Objective: To systematically evaluate the effect of acupuncture and moxibustion on pregnancy outcomes in vitro insemination and embryo transfer (IVF-ET). Methods:Randomized controlled trials (RCTs) on acupuncture-assisted in vitro fertilization and embryo transfer were searched through CNKI, Wanfang, VIP, CBM and PubMed, Web of Science, Cochrane Library and Embase. The search period is up to December 31, 2022. After literature screening, data extraction, and integration, Cochrane bias risk assessment tool was used to evaluate the quality of the included literature, and statistical analysis software Stata 16.0 was used to perform meta-analysis of the data. Results: 28 literatures with a total of 1315 patients were included. The results of meta-analysis showed that acupuncture could improve the clinical pregnancy rate, implantation rate and implantation rate of IVF-ET , and the combined differences were statistically significant (Z clinical pregnancy rate = 4.52 , P = 0.000 ; Z implantation rate = 2.5 , P = 0.012 ; Z implantation rate = 2.79, P = 0.005) ; There was no significant difference in the rate of continuous pregnancy, live birth rate, biochemical pregnancy rate and spontaneous abortion rate (Z continuous pregnancy rate = 1.24 , P = 0.215 ; Z live birth rate = 1.54 , P = 0.123 ; Z biochemical pregnancy rate = 0.28 , P = 0.777 ; Z spontaneous abortion rate = 0.32 , P = 0.746) . Conclusions: Currently, there is limited evidence that acupuncture can improve the pregnancy outcome of in vitro insemination and embryo transfer, but the number and quality of included studies are limited, so higher quality RCTs need to be validated to provide more reliable evidence-based evidence for the application of acupuncture in the field of assisted reproduction.