针灸对体外受精促排卵周期中卵泡发育及优质胚胎的影响

目的:探讨针灸对促排卵期间卵泡发育及优质胚胎率的影响。方法:将99例受试者随机分成安神补肾针灸组、常规针灸组和对照组三组,在促排卵期间采用不同方案针灸治疗及单纯促排卵方案刺激,经阴道B超观察促排当日、人体绒膜促性腺激素(HCG)注射前7 d及HCG注射日三个时间点中卵泡数及卵泡大小,并最终比较三组的取卵数、受精率、优质胚胎率。结果:HCG注射前7 d及HCG注射当日,两个针灸组平均卵泡直径均大于对照组,但前两者组间比较差异无统计学意义。卵泡个数方面三组间比较无统计学差异,但安神补肾针灸组受试者在HCG注射当日,直径大于14 mm的卵泡个数占优(P<0.05)。优质胚胎个数仍以安神补肾针灸组最高,常规针灸组次之,与对照组之间比较差异无统计学意义。但优质胚胎率的比较中,安神补肾针灸组、常规针灸组与对照组存在统计学差异(P<0.05)。结论:针灸可以促进促排卵期卵泡发育,使同批卵泡的大小更为均衡,提高受精率和优势胚胎率,为顺利移植奠定基础。

Effect of acupuncture and moxibustion on follicle development and high-quality embryos during ovulation induction in IVF

Objective:To investigate the effect of acupuncture and moxibustion on follicle development and high-quality embryo rate during ovulation induction.Methods:Ninety-nine participants were randomly divided into relieving uneasiness-tonifying kidney acupuncture group,routine acupuncture group and control group.Different acupuncture stimulations were carried on in the former two groups,during the period of promoting ovulation.On the first day of ovulation induction,seventh day before HCG injection and HCG injection day,number and size of follicles were measured three times by transvaginal B ultrasound,respectively.Finally,number of eggs,rate of fertilization and high-quality embryos were compared among three groups. Results:On the seventh day before and the day of HCG injection,mean follicle diameters of two acupuncture groups were larger than that of control group,but there was no statistical difference between the former two.In terms of the number of follicles,there was no significant difference among three groups.But,relieving uneasiness-tonifying kidney acupuncture group had got more follicles with diameter greater than 14 mm on the day of HCG injection(P<0.05),also kept the highest number of high-quality embryos,followed by routine acupuncture group.Still these two acupuncture groups had no significant difference with control group.However,in the comparison of the rate of high-quality embryos,there were significant difference between two acupuncture groups and control group(P<0.05).Conclusion:Acupuncture and moxibustion promote follicle development during ovulation induction in IVF,by facilitating follicle size and keeping development synchronization,thus improve the rate of fertilization and high-quality embryos,and lay a foundation for successful transplantation.