OBJECTIVE: The primary objective of the present review was to determine what pain-relieving effect had been reported for acupuncture and other conscious sedation methods in assisted reproduction therapy since 1990. The secondary objective was to determine pregnancy rates, when possible. METHODS: The data source was the Medline database of the National Library of Medicine covering the period January 1990-January 2004. Bibliographies of relevant publications and review articles were scanned. A systematic review and meta-analyses of randomized, controlled trials comparing the pain-relieving effect of acupuncture and other conscious sedation methods was carried out. RESULTS: Of the 30 trials identified, 12 met the selection criteria for this systematic review and were included in the analysis. Five of the 12 studies reported differences in pain experiences during oocyte aspiration, but it was only possible to group the three trials evaluating the effect of electro-acupuncture (EA). The outcomes of these three studies were homogenous except from maximal and average pain. CONCLUSION: No method could be regarded as being superior to another, and no consensus on which method is optimal for pain relief during oocyte retrieval was found. Low doses of lignocaine can, however, be recommended in paracervical block (PCB) as well as EA without pre-medication. The clinical pregnancy rates appeared to be similar between the studies. Since pain experience varies from individual to individual, the optimal method of conscious sedation may also be individualized.