Effects Of Acupuncture Intervention At Different Time Points On The Pregnancy Rate Of Frozen-thawed Embryo Transfer

BackgroundIn the past ten years,the use of freeze-thaw embryo transfer has greatly increased.Currently,as many as one-half of the embryo transfer cycle is cryopreserved.The indications for frozen embryo transfer are expanding.The success rate of embryo transfer is essentially the pregnancy rate after embryo transfer.By observing the effect of acupuncture on the clinical pregnancy rate of frozen-thawed embryo transfer(FET),it is helpful to evaluate the auxiliary function of acupuncture in IVF-FET,so that it can play a better role in IVF-FET.PurposeTaking frozen-thawed embryo transfer women as the research subjects,they were divided into transplantation day acupuncture group and transplantation cycle acupuncture group.Acupuncture intervention was carried out.The clinical pregnancy rate(CPR)results of these two groups and the control group(no acupuncture group)were observed.In order to explore the effect of acupuncture intervention at different time points on the pregnancy rate of in vitro fertilization-frozen embryo transfer.Methods1.GroupThe data was collected from Apr 2019 to May 2020 in 99 cases of women aged 26 to 42 who were enrolled in IVF-FET by the Central New York Fertility Center(CNY fertility center).Adopt a non-randomized parallel controlled clinical trial program that follows patient wishes?33 cases respectively of control group,transplantation day acupuncture group and transplantation cycle acupuncture group were treated and observed.2.Treatment2.1 Non-treatment group:No acupuncture treatment was performed during the transplantation cycle.2.2 Acupuncture group on the day of transplantation:on transplantation day:Acupuncture treatment was performed 1 hour before transplantation.Acupuncture points:Uterus,Guanyuan,Zhongji,Taichong,Hegu,Baihui,Yintang,each point was directly or obliquely punctured by 0.5 to 1.0 inch.After getting qi,apply the technique of leveling,reinforcing and reducing,and keeping the needle.30 minutes.Acupuncture was performed again within 30 minutes after transplantation.Points were selected:Zusanli,Xuehai,Sanyinjiao,Neiguan,and Diji.Directly puncture each point 0.5 to 1.0 cun.After getting qi,apply the technique of leveling,reinforcing and reducing,and keeping the needle.30 minutes.2.3 Transplantation cycle acupuncture group:Start acupuncture treatment 5 weeks before FET,and treatment once a week(the treatment days should be the same as possible each week,and the treatment should be no more than one day after the wrong one)for a total of 5 treatments.Acupoint selection:Uterus,Guanyuan,Zhongji,Taichong,Hegu,Baihui,Yintang,Zusanli,Xuehai,Sanyinjiao,Neiguan,Diji,each point is directly or obliquely punctured 0.5 to 1.0 inch,After getting qi,apply the technique of leveling,reinforcing and reducing,and keeping the needle.30 minutes.The same treatment as the acupuncture group on the day of transplantation was also performed on the day of transplantation.3.Observation indicators3.1 Efficacy indicator(1)Determination of blood chorionic gonadotropin(HCG),thyroid stimulating hormone(TSH).It is tested two weeks after transplantation to determine whether it is a biochemical pregnancy.(2)Two to three weeks after embryo transfer,the gestational sac(GS)and yolk sac(YS)diameters,crown-rump length(CRL)and heart rate(HR)measurements are obtained in singleton pregnancy by two-dimensional vaginal ultrasound to determine whether for clinical pregnancy.3.2 Safety indicators:including observations of acupuncture safety assessments,adverse events,or serious adverse events,and evaluations during treatment.ResultsA total of 99 IVF-FET patients were enrolled.During the treatment,3 cases were dropped and eliminated in the non-treatment group;4 cases were dropped and eliminated in the transplantation day acupuncture group;4 cases were dropped and eliminated in the transplantation cycle acupuncture group;finally 88 cases were treated.That is,there were 30 cases in the non-treatment group,29 cases in the transplantation day acupuncture group,and 29 cases in the transplantation cycle acupuncture group.1 Basic dataThrough the analysis and comparison of demographic data such as patient age,body density index,age at menarche,there is no statistical difference between the three groups,and they are comparable.2.Baseline analysis:Follicle stimulating hormone(FSH),anti-Mullerian factor(AMH),estradiol(E2),thyroid stimulating hormone(TSH)and other hormone biochemistry before IVF-FET cycle in three groups of patients.The index values were analyzed,and there was no statistical difference in FSH,AMH,E2,TSH,etc.between the three groups.The three sets of data are comparable.3.Results3.1 Number of clinical pregnancy cases:Among the 30 patients in the control group,14 were biochemical pregnancy and 12 were clinical pregnancy.Among the 29 patients in the acupuncture group on the day of transplantation,18 were biochemical pregnancy and 16 were clinical pregnancy.Among the 29 patients in the transplantation cycle acupuncture group,22 were biochemical pregnancy and 20 were clinical pregnancy.3.2 Comparison of chemical pregnancy ratesComparison of biochemical pregnancy rates:The biochemical pregnancy rates of the control group,the transplantation day acupuncture group,and the transplantation cycle acupuncture group were 46.67%,62.07%,and 75.86%,respectively.Comparing the control group and the transplantation day acupuncture group,the transplantation day acupuncture group and the transplantation cycle acupuncture group,the success rate increased by 15%and 13%respectively,both of which have an upward trend,but P>0.05,which is not statistically significant;Compared with the control group and the transplantation cycle treatment group,P<0.05,there is a statistical difference.Comparison of clinical pregnancy rates:The clinical pregnancy rates of the control group,the transplantation day acupuncture group,and the transplantation cycle acupuncture group were 40%,55.17%,and 68.97%,respectively.Comparing the control group and the transplantation day acupuncture group,the transplantation day acupuncture group and the transplantation cycle acupuncture group,the success rate increased by 15%and 13%respectively,both of which have an upward trend,but P>0.05,which is not statistically significant;Compared between the control group and the transplantation cycle treatment group,P<0.05,there is a statistical difference.Conclusion1.Combined with acupuncture intervention in freeze-thaw embryo transfer,it has a trend to improve the biochemical and clinical pregnancy rate;2.On the day of transplantation,acupuncture intervention before and after transplantation has a tendency to improve the biochemical and clinical pregnancy rate;3.Acupuncture intervention during the transplantation cycle has a tendency to increase the biochemical and clinical pregnancy rate than only on the day of transplantation;4.Acupuncture intervention during the transplantation cycle can significantly improve the biochemical and clinical pregnancy rate.