针刺对卵巢储备功能减退不孕症激素替代周期冻融胚胎移植中妊娠结局的影响

The effect of acupuncture on infertility with diminished ovarian reserve for pregnancy outcomes in frozen-thawed embryo transfer during the hormone replacement cycle

关键词:  针刺  卵巢储备功能减退  不孕症  冻融胚胎移植  妊娠结局

Key words:  acupuncture  diminished ovarian reverse  infertility  frozen-thawed embryo transfer  pregnancy outcome

摘要:

[目的] 探讨针刺对卵巢储备功能减退(DOR)不孕症激素替代周期-冻融胚胎移植(HRT-FET)中妊娠结局的影响。[方法] 将100例行HRT-FET治疗的DOR患者随机分为对照组和针刺组各50例。两照组均常规HRT准备内膜;针刺组在对照组基础上,在内膜准备阶段加用针刺治疗,每周3次,治疗2周。比较两组内膜转化日血清雌激素(E₂)、孕激素(P)水平,移植前日子宫内膜厚度、子宫动脉血流动力学参数[收缩期峰值与舒张末期流速比值(S/D),阻力指数(RI)与搏动指数(PI)]、移植胚胎数、移植周期临床妊娠率以及活产率。[结果] 针刺组子宫内膜厚度大于对照组,差异有统计学意义(P＜0.05)。针刺组S/D指数低于对照组,差异有统计学意义(P＜0.05)。两组间比较RI与PI指数,差异无统计学意义(均P＞0.05)。针刺组移植周期临床妊娠率为56%(28/50),对照组临床妊娠率为36%(18/50),差异有统计学意义(P＜0.05)。针刺组移植周期活产率为44%(22/50),对照组活产率为32%(16/50),差异无统计学意义(P＞0.05)。[结论] 针刺在DOR不孕症激素替代周期冻融胚胎移植中,能降低子宫血运阻力,增加血液循环,有利于子宫内膜的生长,增加内膜厚度,改善容受性,提高妊娠率。

Abstract:

[Objective] To discuss the effect of acupuncture on infertility with diminished ovarian reserve (DOR) for pregnancy outcomes in frozen-thawed embryo transfer (FET) during the hormone replacement cycle (HRT).[Methods] 100 infertility patients with DOR who planned to receive HRT-FET were selected and divided into control group (n=50) and acupuncture group (n=50). Control group received routine HRT-FET. Acupuncture group received acupuncture treatment during HRT before FET. Acupuncture was three times a week for 2 weeks. The serum estradiol (E₂) and progesterone (P) level on endometrium transformation day,endometrial thickness and uterine artery hemodynamics[resistance index (RI),pulsatility index (PI) and peak systolic velocity/end diastolic velocity (S/D)] on the day before embryo transfer,embryo transfer number and clinical pregnancy outcome were compared among the groups.[Results] the endometrial thickness in acupuncture group were more than that in control group (P＜0.05). S/D was lower in acupuncture group and the difference was statistically significant (P＜0.05). The differences about RI and PI were not statistically significant (P＞0.05). The clinical pregnancy outcome was 56% (28/50) in acupuncture group and 36% (18/50) in control group (P＜0.05). The live birth rate was 44% (22/50) in acupuncture group and 32% (16/50) in control group (P＞0.05).[Conclusion] Acupuncture could reduce uterine blood flow resistance,improve uterine blood flow,which was beneficial to the growth of endometrium,increase the thickness,improve the receptivity and increase the pregnancy rate on infertility with DOR during HRT-FET.