Su Wen-Wu, Tian Ju-Sheng, Gao Xiu-An
Department of TCM, Foshan Women and Children Health Care Center, Foshan 528000, Guangdong Province, China.
Department of Acupuncture-Moxibustion and Tuina, Third Affiliated Hospital of Guangzhou University of CM.
Zhongguo Zhen Jiu. 2020 May 12;40(5):498-502. doi: 10.13703/j.0255-2930.20190504-k0002.
To observe the effect of warming acupuncture on uterine blood perfusion in the patients with failed high-quality freeze-thawed embryo transfer (FET) and explore its effect mechanism on the improvement of clinical pregnancy rate after re-tranfer.
A total of 72 patients of failed high-quality FET were randomized into an observation group and a control group, 36 cases in each one. In the observation group, after the menstrual period ended, warming acupuncture started at the acupoints located on the abdomen, e.g. Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3) and Qugu (CV 2) and those on the lumbar sacral region, e.g. Shenshu (BL 23), Mingmen (GV 4) and Yaoyangguan (GV 3), 50 min in each treatment, once daily, at the interval of 1 day after 4-day treatment. The treatment was discontinued till the patients were at the ovulatory stage. In the control group, capsules were taken orally and continuously after the end of menstrual period, 3 capsules each time, three times a day and stopped at the ovulatory stage. The treatment of one menstrual cycle was taken as one course and the treatment for 3 menstrual cycles was required. Before and after treatment, the uterine artery pulsation index (PI), endometrial thickness, endometrial type, uterine blood perfusion, the recovery time of sufficient uterine blood flow, the endomentrial receptivity (ER) during the implantation window period and the clinical pregnancy rate were observed in the two groups.
After treatment, the endometrial thickness was increased and PI decreased obviously in the two groups (<0.05) and PI in the observation group was lower than that in the control group (<0.05). After treatment, the proportion of type a and type A of endometrium was increased markedly in the two groups (<0.05) and the proportion in the observation group was higher than the control group (<0.05). After treatment, the case proportion of sufficient uterine blood flow was increased obviously in the two groups (<0.05) and the value in the observation group was higher than the control group [83.3% (30/36) vs 69.4% (25/36), <0.05]. After treatment, the proportion of ER during the implantation window period was increased remarkably in the two groups (<0.05) and the value in the observation group was higher than the control group [72.2% (26/36) vs 50.0% (18/36), <0.05]. The recovery time of sufficient uterine blood flow in the observation group was shorter than the control group (<0.05) and the clinical pregnancy rate was higher than the control group [47.2% (17/36) vs 33.3% (12/36), <0.05].
Warming acupuncture enhances uterine blood perfusion and improves uterine endometrial receptivity so that the clinical pregnancy rate is increased after re-transfer in the patients with failed high-quality freeze-thawed embryo transfer.
观察温针灸对优质冻融胚胎移植（FET）失败患者子宫血流灌注的影响，并探讨其对再次移植后临床妊娠率改善的作用机制。
将72例优质FET失败患者随机分为观察组和对照组，每组36例。观察组在月经周期结束后，于腹部穴位如气海（CV6）、关元（CV4）、中极（CV3）、曲骨（CV2）以及腰骶部穴位如肾俞（BL23）、命门（GV4）、腰阳关（GV3）进行温针灸，每次治疗50分钟，每天1次，治疗4天后间隔1天，直至患者进入排卵期停止治疗。对照组在月经周期结束后口服胶囊，每次3粒，每日3次，至排卵期停药。以1个月经周期的治疗为1个疗程，共需治疗3个月经周期。观察两组治疗前后子宫动脉搏动指数（PI）、子宫内膜厚度、内膜类型、子宫血流灌注、子宫血流充分恢复时间、着床窗期子宫内膜容受性（ER）及临床妊娠率。
治疗后，两组子宫内膜厚度均增加，PI均明显降低（<0.05），且观察组PI低于对照组（<0.05）。治疗后，两组a型和A型内膜比例均明显增加（<0.05），且观察组比例高于对照组（<0.05）。治疗后，两组子宫血流充分的病例比例均明显增加（<0.05），且观察组数值高于对照组[83.3%（30/36）对69.4%（25/36），<0.05]。治疗后，两组着床窗期ER比例均显著增加（<0.05），且观察组数值高于对照组[72.2%（26/36）对50.0%（18/36），<0.05]。观察组子宫血流充分恢复时间短于对照组（<0.05），临床妊娠率高于对照组[47.2%（17/36）对33.3%（12/36），<0.05]。
温针灸可增强子宫血流灌注，改善子宫内膜容受性，从而提高优质冻融胚胎移植失败患者再次移植后的临床妊娠率。
