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["基于月经周期的针刺疗法"对卵巢储备功能下降患者体外受精-胚胎移植的影响]

[Effects of "menstrual cycle-based acupuncture therapy" on IVF-ET in patients with decline in ovarian reserve].

作者信息

Zhou Li, Xia Youbing, Ma Xiang, Tang Limei, Lu Jing, Tang Qingqing, Wang Yinping

出版信息

Zhongguo Zhen Jiu. 2016 Jan;36(1):25-8.

Abstract

OBJECTIVE

To observe the effects of "menstrual cycle-based acupuncture therapy" on ovarian function and pregnancy results of in vitro fertilization-embryo transfer (IVF-ET) in patients with decline in ovarian reserve (DOR).

METHODS

A total of 63 patients of DOR who received treatment of IVF/intracytoplasmic sperm injection (ICSI) were randomly divided into an observation group (30 cases) and a control group (33 cases). The patients in the observation group were treated with "menstrual cycle-based acupuncture therapy". The syndrome differentiation and treatment were given based on different phases of menstruation. Shiqizhui (EX-B 8) and Mingmen (GV 4) were selected during menstrual phase, Shenshu (BL 23), Geshu (BL 17), Sanyinjiao (SP 6) and Taixi (KI 3) were selected after menstruation, Qihai (CV 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zusanli (ST 36) were selected during ovulatory period, Qihai (CV 6), Guanyuan (CV 4), Yanglingquan (GB 34), Taichong (LR 3) were selected before menstruation. The acupuncture was given twice a week until second menstrual cycle of oocyte retrieval. The total times of acupuncture was (15 ± 2). After acupuncture, patients were treated with IVF-ET. The patients in the control group were treated with IVF-ET but no acupuncture. The indices of ovarian reserve function, including basic follicle-stimulating hormone (FSH), estradiol (E2), antral follicle count (AFC), number of retrieved oocytes, number of fertilization and number of high quality embryo, were compared and analyzed before and after acupuncture in the observation group. The differences of outcomes of IVF-ET, including the cycle cancellation rate, implantation rate, the clinical pregnancy rate, were compared between the two groups.

RESULTS

Compared before acupuncture, the E2, AFC, number of retrieved oocytes, number of high quality embrgo and number of fertilization were all increased after acupuncture in the observation group (all P< 0. 05). Compared with the control group, levels of the E2, the number of retrieved oocytes, number of fertilization and number of high quality embryo were all increased in the observation group (all P < 0.05). Also, the implantation rate, the clinical pregnancy rate were improved (both P < 0.01) and cycle cancellation rate was reduced (P< 0.01).

CONCLUSION

The "menstrual cycle-based acupuncture therapy" can effectively improve the ovarian reserve function in DOR patients, leading to an improved clinical pregnancy rate of IVF-ET.

摘要

目的

观察“基于月经周期的针刺疗法”对卵巢储备功能下降(DOR)患者体外受精-胚胎移植(IVF-ET)中卵巢功能及妊娠结局的影响。

方法

将63例接受IVF/卵胞浆内单精子注射(ICSI)治疗的DOR患者随机分为观察组(30例)和对照组(33例)。观察组患者采用“基于月经周期的针刺疗法”,根据月经不同阶段进行辨证论治。月经期选取十七椎(EX-B 8)、命门(GV 4);月经后选取肾俞(BL 23)、膈俞(BL 17)、三阴交(SP 6)、太溪(KI 3);排卵期选取气海(CV 6)、关元(CV 4)、子宫(EX-CA 1)、足三里(ST 36);月经前选取气海(CV 6)、关元(CV 4)、阳陵泉(GB 34)、太冲(LR 3)。每周针刺2次,直至取卵后的第二个月经周期。针刺总次数为(15±2)次。针刺后进行IVF-ET治疗。对照组仅进行IVF-ET治疗,不进行针刺。比较观察组针刺前后卵巢储备功能指标,包括基础促卵泡生成素(FSH)、雌二醇(E2)、窦卵泡计数(AFC)、取卵数、受精数及优质胚胎数,并进行分析。比较两组IVF-ET结局的差异,包括周期取消率、种植率、临床妊娠率。

结果

观察组针刺后E2、AFC、取卵数、优质胚胎数及受精数均较针刺前增加(均P<0.05)。与对照组比较,观察组E2水平、取卵数、受精数及优质胚胎数均增加(均P<0.05)。且种植率、临床妊娠率提高(均P<0.01),周期取消率降低(P<0.01)。

结论

“基于月经周期的针刺疗法”能有效改善DOR患者的卵巢储备功能,提高IVF-ET的临床妊娠率。

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