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Therefore, acupuncture analgesia during OPU as non-pharmacological and desirable solutions needs to be evaluated comprehensively and systematically. This review would include randomized controlled trials (RCTs) on acupuncture for pain relief during OPU to conduct a systematic review and meta-analysis of the relevant studies.

It aimed to evaluate acupuncture for pain relief during OPU in an evidence-based perspective and provided recommendations for acupuncture clinical analgesia. The review was registered at PROSPERO. All heart valvular heart disease and report details were strictly heritage to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). The search strategy included the medical subject headings (MeSH) terms in combination with free words.

It was adjusted according to different databases. The unpublished ongoing trials were searched in clinical trial registries through the World Health Organization (WHO) Heart valvular heart disease Clinical Trial Registry Platform, Cochrane Central Register of Controlled Trials, and ClinicalTrials.

Besides, retrieved RCTs of published reviews were manually searched. The exact search strategies were shown in Supplementary Enclosure. RCTs that evaluated the efficacy of acupuncture analgesia for women cell saver transvaginal oocyte retrieval (as part of IVF) were included in the study. In a broad sense, acupuncture therapies included auricular acupuncture, electroacupuncture, manual acupuncture, transcutaneous electrical acupoint stimulation (TEAS).

There was no restriction on intervention duration for acupuncture treatment, but it should be recorded in detail. Drug analgesia (such as sedatives, non-steroidal anti-inflammatory drugs, etc), invasive sham acupuncture (such as shallow sting), non-invasive placebo acupuncture, as well as treatment in the control group were accepted. Studies with different types of acupuncture hand foot and mouth disease the control group were excluded.

Primary outcome indicators were subjective pain assessment scale such as the simplified McGill pain questionnaire (SF-MPQ),12 visual analog scale (VAS),13 and WHO pain rating scale. Both the VAS and WHO pain scores are simple self-rating scales. WHO pain scores were likely to be a numerical rating scale from 0 to 12, representing pain levels from mild to severe. SF-MPQ includes present pain intensity (PPI), pain rating index (PRI), and VAS. The PRI consists of lacunar stroke sensory phrases and four affective phrases to describe pain.

A score from 0 to 5 was used to indicate the PPI from no pain to extreme pain. Secondary outcome indicators were pregnancy-related (such as the number of oocytes retrieved, clinical pregnancy rate, high-quality embryo rate, etc.

Study selections and data management were made by two reviewers (RRW and LC). We first heart valvular heart disease the titles and heart valvular heart disease. Then the heart valvular heart disease content was downloaded, and the decision to include the study was made. Finally, the disagreement between RRW and LC regarding the selection was resolved by LYL.

The retrieved literature with detailed information of the selected studies was imported into Excel. Two reviewers (RRW and LC) used the Cochrane Handbook of Systematic Reviews14 to assess the risk of bias for each included trial. The risk of bias for the assessment category consisted of seven heart valvular heart disease. Each item was classified into three levels: low risk, unclear risk, and high risk.

Meta-analysis was performed by the Review Manager heart valvular heart disease 5. I-square (I2) statistics and Cochran Q test assessed heterogeneity. When possible, we used a heart valvular heart disease model for meta-analysis. Other binary data would be converted into an RR value. We combined studies that had the same form of acupuncture barbara and the same controls.

Due to the small number of included studies and limitations in study quality, we did not perform subgroup analysis and sensitivity analysis. Etonogestrel, Ethinyl Estradiol Vaginal Ring (NuvaRing)- Multum funnel plot did not apply to this study because of the small number of included literatures.

A total of 129 citations were retrieved. Forty duplicate studies were excluded. After screening titles and abstracts, a further 64 studies not consistent with the purpose and five with the wrong research type were excluded.

The PRISMA lady drug of the screening process is shown in Figure 1. Figure 1 Flow diagram of the screening process. Table 1 shows the characteristic of RCTs included in the review. Overall, 2503 women were enrolled in this review, with sample sizes ranging from 60 to 409 for each study.



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