电针干预对IVF-ET肾虚痰瘀型患者子宫内膜容受性及妊娠结局的影响

目的:观察电针干预对体外受精-胚胎移植(IVF-ET)肾虚痰瘀型患者子宫内膜容受性及妊娠结局的影响。方法:纳入64例拟行IVF-ET治疗的肾虚痰瘀型不孕症患者,随机分为观察组和对照组,每组各32例。观察组患者在进入IVF-ET前采用电针针刺治疗,治疗时间为1个月经周期;对照组患者空白等待1个月经周期后进入IVF-ET治疗。在扳机日检测两组患者的子宫内膜厚度、血流参数包括搏动指数(PI)、阻力指数(RI)、收缩期血流/舒张期血流(S/D)比值]及内膜形态分型,比较两组患者的获卵数、受精卵数、胚胎数及优质胚胎数,评价两组患者的人绒毛膜促性腺激素(HCG)阳性率及临床妊娠率。结果:研究过程中,观察组2例患者脱落或剔除,对照组1例患者脱落,最终观察组30例、对照组31例患者纳入统计分析。扳机日两组患者的子宫内膜厚度、形态比较,差异均无统计学意义(P>0.05);观察组患者的血流参数PI、S/D比值均明显低于对照组(P<0.05)。两组患者的获卵数、受精卵数、胚胎数比较,差异均无统计学意义(P>0.05);观察组患者的优质胚胎数较对照组明显增多(P<0.05)。观察组患者的HCG阳性率明显高于对照组(P<0.05)。结论:电针针刺治疗能够改善IVF-ET肾虚痰瘀型患者的子宫内膜血流,提高卵巢反应性,增加优质胚胎数,进而提高患者的HCG阳性率,改善临床妊娠结局。

Effects of electroacupuncture intervention on endometrial receptivity and pregnancy outcome in patients undergoing IVF-ET with syndrome of kidney deficiency and phlegm stasis

  Objective: To observe the effects of electroacupuncture intervention on the endometrial receptivity and pregnancy outcome in patients undergoing in vitro fertilization-embryo transfer (IVF-ET) with syndrome of kidney deficiency and phlegm stasis.   Methods: Sixty-four infertile patients with syndrome of kidney deficiency and phlegm stasis who undergoing IVF-ET were included and randomly divided into the observation group and control group, 32 cases in each group. The patients in the observation group were treated with electroacupuncture before IVF-ET, with a course of one menstrual cycle; the patients in the control group were treated with no intervention for one menstrual cycle and then performed IVF-ET therapy. The endometrial thickness, blood flow indexes including pulsatility index (PI), resistance index (RI) and systolic blood flow/diastolic blood flow (S/D) ratio, and endometrial morphology were detected on the day of human chorionic gonadotropin (HCG) injection, the number of retrieved oocytes, fertilization eggs, embryos and high-quality embryos was compared, and the HCG positive rate and the clinical pregnancy rate were evaluated.   Results: In the process of research, two patients in the observation group were excluded or shed, and one patient in the control group shed. Finally 30 patients in the observation group and 31 patients in the control group were included in the statistical analysis. On the day of HCG injection, there were no statistically significant differences in the endometrial thickness and morphology between the two groups (P>0.05), and the endometrial blood flow indexes PI and S/D ratio in the observation group were significantly lower than those in the control group (P<0.05). There were no statistically significant differences in the number of retrieved oocytes, fertilization eggs and embryos between the two groups (P>0.05), and the number of high-quality embryos in the observation group was more than that in the control group (P<0.05). The HCG positive rate of the observation group was significantly higher than that of the control group (P<0.05).   Conclusion: Electroacupuncture therapy can improve the endometrial blood flow in patients undergoing IVF-ET with syndrome of kidney deficiency and phlegm stasis, enhance the ovarian reactivity, increase the number of high-quality embryos, and further increase the HCG positive rate and improve the clinical pregnancy outcome.