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[电针疗法对体外受精-胚胎移植临床结局及卵巢过度刺激综合征的影响]

[Effect of electro-acupuncture on clinical outcomes and ovarian hyperstimulation syndrome in in vitro fertilization and embryo transplantation].

作者信息

Hong Yan-Li, Tan Yong, Yin Yan-Yun, Zou Yi-Jie, Guo Yin-Hua, Nie Xiao-Wei

机构信息

Department of Gynecology, Nanjing University of Chinese Medicine, China.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2014 Nov;34(11):1292-6.

Abstract

OBJECTIVE

To observe the effect of electro-acupuncture (EA) on clinical outcomes and the occurrence of ovarian hyperstimulation syndrome (OHSS) in in vitro fertilization and embryo transplantation.

METHODS

Totally 109 patients who routinely received in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) at Reproductive Center were assigned to the control group (56 cases) and the EA group (53 cases) according to even and odd-numbered date. Patients in the control group received controlled ovarian hyperstimulation (COH) referring to GnRH-a long protocol. On the basis of COH, those in the EA group received EA from the day of Gn injection to the day of embryo transfer. Estradiol (E2), vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), and angiotensin (AT) II were measured in all patients on the day of hCG injection, the day of ovum pick up (OPU), and the day of embryo transfer (ET), respectively. The oocyte retrieval rate, good quality embryo rate, clinical pregnancy rate, the abortion rate, and the occurrence of OHSS were compared between the two groups.

RESULTS

Compared with the control group, serum E2 levels on the day of OPU and the day of ET were significantly lower in the EA group (P < 0.05). On the day of OPU levels of VEGF and IL-6 also significantly decreased (P < 0.05). Serum levels of VEGF and IL-6 reached the highest line on the day of hCG in the two groups, and then showed a decreasing trend. Compared with the control group at the same time point, serum levels of VEGF and IL-6 obviously decreased on on the day of OPU, hCG, and ET (P < 0.05). The occurrence of OHSS and the canceling rate of transplant cycle were significantly lower in the EA group than in the control group (P < 0.05).

CONCLUSIONS

EA, as an adjunctive therapy, could reduce the occurrence of OHSS in IVF. Besides, it did not decrease good embryo rates and pregnancy rates in IVF-ET, which might be associated with lowering local vascular permeability of ovaries.

摘要

目的

观察电针(EA)对体外受精-胚胎移植临床结局及卵巢过度刺激综合征(OHSS)发生情况的影响。

方法

将生殖中心109例行常规体外受精/卵胞浆内单精子注射(IVF/ICSI)的患者按日期奇偶分为对照组(56例)和电针组(53例)。对照组采用GnRH-a长方案进行控制性卵巢刺激(COH)。电针组在COH基础上,于Gn注射日至胚胎移植日接受电针治疗。分别于注射hCG日、取卵日(OPU)及胚胎移植日(ET)检测所有患者的雌二醇(E2)、血管内皮生长因子(VEGF)、白细胞介素-6(IL-6)和血管紧张素(AT)Ⅱ。比较两组的取卵率、优质胚胎率、临床妊娠率、流产率及OHSS发生情况。

结果

与对照组比较,电针组OPU日及ET日血清E2水平显著降低(P<0.05)。OPU日VEGF及IL-6水平也显著降低(P<0.05)。两组VEGF及IL-6血清水平在hCG日达最高值,随后呈下降趋势。与对照组同期比较,OPU日、hCG日及ET日VEGF及IL-6血清水平明显降低(P<0.05)。电针组OHSS发生率及移植周期取消率显著低于对照组(P<0.05)。

结论

电针作为辅助治疗可降低IVF中OHSS的发生。此外,其并未降低IVF-ET中的优质胚胎率及妊娠率,这可能与降低卵巢局部血管通透性有关。

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