2022 Frontiers in Public Health

The study found that acupuncture as an adjuvant therapy for frozen-thawed embryo transfer (FET) in infertile women had positive effects on pregnancy outcomes.

The study investigates the effects of acupuncture as supplementary therapy for frozen-thawed embryo transfer (FET) in infertile women. It finds significant positive impacts on clinical pregnancy rate, biochemical pregnancy rate, endometrial thickness, and pattern. However, the evidence quality is considered unsatisfactory, prompting a call for more robust research and refined acupuncture protocols.

Effects of acupuncture on the pregnancy outcomes of frozen-thawed embryo transfer: A systematic review and meta-analysis Zhu C, Xia W, Huang J, Zhang X, Li F, Yu X, Ma J, Zeng Q

2022 Current Drug Discovery Technologies

Edible medicinal plants like saffron, chamomile, dill seeds, and castor oil have demonstrated positive effects on various aspects of labor, indicating potential natural alternatives for aiding childbirth.

This systematic review explores the potential of oral herbs in aiding childbirth, given the rising interest in natural treatments despite advancements in medical interventions. More than 20% of pregnancies require labor induction, often associated with adverse effects and increased cesarean risk. The study investigates edible plants' impact on cervical readiness, labor onset, pain reduction, and labor duration. Among 20 clinical trials, saffron, chamomile, boiled dill seeds, date, date syrup, Descurainia Sophia, and castor oil have demonstrated positive effects on various labor aspects. Nonetheless, larger-scale studies are needed for a comprehensive understanding of these herbs' mechanisms and effectiveness in facilitating labor.

Edible Medicinal Plants on Facilitating Childbirth: A Systematic Review Ivari FR, Vatanchi AM, Yousefi M, Badaksh F, Salari R

2022 Frontiers in Endocrinology

PCOS patients suggests that combining acupuncture with metformin might enhance pregnancy and ovulation rates, as well as improve insulin resistance.

The study initially screened 330 relevant articles, eventually including nine randomized controlled trials (RCTs) that met the inclusion criteria. These trials encompassed 1,159 patients with PCOS who underwent acupuncture or acupuncture combined with metformin treatment. Using the GRADE method, a "Summary of Findings" table was employed to evaluate the quality of evidence for various outcome measures. The main results indicated that acupuncture combined with metformin exhibited superiority over metformin alone in terms of pregnancy rate, ovulation rate, and HOMA-IR (insulin resistance). Subgroup analysis highlighted that diagnostic criteria and random methods contributed to heterogeneity in results.

However, the evidence's quality was predominantly low or very low due to study limitations, inconsistencies, and imprecisions. The intervention measures, such as acupuncture methods and treatment parameters, varied substantially among studies. Challenges in contacting original authors and incomplete information posed further limitations. The study suggested potential improvements in pregnancy rate, ovulation rate, and HOMA-IR with acupuncture combined with metformin, but these findings were subject to uncertainties related to diagnostic criteria and overall evidence quality. Consequently, the conclusive efficacy of acupuncture combined with metformin for treating PCOS remains uncertain due to the dearth of high-quality research. The study called for well-designed and well-executed RCTs to address this question under standardized diagnostic criteria and treatment protocols for acupuncture and metformin.

Acupuncture combined with metformin versus metformin alone to improve pregnancy rate in polycystic ovary syndrome: A systematic review and meta-analysis Chen X, Lan Y, Yang L, Liu Y, Li H, Zhu X, Zhao Y, Long C, Wang M, Xie Q, Li Z, Wu J

2021 Evidence-Based Complementary and Alternative Medicine

Acupuncture is an effective approach for hyperemesis gravidarum and has a great potential to mitigate ketonuria, ease nausea and vomiting, increase food intake, and shorten the hospital stay.

Studies meeting inclusion criteria, from 1995 to 2020, have been incorporated into this meta-analysis to make evaluations on the outcome of acupuncture in the treatment of hyperemesis gravidarum (HG). Totally, 16 studies and 1043 patients (531 vs 512) were covered. According to this study, acupuncture was more effective than the conventional treatment of HG; it could better promote the conversion of the urinary ketone to improve ketonuria. In terms of symptoms, acupuncture seems to be more effective in reducing nausea and vomiting and increasing food intake.

In short, acupuncture is an effective approach for HG and has a great potential to mitigate ketonuria, ease nausea and vomiting, increase food intake, and shorten the hospital stay. There is some evidence that acupuncture may be utilized as a supplement and alternative to HG. However, the poor quality of the incorporated studies and potential publication bias can exert a certain impact on the results. For the better clinical application and promotion of acupuncture in the treatment of HG, more large-scale samples, multi-center, and top-quality RCTs are needed urgently. In the future, it is necessary to further study the relationship between acupuncture and conventional medication and acupuncture placebo to obtain the best clinical solution.

Effectiveness of Acupuncture in the Treatment of Hyperemesis Gravidarum: A Systematic Review and Meta-Analysis Haizhen Lu, Chengwen Zheng, Yanmei Zhong, Linhao Cheng, Yi Zhou

2021 Metabolites

The date palm enhances both male and female fertility parameters through its nutritional attributes and antioxidant functionality.

The research conducted a thorough review of the role of date palm in treating infertility. The health benefits of date palm and its varied components were explored, with a focus on their effects on reproductive parameters in both sexes. The comprehensive review shed light on how the substantial nutrients and antioxidant features of date palm can be beneficial for people dealing with infertility.

In men, the study found direct links between consumption of date palm and improved hormonal levels alongside notable enhancements in seminal vesicle parameters and sperm quality. For women, this natural remedy showed a positive impact on the process of oogenesis, hormone regulation, and improving pregnancy outcomes. The focus was on the potential of date fruit as a natural enhancer of fertility, downplaying the role of any synthetic or invasive medical interventions. The study thus testifies to the innovative use of a widely available natural resource in addressing a pressing health issue.

Therapeutic Potential of Date Palm against Human Infertility: A Review Shehzad M, Rasheed H, Naqvi SA, Al-Khayri JM, Lorenzo JM, Alaghbari MA, Manzoor MF, Aadil RM

2021 Current Reviews in Clinical and Experimental Pharmacology

Inhalation of chamomile oil significantly reduces pain after cesarean section in first-time mothers, decreasing the need for analgesics.

The study was a randomized, double-blind clinical trial involving 128 first-time pregnant women who elected to have a cesarean section. Participants were either given one drop of 5% chamomile oil, or a placebo drop, which they inhaled for 15-20 minutes from a distance of 5 cm from their noses, concurrently at 4, 8, and 12 hours after surgery. Pain intensity was measured using the Visual Analog Scale (VAS) both half an hour before and after the inhalation.

The results revealed that there was no significant statistical difference between the chamomile and placebo group regarding baseline pain prior to the intervention. However, after the administration of the chamomile oil or placebo, a significant difference in pain was observed at 4, 8, and 12 hours after the intervention. Chamomile oil inhalation was found to dramatically reduce the intensity of pain compared to the post-intervention pain experienced by the placebo group. The use of chamomile oil as a form of aromatherapy after the cesarean section was noted to not only reduce pain in first-time mothers, but also lessen their need for analgesics.

Effect of Chamomile Oil on Cesarean Section Pain in Primiparous Women: A Randomized Clinical Trial Zardosht R, Basiri A, Sahebkar A, Emami SA

2020 Nutrients

Ginger has been effective in a majority of studies, including those that examined the alleviation of nausea and vomiting of pregnancy, digestive function, improvement in the expression level of markers for colorectal cancer risk, and anti-inflammatory functions.

Ginger is a natural spice that is used in diverse regions to add a pungent flavor to food. Furthermore, ginger has been used as an herbal medicine for common health problems. This systematic review is the first study that has exclusively collected RCTs regarding the efficiency of ginger in several human health conditions. The clinical effects of ginger have been introduced as six subsections: nausea and vomiting, gastrointestinal function, pain, inflammation, metabolic syndromes, and other symptoms. Reportedly, ginger has been effective in a majority of studies, including those that examined the alleviation of nausea and vomiting of pregnancy, digestive function, improvement in the expression level of markers for colorectal cancer risk, and anti-inflammatory functions. Several other functions have also been regarded as beneficial in trials, with some confronting results. However, a few drawbacks regarding the quality of the trials, inconsistent evaluation systems or parameters, and the generally small size of the studies need to be noted. Therefore, systematically designed research with detailed descriptions of methodology and a sufficient pool of participants is necessary for future clinical trials to address the functional characteristics of ginger.

Ginger on Human Health: A Comprehensive Systematic Review of 109 Randomized Controlled Trials Anh NH, Kim SJ, Long NP, Min JE, Yoon YC, Lee EG, Kim M, Kim TJ, Yang YY, Son EY, Yoon SJ, Diem NC, Kim HM, Kwon SW.

2020 BioMed Research International

Endometriosis and Adenomyosis can have impact on miscarriage risk in pregnancy.

The study analyzed 39 publications involving 697,984 women to assess the impact of endometriosis (EMS) and adenomyosis (AD) on miscarriage risk. Women with EMS showed increased miscarriage risk in spontaneous conception (SC), but similar risk in assisted reproductive technology (ART) compared to tubal infertility. AD was associated with higher miscarriage risk in ART. Sensitivity analyses supported these conclusions. EMS staging did not significantly alter miscarriage risk. Early-stage EMS showed higher early abortion risk. No significant associations were found between EMS and low birthweight, placental abruption, intrauterine growth restriction, or preeclampsia. EMS correlated with higher odds of antepartum hemorrhage, postpartum hemorrhage, preterm birth, placenta praevia, and stillbirth. SUP and DIE were linked to increased miscarriage risk, while OMA showed no significant association. The findings suggest the need for closer monitoring and follow-up for pregnant women with EMS or AD, particularly in early pregnancy. Standardized recording of EMS types, stages, and miscarriage timing is recommended for future studies.

Miscarriage on Endometriosis and Adenomyosis in Women by Assisted Reproductive Technology or with Spontaneous Conception: A Systematic Review and Meta-Analysis Yangxue Huang, Xianhong Zhao, Yiyuan Chen, Jie Wang, Weilin Zheng, Lixing Cao

2020 Complementary Therapies in Medicine

Clinical trials categorize botanical parts of date palm as being most effective in eight different areas such as obstetrics, oncology, and endocrinology.

In the study, a comprehensive review was conducted on all types of clinical trials (including randomized, pilot, quasi-experimental, cross-over, and non-randomized) assessing the clinical impacts of date palm for the period between 2000 to August 2019. These trials were sourced from both English and Persian language papers. The methodological quality of these trials was scrutinized based on the risk of bias assessment laid out by the Cochrane handbook of systematic reviews and subsequently, results were reported via the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement.

The study saw twenty-six research works fitting the criteria set for inclusion. These studies spanned across eight categories based on the varied botanical derivatives of the date palm. These categories consisted of fields like obstetrics, gynecology, oncology, dermatology, hematology, gastroenterology, endocrinology, metabolism, and infertility. However, there were concerns raised regarding existing biases in trial conduction, with about 80% of the studies indicating performance and detection bias, roughly half indicating selection bias, and about 20% indicating attrition and reporting bias. Regardless, these clinical trials provide useful insights into the possible health benefits of various date palm components.

Clinical effects of date palm (Phoenix dactylifera L.): A systematic review on clinical trials Bagherzadeh karimi A, Elmi A, Zargaran A, Mirghafourvand M, Fazljou SMB, araj-Khodaei M, Baghervand Navid R

2019 BioMed Research International

Acupuncture could reduce Hamilton Rating Scale for Depression (HAMD) scores for postpartum depression.

Though our meta-analysis revealed that acupuncture had a lower efficacy compared to other antidepression treatments, symptoms of depression relief were observed in the majority of the studies analysed. These findings indicate that although the efficacy of acupuncture was lower compared to antidepressants, the benefits of acupuncture were still attractive to women with postpartum depression due to their negligible side-effects.

In summary, despite the limitations mentioned above, this current systematic review suggests that acupuncture could reduce HAMD scores. However, EPDS, clinical response, and serum estradiol levels were unaffected by acupuncture treatment. Furthermore, our analysis revealed that treatment efficacy was variable and depended on the control types used. Large-scale and well-designed RCTs are required before a conclusive statement could be made regarding the efficacy of acupuncture for the treatment of postpartum depression.

Effectiveness of Acupuncture Used for the Management of Postpartum Depression: A Systematic Review and Meta-Analysis Li W, Yin P, Lao L, Xu S

2019 Journal of Pharmaceutical Research International

Administration of honey saffron syrup reduces the length of all stages of labor in nulliparous women.

The study divided eligible nulliparous women randomly into three equal groups. The first group was given saffron syrup prepared with honey, the second group received saffron syrup made with sugar, and the control group received a placebo. These were given orally every two hours. Analysis was conducted via Fisher’s test, ANOVA with Fisher’s post hoc test, and a Repeated measure statistical method.

In the results, it was evident that the mean duration of labor in the groups administered with the saffron syrups was significantly shorter than in the control group. Moreover, the length of the first stage of labor in the honey saffron syrup group was considerably less than in the sugar saffron syrup group. This indicates the effectiveness of honey saffron in shortening labor duration.

The Effect of Honey Saffron Syrup on Labor Progression in Nulliparous Women Ghaderi S, Zaheri F, Nouri B, Shahoei R

2019 Women and Birth

Aromatherapy significantly reduces labor pain and duration without impacting emergency caesarean section, membrane rupture, and the onset of spontaneous labor.

Researchers undertook a meta-analysis of randomized controlled trials for determining the efficacy of aromatherapy in mitigating labor pain and reducing its duration. Various academic and scientific databases such as PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Google Scholar, and Clinicaltrials.gov were employed to find relevant trials. A total of 17 trials involving low-risk laboring women were identified and included in the meta-analysis.

Observations from the meta-analysis revealed that aromatherapy effectively alleviated labor pain during the transition phase and reduced the periods of active phase and third stage labor. Additionally, a trend of decreasing duration was noticed during the second stage. Notably, aromatherapy did not have any marked effects on emergency caesarean sections, membrane ruptures, or the initiation of spontaneous labor, indicating its general safety for expectant mothers. However, the diversity of outcomes across different trials was noted.

Labour pain control by aromatherapy: A meta-analysis of randomised controlled trials Chen SF, Wang CH, Chan PT, Chiang HW, Hu TM, Tam KW, Loh EW

2018 Acupuncture in Medicine

Acupuncture appears to be effective for postpartum depression with respect to certain outcomes.

Nine trials involving 653 women were selected. The result of this meta-analysis demonstrated that the acupuncture group had a significantly greater overall effective rate compared with the control group. Moreover, acupuncture significantly increased oestradiol levels compared with the control group. Regarding the Hamilton Rating Scale for Depression (HAMD) and Edinburgh Postnatal Depression Scale (EPDS) scores, no difference was found between the two groups.

Effectiveness of Acupuncture in Postpartum Depression: A Systematic Review and Meta-Analysis Li S, Zhong W, Peng W, Jiang G

2018 British Journal of Midwifery

Acupuncture in postpartum depression was at least as effective as fluoxetine hydrochloride, supporting the notion that acupuncture may be a safe and effective option.

Of the 1592 studies reviewed, three met the inclusion criteria for quantitative analysis. Two studies reported no significant differences between acupuncture and fluoxetine for depression, while the third reported significant improvements.

Acupuncture versus antidepressants in the management of postpartum depression: A systematic review Akari Komori, David Arthur, Samara Radford, Hsiewe Ying Tan, Li Zheng, Mira An, Rika Umeda, and Zhen Zheng

2018 Nursing and Midwifery Studies

Inhalation aromatherapy with Boswellia Carterii essential oil can significantly reduce labor pain intensity in nulliparous women.

In this randomized controlled trial, 126 nulliparous women were split into two groups — an aromatherapy group and a placebo group. A piece of gauze was soaked with Boswellia Carterii essential oil diluted in normal saline for the aromatherapy group and was attached to the collar of each woman in this group. This intervention was repeated at 30-minute intervals up to a cervical dilation of 10 centimeters. The placebo group intervention mirrored those of the aromatherapy group but used only normal saline on the gauze. The intensity of labor pain was assessed before the intervention and at certain cervical dilation stages using a numeric pain rating scale.

The results revealed that the aromatherapy group experienced significantly less labor pain compared to the placebo group at all tracked stages of cervical dilation. It was found that Boswellia Carterii essential oil can indeed mitigate labor pain when used in inhalation aromatherapy. No significant differences were observed concerning the 1 and 5 minute Apgar scores across both groups.

The effects of inhalation aromatherapy with Boswellia carterii essential oil on the intensity of labor pain among nulliparous women Esmaelzadeh-Saeieh S, Rahimzadeh M, Khosravi-Dehaghi N, Torkashvand S

2016 BMC Pregnancy and Childbirth

Acupuncture was a feasible intervention and reduced threatened miscarriage symptoms when compared to a touch intervention.

Threatened miscarriage is a common complication of early pregnancy increasing the risk of miscarriage or premature labour. Currently there is limited evidence to recommend any biomedical pharmacological or self-care management, resulting in a ‘watchful waiting’ approach. The objective of this study was to examine the feasibility of offering acupuncture as a therapeutic treatment for women presenting with threatened miscarriage.

Acupuncture was a feasible intervention and reduced threatened miscarriage symptoms when compared to a touch intervention. Further research is required to further explore acupuncture use for this common complication and whether it can reduce the incidence of miscarriage.

Does acupuncture have a role in the treatment of threatened miscarriage? Findings from a feasibility randomised trial and semi-structured participant interviews Betts D, Smith CA, Dahlen HG.

2014 Acupuncture in Medicine

Acupuncture during pregnancy appears to be associated with few adverse events when correctly applied.

Of 105 included studies, detailed adverse events (AE) were reported only in 25 studies represented by 27 articles (25.7%). AEs evaluated as certain, probable or possible in the causality assessment were all mild/moderate in severity, with needling pain being the most frequent. Severe AEs or deaths were few and all considered unlikely to have been caused by acupuncture. Total AE incidence was 1.9%, and the incidence of AEs evaluated as certainly, probably or possibly causally related to acupuncture was 1.3%.

The Safety of Acupuncture during Pregnancy: A Systematic Review Park J, Sohn Y, White AR, Lee H.

2013 Medical Acupuncture

There is high-level evidence to support the use of acupuncture for treating major depressive disorder in pregnancy.

Six articles used the desired inclusion and exclusion criteria. The quality of research varied heavily. Five studies were properly randomized. Three were double-blinded. Three used individualized acupuncture. Four studies were of at least reasonable quality. One was of marginal quality, and one was of poor quality. There was a significant difference between acupuncture and at least one control in all six trials.

Acupuncture for Treating Anxiety and Depression in Women: A Clinical Systematic Review Sniezek DP, Siddiqui IJ.

2013 Medical Acupuncture

Acupuncture's efficacy in treating gynecologic and obstetric disorders

This comprehensive review evaluates acupuncture's efficacy and safety in treating gynecologic and obstetric disorders. Examining systematic reviews and randomized controlled trials, the study addresses conditions like pregnancy-related pelvic and low-back pain, labor pain, primary dysmenorrhea, and menopausal symptoms. The results are inconclusive, with some evidence supporting acupuncture's potential in reducing pelvic and back pain during pregnancy and alleviating climacteric vasomotor symptoms. However, more rigorous research is necessary for definitive conclusions. Adverse effects were minimal. The review emphasizes the need for well-designed studies to enhance the precision and reliability of findings regarding acupuncture's therapeutic benefits in these disorders.

Efficacy and Safety of Needle Acupuncture for Treating Gynecologic and Obstetric Disorders: An Overview Selva Olid A, Martinez Zapata MJ, Sola I, Stojanovic Z, Uriona Tuma SM, Bonfill Cosp X.