Objective: To explore the effect of electroacupuncture on endometrial receptivity and the pregnancy outcomes of in vitro fertilization and embryo transfer (IVF-ET) in the patients with diminished ovarian reserve (DOR).
Methods: Sixty-eight patients of DOR undertaken IVF-ET were randomized into an observation group (34 cases, 2 cases dropped off) and a control group (34 cases, 1 case dropped off). In the control group, endometrial preparation was performed according to the routine protocol. In the observation group, on the base of the treatment as the control group, acupuncture was applied to Geshu (BL 17), Shenshu (BL 23), Mingmen (GV 4), Shiqizhui (EX-B 8), Ciliao (BL 32), Zhongliao (BL 33), Tianshu (ST 25), Qihai (CV 6) and Guanyuan (CV 4), etc. Electric stimulation was given at Ciliao (BL 32)-Zhongliao(BL 33), Tianshu (ST 25)-Zigong (EX-CA 1), with disperse-dense wave, 2 Hz/15 Hz in frequency and tolerable current in intensity. Electroacupuncture was given once every two days, 3 times weekly, lasing 3 menstrual cycles till 1 day before embryo transfer. The endometrial thickness and morphology were observed on the day of human chorionic gonadotropin (HCG) of egg retrieval cycle, the day of endometrial transformation in frozen-thawed embryo transfer (FET) cycle and the day of embryo transfer in both groups successively; as well as HCG positive rate, clinical pregnancy rate, embryo implantation rate and live birth rate.
Results: In the observation group, the proportion of type A endometrium on the embryo transfer day was higher than those on HCG day of the egg retrieval cycle and the endometrial transformation day of FET cycle (P<0.05), and also higher than that of the control group (P<0.01). In the observation group, HCG positive rate, clinical pregnancy rate, embryo implantation rate and live birth rate were 75.0% (24/32), 71.9% (23/32), 47.4% (27/57) and 56.3% (18/32) respectively, and all higher than 36.4% (12/33), 30.3% (10/33), 18.0% (11/61) and 15.2% (5/33) in the control group separately (P<0.01).
Conclusion: Electroacupuncture improves the endometrial receptivity and IVF-ET pregnancy outcomes in the patients of diminished ovarian reserve.
目的：观察电针对卵巢储备功能下降（DOR）患者子宫内膜容受性和体外受精-胚胎移植（IVF-ET）妊娠结局的影响。方法：将68例拟行IVF-ET的DOR患者随机分为观察组（34例，脱落2例）和对照组（34例，脱落1例）。对照组采用常规方案进行内膜准备；在对照组治疗基础上，观察组于膈俞、肾俞、命门、十七椎、次髎、中髎、天枢、气海、关元等穴行针刺治疗，同侧次髎、中髎，天枢、子宫连接电针，疏密波，频率2 Hz/15 Hz，强度以患者耐受为度，隔日1次，每周3次，持续3个月经周期至胚胎移植前1天。观察两组患者取卵周期人绒毛膜促性腺激素（HCG）日、冻融胚胎移植（FET）周期的转化内膜日、胚胎移植日的子宫内膜厚度及形态，HCG阳性率、临床妊娠率、胚胎种植率和活产率。结果：观察组胚胎移植日子宫内膜A型比例高于取卵周期HCG日、FET周期的转化内膜日（P<0.05），且高于对照组（P<0.01）。观察组HCG阳性率、临床妊娠率、胚胎种植率和活产率分别为75.0%（24/32）、71.9%（23/32）、47.4%（27/57）和56.3%（18/32），高于对照组的36.4%（12/33）、30.3%（10/33）、18.0%（11/61）和15.2%（5/33，P<0.01）。结论：电针可改善DOR患者的子宫内膜容受性及IVF-ET妊娠结局。.
Keywords: diminished ovarian reserve; electroacupuncture; endometrial receptivity; in vitro fertilization and embryo transfer; pregnancy outcomes; randomized controlled trial (RCT).