Clinical study on the effect of transcutaneous electrical acupoint stimulation intervention on pregnancy outcome in patients with poor ovarian response

OBJECTIVE: In this study, transcutaneous electrical acupoint stimulation (TEAS) intervention was applied to patients with poor ovarian response to observe changes in their basal endocrine levels and the effect of TEAS intervention on pregnancy outcome, and to explore possible pathways of effect. METHODS: Eighty patients meeting the diagnosis of poor ovarian response or poor ovarian reserve were randomly divided into an observation group (40 cases) and a blank group (40 cases). The observation group received 3 courses of TEAS intervention, while the blank group received no intervention and was observed for 3 courses. Basal endocrine levels on day 2 of menstruation, antral follicle count and endometrial thickness were compared between the two groups before and after treatment. Patients in both groups who were suitable for in vitro fertilization and embryo transfer (IVF-ET) received a short-protocol ovulation induction; during controlled ovarian hyperstimulation, the observation group additionally received TEAS until hCG day. Gonadotropin dose, days of medication, endometrial thickness and hormone levels on hCG injection day were analyzed, and the number of oocytes retrieved, fertilization rate, cleavage rate, high-quality embryo rate, number of frozen embryos, implantation rate, pregnancy rate and cycle cancellation rate were compared between the two groups. RESULTS: There were no significant differences in any indicator between the two groups before treatment. After treatment: 1. After 3 months of treatment, 3 patients in the observation group conceived naturally; bFSH levels in the observation group decreased significantly (P<0.05) and the antral follicle count increased significantly (P<0.05). 2. E2 level and endometrial thickness on hCG injection day were higher than in the blank group, with significant differences (P<0.05). 3. The number of oocytes retrieved and the number of frozen embryos in the observation group were significantly higher than in the blank group (P<0.05). 4. The number of pregnancies after IVF-ET was higher in the observation group than in the blank group, but the difference was not significant (P>0.05). CONCLUSIONS: In patients with poor ovarian response or predicted poor ovarian response, TEAS intervention before IVF-ET can exert a benign regulatory effect on the hypothalamic-pituitary-ovarian axis, improve ovarian response, increase the number of oocytes retrieved and ultimately achieve a higher pregnancy rate. These results provide a theoretical basis and a treatment method for improving pregnancy outcomes in patients with poor ovarian response, especially older infertile women.