[Effect of Tiaojing Cuyun acupuncture therapy on pregnancy outcomes in women with diminished ovarian reserve undergoing IVF-ET: a cohort study]

Zhongguo Zhen Jiu. 2024 Jun 12;44(6):653-8. doi: 10.13703/j.0255-2930.20230716-k0002.
[Article in Chinese]

Abstract

Objective: To assess the effect of Tiaojing Cuyun acupuncture therapy (acupuncture for regulating menstruation and promoting pregnancy) on pregnancy outcomes in patients with diminished ovarian reserve (DOR) undergoing in vitro fertilization-embryo transfer (IVF-ET).

Methods: Eighty women with DOR were divided into an observation group (40 cases, 1 case dropped out) and a control group (40 cases, 1 case dropped out) according to whether Tiaojing Cuyun acupuncture therapy was given or not. In the control group, IVF-ET was delivered. In the observation group, before IVF-ET, Tiaojing Cuyun acupuncture therapy was given. Two groups of acupoints were used alternatively, including Baihui (GV 20), Shenting (GV 24), Benshen (GB 13), Zhongwan (CV 12), Guanyuan (CV 4), and bilateral Tianshu (ST 25), Shenshu (BL 23), Ciliao (BL 32), etc. Acupuncture was operated once every other day, three interventions a week, for 12 weeks. The primary outcome was clinical pregnancy rate (CPR). Secondary outcomes included the total days and amount of gonadotropin (Gn) used, the number of oocytes retrieved, the number of oocytes in metaphase of second meiosis (MⅡ), the number of transferable embryos, the number of high-quality embryos, the cycle cancellation rate, the positive rate of human choriogonadotropin (HCG), the embryo implantation rate, live birth rate (LBR), the basal serum levels of sex hormones (follicular stimulating hormone [FSH], estradiol (E2), FSH/luteinizing hormone [LH]) and antral follicle count (AFC).

Results: CPR in the observation group was higher than that in the control group (53.8% [21/39] vs. 17.9% [7/39], P<0.05). The results of the number of oocytes retrieved, the number of oocytes in MⅡ, the number of transferable embryos, the number of high-quality embryos, the positive rate of HCG, the embryo implantation rate, and LBR in the observation group were higher than those in the control group (P<0.05). The serum level of FSH and FSH/LH in the observation group were lower thau those in the control group (P<0.05). The differences were not significant statistically in the total days and amount of Gn used, the cycle cancellation rate, serum level of E2 and AFC between the two groups (P>0.05). Logic regression analysis showed that CPR increased in the observation group when compared with that of the control group (OR = 5.33, 95%CI: 1.90-14.97, P = 0.001).

Conclusion: Acupuncture can improve the pregnancy outcomes of DOR women undergoing IVF-ET.

目的:评价调经促孕针法对卵巢储备功能减退(DOR)患者体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法:将80例DOR患者按照是否接受调经促孕针法治疗分为观察组(40例,脱落1例)和对照组(40例,脱落1例)。对照组予IVF-ET,观察组在IVF-ET前采用调经促孕针法治疗,取百会、神庭、本神、中脘、关元及双侧天枢、肾俞、次髎等两组穴位,交替使用,隔日1次,每周3次,共治疗12周。以临床妊娠率为主要结局指标,以促性腺激素(Gn)使用天数及总量、获卵数、第2次减数分裂中期(MⅡ)卵数、可移植胚胎数、优质胚胎数、周期取消率、人体绒膜促性腺激素(HCG)阳性率、胚胎种植率、活产率及血清基础性激素水平[卵泡刺激素(FSH)、雌二醇(E2)、FSH/黄体生成素(LH)]、窦卵泡计数(AFC)为次要结局指标。结果:观察组临床妊娠率[53.8%(21/39)]高于对照组[17.9%(7/39),P<0.05]。观察组获卵数、MⅡ卵数、可移植胚胎数、优质胚胎数、HCG阳性率、胚胎种植率及活产率均高于对照组(P<0.05),血清FSH水平、FSH/LH均低于对照组(P<0.05);两组Gn使用天数及总量、周期取消率和血清E2水平、AFC比较,差异无统计学意义(P>0.05)。逻辑回归分析显示,与对照组比较,观察组患者临床妊娠率升高(OR=5.33, 95%CI: 1.90~14.97,P=0.001)。结论:针刺可以改善DOR患者IVF-ET的妊娠结局。.

Keywords: acupuncture; clinical pregnancy rate; cohort study; diminished ovarian reserve; in vitro fertilization-embryo transfer (IVF-ET); live birth rate.

Publication types

  • English Abstract

MeSH terms

  • Acupuncture Points
  • Acupuncture Therapy*
  • Adult
  • Cohort Studies
  • Embryo Transfer*
  • Female
  • Fertilization in Vitro*
  • Humans
  • Infertility, Female / physiopathology
  • Infertility, Female / therapy
  • Ovarian Reserve*
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Rate
  • Young Adult