2024
The effect of improved metabolic syndrome parameters on live birth
Spitzer T, Diamond M, Wild R, Legro R, Zhang H, Sun F, Ling S, Santoro N. The effect of improved metabolic syndrome parameters on live birth. Fertility And Sterility 2024, 122: 373-375. PMID: 38641159, DOI: 10.1016/j.fertnstert.2024.04.020.Peer-Reviewed Original ResearchMetabolic syndrome Z-scoreLifestyle interventionLive birthsLive birth rateMetabolic syndrome parametersZ-scoreMetabolic syndromeUnexplained infertilityIntrauterine inseminationOvarian stimulationSyndrome parametersMetabolic parametersObese WomenBirth outcomesLive birth outcomesIntervention phaseImprove metabolic syndromeSecondary analysisFisher's exact testStudy participantsZ-score differenceLifestyle modificationStudent's t-testBirth rateLogistic regression
2023
Prednisone vs Placebo and Live Birth in Patients With Recurrent Implantation Failure Undergoing In Vitro Fertilization
Sun Y, Cui L, Lu Y, Tan J, Dong X, Ni T, Yan J, Guan Y, Hao G, Liu J, Zhang B, Wei D, Hong Y, He Y, Qi J, Xu B, Lu J, Zhang Q, Zhao S, Ji X, Du X, Zhang J, Liu J, Wang J, Huang Y, Huang D, Du Y, Vankelecom H, Zhang H, Chen Z. Prednisone vs Placebo and Live Birth in Patients With Recurrent Implantation Failure Undergoing In Vitro Fertilization. JAMA 2023, 329: 1460-1468. PMID: 37129654, PMCID: PMC10155063, DOI: 10.1001/jama.2023.5302.Peer-Reviewed Original ResearchConceptsRecurrent implantation failureFrozen-thawed embryo transferBiochemical pregnancy lossLive birthsImplant failurePlacebo groupPrednisone groupPreterm deliveryEmbryo transferPregnancy lossRisk of preterm deliveryRates of biochemical pregnancyEmbryo transfer cyclesGood-quality embryosLive birth rateLive birth outcomesTreatment of recurrent implantation failureStatistically significant between-group differencesHistory of 2Randomized clinical trialsProbability of implantationImmune-regulatory agentSignificant between-group differencesNeonatal complicationsWeeks gestation
2022
Live Birth With or Without Preimplantation Genetic Testing for Aneuploidy
Yan J, Qin Y, Zhao H, Sun Y, Gong F, Li R, Sun X, Ling X, Li H, Hao C, Tan J, Yang J, Zhu Y, Liu F, Chen D, Wei D, Lu J, Ni T, Zhou W, Wu K, Gao Y, Shi Y, Lu Y, Zhang T, Wu W, Ma X, Ma H, Fu J, Zhang J, Meng Q, Zhang H, Legro R, Chen Z. Live Birth With or Without Preimplantation Genetic Testing for Aneuploidy. Obstetrical & Gynecological Survey 2022, 77: 159-161. DOI: 10.1097/01.ogx.0000822436.67205.20.Peer-Reviewed Original ResearchPreimplantation genetic testingLive birth rateIn vitro fertilizationPGT-AGenetic testingWomen of advanced maternal ageIncreased live birth rateAdvanced maternal ageBirth experienceHigh quality embryosBirth rateMaternal ageQuality embryosLive birthsMorphology scorePreimplantationAneuploidyGenetic statusWomenPrognosisScoresBirth
2021
Live Birth with or without Preimplantation Genetic Testing for Aneuploidy
Yan J, Qin Y, Zhao H, Sun Y, Gong F, Li R, Sun X, Ling X, Li H, Hao C, Tan J, Yang J, Zhu Y, Liu F, Chen D, Wei D, Lu J, Ni T, Zhou W, Wu K, Gao Y, Shi Y, Lu Y, Zhang T, Wu W, Ma X, Ma H, Fu J, Zhang J, Meng Q, Zhang H, Legro R, Chen Z. Live Birth with or without Preimplantation Genetic Testing for Aneuploidy. New England Journal Of Medicine 2021, 385: 2047-2058. PMID: 34818479, DOI: 10.1056/nejmoa2103613.Peer-Reviewed Original ResearchConceptsConventional in vitro fertilizationCumulative live birth rateLive birth rateIn vitro fertilizationGood-quality blastocystsPGT-A groupPGT-APreimplantation genetic testingLive birthsGenetic testingClinical pregnancy lossImprove pregnancy outcomesInitial embryo transferEmbryo-transfer proceduresYears of ageNeonatal complicationsPregnancy outcomesSubfertile womenEmbryo transferAdverse eventsPregnancy lossNoninferiority marginEmbryo selectionPrimary outcomeBlastocyst
2020
Factors associated with study protocol adherence and bio banking participation in reproductive medicine clinical trials and their relationship to live birth
Engmann L, Sun F, Legro RS, Diamond MP, Zhang H, Santoro N, Bartlebaugh C, Dodson W, Estes S, Ober J, Brzyski R, Easton C, Hernandez A, Leija M, Pierce D, Robinson R, Awonuga A, Cedo L, Cline A, Collins K, Krawetz S, Puscheck E, Singh M, Yoscovits M, Barnhart K, Coutifaris C, Lecks K, Martino L, Marunich R, Snyder P, Alvero R, Comfort A, Crow M, Schlaff W, Casson P, Hohmann A, Mallette S, Christman G, Ohl D, Ringbloom M, Tang J, Bates G, Mason S, DiMaria N, Usadi R, Lucidi R, Rhea M, Baker V, Turner K, Trussell J, DelBasso D, Huang H, Li Y, Makuch R, Patrizio P, Sakai L, Scahill L, Taylor H, Thomas T, Tsang S, Yan Q, Zhang M, Haisenleder D, Lamar C, DePaolo L, Herring A, Redmond J, Thomas M, Turek P, Wactawski-Wende J, Rebar R, Cato P, Dukic V, Lewis V, Schlegel P, Witter F. Factors associated with study protocol adherence and bio banking participation in reproductive medicine clinical trials and their relationship to live birth. Human Reproduction 2020, 35: 2819-2831. PMID: 33190149, PMCID: PMC8453415, DOI: 10.1093/humrep/deaa232.Peer-Reviewed Original ResearchConceptsPolycystic ovary syndromeClinical trial protocolMedicine clinical trialsU10 HD055942U10 HD38998Baseline characteristicsTrial protocolClinical trialsLive birthsPolycystic Ovary Syndrome IIU10 HD38992U10 HD39005U10 HD27049STUDY FUNDING/COMPETINGMultiple Intrauterine GestationsStudy protocol adherenceUS multicenter trialRegular ovulatory cyclesClinical trial findingsPolycystic ovarian morphologyPARTICIPANTS/MATERIALSROLE OF CHANCELower household incomeAfrican AmericansAspects of adherenceShort-term weight change and live birth among women with unexplained infertility and polycystic ovary syndrome undergoing ovulation induction
Vitek W, Sun F, Hoeger KM, Santoro N, Diamond MP, Zhang H, Legro RS, Network E, Coutifaris C, Christman G, Robinson R, Brzyski R, Schlaff W, Casson P, Trussell J, Eisenberg E, Lamar C, DePaolo L. Short-term weight change and live birth among women with unexplained infertility and polycystic ovary syndrome undergoing ovulation induction. Fertility And Sterility 2020, 114: 1032-1039. PMID: 33036790, PMCID: PMC7953832, DOI: 10.1016/j.fertnstert.2020.06.002.Peer-Reviewed Original ResearchConceptsPolycystic ovary syndromeShort-term weight changeUnexplained infertilityLive birth rateOvulation inductionOvary syndromeWeight changeWeight gainCycles of clomipheneBody mass indexMean weight changeBirth rateRandomized trialsMass indexRegular intercourseIntrauterine inseminationTreatment allocationLive birthsMAIN OUTCOMESecondary analysisWomenWeight assessmentBirthSyndromeInfertilityEndometrial thickness after ovarian stimulation with gonadotropin, clomiphene, or letrozole for unexplained infertility, and association with treatment outcomes
Quaas AM, Gavrizi SZ, Peck JD, Diamond MP, Legro RS, Robinson RD, Casson P, Christman GM, Zhang H, Hansen KR, Network E. Endometrial thickness after ovarian stimulation with gonadotropin, clomiphene, or letrozole for unexplained infertility, and association with treatment outcomes. Fertility And Sterility 2020, 115: 213-220. PMID: 32972733, PMCID: PMC7796980, DOI: 10.1016/j.fertnstert.2020.07.030.Peer-Reviewed Original ResearchConceptsLive birth rateEndometrial thicknessUnexplained infertilityOvarian stimulationRisk ratioLive birthsEMT groupHuman chorionic gonadotropin administrationHigher live birth rateIntrauterine insemination treatmentMean endometrial thicknessMultiple Intrauterine GestationsOvarian stimulation medicationChorionic gonadotropin administrationProspective cohort analysisUnadjusted risk ratioAdjusted risk ratioBirth rateOS-IUIThin endometriumIntrauterine gestationGonadotropin administrationStimulation medicationsClinical trialsTreatment outcomesIntrauterine insemination performance characteristics and post-processing total motile sperm count in relation to live birth for couples with unexplained infertility in a randomised, multicentre clinical trial
Hansen KR, Peck JD, Coward RM, Wild RA, Trussell JC, Krawetz SA, Diamond MP, Legro RS, Coutifaris C, Alvero R, Robinson RD, Casson P, Christman GM, Santoro N, Zhang H. Intrauterine insemination performance characteristics and post-processing total motile sperm count in relation to live birth for couples with unexplained infertility in a randomised, multicentre clinical trial. Human Reproduction 2020, 35: 1296-1305. PMID: 32432326, PMCID: PMC7316499, DOI: 10.1093/humrep/deaa027.Peer-Reviewed Original ResearchConceptsTotal motile sperm countLive birth rateHigher total motile sperm countUnexplained infertilityMulticentre clinical trialMotile sperm countClinical trialsLive birthsOvarian stimulationHCG injectionBirth ratePatient discomfortSperm countTreatment cyclesSecondary analysisEunice Kennedy Shriver National InstituteSTUDY FUNDING/COMPETINGLive birth successMultiple Intrauterine GestationsDuration of infertilityIUI treatment cyclesLive birth outcomesPARTICIPANTS/MATERIALSROLE OF CHANCEYears of ageOR11-04 Effect of Preconception Intensive vs. Standard Lifestyle Intervention on Birth Outcomes in Obese Women With Unexplained Infertility: A Multicenter Randomized Trial
Legro R, Hansen K, Diamond M, Steiner A, Mersereau J, Sarwer D, Kris-Etherton P, Wild R, Krawetz S, Hoeger K, Usadi R, Johnstone E, Hao H, Eisenberg E, Santoro N, Zhang H. OR11-04 Effect of Preconception Intensive vs. Standard Lifestyle Intervention on Birth Outcomes in Obese Women With Unexplained Infertility: A Multicenter Randomized Trial. Journal Of The Endocrine Society 2020, 4: or11-04. PMCID: PMC7209215, DOI: 10.1210/jendso/bvaa046.2149.Peer-Reviewed Original ResearchStandard lifestyle modificationBetter birth outcomesUnexplained infertilityLive birthsObese womenBirth outcomesPregnancy lossLifestyle modificationLifestyle interventionWeight lossPhysical activityIL groupLow perinatal morbidityMajor pregnancy complicationsPreconception lifestyle interventionStandard lifestyle interventionGI side effectsKey secondary outcomesMulticenter Randomized TrialUse of orlistatMajor congenital anomaliesModerate weight lossPregnancy complication rateEarly pregnancy lossGestational DMAndrogenicity and fertility treatment in women with unexplained infertility
Wang ET, Diamond MP, Alvero R, Casson P, Christman GM, Coutifaris C, Hansen KR, Sun F, Legro RS, Robinson RD, Usadi RS, Pisarska MD, Santoro NF, Zhang H, Network I. Androgenicity and fertility treatment in women with unexplained infertility. Fertility And Sterility 2020, 113: 636-641. PMID: 32192596, PMCID: PMC7088440, DOI: 10.1016/j.fertnstert.2019.10.034.Peer-Reviewed Original ResearchConceptsLive birth rateBody mass indexUnexplained infertilityClinical pregnancyMass indexPregnancy lossClinical markersLive birthsAndrogenic activityFree androgen index valuesHigher body mass indexMultivariable logistic regression modelMultiple Intrauterine GestationsNormal uterine cavityHigh waist circumferenceOvarian stimulation treatmentPatent fallopian tubesBirth rateLogistic regression modelsAndrogen markersSerum TTOvarian stimulationRegular mensesInfertility populationIntrauterine gestationThe effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial
Steiner AZ, Hansen KR, Barnhart KT, Cedars MI, Legro RS, Diamond MP, Krawetz SA, Usadi R, Baker VL, Coward RM, Huang H, Wild R, Masson P, Smith JF, Santoro N, Eisenberg E, Zhang H, Network R. The effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial. Fertility And Sterility 2020, 113: 552-560.e3. PMID: 32111479, PMCID: PMC7219515, DOI: 10.1016/j.fertnstert.2019.11.008.Peer-Reviewed Original ResearchConceptsMonths of treatmentMale factor infertilityFactor infertilityLive birthsSemen parametersPlacebo groupPrimary outcomeSperm concentrationPlacebo-controlled trialLive birth rateCumulative live birthDNA fragmentationFemale partnersSperm DNA fragmentation indexLycopene dailyVivo pregnancyClomiphene citrateSecondary outcomesEntire cohortAsthenospermic menFertility centerIntrauterine inseminationMonth 4Tubal patencyClinical trials
2019
First-line ovulation induction for polycystic ovary syndrome: an individual participant data meta-analysis
Wang R, Li W, Bordewijk E, Legro R, Zhang H, Wu X, Gao J, Morin-Papunen L, Homburg R, König T, Moll E, Kar S, Huang W, Johnson N, Amer S, Vegetti W, Palomba S, Falbo A, Özmen Ü, Nazik H, Williams C, Federica G, Lord J, Sahin Y, Bhattacharya S, Norman R, van Wely M, Mol B, Network+ R, Collaboration T. First-line ovulation induction for polycystic ovary syndrome: an individual participant data meta-analysis. Human Reproduction Update 2019, 25: 717-732. PMID: 31647106, DOI: 10.1093/humupd/dmz029.Peer-Reviewed Original ResearchConceptsPolycystic ovary syndromeClinical pregnancy rateClomiphene citrateLive birth rateOvulation inductionTime-to-pregnancyAnovulatory infertilityFrequent cause of anovulatory infertilityPregnancy rateCause of anovulatory infertilityBirth rateMetformin to CCOvulation induction agentsIncreased clinical pregnancyLive birthsPrimary randomised controlled trialsClinical pregnancyRandomised controlled trialsInfertilityIndividual participant dataIPD meta-analysesWomenPositive interactionsLetrozoleAccurate assessment of outcomesAssociation between testosterone, semen parameters, and live birth in men with unexplained infertility in an intrauterine insemination population
Trussell JC, Coward RM, Santoro N, Stetter C, Kunselman A, Diamond MP, Hansen KR, Krawetz SA, Legro RS, Heisenleder D, Smith J, Steiner A, Wild R, Casson P, Coutifaris C, Alvero RR, Robinson RB, Christman G, Patrizio P, Zhang H, Lindgren MC, Network R. Association between testosterone, semen parameters, and live birth in men with unexplained infertility in an intrauterine insemination population. Fertility And Sterility 2019, 111: 1129-1134. PMID: 30982604, PMCID: PMC6557574, DOI: 10.1016/j.fertnstert.2019.01.034.Peer-Reviewed Original ResearchMeSH KeywordsAdultBiomarkersDown-RegulationFemaleFertilityHumansInfertility, MaleInsemination, Artificial, HomologousLive BirthMaleMulticenter Studies as TopicPregnancyPregnancy RateRandomized Controlled Trials as TopicRisk FactorsSperm CountSperm MotilitySpermatogenesisTestosteroneTreatment OutcomeConceptsUnexplained infertilityLow TTMale partnersLive birthsSemen parametersSecondary analysisMultiple Intrauterine GestationsLive birth rateBody mass indexMulticenter clinical trialAbnormal sperm morphologyOvarian stimulationIntrauterine gestationPregnancy outcomesMass indexInfertility clinicClinical trialsMAIN OUTCOMETotal motile spermSemen analysisAbnormal spermatogenesisInfertilityLogistic regressionSperm concentrationSemen volume
2018
Vitamin D Deficiency Is Associated With Poor Ovarian Stimulation Outcome in PCOS but Not Unexplained Infertility
Butts SF, Seifer DB, Koelper N, Senapati S, Sammel MD, Hoofnagle AN, Kelly A, Krawetz SA, Santoro N, Zhang H, Diamond MP, Legro RS, Network E. Vitamin D Deficiency Is Associated With Poor Ovarian Stimulation Outcome in PCOS but Not Unexplained Infertility. The Journal Of Clinical Endocrinology & Metabolism 2018, 104: 369-378. PMID: 30085176, PMCID: PMC6300410, DOI: 10.1210/jc.2018-00750.Peer-Reviewed Original ResearchConceptsVitamin D deficiencyPolycystic ovary syndromeD deficiencyEarly pregnancy lossOvarian stimulationUnexplained infertilityLive birthsPregnancy lossDiagnosis of PCOSMultiple Intrauterine GestationsOvarian stimulation outcomesRetrospective cohort studyInvestigation of womenBanked seraPPCOS IICohort studyIntrauterine gestationOvary syndromeInfertile womenInfertility diagnosisPregnant subjectsElevated riskImportant treatmentReproductive outcomesTrial dataAllostatic load, a measure of chronic physiological stress, is associated with pregnancy outcomes, but not fertility, among women with unexplained infertility
Barrett ES, Vitek W, Mbowe O, Thurston SW, Legro RS, Alvero R, Baker V, Bates GW, Casson P, Coutifaris C, Eisenberg E, Hansen K, Krawetz S, Robinson R, Rosen M, Usadi R, Zhang H, Santoro N, Diamond M. Allostatic load, a measure of chronic physiological stress, is associated with pregnancy outcomes, but not fertility, among women with unexplained infertility. Human Reproduction 2018, 33: 1757-1766. PMID: 30085177, PMCID: PMC6454470, DOI: 10.1093/humrep/dey261.Peer-Reviewed Original ResearchConceptsAdverse pregnancy outcomesOvarian stimulationPreterm birthPregnancy outcomesLive birthsUnexplained infertilityLipoprotein cholesterolBlood pressureBirth outcomesLow birthweightAllostatic loadSpontaneous abortionReproductive outcomesHigh-density lipoprotein cholesterolLow-density lipoprotein cholesterolAL scoreSTUDY FUNDING/COMPETINGChronic physiological stressMulti-variable logistic regression modelAdvanced Reproductive CareMultiple Intrauterine GestationsDiastolic blood pressureNon-pregnant stateSystolic blood pressureType of infertilityMidluteal Progesterone: A Marker of Treatment Outcomes in Couples With Unexplained Infertility
Hansen KR, Eisenberg E, Baker V, Hill MJ, Chen S, Talken S, Diamond MP, Legro RS, Coutifaris C, Alvero R, Robinson RD, Casson P, Christman GM, Santoro N, Zhang H, Wild RA, Network N. Midluteal Progesterone: A Marker of Treatment Outcomes in Couples With Unexplained Infertility. The Journal Of Clinical Endocrinology & Metabolism 2018, 103: 2743-2751. PMID: 29767754, PMCID: PMC6276712, DOI: 10.1210/jc.2018-00642.Peer-Reviewed Original ResearchConceptsMidluteal progesterone levelsUnexplained infertilityLive birthsOS-IUIProgesterone levelsPregnancy outcomesClinical trialsTreatment groupsIntrauterine insemination treatmentMultiple Intrauterine GestationsOvarian stimulation medicationSuccessful pregnancy outcomeMulticenter clinical trialLow progesterone levelsMidluteal progesteroneClomiphene citrateOvarian stimulationIntrauterine gestationEndometrial changesPathophysiologic mechanismsGonadotropin treatmentStimulation medicationsProgesterone exposureTreatment outcomesProgesterone concentrationsThe Effect of Supraphysiological Estradiol on Pregnancy Outcomes Differs Between Women With PCOS and Ovulatory Women
Wei D, Yu Y, Sun M, Shi Y, Sun Y, Deng X, Li J, Wang Z, Zhao S, Zhang H, Legro RS, Chen ZJ. The Effect of Supraphysiological Estradiol on Pregnancy Outcomes Differs Between Women With PCOS and Ovulatory Women. The Journal Of Clinical Endocrinology & Metabolism 2018, 103: 2735-2742. PMID: 29718297, DOI: 10.1210/jc.2018-00613.Peer-Reviewed Original ResearchConceptsPolycystic ovary syndromeFrozen embryo transferFresh embryo transferLive birth rateOvulatory womenOvarian stimulationEmbryo transferSupraphysiological estradiolPregnancy outcomesEstradiol levelsBirth ratePeak estradiol levelsMulticenter Randomized TrialSimilar study designPCOS womenOvary syndromeOvarian responsePrimary outcomeRandomized trialsEstradiol exposureLive birthsMAIN OUTCOMEEmbryo implantationPg/Secondary analysisTransfer of Fresh versus Frozen Embryos in Ovulatory Women
Shi Y, Sun Y, Hao C, Zhang H, Wei D, Zhang Y, Zhu Y, Deng X, Qi X, Li H, Ma X, Ren H, Wang Y, Zhang D, Wang B, Liu F, Wu Q, Wang Z, Bai H, Li Y, Zhou Y, Sun M, Liu H, Li J, Zhang L, Chen X, Zhang S, Sun X, Legro R, Chen Z. Transfer of Fresh versus Frozen Embryos in Ovulatory Women. New England Journal Of Medicine 2018, 378: 126-136. PMID: 29320646, DOI: 10.1056/nejmoa1705334.Peer-Reviewed Original ResearchConceptsFresh embryo transferFrozen embryo transferLive birth rateOvarian hyperstimulation syndromeHyperstimulation syndromeElective frozen embryo transferOvulatory womenFrozen-embryo groupFresh embryo groupIn vitro fertilization cyclesHigher live birth ratesPolycystic ovary syndromeRate of implantsCleavage-stage embryosOverall pregnancy lossAnovulatory womenNeonatal complicationsClinical pregnancyOngoing pregnancyFrozen embryosEmbryo cryopreservationBetween-group differencesEmbryo transferLive birthsFertilization cycles
2017
Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women
Seungdamrong A, Steiner AZ, Gracia CR, Legro RS, Diamond MP, Coutifaris C, Schlaff WD, Casson P, Christman GM, Robinson RD, Huang H, Alvero R, Hansen KR, Jin S, Eisenberg E, Zhang H, Santoro N, Network E. Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women. Fertility And Sterility 2017, 108: 843-850. PMID: 29102040, PMCID: PMC8129952, DOI: 10.1016/j.fertnstert.2017.08.026.Peer-Reviewed Original ResearchAnti-TPO antibodiesLive birth rateThyroid-stimulating hormoneAntithyroid peroxidase antibodiesMIU/LInfertile womenClinical pregnancyPeroxidase antibodiesLive birthsReproductive outcomesBirth rateEunice Kennedy Shriver National InstituteMultivariable logistic regression analysisMultivariable logistic regression modelReproductive Medicine NetworkMIU/L.Adverse reproductive outcomesHigher miscarriage ratePoor reproductive outcomesRisk of miscarriageLogistic regression analysisLogistic regression modelsSimilar conception ratesMiscarriage rateTSH levelsEffect of Acupuncture and Clomiphene in Chinese Women With Polycystic Ovary Syndrome: A Randomized Clinical Trial
Wu XK, Stener-Victorin E, Kuang HY, Ma HL, Gao JS, Xie LZ, Hou LH, Hu ZX, Shao XG, Ge J, Zhang JF, Xue HY, Xu XF, Liang RN, Ma HX, Yang HW, Li WL, Huang DM, Sun Y, Hao CF, Du SM, Yang ZW, Wang X, Yan Y, Chen XH, Fu P, Ding CF, Gao YQ, Zhou ZM, Wang CC, Wu TX, Liu JP, Ng EHY, Legro RS, Zhang H. Effect of Acupuncture and Clomiphene in Chinese Women With Polycystic Ovary Syndrome: A Randomized Clinical Trial. JAMA 2017, 317: 2502-2514. PMID: 28655015, PMCID: PMC5815063, DOI: 10.1001/jama.2017.7217.Peer-Reviewed Original ResearchConceptsPolycystic ovary syndromeControl acupunctureActive acupunctureOvary syndromeLive birthsChinese womenClomiphene groupAcupuncture groupPlacebo groupLow-frequency electrical stimulationActive acupuncture groupControl acupuncture groupSuperficial needle insertionEffect of acupunctureLive birth rateUse of acupunctureMonths of pregnancyNeedle insertionRandomized womenAdverse eventsSecondary outcomesPrimary outcomeClinical evidenceClinical trialsInfertility treatment