PDF(Pubmed)
Abstract：
Objective: The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) on pregnancy outcomes in women undergoing in vitro fertilization-embryo transfer (IVF-ET), in order to provide evidence-based medical support. Methods: We searched the Cochrane Library, Embase, PubMed, Web of Science, SinoMed, and CNKI for relevant randomized controlled trials (RCTs) from inception to 31 May 2022, using the search terms \"transcutaneous electrical acupoint stimulation,\" \"TEAS,\" \"in vitro fertilization-embryo transfer,\" \"IVF-ET,\" \"randomized controlled trial,\" and \"clinical trials.\" The experimental group was treated with TEAS or combined with ovulation-inducing medication, and the control group was treated with mock TEAS (mTEAS), ovulation-inducing medication, or no intervention. The main outcome was the clinical pregnancy rate. Secondary outcomes were the embryo implantation rate, live birth rate, biochemical pregnancy rate, and number of oocytes retrieved. Stata15.1 software was used for data summary and analysis. Results: This review involved 15 RCTs and 4,281 participants. TEAS were superior to the control group for improving the clinical pregnancy rate [RR: 1.29, 95% CI: 1.19 to 1.40; p < 0.001; I2 = 23.0%], embryo implantation rate [RR: 1.43, 95% CI: 1.22 to 1.69; p < 0.001; I2 = 35.9%], live birth rate [RR: 1.33, 95% CI: 1.14 to 1.54; p < 0.001; I2 = 47.3%], and biochemical pregnancy rate [RR: 1.15, 95% CI: 1.05 to 1.26; p = 0.003; I2 = 49.1%], without significant heterogeneity. TEAS had no statistically significant effect on the number of oocytes retrieved as compared with the control group, and the heterogeneity was high [SMD: 0.34, 95% CI: -0.04 to 0.72; p = 0.081; I2 = 77.6%]. We performed subgroup analysis based on the sample size, interventions and intervention time-point. The results showed that the sample size had no effect on the results. There was no significant difference between TEAS and ovulation-inducing medication in the clinical pregnancy rate or the embryo implantation rate. In addition, TEAS did not significantly increase the embryo implantation rate or the live birth rate, compared with no intervention. In terms of safety, mild allergic symptoms were found in both the experimental group and the control group. Conclusion: In general, existing evidence supports the potential value of TEAS as an adjunctive treatment for improving pregnancy outcomes. High-quality, large-sample RCTs are needed to further support this conclusion. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=334892, identifier PROSPERO CRD42022334892.
摘要：
目的：本系统评价和荟萃分析的目的是评估经皮穴位电刺激（TEAS）对体外受精-胚胎移植（IVF-ET）妇女妊娠结局的有效性和安全性。以提供循证医学支持。方法：我们搜索了Cochrane图书馆，Embase,PubMed,WebofScience,SinoMed,和从开始到2022年5月31日的相关随机对照试验(RCT)，使用搜索词“经皮穴位电刺激，\"\"TEAS,体外受精-胚胎移植，\"\"IVF-ET,“”随机对照试验，“和”临床试验。"实验组采用TEAS或联合促排卵药物治疗,对照组采用模拟TEAS（mTEAS）治疗，促排卵药物,或者不干预。主要结局是临床妊娠率。次要结果是胚胎着床率，活产率,生化妊娠率，和检索到的卵母细胞数量。使用Stata15.1软件进行数据汇总和分析。结果：本综述涉及15个RCT和4,281名参与者。TEAS在改善临床妊娠率方面优于对照组[RR：1.29，95％CI：1.19至1.40；p<0.001；I2=23.0％]，胚胎着床率[RR：1.43，95%CI：1.22至1.69；p<0.001；I2=35.9%]，活产率[RR：1.33，95%CI：1.14至1.54；p<0.001；I2=47.3%]，和生化妊娠率[RR：1.15，95％CI：1.05至1.26；p=0.003；I2=49.1％]，没有显著的异质性。与对照组相比，TEAS对回收的卵母细胞数量没有统计学意义，异质性高[SMD：0.34，95％CI：-0.04至0.72；p=0.081；I2=77.6％]。我们根据样本量进行了亚组分析，干预措施和干预时间点。结果表明，样本量对结果没有影响。TEAS和促排卵药物在临床妊娠率或胚胎着床率方面无明显差异。此外,TEAS没有显著增加胚胎着床率或活产率，与没有干预相比。在安全方面,实验组和对照组均出现轻度过敏症状。结论：总的来说，现有证据支持TEAS作为改善妊娠结局的辅助治疗的潜在价值.高品质，需要大样本随机对照试验来进一步支持这一结论。系统审查注册：https://www。crd.约克。AC.uk/PROSPERO/display_record。php?RecordID=334892，标识符PROSPEROCRD42022334892。
