{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:04:56Z","timestamp":1785305096103,"version":"3.55.0"},"reference-count":135,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"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>Polycystic ovary syndrome (PCOS) is a prevalent gynecological disorder that significantly impairs quality of life and reduces patient confidence in treatment. The efficacy of current Western pharmacological therapies is limited. Acupuncture has shown promise in the management of PCOS, but comparative research on different acupuncture modalities remains scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and the Chinese Biomedical Literature Database were comprehensively searched from database inception to 18 August 2024. Two reviewers independently screened studies, extracted data, and assessed the risk of bias in the eligible studies. Network meta-analysis was conducted using STATA 15.1 and R 4.4.1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety-two randomized controlled trials (RCTs) involving 15 acupuncture-based interventions or combinations were included. According to the surface under the cumulative ranking curve (SUCRA) analysis, for total efficacy (TE), electroacupuncture (99.03%), filiform needle + thunder fire moxibustion (74.77%), and filiform needle with electroacupuncture (64.02%) ranked the highest. For follicle-stimulating hormone (FSH) regulation, fire needle (90.99%) ranked first, followed by filiform needle + electroacupuncture (75.29%) and filiform needle + warming needle moxibustion + electroacupuncture (66.76%). For luteinizing hormone (LH) regulation, warming needle moxibustion (86.75%) ranked first, followed by warming needle moxibustion + electroacupuncture (72.76%) and filiform needle alone (69.55%). For testosterone reduction, filiform needle + moxibustion (96.53%) ranked first, followed by catgut embedment in acupoint + moxibustion (85.64%) and electroacupuncture (82.33%). For LH\/FSH ratio improvement, catgut embedment in acupoint (77.73%), warming needle moxibustion + electroacupuncture (72.87%), and filiform needle + warming needle moxibustion + electroacupuncture (66.39%) ranked the highest. For adverse events, fire needle (91.69%) ranked highest, followed by Western medicine (83.17%) and catgut embedment in acupoint (64.08%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No statistically significant differences were observed between single and combined acupuncture therapies. However, modalities incorporating electrical, thermal, or sustained stimulation appear to be more effective. Given the methodological limitations of the included studies, high-quality, rigorously designed RCTs are warranted to validate these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>PROSPERO<\/jats:ext-link>\n                      , CRD42024609903.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1895421","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:57:37Z","timestamp":1785304657000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of acupuncture therapies for polycystic ovary syndrome: a network meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Ning","family":"Yang","sequence":"first","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese Medicine","place":["Jilin, Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunxi","family":"Li","sequence":"additional","affiliation":[{"name":"Shenzhen Traditional Chinese Medicine Hospital","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese Medicine","place":["Jilin, Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rulin","family":"Wang","sequence":"additional","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese Medicine","place":["Jilin, Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese Medicine","place":["Jilin, Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"Tang","sequence":"additional","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese Medicine","place":["Jilin, Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiying","family":"Liu","sequence":"additional","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese Medicine","place":["Jilin, Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhong","family":"Xie","sequence":"additional","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese Medicine","place":["Jilin, Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sixian","family":"Wang","sequence":"additional","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese Medicine","place":["Jilin, Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijie","family":"Li","sequence":"additional","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese Medicine","place":["Jilin, Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihao","family":"Dong","sequence":"additional","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese Medicine","place":["Jilin, Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinying","family":"Zhao","sequence":"additional","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese Medicine","place":["Jilin, Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuchun","family":"Wang","sequence":"additional","affiliation":[{"name":"Acupuncture and Massage College, Changchun University of Chinese 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Med"},{"key":"ref27","first-page":"32","article-title":"Effect of Ren-Du channel-regulating acupuncture on pregnancy and hormone levels in infertile patients with polycystic ovary syndrome","volume":"5","author":"Yang","year":"2021","journal-title":"Mod Med Health Res"},{"key":"ref28","first-page":"565","article-title":"Effect of Ren-Du channel-regulating acupuncture on pregnancy outcomes after IVF-ET in infertile PCOS patients","volume":"40","author":"Wu","year":"2021","journal-title":"Shanghai J Acupunct Moxibustion"},{"key":"ref29","first-page":"171","article-title":"Efficacy of Ren-Du channel-regulating acupuncture combined with letrozole for kidney-yang deficiency PCOS infertility and effects on lipid metabolism and sex hormones","volume":"24","author":"Li","year":"2022","journal-title":"J Liaoning Univ Tradit Chin Med"},{"key":"ref30","first-page":"261","article-title":"Clinical observation of Ren-Du channel-regulating acupuncture combined with Tongyuan acupuncture for PCOS 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infertility","volume":"35","author":"Xu","year":"2020","journal-title":"China J Tradit Chin Med Pharm"},{"key":"ref35","first-page":"69","article-title":"Clinical study on metformin combined with acupuncture for glycolipid metabolism and adipokines in obese PCOS","volume":"27","author":"Wang","year":"2020","journal-title":"China Mod Med"},{"key":"ref36","first-page":"162","article-title":"Clinical study on metformin combined with staged acupuncture for obese PCOS","volume":"22","author":"Huang","year":"2024","journal-title":"China Prescrip Drug"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.13703\/j.0255-2930.2016.11.015","article-title":"Flying needle acupuncture combined with clomiphene for ovulation disorder in PCOS: a randomized controlled trial","volume":"36","author":"Ma","year":"2016","journal-title":"Chin Acupunct Moxibustion"},{"key":"ref38","first-page":"2403","article-title":"Efficacy of metformin combined with acupuncture for obese PCOS 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acupuncture combined with conventional Western medicine on PCOS infertility","volume":"33","author":"Huang","year":"2021","journal-title":"Med J Chin Peoples Health"},{"key":"ref52","first-page":"117","article-title":"Efficacy of Longsha Kaiheshu acupuncture combined with letrozole for PCOS infertility","volume":"20","author":"Wen","year":"2023","journal-title":"China Med Herald"},{"key":"ref53","first-page":"30","article-title":"Efficacy of umbilical acupuncture combined with letrozole for kidney deficiency-phlegm dampness PCOS with infertility","volume":"11","author":"Zheng","year":"2024","journal-title":"Electr J Pract Gynecol Endocrinol"},{"key":"ref54","first-page":"53","article-title":"Effect of periumbilical eight-point catgut embedding on IVF-ET outcomes in obese PCOS infertility","volume":"43","author":"Fu","year":"2024","journal-title":"Shandong J Tradit Chin Med"},{"key":"ref55","first-page":"1699","article-title":"Efficacy analysis of periumbilical eight-point acupuncture 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PCOS","volume":"19","author":"Li","year":"2019","journal-title":"Pract Clin J Integr Tradit Chin Western Med"},{"key":"ref68","first-page":"48","article-title":"Effect of catgut embedding on follicular microenvironment and IVF-ET pregnancy outcomes in PCOS with insulin resistance","volume":"14","author":"Li","year":"2022","journal-title":"Chin J Fam Plann Gynecotokol"},{"key":"ref69","first-page":"60","article-title":"Effect of catgut embedding on sex hormone-related indices in obese PCOS","volume":"21","author":"Tang","year":"2015","journal-title":"Clin J Chin Med"},{"key":"ref70","first-page":"33","article-title":"Clinical efficacy of catgut embedding combined with Diane-35 on endocrine metabolic abnormalities in PCOS","volume":"32","author":"Yang","year":"2016","journal-title":"J Clin Acupunct Moxibustion"},{"key":"ref71","first-page":"53","article-title":"Catgut embedding combined with Diane and metformin for obese PCOS: 36 cases","volume":"4","author":"Xiao","year":"2014","journal-title":"Jiangxi J Tradit Chin Med"},{"key":"ref72","first-page":"339","article-title":"Efficacy of catgut embedding combined with cyproterone acetate\/ethinylestradiol for PCOS","volume":"39","author":"Zhang","year":"2020","journal-title":"Shanghai J Acupunct Moxibustion"},{"key":"ref73","first-page":"171","article-title":"Clinical observation of catgut embedding combined with metformin hydrochloride for insulin resistance in kidney deficiency-phlegm dampness PCOS: 50 cases","volume":"2","author":"Jiang","year":"2014","journal-title":"Hebei J Tradit Chin Med"},{"key":"ref74","first-page":"215","article-title":"Clinical efficacy analysis of catgut embedding combined with Diane-35 for polycystic ovary syndrome","volume":"33","author":"Zhang","year":"2022","journal-title":"J Aerospace Med"},{"key":"ref75","first-page":"669","article-title":"Clinical observation of catgut embedding for overweight\/obese PCOS","volume":"38","author":"Yan","year":"2023","journal-title":"Guangming J Chin Med"},{"key":"ref76","first-page":"665","article-title":"Effect of catgut embedding on metabolism and hormone levels in PCOS","volume":"22","author":"Xu","year":"2024","journal-title":"Chin J Gen Pract"},{"key":"ref77","first-page":"90","article-title":"Clinical study on catgut embedding for polycystic ovary syndrome","volume":"18","author":"Huang","year":"2022","journal-title":"Asia Pac Tradit Med"},{"key":"ref78","first-page":"12","article-title":"Clinical study of catgut embedding for obese PCOS","volume":"42","author":"He","year":"2020","journal-title":"Hubei J Tradit Chin Med"},{"key":"ref79","first-page":"58","article-title":"Clinical efficacy of catgut embedding for clomiphene-resistant PCOS","volume":"14","author":"Chen","year":"2019","journal-title":"China Pract Med"},{"key":"ref80","first-page":"74","article-title":"Effect of acupoint application combined with clomiphene on kidney 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