SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Reproduction
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1610338
This article is part of the Research TopicTraditional Chinese Medicine Strategies for Preventing and Treating Reproductive Endocrine Disorders Caused by Various FactorsView all 9 articles
Dose-Response of Acupuncture on Ovulation Rates in Polycystic Ovary Syndrome：A meta-analysis and exploratory dose-response analysis
Provisionally accepted
- 1Shandong University of Traditional Chinese Medicine, Jinan, China
- 2Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
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Objective: This study aimed to evaluate the efficacy of acupuncture in improving ovulation rates in women with polycystic ovary syndrome (PCOS) and to identify optimal dosage parameters, including the number of acupoints, treatment frequency, and session duration, using integrated pairwise meta-analysis, network meta-analysis (NMA), and model-based dose-response modeling.Methods: Nine databases were searched up to January 2025, yielding 43 randomized controlled trials (RCTs) involving 4,827 participants that compared acupuncture with sham acupuncture, pharmacotherapy, or conventional therapy control group. Pairwise meta-analysis, NMA, and model-based dose-response modeling were performed.Results: Acupuncture alone significantly increased ovulation rates compared with sham acupuncture (RR = 1.15, 95% CI: 1.04-1.27) and pharmacotherapy (RR = 1.11, 95% CI: 1.04-1.20). Additionally, acupuncture combined with herbal medicine outperformed pharmacotherapy (RR = 1.27, 95% CI: 1.12-1.43). NMA ranked acupuncture combined with herbal medicine as the most effective intervention (SUCRA = 97.8%). Dose-response modeling identified the following optimal protocols: for acupuncture alone, 30 minutes per session, 29 acupoints, three sessions per week for 24 weeks; and for combined therapy, 19 minutes per session, 26 acupoints, four sessions per week for 24 weeks.Acupuncture is an effective non-pharmacological intervention for PCOSrelated ovulatory dysfunction, with its efficacy dependent on precise dosing parameters.These findings highlight the need for standardized protocols in future trials to validate dose-response thresholds and to optimize personalized treatment strategies.
Keywords: Acupuncture, Polycystic Ovary Syndrome, Ovulation, Meta-analysis, Dose-response analysis
Received: 11 Apr 2025; Accepted: 07 Aug 2025.
Copyright: © 2025 Wei, SHEN, Zhao, Xie, Bai, Yin and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jian Wang, Shandong University of Traditional Chinese Medicine, Jinan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.