Effects of acupuncture on the relief of anxiety and/or depression during in vitro fertilization: A systematic review and meta-analysis

Introduction: Although effects of acupuncture on pregnancy outcomes among women undergoing in vitro fertilization (IVF) have been analyzed Using systematic reviews and meta-analysis, few have been focused on psychological issues. The present systematic review and meta-analysis was designed to evaluate the efficacy of acupuncture on relieving anxiety and/or depression during IVF treatment. Methods: As of November 2020, randomized controlled trials (RCTs) and quasi-RCTs to observe the therapeutic effects of acupuncture used to relieve anxiety and/or depression during IVF treatment were identified from the following databases: Pubmed, Embase, the Cochrane Library, Web of Science; China National Knowledge Infrastructure, Wanfang, VIP and Chinese Biomedicine database. Study selection, data collection and quality assessment were carried out. Study characteristics, results on anxiety and/or depression relief, IVF outcomes and adverse events were summarized. Meta-analysis was performed using Review Manager 5.3 software. Results: Twelve studies with 2867 participants were included. A significant difference (3 studies, 547 participants, MD-9.26, 95%CI & minus; 12.01 to-6.51, P < 0.01) was observed for the relief of anxiety comparing acupuncture with controls during IVF treatment. No significant difference (9 studies, 1896 participants, RR = 1.30, 95%CI 1.03 to 1.64; P = 0.02) was found for clinical pregnancy rate. Only 2 out of 12 studies assessed remission of depression but there was no clear effect shown for acupuncture. Conclusions: Acupuncture may have a positive effect on anxiety relief during IVF treatment, while its effect on depression relief is inconclusive. More standardized, large-size, randomized and multicenter studies should be carried out on whether acupuncture can alleviate the anxiety and/or depression during IVF treatment.