Objective: To observe the effects of electroacupuncture (EA) on ovarian reaction, egg and embryo quality, as well as pregnancy rate in poor ovarian response (POR) patients of kidney essence deficiency and undergoing in vitro fertilization-embryo transfer (IVF-ET).
Methods: Ninety-six patients who met the inclusion criteria were randomly divided into an EA group and a control group, with 48 cases in each group. Before IVF-ET, the patients in the EA group received EA, once daily, 2 or 3 treatments a week for 12 weeks. Before and after the treatment, traditional Chinese medicine (TCM) syndrome score and clinical pregnancy rate were assessed in two groups. The concentrations of serum follicle-stimulating hormone (FSH), luteinsing hormone, estradiol, progesterone and anti-mullerian hormone were detected by chemiluminescence; the contents of serum insulin-like growth factor-1, serum inhibin B (INHB) and Kisspeptin in follicular fluid were determined by enzyme linked immunosorbent assay (ELISA); the antral follicle counting (AFC) was detected by color Doppler ultrasonography; and the egg and embryo conditions were observed under microscope. Fourteen days after embryo transfer, the positive rate of serum hemchoriconic gonadotropin (HCG) and clinical pregnancy rate were calculated.
Results: After the treatment, the TCM syndrome score and level of serum FSH were reduced (P<0.05); the INHB in serum and AFC were increased (P<0.05) when compared with those before the treatment in the EA group. After the treatment, in comparison with the control group, the TCM syndrome score and level of serum FSH were lower (P<0.05); and the contents of serum INHB, AFC, the numbers of MⅡ eggs and high-quality embryos, as well as serum HCG positive rate were all increased (P<0.05) in the EA group.
Conclusion: EA can relieve the clinical symptoms of TCM in POR patients of kidney essence deficiency and undergoing IVF-ET, increase the ovarian reserve, reduce the serum FSH level, and improve the content of serum INHB, and the quality of eggs and embryos. This therapy tends to improve the clinical pregnancy rate and clinical pregnancy outcome.
目的：观察电针对体外受精-胚胎移植(IVF-ET)肾精亏虚型卵巢低反应（POR）患者的卵巢反应性、卵子和胚胎质量及妊娠率的影响。方法：将符合纳入标准的96例患者随机分为电针组48例（脱落2例）和对照组48例。在进入IVF-ET前，电针组在对照组(空白等待)基础上予电针关元、气海、三阴交、肾俞等穴治疗12周，1次/d，每周2~3 d。评估两组患者治疗前后中医证候评分；化学发光法检测血清促卵泡生成激素(FSH)、促黄体生成激素、雌二醇、孕酮、抗缪勒管激素含量；ELISA法检测血清胰岛素样生长因子-1、血清抑制素B(INHB)、卵泡液Kisspeptin的含量；彩色多普勒超声观察卵巢窦卵泡数目(AFC)；显微镜下观察卵子及胚胎情况等，胚胎移植14 d后计算血绒毛膜促性腺激素(HCG)阳性率、临床妊娠率。结果：与本组治疗前比较，电针组患者治疗后中医证候评分、血清FSH水平均降低(P<0.05)；INHB含量、AFC均升高(P<0.05)。治疗后与对照组比较，电针组患者中医证候评分、血清FSH水平均降低(P<0.05)；血清INHB含量、AFC、MⅡ卵子数、优质胚胎数及血HCG阳性率均升高(P<0.05)。结论：电针能改善IVF-ET肾精亏虚型POR患者的中医临床症状，提高患者的卵巢储备功能，降低血清FSH水平，提高血清INHB含量及卵子、胚胎质量，提高患者血清HCG阳性率，有改善临床妊娠结局的趋势。.
Keywords: Electroacupuncture; In vitro fertilization-embryo transfer; Kidney essence deficiency; Poor ovarian response; Pregnancy outcome.