Clinical evidence of acupuncture for infertile women with diminished ovarian reserve undergoing IVF/ICSI: a systematic review and meta-analysis.

Background: Diminished ovarian reserve (DOR) is a major cause of infertility and remains a core challenge in reproductive medicine. Although previous studies have suggested that acupuncture may improve reproductive outcomes in infertile women with DOR undergoing Methods: Eight databases were systematically searched for eligible RCTs up to February 28, 2026. The findings were presented in forest plots, with one primary outcome and ten secondary outcomes. Sensitivity analyses were carried out to assess the robustness of the pooled estimates. Subgroup analyses were conducted to explore whether the efficacy of acupuncture on the primary outcome was associated with the type of acupuncture or the number of acupoints adopted per treatment. Evidence grading was performed using the GRADEpro GDT. Results: 11 RCTs involving 885 infertile women with DOR undergoing IVF/ICSI were finally included in the meta-analysis. The pooled evidence showed that acupuncture remarkably increased clinical pregnancy rate by 25% (risk difference [RD] = 0.25, 95% CI: 0.18 to 0.32; Conclusions: Based on this pooled clinical evidence, acupuncture may be a beneficial intervention for improving clinical outcomes in women with DOR undergoing IVF/ICSI, although confirmation by future rigorously designed RCTs is warranted. Systematic Review Registration: https://www.crd.york.ac.uk, identifier CRD420261330054.