经皮穴位电刺激对IVF中POI患者卵巢功能影响的临床观察
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摘要
目的探讨经皮穴位电刺激(TEAS)对体外受精-胚胎移植(IVF-ET)中POI患者卵巢功能的影响。方法选取接受IVF治疗的POI患者60例,随机分为TEAS组、人工周期组及空白对照组各20例。TEAS组进行为期3个月的干预,观察POI患者血清内分泌激素水平、抗苗勒试管激素(AMH)、窦卵泡数(AFC)、卵巢动脉血流指标及临床结局的影响。结果TEAS组、人工周期组患者治疗后内分泌激素、AMH、AFC较治疗前的差异有统计学意义(P<0.05),治疗后TEAS组与空白对照组相比较,基础内分泌、AMH水平、AFC均有统计学差异(P<0.05)。TEAS组与人工周期组、空白对照组相比,获卵数、优质胚胎率及临床妊娠率均明显增加,差异有统计学意义(P<0.05)。结论 TEAS疗法可以调节下丘脑-垂体-卵巢轴,改善POI患者基础内分泌指标,提高卵巢储备功能。
Objective:To explore the effects of transcutaneous electric acupoint stimulation(TEAS)on the ovarian function of premature ovarian insufficiency patients in in vitro fertilization-embryo transfer(IVF-ET). Methods:60 cases were randomly divided into 3 groups,20 cases in the TEAS group,20 case in the hormone replacement therapy(HRT)group and 20 cases in the control group. Observed the effects of serum endocrine hormone level,anti-mullerian hormone(AMH),antral follicle count(AFC),ovarian artery blood flow index and clinical outcome after intervention for 3 months. Results:There were statistically significant differences in endocrine hormone,AMH and AFC in both TEAS group and HRT group as compared with prior treatment(P<0.05). As compared with the HRT group and the blank control group,the number of retrieved oocytes,high-quality embryos and clinical pregnancy rate in the TEAS group had been significantly increased(P<0.05). Conclusion:TEAS can regulate the hypothalamic-pituitary-ovarian axis,improve basic endocrine indexes of POI patients,and then improve ovarian reserve function.
Objective:To explore the effects of transcutaneous electric acupoint stimulation(TEAS)on the ovarian function of premature ovarian insufficiency patients in in vitro fertilization-embryo transfer(IVF-ET). Methods:60 cases were randomly divided into 3 groups,20 cases in the TEAS group,20 case in the hormone replacement therapy(HRT)group and 20 cases in the control group. Observed the effects of serum endocrine hormone level,anti-mullerian hormone(AMH),antral follicle count(AFC),ovarian artery blood flow index and clinical outcome after intervention for 3 months. Results:There were statistically significant differences in endocrine hormone,AMH and AFC in both TEAS group and HRT group as compared with prior treatment(P<0.05). As compared with the HRT group and the blank control group,the number of retrieved oocytes,high-quality embryos and clinical pregnancy rate in the TEAS group had been significantly increased(P<0.05). Conclusion:TEAS can regulate the hypothalamic-pituitary-ovarian axis,improve basic endocrine indexes of POI patients,and then improve ovarian reserve function.
引文
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[7]徐文君,高慧,李杨.中药补肾调冲方治疗模型大鼠卵巢早衰相关性研究[J].中国煤炭工业医学杂志,2016,11(2):1601-1606.
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[9] Craig J,Orisaka M,Wang H. Gonadotropin and intra-ovarian signals regulating follicle development and atresia:the delicate balance between life and death[J]. Front Biosci,2007,12(2):3628-3639.
[10] Lainas TG,Sfontouris IA,Venetis CA,et al. Live birth rates after modified natural cycle compared with high-dose FSH stimulation using GnRH antagonists in poor responders[J].Human Reproduction,2015,30(10):2321-2330.
[11] Abdalla H,Thum MY. An elevated basal FSH reflects a quantitative rather than qualitative decline of the ovarian reserve[J].Hum Reprod,2004,19(4):893-8.
[12] Ji J,Liu Y,Tong XH,et al. The optimum number of oocytes in IVF treatment:an analysis of 2 455 cycles in China[J]. Hum Reprod,2013,28(10):2728-34.
[13] Lee Y,Kim TH,Park JK,et al. Predictive value of antral follicle count and serum anti-Müllerian hormone:Which is better for live birth prediction in patients aged over 40 with their first IVF treatment?[J].Eur J Obstet Gynecol Reprod Biol,2018,221:151-155.
[2] Li J,Cui W,Sun W,et al. Effect of electroacupuncture on egg quality and tumomecrosis factor of patients with polycystic ovarian syndrome[J]. World Journal of Acupuncture-Moxibustion,2014,24(3):9-15.
[3] The ESHRE Guideline Group on POI,Webber L,Davies M,et al.ESHRE Guideline:management of women with premature ovarian insufficiency[J]. Hum Reprod,2016,31(5):926-937.
[4] Li J,Ng EH,Stener-Victorin E,et al. Comparison of acupuncture pretreatment followed by letrozole versus letrozole alone on live birth in anovulatory infertile women with polycystic ovary syndrome:a study protocol for a randomised controlled trial[J].BMJ Open,2016,6(10):e010955.
[5] Sun J,Jin C,Wu H,et al. Effects of electro-acupuncture on ovarian P450arom,P450c17αand mRNA expression induced by letrozole in PCOS rats[J]. PLoS One,2013,26(4):184-191.
[6] Li J,Cui W,Sun W,et al. Effect of electroacupuncture on egg quality and tumomecrosis factor of patients with polycystic ovarian syndrome[J]. World Journal of Acupuncture-Moxibustion,2014,24(3):9-15.
[7]徐文君,高慧,李杨.中药补肾调冲方治疗模型大鼠卵巢早衰相关性研究[J].中国煤炭工业医学杂志,2016,11(2):1601-1606.
[8] Persani L,Rossetti R,Cacciatore C. Genes involved in human premature ovarian failure[J]. J Mol Endocrinao,2010,45(5):257-279.
[9] Craig J,Orisaka M,Wang H. Gonadotropin and intra-ovarian signals regulating follicle development and atresia:the delicate balance between life and death[J]. Front Biosci,2007,12(2):3628-3639.
[10] Lainas TG,Sfontouris IA,Venetis CA,et al. Live birth rates after modified natural cycle compared with high-dose FSH stimulation using GnRH antagonists in poor responders[J].Human Reproduction,2015,30(10):2321-2330.
[11] Abdalla H,Thum MY. An elevated basal FSH reflects a quantitative rather than qualitative decline of the ovarian reserve[J].Hum Reprod,2004,19(4):893-8.
[12] Ji J,Liu Y,Tong XH,et al. The optimum number of oocytes in IVF treatment:an analysis of 2 455 cycles in China[J]. Hum Reprod,2013,28(10):2728-34.
[13] Lee Y,Kim TH,Park JK,et al. Predictive value of antral follicle count and serum anti-Müllerian hormone:Which is better for live birth prediction in patients aged over 40 with their first IVF treatment?[J].Eur J Obstet Gynecol Reprod Biol,2018,221:151-155.