The impact of acupuncture and moxibustion treatment in individuals with recurrent implantation failures: A systematic review and meta-analysis.

BACKGROUND: The therapeutic efficacy of acupuncture and moxibustion in addressing recurrent implantation failure (RIF) remains a topic of debate. This systematic review and meta-analysis aims to synthesize current evidence on the benefits of acupuncture and moxibustion for patients with RIF. METHODS: Embase, PubMed, Cochrane, Web of Science, CBM, WanFang, CNKI, and VIP databases were retrieved, with the search period spanning from each database's inception to January 19, 2024, and an updated search was conducted on September 18, 2025. Studies were selected based on predefined criteria, and the quality was assessed using the RoB-2 tool. Data were analyzed using Review Manager5.3 software. RESULTS: The meta-analysis included 15 studies, encompassing 1029 subjects. The results revealed several notable benefits of acupuncture and moxibustion in patients grappling with RIF. Statistically significant enhancements were observed in clinical pregnancy rates (risk ratio [RR] = 1.84, 95% confidence interval [CI] = 1.53-2.20, P < .05), live birth rates (RR = 2.39, 95% CI = 1.59-3.58, P < .05), endometrial thickness (mean difference [MD] = 1.37, 95% CI = 0.95-1.80, P < .05), endometrial morphology (RR = 1.67, 95% CI = 1.30-2.14, P < .05), and serum estradiol levels (standardized mean difference = 2.70, 95% CI = 0.20-5.21, P < .05) when acupuncture and moxibustion therapy was administered, compared to the control group. A subgroup analysis was conducted on the outcome of endometrial thickness, and the results showed that: interventions lasting for 3 menstrual cycles (MD = 1.62, 95% CI: 0.92-2.33, P < .001, I² = 92.4%), treatment using electroacupuncture combined with warm acupuncture (MD = 2.41, 95% CI: 2.05-2.77, P < .001, I² = 0%), and the use of staged acupuncture point selection (MD = 2.41, 95% CI: 2.05-2.77, P < .001, I² = 0%) were more effective in increasing endometrial thickness in patients with repeated implantation failure. CONCLUSION: In comparison to continuous oral estrogen and traditional hormone replacement therapies, acupuncture and moxibustion treatment has been found to provide more substantial advantages in enhancing clinical pregnancy rates, live birth rates, endometrial thickness, endometrial morphology, and serum estradiol levels among patients experiencing RIF.