{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T06:14:35Z","timestamp":1776147275623,"version":"3.50.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"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. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recurrent implantation failure (RIF) presents significant clinical and psychological challenges. While acupuncture is a potential adjunctive therapy during embryo transfer (ET), comprehensive evidence regarding its multidimensional effects remains limited. This study systematically evaluates acupuncture\u2019s impact on pregnancy outcomes, endometrial receptivity, and psychological status in RIF patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing acupuncture\u202f+\u202fET with ET alone in patients with RIF. Eight major databases were searched from inception through October 2025. Risk of bias was assessed using the Risk of Bias 2 (RoB 2) tool, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen RCTs involving 1,428 patients were included. Regarding clinical efficacy, acupuncture\u202f+\u202fET significantly increased the clinical pregnancy rate (relative risk [RR]\u202f=\u202f1.73, 95% confidence interval [CI] [1.51, 1.99],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), the embryo implantation rate (RR\u202f=\u202f1.69, 95% CI [1.34, 2.13],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and the live birth rate (RR\u202f=\u202f1.82, 95% CI [1.16, 2.86],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.009), while reducing the miscarriage rate (RR\u202f=\u202f0.40, 95% CI [0.17, 0.97],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.04). In terms of endometrial receptivity, acupuncture significantly increased endometrial thickness (mean difference [MD]\u202f=\u202f1.20, 95% CI [0.75, 1.66],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and reduced the endometrial pulsatility index (MD\u202f=\u202f\u22120.49, 95% CI [\u22120.93, \u22120.06],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.03) and resistance index (MD\u202f=\u202f\u22120.21, 95% CI [\u22120.30, \u22120.13],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Furthermore, significant reductions in Self-Rating Anxiety Scale and Self-Rating Depression Scale scores were observed (MD\u202f=\u202f\u22125.89,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.02 and MD\u202f=\u202f\u22126.83,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003, respectively). However, the certainty of evidence ranged from very low to moderate due to methodological limitations and high heterogeneity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Acupuncture may be a promising adjunctive therapy for RIF patients undergoing ET. However, the current evidence is constrained by significant methodological limitations. These results support the clinical integration of acupuncture into multidisciplinary RIF management but should be further confirmed by multicenter, rigorously blinded trials with standardized protocols and long-term outcome assessments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?RecordID=1237224<\/jats:ext-link>\n                      , the Unique Identifier is PROSPERO CRD420251237224.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1758790","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T05:39:58Z","timestamp":1776145198000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of acupuncture for recurrent implantation failure: a systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.3389","volume":"13","author":[{"given":"Qin","family":"Huang","sequence":"first","affiliation":[{"name":"Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin-Yue","family":"Liu","sequence":"additional","affiliation":[{"name":"Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zi-Meng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian-Shu","family":"Hou","sequence":"additional","affiliation":[{"name":"Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Long","sequence":"additional","affiliation":[{"name":"Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Si-Hui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, Xinqiao Hospital, Third Military Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian-Hui","family":"Huang","sequence":"additional","affiliation":[{"name":"Pujiangxian Hospital of Traditional Chinese Medicine","place":["Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-Mei","family":"Yang","sequence":"additional","affiliation":[{"name":"Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Ran","family":"Wang","sequence":"additional","affiliation":[{"name":"Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiao-Feng","family":"Wu","sequence":"additional","affiliation":[{"name":"Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"529","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 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acupuncture point stimulation improves pregnancy outcomes in patients with recurrent implantation failure undergoing in vitro fertilisation and embryo transfer: a prospective, randomised trial","volume":"37","author":"Shuai","year":"2019","journal-title":"Acupunct Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"939","DOI":"10.13702\/j.1000-0607.20230084","article-title":"Clinical study of acupuncture on pregnancy outcomes in patients with thrombosis-prone infertility and recurrent implantation failure","volume":"48","author":"You","year":"2023","journal-title":"Acupunct Res"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"32","DOI":"10.16306\/j.1008-861x.2019.05.007","article-title":"Acupuncture improves uterine receptivity, anxiety, and depression in IVF-ET patients with kidney deficiency and liver stagnation type recurrent implantation failure: a clinical study","volume":"33","author":"Ma","year":"2019","journal-title":"J Shanghai Univ Tradit Chin 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failure","volume":"43","author":"Xing","year":"2023","journal-title":"Chin Acupunct Moxibustion"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"8","DOI":"10.13460\/j.issn.1005-0957.2024.13.4007","article-title":"Acupuncture's effects on pregnancy outcomes and sleep disturbances following recurrent implantation failure","volume":"44","author":"Xu","year":"2025","journal-title":"Shanghai J Acupunct"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"723","DOI":"10.13460\/j.issn.1005-0957.2025.06.0723","article-title":"Effect of acupuncture on pregnancy rate in patients with recurrent failure of IVF-ET","volume":"44","author":"Zhao","year":"2025","journal-title":"Shanghai J Acupunct"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1184","DOI":"10.1186\/s12884-025-08372-8","article-title":"Incidence of pregnancy outcomes among patients with recurrent implantation failure: a systematic review and 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implantation","volume":"17","author":"L\u00e9d\u00e9e-Bataille","year":"2002","journal-title":"Hum Reprod"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.fertnstert.2013.11.004","article-title":"The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening","volume":"101","author":"Franasiak","year":"2013","journal-title":"Fertil Steril"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1609519","DOI":"10.3389\/fmed.2025.1609519","article-title":"The efficacy of acupuncture on endometrial receptivity in infertile women: an overview of systematic review and meta-analysis","volume":"12","author":"Fan","year":"2025","journal-title":"Front Med"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1186\/s12905-022-02096-z","article-title":"Endometrial microstimulation effects on endometrial receptivity assessed by 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patients with repeated implantation failure","volume":"19","author":"Ni","year":"2021","journal-title":"Health Qual Life Outcomes"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"109175","DOI":"10.5498\/wjp.v15.i9.109175","article-title":"Anxiety and depression in recurrent implantation failure after frozen-thawed embryo transfer and efficacy of endometrial receptivity testing","volume":"15","author":"Guo","year":"2025","journal-title":"World J Psychiatry"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"e056714","DOI":"10.1136\/bmjopen-2021-056714","article-title":"Endometrial factors in the implantation failure spectrum: protocol of a MUltidisciplinary observational cohort study in women with Repeated Implantation failure and recurrent Miscarriage (MURIM study)","volume":"12","author":"Stevens Brentjens","year":"2022","journal-title":"BMJ Open"}],"container-title":["Frontiers in 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