Table 1.
Characteristics of the included studies.
| Study | Year | Country | Type of disease | Included studies | Mean age | Sample size | Intervention type | Control | Risk of bias assessment, high quality/total studies | High quality studies (%) | Follow-up duration (month) | Outcomes | Quality |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lim (62) | 2016 | Australia | PCOS | 5 | NR | 413 | Acupuncture | Shame acupuncture/Medications | Cochrane tool, 1/5 | 20 | 2.5 | Pregnancy rate, resumption of menstruation | High |
| Lim (50) | 2019 | Australia | PCOS | 8 | NR | 1,546 | Acupuncture | Shame acupuncture/Medications | Cochrane tool, 1/8 | 12 | NR | Pregnancy rate, ovulation rate, live birth, abortion | High |
| Chen (24) | 2022 | China | PCOS | 9 | 27.44 | 1,159 | Acupuncture plus medications | Medications | Cochrane tool, 1/9 | 11 | 3.8 | Pregnancy rate, ovulation rate, HOMA-IR | Moderate |
| Ma (64) | 2014 | China | PCOS | 6 | NR | 587 | Acupuncture | Medications | Cochrane tool, 0/6 | 0 | 3 | ovulation rate, testosterone | Low |
| Jo (55) | 2017 | Republic of Korea | PCOS | 4 | 29.75 | 430 | Acupuncture | Medications | Cochrane tool, 3/4 | 75 | NR | Pregnancy rate, live birth | Moderate |
| Zheng (38) | 2021 | China | PCOS | 10 | 24.71 | 737 | Acupuncture | Medications | Cochrane tool, 5/10 | 50 | 4.62 | HOMA-IR, BMI, FPG, OGTT | Moderate |
| Wu (44) | 2020 | China | PCOS | 22 | 27.88 | 2,315 | Acupuncture Acupuncture plus medications |
Shame acupuncture/Medications | Cochrane tool, 14/22 | 63 | 3.9 | Pregnancy rate, ovulation rate, LH, testosterone, live birth, LH/FSH ratio | Moderate |
| Jo (56) | 2017 | Korea | PCOS | 28 | 23.98 | 2093 | Acupuncture Acupuncture plus medications |
Shame acupuncture/Medications | Cochrane tool, 6/28 | 21 | 3.2 | Pregnancy rate, LH, testosterone, LH/FSH ratio, fasting insulin | High |
| Li (37) | 2022 | China | PCOS | 25 | 35.38 | 1991 | Acupuncture plus Moxibustion | Shame acupuncture/Medications | Cochrane tool, 0/25 | 0 | 4.28 | Pregnancy rate, ovulation rate, LH, testosterone, LH/FSH ratio, FSH, abortion, fasting insulin, BMI | High |
| Liang (33) | 2023 | China | PCOS | 47 | NR | 3,537 | Acupuncture plus TCM | Shame acupuncture/Medications plus TCM | Cochrane tool, 19/47 | 40 | NR | Pregnancy rate, ovulation rate, LH, testosterone, LH/FSH ratio, BMI | Moderate |
| Yun (48) | 2019 | China | PCOS | 22 | 20–40 years | 2,591 | Acupuncture plus medications Acupuncture plus TCM and Medications |
Medications | Cochrane tool, 0/22 | 0 | NR | Pregnancy rate, ovulation rate, LH, LH/FSH ratio, endometrial thickness | Moderate |
| Qu (61) | 2016 | China | PCOS | 9 | NR | 531 | Acupuncture Acupuncture plus TCM |
Shame acupuncture/Medications plus TCM | Cochrane tool, 2/9 | 22 | NR | LH, LH/FSH ratio, FSH, fasting insulin, BMI, FPG | Moderate |
| Hu (40) | 2021 | China | PCOS | 13 | 29.5 | 1,297 | Acupuncture plus medications | Medications | Cochrane tool, 6/13 | 46 | NR | LH | Moderate |
| Liu (32) | 2022 | China | PCOS | 7 | 26.76 | 728 | Electroacupuncture Acupuncture plus Medications Acupuncture |
Shame acupuncture/Medications | Cochrane tool, 3/7 | 42 | 4.6 | HOMA-IR, fasting insulin, BMI, FPG, OGTT | Moderate |
| Chao-chao | 2017 | China | PCOS | 25 | NR | 1,636 | Acupoint catgut embedding | Medications | Cochrane tool, 0/32pcos | 0 | NR | Testosterone, resumption of menstruation | Moderate |
| Meizhu (31) | 2023 | China | PCOS | 15 | NR | 1,205 | Acupuncture | Medications | NR | 3.6 | LH, testosterone, FSH, BMI | Low | |
| Ruigen (60) | 2016 | China | PCOS | 14 | NR | 1,617 | Acupuncture | Medications | Cochrane tool, NR | NR | 3.78 | Pregnancy rate | Low |
| Ping | 2020 | China | PCOS | 7 | NR | 514 | Acupuncture | Medications | NR | NR | NR | Pregnancy rate | Low |
| Lina (52) | 2018 | China | PCOS | 9 | NR | 769 | Acupuncture plus TCM Acupuncture |
Medications | NR | NR | NR | Pregnancy rate, LH, FSH | Moderate |
| Yang (30) | 2023 | China | PCOS | 6 | 28.93 | 1,410 | Acupuncture plus Moxibustion | Medications | Cochrane tool, 3/6 | 50 | 3.16 | Endometrial thickness | Moderate |
| Li (34) | 2023 | China | POI | 10 | 33.35 | 594 | Electroacupuncture plus TCM Needle acupuncture plus TCM |
HRT | Cochrane tool, 0/10 | 0 | 3.6 | LH, FSH, estradiol | High |
| Jo (63) | 2015 | Republic of Korea | POI | 8 | 35.46 | 620 | Acupuncture | Shame acupuncture or HRT | Cochrane tool, 0/8 | 0 | 4.8 | LH, FSH, estradiol | High |
| Wang (23) | 2017 | China | POI | 8 | Under 40 | 368 | Acupuncture | HRT | Cochrane tool, 0/8 | 0 | NR | LH, FSH, estradiol | Moderate |
| Ya-Jian | 2020 | China | POI | 8 | NR | 496 | Acupuncture Acupuncture plus HRT |
HRT | Cochrane tool, 0/8 | 0 | 5.4 | LH, FSH, estradiol | Moderate |
| Li | 2020 | China | POI | 14 | 31.21 | 1,030 | Acupuncture | HRT | Cochrane tool, 0/14 | 0 | 5.7 | LH, FSH, estradiol | High |
| Yuanbo | 2019 | China | POI | 14 | NR | 879 | Acupuncture plus TCM | HRT | Cochrane tool, 7/14 | 50 | 3.42 | LH, FSH, estradiol | Low |
| Runzi (54) | 2016 | China | POI | 7 | Under 40 | 538 | Acupuncture | HRT | NR | NR | NR | LH, FSH, estradiol | Low |
| Tingting (45) | 2018 | China | POI | 16 | NR | 1,357 | Acupuncture | HRT | Cochrane tool, 0/16 | 0 | 5.43 | LH, FSH, estradiol | Moderate |
| Xiaoyang (39) | 2019 | China | POI | 14 | NR | 962 | Acupuncture plus TCM Electroacupuncture plus TCM Auricular points plus TCM Acupoint catgut embedding plus TCM Moxibustion plus TCM |
HRT | Cochrane tool, 0/14 | 0 | 3.85 | LH, FSH, estradiol | Moderate |
| Meiling (51) | 2018 | China | POI | 10 | 32.25 | 690 | Needle acupuncture | HRT | Jadad score, 3/12 | 25 | 5.16 | LH, FSH, estradiol | Low |
| Xiaojuan (35) | 2022 | China | POI | 11 | Under 40 | 775 | Acupuncture | Shame acupuncture or HRT | Cochrane tool, 0/11 | 0 | 4.57 | FSH, estradiol | Moderate |
| Jin-Huan (47) | 2020 | China | POI | 16 | 32 | 1,102 | Acupuncture and Moxibustion | HRT | Cochrane tool, 5/16 | 31 | NR | LH, FSH, estradiol | Low |
| Xi (59) | 2016 | China | POI | 12 | 34.2 | 863 | Acupuncture Acupuncture plus HRT |
HRT | NR | NR | NR | LH, FSH | Moderate |
| Yong (58) | 2016 | China | POI | 9 | NR | 719 | Acupuncture | HRT | NR | NR | NR | LH, FSH, estradiol | Low |
| Zhang (41) | 2020 | China | POI | 16 | 32.93 | 1,307 | Acupuncture Warm acupuncture Acupoint catgut embedding Acupuncture and Moxibustion |
HRT | Cochrane tool, NR | NR | 3.75 | LH, FSH, estradiol | Moderate |
| Xiao | 2017 | China | POI | 7 | NR | 512 | Acupuncture plus HRT | HRT | NR | NR | 5 | LH, FSH, estradiol | Moderate |
| Long (36) | 2022 | China | POI | 32 | NR | 3,231 | Acupuncture and Moxibustion Acupoint catgut embedding Acupuncture plus HRT Acupoint catgut embedding plus HRT Moxibustion Acupuncture Acupuncture plus TCM |
HRT | Cochrane tool, 6/32 | 18 | 4.06 | FSH | Moderate |
TCM, traditional Chinese medicine; NR, not reported; LH, luteinizing hormone; FSH, follicle stimulating hormone; OGTT, oral glucose tolerance test; HOMA-IR, homeostatic model assessment for insulin resistance; BMI, body mass index; HRT, hormone replacement therapy; PCOS, polycystic ovary syndrome; POI, primary ovarian insufficiency.