Acupuncture Combined with Chinese Herbal Medicine for Tubal Obstructive Infertility: A Systematic Review and Meta-Analysis

Abstract Background: Tubal obstruction is the leading cause of infertility. Acupuncture and Chinese herbal medicine (CHM) are widely used in treating tubal obstruction infertility (TOI), and clinical research is increasing. However, there is still controversy about its efficacy and safety. This systematic review aimed to assess the efficacy and safety of acupuncture and CHM in treating TOI. Methods: We searched eight databases to collect randomized controlled trials comparing Hydrotubation with Acupuncture combined with CHM from inception to July 31, 2022. A total of 1580 papers were collected, and the methodological quality of the included trials was assessed in line with the criteria of the Cochrane risk of the bias assessment tool. In the end, only 18 randomized clinical trials met the requirements and were included. Results: Meta-analysis showed that acupuncture and CHM was associated with a higher pregnancy rate [RR 1.74, 95% CI (1.54, 1.95), P < 0.00001] and a lower ectopic pregnancy rate [OR 0.61, 95 % CI (0.19, 1.92), P＜0.0001]. The success rate of tubal recanalization was significantly improved with acupuncture combined with CHM treatment[RR 1.37, 95 % CI (1.20, 1.57), P＜0.0001], and signs and symptoms were better relieved [OR 3.44, 95 % CI (2.22, 5.33), P＜0.00001]. Conclusions: This meta-analysis suggests that acupuncture and CHM can be used as complementary therapies to treat tubal obstructive infertility with better outcomes than Hydrotubation.