Objective: To observe the impacts on endometrial and pregnancy outcomes treated with acupuncture and moxibustion in the patients of in vitro fertilization-embryo transfer (IVF-ET) and explore the application value, of acupuncture and moxibustion in IVF-ET treatment.
Methods: One hundred and fourteen patients of IVF-ET treated with standard long-term program at luteal phase were randomized into an observation group and a control group, 57 cases in each one. In the observation group, at the beginning of ovulatory induction, moxibustion was applied to Shenque (CV 8) and acupuncture was to Zhongji (CV 3), Guanyuan (CV 4), Qihai (CV 6), Zigong (EX-CA 1), Xuebai (SP 10), etc. till the transfer time for one session of treatment. Totally, 3 sessions were required. In the control group, no intervention of acupuncture and moxibustion was applied. The endometrial morphology, subendometrial blood flow index, the levels of serum estradiol (E2), progesterone (P) and luteinizing hormone (LH) on the day of injection of human chorionic gonadotropin (hCG), the dosage and time of gonadotropin (Gn), oocyte count, high-quality embryo number, embryo cultivation rate and clinical pregnant rate were observed in the two groups.
Results: The A type endometrial proportion on hCG day and high-quality embryo rate in the observation group were higher than those in the control group, indicating the significant differences (both P< 0.05). The difference in endometrial thickness on hCG day was not significant between the two groups (P> 0.05). In the observation group, endometrial hemodynamic index (peak systolic blood velocity/end-diastolic blood velocity, S/D), resistive index (RI) and pulse index (PI) were lower than those in the control group (P<0. 01, P<0. 05). The levels of serum E2 and P on hCG day in the observation group were higher than those in the control group (both P<0. 05). The differences were not significant in Gn dose, Gn medication time, numbers of follicles >1. 6 cm on hCG day, oocyte count, embryo cultivation rate and clinical pregnancy rate and LH level on hCG day between the two groups (all P>0. 05).
Conclusion: In IVF-ET treatment, acupuncture and moxibustion affect estrogen level on hCG day, improve high-quality embryo rate, endometrial blood flow state and morphology so that the endometrial receptivity is increased and the method is expected to be the assistant therapeutic approach for the improvement of IVF-ET outcome.