Clinical study on the effect of transcutaneous electrical acupoint stimulation on IVF-ET pregnancy outcomes in infertile patients with poor ovarian response

OBJECTIVE: In this study, patients with poor ovarian response received transcutaneous electrical acupoint stimulation (TEAS), and changes in serum sex hormone levels, anti-Müllerian hormone (AMH), antral follicle count, ovarian artery blood flow and kidney-deficiency symptoms, as well as the effect on IVF-ET pregnancy outcomes, were observed. METHODS: Ninety-six patients with kidney-deficiency pattern meeting the diagnosis of poor ovarian response were randomly divided into a TEAS plus artificial cycle group (32 cases), a TEAS group (32 cases) and an artificial cycle group (32 cases). The TEAS plus artificial cycle group received 3 courses of TEAS combined with a Western-medicine artificial cycle; the TEAS group received 3 courses of TEAS alone; the artificial cycle group received the artificial cycle alone; all were observed for 3 courses. Basal endocrine levels on day 2 of menstruation, AMH, antral follicle count and ovarian artery blood flow indices were compared before and after treatment in the three groups, and efficacy was compared among the three groups after treatment. Patients in the three groups suitable for in vitro fertilization-embryo transfer (IVF-ET) received controlled ovarian hyperstimulation with a modified ultra-short protocol; during stimulation, the TEAS plus artificial cycle group and the TEAS group continued TEAS until the HCG day. Gonadotropin (Gn) dosage, days of medication, hormone levels on the HCG injection day and endometrial thickness were analysed, and the number of oocytes retrieved, fertilization rate, high-quality embryo rate, number of frozen embryos, number implanted, cycle cancellation rate and pregnancy rate were compared among the three groups. RESULTS: 1. After treatment, basal endocrine levels, AMH, antral follicle count and kidney-deficiency symptoms differed significantly from pre-treatment values in all three groups; after treatment, the TEAS plus artificial cycle group and the TEAS group differed significantly from the artificial cycle group in these parameters (P<0.05), but there was no significant difference between the first two groups (P>0.05). 2. In the TEAS plus artificial cycle group and the TEAS group, the ovarian artery PI and RI on day 2 of menstruation decreased after treatment, with statistically significant differences (P<0.05). 3. E2 levels on the HCG injection day were higher in the TEAS plus artificial cycle group and the TEAS group than in the artificial cycle group (P<0.05), with no significant difference between the first two groups (P>0.05). 4. More patients in the TEAS group underwent IVF-ET than in the TEAS plus artificial cycle group and the artificial cycle group, but there was no significant difference among the three groups (P>0.05). 5. The number of oocytes retrieved was higher in the TEAS plus artificial cycle group than in the artificial cycle group (P<0.05), and the high-quality embryo rate in the HANS group was significantly higher than in the artificial cycle group (P<0.05). 6. Comparison of overall clinical efficacy: the overall efficacy of the TEAS plus artificial cycle group and the TEAS group was better than that of the artificial cycle group (P<0.05). There was no statistical difference in overall efficacy between the two groups (P<0.05). There were no statistical differences in any indicator among the three groups before treatment (P>0.05). CONCLUSIONS: In patients with poor ovarian response, TEAS before IVF-ET can benignly regulate the hypothalamic-pituitary-ovarian axis, improve endocrine levels, ovarian blood supply and kidney-deficiency symptoms, enhance ovarian response, increase the number of oocytes retrieved and raise the high-quality embryo rate. The results provide a theoretical basis and a treatment method for improving ovarian function in patients with poor ovarian response.