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Abstract
Background and Aims
There is evidence of the beneficial effects of acupuncture in the treatment of polycystic ovary syndrome (PCOS). This study aimed to compare acupuncture with clomiphene in ovulation induction among infertile women with PCOS.
Methods
This randomized clinical trial was conducted on infertile women with PCOS who were referred to the gynecology clinic of Imam Reza Hospital and Milad Infertility Center, Mashhad, Iran, from December 2015 to July 2016. Patients were randomly assigned to two groups; the intervention group (38 patients) received true acupuncture plus placebo clomiphene, whereas the control group (39 patients) received clomiphene plus sham acupuncture. Patients were compared in terms of folliculare growth, evidence of ovulation, and side effects of treatment.
Results
There was no statistically significant difference between the two groups in terms of demographic characteristics and PCOS criteria. The ovulation rates were 31.5% and 41.6% in the intervention and control groups respectively, indicating no statistically significant difference(p = 0.36). Also, in terms of side effects, the statistical difference between the two groups was not significant, except for headache which was significantly more common in the intervention group (p = 0.001). The rate of folliculargrowth was significantly higher in the control group during the first and third cycles (p = 0.01), whereas no significant difference was observed in the second cycle (p = 0.93).
Conclusion
Acupuncture can be as effective as clomiphene treatment in inducing ovulation in infertile women with PCOS. Moreover, considering the few side effects of acupuncture, its application can be considered a safe option.
Chen S et al., 2026·International journal of women's health
Polycystic ovary syndrome (PCOS) is a heterogeneous reproductive, endocrine, and metabolic disorder in which autonomic, neuroendocrine, inflammatory, and metabolic abnormalities may converge on ovarian and endometrial function. This narrative review evaluates evidence relevant to acupuncture in PCOS, with emphasis on evidence source, directness, and clinically meaningful reproductive outcomes. PubMed, Embase, and Web of Science were searched from inception to March 31, 2026, supplemented by backward citation tracking. We prioritized human PCOS trials and mechanistic studies, followed by PCOS-specific preclinical evidence; findings from other conditions were included only as explicitly labeled indirect evidence. No formal risk-of-bias assessment or meta-analysis was undertaken. Clinical evidence most consistently suggests possible effects on menstrual or ovulatory function, sympathetic activity, and insulin resistance, although results vary across protocols and PCOS phenotypes. Evidence for pregnancy, ongoing pregnancy, embryo quality, and live birth remains limited and inconsistent, and acupuncture has not been established as a substitute for guideline-based fertility treatment. Human data directly linking acupuncture to immune-cell reprogramming, endometrial immune tolerance, or correction of window-of-implantation timing are scarce. PCOS-specific animal studies provide plausible signals involving hypothalamic-pituitary-ovarian regulation, ovarian sympathetic signaling, inflammatory pathways, oxidative stress, and insulin signaling, but these findings cannot be assumed to translate to clinical reproductive benefit. Overall, the neuroendocrine-immune framework is best viewed as a hypothesis-guiding map that distinguishes relatively supported clinical domains from preclinical and indirect mechanisms. Future trials should combine standardized acupuncture protocols with phenotype stratification, prespecified ovulation, ongoing-pregnancy, and live-birth outcomes, and longitudinal autonomic, metabolic, inflammatory, ovarian, and endometrial measurements.
El-Shamy FF et al., 2018·Journal of lasers in medical sciences
Polycystic ovarian syndrome (PCOS) is one of the most widely recognized reasons for infertility. The aim of this study was to examine the impact of laser acupuncture on PCOS women. Twenty-five PCOS women were randomly allocated to either the study group (SG; n=13), treated by laser acupuncture, or the control group (CG; n = 12). Blood hormonal levels and insulin resistance were measured at baseline and after 12 weeks of intervention. The pre-intervention levels showed no statistically significant differences between SG and CG for baseline characteristics (P>0.05). After 12 weeks of intervention, within-group analyses showed that body mass index (BMI), blood hormonal levels, and insulin resistance were significantly decreased (P<0.05), while no significant changes in follicle-stimulating hormone (P>0.05) were recorded in the 2 groups. Between-groups analyses showed that most outcomes measures were significantly decreased (P<0.05) in SG compared with CG, with no significant changes in FSH and BMI (P>0.05). Laser acupuncture can be suggested as an effective management for PCOS women.
Gao Y et al., 2022·Frontiers in Endocrinology·Free full text on PubMed Central
Polycystic ovary syndrome (PCOS) is one of the most common reasons for infertility. The consensus of the treatment of infertile women with PCOS is ovulation induction (OI) for six to nine attempts beforein vitrofertilization (IVF)/intracytoplasmic sperm injection (ICSI). Nowadays, more attention was paid to a rising, noninvasive treatment, intrauterine insemination (IUI), as some experts claimed IUI could benefit PCOS patients with infertility. Our study means to investigate the outcomes of IUI for PCOS patients and if patients’ previous OI cycles can be a predictive factor for IUI outcomes. A total of 1,086 PCOS patients was included and 1,868 IUI cycles were performed between January 2007 and July 2021 in the department of assisted reproduction in Shanghai Ninth People’s Hospital. All included patients underwent IUI treatments with letrozole+human menopausal gonadotropin (LE+hMG) for ovarian stimulation. The pregnancy outcomes were not associated with the attempts of failed OI cycles previously. Specifically, the clinical pregnancy rate was 21.14% for PCOS patients without previous OI cycles, 21.95% for PCOS patients with 1-2 previous OI cycles and 23.64% for PCOS patients with 3 or more previous OI cycles (p=0.507). The corresponding live birth rate was 16.64%, 18.06%, and 18.68%, respectively, of which the difference was not statistically significant (p=0.627). The cumulative rate per patient was 38.59% for clinical pregnancy and 31.03% for live birth, and approximately 98% of the pregnancies occurred in the first 3 cycles of IUI. PCOS women with different attempts of OI cycles had similar pregnancy outcomes after IUI, thus a history of repeated failures of OI treatments was not a predictive factor for the pregnancy outcomes in IUI cycles. Most pregnancies occurred in the first three cycles of IUI, so we strongly recommended three attempts of IUI for PCOS women before they switched to IVF/ICSI. Generally, IUI might be an assist for infertile women with PCOS before IVF/ICSI and might accelerate pregnancy for target women without invasive manipulations.
Despite the widespread use of clomiphene citrate (CC) for ovulation induction, the pregnancy rates (PRs) in women who take CC are less than expected based on ovulation rates. The causes of this discrepancy between the PRs and ovulation rates have been explained by the antiestrogenic effects on cervical mucus and endometrial differentiation (1). Despite these adverse effects, CC therapy is so simple and safe that it is widely administered even to normally ovulatory women in the expectation of inducing multiple ovulation and increasing the chances of conception.
On the other hand, cyclofenil, which has been reported to exert less antiestrogenic activity than CC (2), is also used to treat infertile women with not only anovulatory cycles but normal ovulatory cycles. The purpose of this study was to assess whether administration of CC or cyclofenil to women with normal ovulatory cycles is beneficial.
One hundred fifty-five normally ovulatory women who received treatment for infertility at Shiga University of Medical Science from June 1998 to June 1999 were recruited for this study. Patients with ovulatory disorders, such as irregular cycles, hypothalamic or pituitary amenorrhea, polycystic ovary syndrome, premature ovarian failure, and hyperprolactinemia, were excluded from the study. Patients with bilateral tubal obstruction or azoospermia were also excluded.
Administration of CC or cyclofenil was withheld for a period of 3 months after the first visit while the timing of coitus was advised. Patients were advised to have sexual intercourse within 24 hours after confirmation of a positive urinary LH with a urinary LH surge detection kit (Gold-sign LH, Morinaga Nyugyo, Tokyo, Japan).
Then the patients who did not conceive were sequentially allocated to three groups: a CC-treated group, a cyclofenil-treated group, and a group with no administration. Briefly, the first patient enrolled in the study was assigned to a CC-treated group, the second patient was assigned to a cyclofenil-treated group, and the third patient was assigned to a group with no administration. Then the fourth patient was assigned to the CC-treated group, and so forth.