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经皮穴位电刺激对体外受精-胚胎移植患者卵巢反应及妊娠结局的影响:一项随机对照试验

Effects of Transcutaneous Electrical Acupoint Stimulation on Ovarian Responses and Pregnancy Outcomes in Patients Undergoing IVF-ET: A Randomized Controlled Trial.

作者信息

Zhai Zhi-Jin, Liu Jia-En, Lei Ling-Ling, Wang Shu-Yu

机构信息

Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.

Center for Reproductive Medicine, Beijing Jia-En De Yun Hospital, Beijing, 100089, China.

出版信息

Chin J Integr Med. 2022 May;28(5):434-439. doi: 10.1007/s11655-021-3457-8. Epub 2021 Nov 10.

Abstract

OBJECTIVE

To evaluate the influence of different transcutaneous electrical acupoint stimulation (TEAS) modes on ovarian responses and pregnancy outcomes in patients with infertility undergoing in vitro fertilization and embryo transfer (IVF-ET).

METHODS

Two hundred infertility patients undergoing IVF-ET were divided randomly into experimental groups (TEAS groups: E-I, E-II, E-III, and E-IV, 40 cases each group) and a control group (mock TEAS group, 40 patients) using the random number method. The patients in the experimental groups received TEAS treatment of 20, 30, 40 and 50 mA for the E-I, E-II, E-III and E-IV groups, respectively. The control group received a treatment of 5 mA. TEAS was applied at acupoints of Guanyuan (RN 4), Zhongji (RN 3), Sanyinjiao (SP 6), Zigong (EX-CA 1), and Taixi (KI 13), once a day for 30 min each time for a treatment period of 10-13 d. Treatment effect was assessed using the following indicators: endometrial thickness on the 6th day of gonadotropin treatment (GN6 day), endometrial thickness on the day on chorionic gonadotropin administration (HCG day), number of ovarian follicles on HCG day, number of ova captured, amount of estrogen required for each harvested ova, number of mature ova divided by the total number of ova, percentage of high-quality embryos, and clinical pregnancy.

RESULTS

Endometrial thickness in the experimental groups on the HCG day was significantly better than that of the control group after TEAS stimulation (P=0.01). TEAS exhibited a greater impact on the number of ova captured (P=0.003). However, the effect of TEAS stimulation on the high-quality embryo rate and clinical pregnancy in patients was not statistically significant (P>0.05).

CONCLUSIONS

TEAS is an effective method in improving the ovarian state. When the stimulus intensity was at 40 mA and above, it could be helpful to improve the patient's endometrial condition and endometrial receptivity and to retrieve more oocytes. (Trial registration No. ChiCTR-TRC-11001780).

摘要

目的

评估不同经皮穴位电刺激(TEAS)模式对接受体外受精-胚胎移植(IVF-ET)的不孕症患者卵巢反应及妊娠结局的影响。

方法

采用随机数字法将200例接受IVF-ET的不孕症患者随机分为实验组(TEAS组:E-I、E-II、E-III和E-IV组,每组40例)和对照组(假TEAS组,40例患者)。实验组患者中,E-I、E-II、E-III和E-IV组分别接受20、30、40和50 mA的TEAS治疗。对照组接受5 mA的治疗。TEAS应用于关元(RN 4)、中极(RN 3)、三阴交(SP 6)、子宫(EX-CA 1)和太溪(KI 13)穴位,每天1次,每次30分钟,治疗周期为10 - 13天。使用以下指标评估治疗效果:促性腺激素治疗第6天(GN6天)的子宫内膜厚度、绒毛膜促性腺激素给药当天(HCG天)的子宫内膜厚度、HCG天的卵巢卵泡数、采集的卵子数、每个采集卵子所需的雌激素量、成熟卵子数除以卵子总数、优质胚胎百分比和临床妊娠情况。

结果

TEAS刺激后,实验组在HCG天的子宫内膜厚度明显优于对照组(P = 0.01)。TEAS对采集的卵子数有更大影响(P = 0.003)。然而,TEAS刺激对患者优质胚胎率和临床妊娠的影响无统计学意义(P>0.05)。

结论

TEAS是改善卵巢状态的有效方法。当刺激强度在40 mA及以上时,有助于改善患者的子宫内膜状况和子宫内膜容受性,并获取更多卵子。(试验注册号:ChiCTR-TRC-11001780)

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