Effect Of Tacupoint Electrical Stimulation Combined Intracavitary Physiotherapy In Intervening Thin Endometrial Receptivity And The Expression Of S100A11 In Kidney-yang Deficiency Patients During FET

Objective: To observe the changes of endometrial receptivity(ER)indexes and cycle outcomes in thin endometrium patients of kidney-yang deficiency during frozen-thawed embryo transplantation(FET).To investigate the effects of tacupoint electrical stimulation combined intracavitary physiotherapy in intervening thin endometrial receptivity and embryo implantation.Methods:60 patients who were under the diagnostic criteria of kidney-yang deficiency type with thin endometrium were randomly divided into treatment group(tacupoint electrical stimulation combined intracavitary physiotherapy+hormone replacement cycle)and control group(hormone replacement cycle).And their endometrial thickness,pulsatility index(PI)and resistance index(RI)of Uterine artery blood flow during ovulatory period were counted before the start of the experiment.From the beginning of the menstrual cycle before frozen-thawed embryo transplantation,the treatment group received tacupoint electrical stimulation combined intracavitary physiotherapy during each clean menstrual period,once every other day until the date of embryo transplantation.The control group didn’t receive intervention treatment.Both of the endometrial transition of the FET and its’ previous cycle,two groups’ endometrial thickness,PI and RI were measured and endometrial tissues were taken during the period of the embryo implantation of the previous cycle.The changes of kidney-yang deficiency syndrome scores、endometrial thickness、artery PI and RI and the differentials of each index during the treatment were analyzed between the two groups.There were comparisons between the both about the rates of FET cycle cancellation,biochemical pregnancy,clinical pregnancy.quantitative real-time PCR(q RT-PCR)and Western Blot were used to detect S100A11 m RNA and protein expression levels in endometrium of the two groups.Results:1.Comparison of kidney-yang deficiency syndrome scores:The difference in scores of pretherapy and post-treatment was prominent(P<0.01).As a consequence,the symptoms were visibly improved.2.Comparison of endometrial receptivity indexes:After therapy,the endometrial thickness of the treatment group was visibly added,and in comparison with the control group,the thickness and the differential were obviously different.The artery PI and RI of the treatment group were markedly lower than before,both of them and the differentials also were obviously different compared with the other(P<0.05).3.Comparison of the expression levels of S100A11:In comparison with the control group,Both of the expression levels of S100A11 m RNA and protein were obviously higher after the remedy of tacupoint electrical stimulation combined intracavitary physiotherapy(P<0.05).4.Comparison of the cycle outcomes:The cancellation rate of transplantation cycle was lower and the biochemical pregnancy rate was higher than that in the other group(P<0.05).Although there was no meaning of the difference in clinical pregnancy rate(P>0.05),the rate(37.04%)was still higher than that in the other one(27.59%).Conclusion:1.During the frozen-thawed embryo transplantation in kidney-yang deficiency patients with thin endometrium,tacupoint electrical stimulation combined intracavitary physiotherapy can obviously decrease the symptom of kidney-yang deficiency and the rate of FET cycle cancellation,and improve the endometrial thickness and the rate of biochemical pregnancy and clinical pregnancy.2.The average values of uterine artery PI and RI in thin endometrium patients were higher.After the remedy of hormone replacement cycle during frozen-thawed embryo transplantation,the values of the two groups showed a downward trend.The effect of exogenous estrogen can increase the endometrial blood flow,and the downward trend was more obvious when tacupoint electrical stimulation combined intracavitary physiotherapy was added.3.Tacupoint electrical stimulation combined intracavitary physiotherapy may promote the process of embryo invasion and adhesion in the uterine cavity by up-regulating the expression of S100A11 in endometrial cells,promoting the uptake,storage and release of Ca2+in the endoplasmic reticulum of endometrial cells,changing the cytoskeletal structure of endometrial cells,inducing cell division and proliferation,and taking part in local angiogenesis.