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Journal of Integrative Medicine ›› 2023, Vol. 21 ›› Issue (2): 136-148.doi: 10.1016/j.joim.2022.12.002

• Systematic Review • Previous Articles     Next Articles

Efficacy and safety of acupuncture for polycystic ovary syndrome: An overview of systematic reviews

Han Yang a 1, Zhi-yong Xiao a 1, Zi-han Yin a 1, Zheng Yu b, Jia-jia Liu a c, Yan-qun Xiao d, Yao Zhou d, Juan Li e, Jie Yang a c, Fan-rong Liang a   

  1. Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
    College of Medical Information and Engineering, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
    Traditional Chinese Medicine Department, Chengdu Xinan Gynecological Hospital, Chengdu 610051, Sichuan Province, China
    Infertility Clinic, Chengdu Xinan Gynecological Hospital, Chengdu 610051, Sichuan Province, China
    Health Preservation and Rehabilitation School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
  • Received:2022-02-09 Accepted:2022-11-10 Online:2023-03-20 Published:2023-04-06
  • Contact: Jie Yang; E-mail Fan-rong Liang; E-mail address:

Polycystic ovary syndrome (PCOS) is the primary cause of anovulatory infertility, bringing serious harm to women's physical and mental health. Acupuncture may be an effective treatment for PCOS. However, systematic reviews (SRs) on the efficacy and safety of acupuncture for PCOS have reported inconsistent results, and the quality of these studies has not been adequately assessed.

To summarize and evaluate the current evidence on the efficacy and safety of acupuncture for PCOS, as well as to assess the quality and risks of bias of the available SRs.

Search strategy:
Nine electronic databases (Cochrane Library, MEDLINE, Embase, PsycINFO, CINAHL, Chinese National Knowledge Infrastructure, Wanfang Data, Chongqing VIP Chinese Science and Technology Periodical Database, and China Biology Medicine disc) were searched from their establishment to July 27, 2022. Based on the principle of combining subject words with text words, the search strategy was constructed around search terms for “acupuncture,” “polycystic ovary syndrome,” and “systematic review.”

Inclusion criteria:
SRs of randomized controlled trials that explored the efficacy and (or) safety of acupuncture for treating patients with PCOS were included.

Data extraction and analysis:
Two authors independently extracted study data according to a predesigned form. Tools for evaluating the methodological quality, risk of bias, reporting quality, and confidence in study outcomes, including A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Risk of Bias in Systematic Reviews (ROBIS), Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A), and the Grading of Recommendations Assessment, Development and Evaluation (GRADE), were used to score the included SRs.

A total of 885 studies were retrieved, and 11 eligible SRs were finally included in this review. The methodological quality of 2 SRs (18.18%) was low, while the other 9 SRs (81.82%) were scored as extremely low. Four SRs (36.36%) were considered to be of low risk of bias. As for reporting quality, the reporting completeness of 9 SRs (81.82%) was more than 70%. Concerning the confidence in study results, 2 study results were considered to have a high quality of evidence (3.13%), 14 (21.88%) a “moderate” quality, 28 (43.75%) a “low” quality, and 20 (31.24%) considered a “very low” quality. Descriptive analyses suggested that combining acupuncture with other medicines can effectively improve the clinical pregnancy rate (CPR) and ovulation rate, and reduce luteinizing hormone/follicle-stimulating hormone ratio, homeostasis model assessment of insulin resistance, and body mass index (BMI). When compared with medicine alone, acupuncture alone also can improve CPR. Further, when compared with no intervention, acupuncture had a better effect in promoting the recovery of menstrual cycle and reducing BMI. Acupuncture was reported to cause no adverse events or some adverse events without serious harm.

The efficacy and safety of acupuncture for PCOS remains uncertain due to the limitations and inconsistencies of current evidence. More high-quality studies are needed to support the use of acupuncture in PCOS.

Key words: Acupuncture, Polycystic ovary syndrome, Systematic review, Meta-analysis

[1] Han-ting Wu, Cong-hua Ji, Rong-chen Dai, Pei-jie Hei, Juan Liang, Xia-qiu Wu, Qiu-shuang Li, Jun-chao Yang, Wei Maob, Qing Guo. Traditional Chinese medicine treatment for COVID-19: An overview of systematic reviews and meta-analyses. Journal of Integrative Medicine, 2022, 20(5): 416-426.
[2] Deng-chao Wang, Miao Yu, Wen-xian Xie, Li-yan Huang, Jian Wei, Yue-hua Lei. Meta-analysis on the effect of combining Lianhua Qingwen with Western medicine to treat coronavirus disease 2019. Journal of Integrative Medicine, 2022, 20(1): 26-33.
[3] Jun-peng Yao, Li-ping Chen, Xian-jun Xiao, Ting-hui Hou, Si-yuan Zhou, Ming-min Xu, Kai Wang, Yu-jun Hou, Lin Zhang, Ying Li. Effectiveness and safety of acupuncture for treating functional constipation: An overview of systematic reviews. Journal of Integrative Medicine, 2022, 20(1): 13-25.
[4] Yang-hao-tian Wu, Wen-bo He, Yin-yan Gao, Xue-mei Han. Effects of traditional Chinese exercises and general aerobic exercises on older adults with sleep disorders: A systematic review and meta-analysis. Journal of Integrative Medicine, 2021, 19(6): 493-502.
[5] Arthur Yin Fan, Sherman Gu, Sarah Faggert Alemi, Research Group for Evidence-based Chinese Medicine. Chinese herbal medicine for COVID-19: Current evidence with systematic review and meta-analysis. Journal of Integrative Medicine, 2020, 18(5): 385-394.
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