{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:02:19Z","timestamp":1791388939291,"version":"4.3.3"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"\n Background<\/jats:title>\n \n Diminished ovarian reserve (DOR) is a major cause of infertility and remains a core challenge in reproductive medicine. Although previous studies have suggested that acupuncture may improve reproductive outcomes in infertile women with DOR undergoing\n in vitro<\/jats:italic>\n fertilization (IVF) or intracytoplasmic sperm injection (ICSI), findings remain inconsistent. This meta-analysis therefore aimed to synthesize evidence from randomized controlled trials (RCTs) to evaluate the efficacy of acupuncture in these women undergoing IVF\/ICSI.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Eight databases were systematically searched for eligible RCTs up to February 28, 2026. The findings were presented in forest plots, with one primary outcome and ten secondary outcomes. Sensitivity analyses were carried out to assess the robustness of the pooled estimates. Subgroup analyses were conducted to explore whether the efficacy of acupuncture on the primary outcome was associated with the type of acupuncture or the number of acupoints adopted per treatment. Evidence grading was performed using the GRADEpro GDT.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 11 RCTs involving 885 infertile women with DOR undergoing IVF\/ICSI were finally included in the meta-analysis. The pooled evidence showed that acupuncture remarkably increased clinical pregnancy rate by 25% (risk difference [RD] = 0.25, 95% CI: 0.18 to 0.32;\n p<\/jats:italic>\n \u00a0&lt;\u00a00.00001), live birth rate by 22% (RD\u00a0=\u00a00.22, 95% CI: 0.05 to 0.40;\n p<\/jats:italic>\n =\u00a00.01), and embryo implantation rate by 30% (RD\u00a0=\u00a00.30, 95% CI: 0.20 to 0.41;\n p<\/jats:italic>\n &lt;\u00a00.00001). In addition, acupuncture effectively improved the number of oocytes retrieved (MD\u00a0=\u00a01.72, 95% CI: 1.03 to 2.41;\n p<\/jats:italic>\n &lt;\u00a00.00001), the number of optimal embryos (MD\u00a0=\u00a01.50, 95% CI: 1.42 to 1.58;\n p<\/jats:italic>\n &lt;\u00a00.00001), and E\n 2<\/jats:sub>\n on the day of hCG trigger (MD\u00a0=\u00a0318.48, 95% CI: 137.16 to 499.80;\n p<\/jats:italic>\n \u00a0=\u00a00.0006). Subgroup analysis further substantiated the value of acupuncture in improving clinical pregnancy rate. Sensitivity analyses confirmed the robustness of the pooled estimates. Evidence certainty for all assessed outcomes ranged from very low to moderate.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Based on this pooled clinical evidence, acupuncture may be a beneficial intervention for improving clinical outcomes in women with DOR undergoing IVF\/ICSI, although confirmation by future rigorously designed RCTs is warranted.<\/jats:p>\n <\/jats:sec>\n \n Systematic Review Registration<\/jats:title>\n \n https:\/\/www.crd.york.ac.uk<\/jats:ext-link>\n , identifier CRD420261330054.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fendo.2026.1840157","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:29:54Z","timestamp":1781065794000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical evidence of acupuncture for infertile women with diminished ovarian reserve undergoing IVF\/ICSI: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Liangliang","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Affiliated Hospital of Gansu University of Chinese Medicine","place":["Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueyan","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Affiliated Hospital of Gansu University of Chinese Medicine","place":["Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Affiliated Hospital of Gansu University of Chinese Medicine","place":["Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruifang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Affiliated Hospital of Gansu University of Chinese Medicine","place":["Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangyao","family":"Lin","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital)","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaili","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Affiliated Hospital of Gansu University of Chinese Medicine","place":["Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Affiliated Hospital of Gansu University of Chinese Medicine","place":["Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Affiliated Hospital of Gansu University of Chinese Medicine","place":["Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dem046","article-title":"International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care","volume":"22","author":"Boivin","year":"2007","journal-title":"Hum Reprod"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deae292","article-title":"Global, regional, and national prevalence and trends of infertility among individuals of reproductive age (15-49 years) from 1990 to 2021, with projections to 2040","volume":"40","author":"Liang","year":"2025","journal-title":"Hum Reprod"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deae218","article-title":"Measuring non-events: infertility estimation 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