KOMBINASI AKUPUNTUR DENGAN METFORMIN ATAU CLOMIPHENE CITRATE TERHADAP POLYCYSTIC OVARY SYNDROME DALAM MENINGKATKAN KEHAMILAN
COMBINATION OF ACUPUNCTURE WITH METFORMIN OR CLOMIPHENE CITRATE FOR POLYCYSTIC OVARY SYNDROME IN PROMOTING PREGNANCY
Abstract
Polycystic Ovary Syndrome (PCOS) is one of the diseases that can cause infertility for women. Pharmacological therapy given is either metformin or clomiphene citrate while non-pharmacological is acupuncture. Both therapies have been shown to be beneficial in increasing pregnancy. Therefore, the purpose of this review is to determine the effect of the combination of acupuncture against metformin or clomiphene in increasing pregnancy rates. The method used was a literature review sourced from Google Scholar, Pub Med, Science Direct. Then identification, screening, adjustment of inclusion and exclusion variables were carried out and then selected titles, abstracts and contents so that only 6 articles were discussed. The results obtained that the combination therapy of acupuncture with metformin has better clinical effectiveness than clomiphene citrate because of minimal side effects and satisfactory outcomes in increasing pregnancy. Thus, it is hoped that further research will be carried out in the use of a combination of acupuncture therapy with metformin or clomiphene citrate.
Abstrak
Polycystic Ovary Syndrome (PCOS) merupakan salah satu penyakit yang dapat mengakibatkan infertilitas bagi wanita. Terapi farmakologi yang diberikan yaitu baik metformin atau clomiphene citrate sedangkan non farmakologi berupa akupuntur. Kedua terapi tersebut terbukti bermanfaat dalam meningkatkan kehamilan. Oleh sebab itu, tujuan tinjauan ini adalah untuk mengetahui efek kombinasi akupuntur terhadap metformin atau clomiphene dalam meningkatkan tingkat kehamilan. Metode yang digunakan berupa kajian literatur yang bersumber dari Google Scholar, Pub Med, Science Direct. Kemudian dilakukan identifikasi, skrining, penyesuaian terhadap variabel inklusi dan eksklusi lalu dilakukan seleksi judul, abstrak dan isi maka yang hanya dibahas berjumlah 6 artikel. Hasil yang didapatkan bahwasannya terapi kombinasi akupuntur dengan metformin memiliki efektifitas klinis yang lebih baik dibandingkan clomiphene citrate sebab efek samping yang lebih minim serta outcomes yang cukup memuaskan dalam meningkatkan kehamilan. Dengan demikian, diharapkan dilakukannya penelitian lebih lanjut dalam pemanfaatan kombinasi terapi akupuntur dengan metformin atau clomiphene citrate.
References
Callahan TL, Caughey A. Blueprint Obstetrics and Gynecology edisi Seventh. 2018. 159–458 p.
Khan A, Karim N, Ainuddin JA, Fahim MF. Polycystic ovarian syndrome: Correlation between clinical hyperandrogenism, anthropometric, metabolic and endocrine parameters. Pakistan J Med Sci. 2019;35(5):1227–32.
Sadeghi HM, Adeli I, Calina D, Docea AO, Mousavi T, Daniali M, et al. Polycystic Ovary Syndrome: A Comprehensive Review of Pathogenesis, Management, and Drug Repurposing. Int J Mol Sci. 2022;23(2).
Bulsara J, Patel P, Soni A, Acharya S. A review: Brief insight into Polycystic Ovarian syndrome. Endocr Metab Sci [Internet]. 2021;3(November 2020):100085. Available from: https://doi.org/10.1016/j.endmts.2021.100085
Deswal R, Narwal V, Dang A, Pundir CS. The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. J Hum Reprod Sci. 2020;13(4):261–71.
Syah I, Loho M, Wagey F. Luaran Pemberian Klomifen Sitrat Berupa Angka Keberhasilan Kehamilan Pada Wanita Sindrom Ovarium Polikistik. e-CliniC. 2015;3(1):6–8.
Suprihanto D. Tahun 2022. Popo. 2022;1(2):1–5.
Mareta R, Amran R. Hubungan Polycystic Ovary Syndrome (PCOS) dengan Infertilitas di Praktik Swasta Dokter Obstetri Ginekologi Palembang. Maj Kedokt Sriwij [Internet]. 2018;50(2):85–91. Available from: https://ejournal.unsri.ac.id/index.php/mks/article/view/8552
Sirait BI. Sindroma Ovarium Polikistik dan Infertilitas. J Ilm WIDYA. 2018;5(3):1–6.
Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol. 2013;6(1):1–13.
Lv Z, Guo Y. Metformin and Its Benefits for Various Diseases. Front Endocrinol (Lausanne). 2020;11(April):1–10.
Johansson J, Stener-Victorin E. Polycystic ovary syndrome: Effect and mechanisms of acupuncture for ovulation induction. Evidence-based Complement Altern Med. 2013;2013.
Cebral, Jua; Mut F, Weir, Jane; Putman C. 基因的改变NIH Public Access. Bone. 2011;23(1):1–7.
Muharam R, Srilestari A, Mihardja H, Callestya LJ, Harzif AK. Combination of electroacupuncture and pharmacological treatment improves insulin resistance in women with polycystic ovary syndrome: Double-blind randomized clinical trial. Int J Reprod Biomed. 2022;20(4):289–98.
Sun Y, Liu X, Ding Q, Yin S, Yang H. Acupuncture combined with metformin for polycystic ovary syndrome: A protocol for systematic review and meta-analysis. Med (United States). 2022;101(49):E32234.
Chen X, Lan Y, Yang L, Liu Y, Li H, Zhu X, et al. Acupuncture combined with metformin versus metformin alone to improve pregnancy rate in polycystic ovary syndrome: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2022;13(August):1–11.
Ma HL, Xie LZ, Gao JS, Cong J, Deng YY, Ng EHY, et al. Acupuncture and clomiphene for Chinese women with polycystic ovary syndrome (PCOSAct): Statistical analysis approach with the revision and explanation. Trials. 2018;19(1):1–10.
Gao R, Guo B, Bai J, Wu Y, Wu K. Acupuncture and clomiphene citrate for anovulatory infertility: a systematic review and meta-analysis. Acupunct Med. 2020;38(1):25–36.
Xi T, Liu Y, Bao X, Mi S. Effects of acupuncture on rates of ovulation and pregnancy in women with unruptured follicular luteinization syndrome: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2019;98(42):e17294.
Wonggokusuma G (Gerry). The Pathophysiology and Treatment of Polycystic Ovarian Syndrome: A Systematic Review. Cermin Dunia Kedokt [Internet]. 2014;41(2):398517. Available from: https://www.neliti.com/publications/398517/
Witchel SF, Oberfield SE, Peña AS. Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment with Emphasis on Adolescent Girls. J Endocr Soc. 2019;3(8):1545–73.
Gangakhedkar GR, Kulkarni AP. Physiological PregnancyChanges in. Indian J Crit Care Med. 2021;25(S3):S189–92.
Zhou W, Benharash P. Effects and mechanisms of acupuncture based on the principle of meridians. JAMS J Acupunct Meridian Stud [Internet]. 2014;7(4):190–3. Available from: http://dx.doi.org/10.1016/j.jams.2014.02.007
Wu J, Chen D, Liu N, Comim F. Effectiveness of acupuncture in polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. Med (United States). 2020;99(22):E20441.
Lim CED, Ng RWC, Cheng NCL, Zhang GS, Chen H. Acupuncture for polycystic ovarian syndrome. Cochrane Database Syst Rev. 2019;2019(7).
Rena G, Hardie DG, Pearson ER. The mechanisms of action of metformin. Diabetologia. 2017;60(9):1577–85.
Dumitrescu R, Mehedintu C, Briceag I, Purcărea VL, Hudita D. Metformin-clinical pharmacology in PCOs. J Med Life. 2015;8(2):187–92.
Shpakov AO. Improvement effect of Metformin on female and male reproduction in endocrine pathologies and its mechanisms. Pharmaceuticals. 2021;14(1):1–45.
Lin SC, Hardie DG. AMPK: Sensing Glucose as well as Cellular Energy Status. Cell Metab [Internet]. 2018;27(2):299–313. Available from: https://doi.org/10.1016/j.cmet.2017.10.009
Wang YW, He SJ, Feng X, Cheng J, Luo YT, Tian L, et al. Metformin: A review of its potential indications. Drug Des Devel Ther. 2017;11:2421–9.
Care D, Suppl SS. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2022. Diabetes Care. 2022;45(January):S125–43.
Fiedler K, Ludwig M. Use of clomiphene citrate in in vitro fertilization (IVF) and IVF/intracytoplasmic sperm injection cycles. Fertil Steril. 2003;80(6):1521–3.
Hoyos LR, Putra Ma, Armstrong AA, Cheng CY, Riestenberg CK, Schooler TA, et al. Measures of patient dissatisfaction with health care in polycystic ovary syndrome: Retrospective analysis. J Med Internet Res. 2020;22(4):1–9.
Yang L, Yang W, Sun M, Luo L, Li HR, Miao R, et al. Meta analysis of ovulation induction effect and pregnancy outcome of acupuncture & moxibustion combined with clomiphene in patients with polycystic ovary syndrome. Front Endocrinol (Lausanne). 2023;14(November):1–16.
Kaur KK. Utilization of Letrozole and Clomiphene Citrate for Better Optimization of Ovulation Induction Rates in PCOS Patients. Medtex [Internet]. 2019;1:22–3. Available from: https://www.researchgate.net/publication/337495786.
Herzog BJ, Nguyen HMT, Soubra A, Hellstrom WJG. Clomiphene Citrate for Male Hypogonadism and Infertility: An Updated Review. Androgens. 2020;1(1):62–9.
Kahyaoğlu S, Yılmaz B, Işık AZ. Pharmacokinetic, pharmacodynamic, and clinical aspects of ovulation induction agents: A review of the literature. J Turkish Ger Gynecol Assoc. 2017;18(1):48–55.
Cohen PR, Erickson CP, Sateesh BR, Uebelhoer NS, Calame A. Melanoma Following In Vitro Fertilization: Co-incident or Coincidence? Cureus. 2019;11(6).
Chen H, Lim CED. The efficacy of using acupuncture in managing polycystic ovarian syndrome. Curr Opin Obstet Gynecol. 2019;31(6):428–32.
Kaur KK. Utilization of Letrozole and Clomiphene Citrate for Better Optimization of Ovulation Induction Rates in PCOS Patients. Medtex [Internet]. 2019;1:22–3. Available from: https://www.researchgate.net/publication/337495786
Copyright (c) 2025 Bima Diokta Alparisi, Teuku Adib Bariq Muzhaffar, Wiwin Suhandri, Imelda Baktiana E. Hutagaol, Samira Amanda
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
