ET (n = 424)k MA Yes Park sham needlesc placed away from known acupuncture points (n = 424)k  
So 2009 [66] Hong Kong IVF outcome On-site 370 Two sessions: (1) 25 m before ET; (2) immediately after ET (n = 185) MA Yes The Streitberger placebo needlesb placed on the same acupoints which the true acupuncture used to give patients a pricking, penetrating sensation (n = 185) BPR、CPR、OPR、LBR、MR、IR
So 2010 [63] Hong Kong FET outcome On-site 226 One session: immediately after ET (n = 113) MA Yes The Streitberger placebo needlesb placed on the same acupoints which the true acupuncture used to give patients a pricking, penetrating sensation (n = 113) BPR、CPR、OPR、LBR、MR、IR
Stener-Victorin 1999 [72] Sweden Pain-relieving effect On-site 150 One session: 30 m before OA and terminated directly after OA (n = 75) EA Yes Alfentanil + PCB (n = 75) CPR、LBR、MR、IR
Stener-Victorin 2003 [70] Sweden IVF outcome On-site 286 One session: 30 m before OA and terminated directly after OA (n = 141) EA Yes Alfentanil + PCB (n = 145) CPR、OPR、IR
Westergaard 2006 [16] Denmark IVF outcome On-site 300 Acupuncture group 1:Two sessions: (1)25 m before ET; (2)immediatelyafter ET (n = 100); Acupuncture group 2: Three sessions: (1) 25 m before ET; (2)immediately after ET; (3) 2 d after ET (n = 100)i MA Yes No adjuvant treatment (n = 100) BPR、CPR、OPR、LBR、MR、IR
  1. Note:Acupoints Acupuncture points, OA oocyte aspiration, ET embryo transfer, COH controlled ovarian hyperstimulation, MA manual acupuncture, EA electro acupuncture, d day, h hour, m minute, BPR biochemical pregnancy rate, CPR clinical pregnancy rate, OPR ongoing pregnancy rate, LBR live birth rate, MR miscarriage rate
  2. aFor all sham-controlled trials, the sham acupuncture procedure was given on the same schedule as that used for the true acupuncture group
  3. bThe tip of the Streitberger placebo needle is blunted, skin penetration did not occur
  4. cPark sham needle has a retractable needle shaft and a blunt tip
  5. dThe treatment assignment and the outcomes for 4/150 randomized participants were not recorded by the trial authors
  6. eThere are two invention groups in the trial:needle acupuncture (AC) and laser acupuncture (LZ AC),and our meta-analysis only included the AC group
  7. fThere are three control groups in the trial:sham laser acupuncture (LZ sham), relaxation (RX) and no treatment (NT),and our meta-analysis only included the NT group
  8. gThe 39 participants (22 acupuncture; 17 control) who did not proceed to embryo transfer were excluded from the trial authors’ analysis (Manheimer, et al., 2013). Our meta-analysis was to re-include these participants and assumed the these participants failure to achieve the clinical pregnancy outcome
  9. hThe number of each group were not available from the publishing information, but other review reported it (Manheimer, et al., 2013)
  10. iThere are two intervention arms in the trial, and we combined them together for the meta-analysis
  11. j8/26 patients in the control group excluded from the study (cancel to participate further after randomization)
  12. k9/424 in acupuncture group and 15/424 in control group excluded from analysis (withdrawal consent for data to be used)