Acupuncture Pretreatment Followed by Letrozole on Live Birth in
Anovulatory Women with Polycystic Ovary Syndrome: a Randomised
Controlled Trial
Abstract
Objective: To evaluate whether acupuncture pretreatment followed by
letrozole leads to a higher live birth rate in PCOS when compared with
letrozole alone. Design: Multicenter randomised controlled trial.
Setting: Three hospitals in China. Population or Sample: Anovulatory
women with PCOS aged from 20 to 40 years who had at least one patent
tube. Methods: Participants were randomly assigned to receive
acupuncture pretreatment followed by letrozole (pretreatment group) or
letrozole alone (control group). Acupuncture pretreatment was given
three times per week for 16 weeks, and letrozole was given five days per
cycle for up to four cycles. Main outcome measures: The cumulative live
birth rate (defined as a delivery after 20 weeks’ gestation). Results:
The cumulative live birth rate was 41.1% (79/192) in the pretreatment
group and 34.4% (66/192) in the control group with no significant
difference between groups but was significantly higher in the
pretreatment group (48/98, 49.0%) among those with baseline HOMA-IR
<2.14, when compared with the control group (19/66, 28.8%).
No significant differences were found between groups stratified by the
letrozole cycle number, body mass index, age, PCOS phenotype, or
hyperandrogenism. Conclusions: Acupuncture pretreatment followed by
letrozole did not increase the cumulative live birth rate of anovulatory
women with PCOS when compared with letrozole alone but may increase the
cumulative live birth rate in those whose baseline HOMA-IR is
<2.14. Key words: acupuncture, letrozole, live birth, PCOS,
pretreatment