Objective The objective of this study is to investigate the effectiveness of acupuncture on in-vitro fertilization outcomes (IVF).Methods PubMed,Ovid,ISI Web of Knowledge,Wanfang Database,and Google Scholar were searched with a time limit until January 2015.Randomized controlled trials (RCTs) comparing the clinical outcome of in-vitro fertilization (IVF) cycles with acupuncture to those with sham acupuncture or without any acupuncture procedure were searched.Data in the selected primary studies with high quality with the assessment of Jadad Scale System were collected,and risk ratio (RR) and 95% confidence intervals (95% CI) were calculated.Results Twelve studies with high quality were included in the final analysis.There is not significant difference in implantation rate (IR) (P=0.41),biochemical pregnancy rate (BPR) (P=0.58),clinical pregnancy rate (CPR) (P=0.52),miscarriage rate (MR) (P=0.83),ongoing pregnancy rate (OPR) (P=0.94) or live birth rate (LBR) (P=0.83) between acupuncture group and sham acupuncture group.Similar results are achieved in implantation rate (IR) (P=0.41),biochemical pregnancy rate (BPR) (P=0.23),miscarriage rate (MR) (P=0.63),and ongoing pregnancy rate (OPR) (P=0.56) comparing acupuncture group to no-acupuncture group.However,significantly higher clinical pregnancy rate (CPR) (P=0.01) and live birth rate (LBR) (P=0.04) are found in acupuncture group compared to no-acupuncture group.Conclusion Acupuncture has no significantly positive effects on in-vitro fertilization (IVF) outcomes compared to sham acupuncture,but it provides positive effects on the aspect of clinical pregnancy rate (CPR) and live birth rate (LBR) compared with no-acupuncture group.Psychological factors are probably the major reason for the results.Well-designed randomized control trials (RCTs) with large samples are still needed to investigate the standard indications and the detailed protocol of acupuncture for patients with in-vitro fertilization (IVF).