The Influence Of The Pelvic Floor Muscle Massage On Pregnancy Outcome In Patients Ongoing IVF With Poor Ovarian Response

Objective: To observe the influence of the pelvic floor muscle massage on pregnancyoutcome in patients ongoing IVF with ovarian poor response. The influence of pelvic floormuscle massage on ovarian blood flow and the level of endocrine secretion was analysedto study the Mechanism.Methods:80patients ongoing IVF with poor ovarian response were enrolled from thereproductive enter, the second hospital affiliated to Shandong university of TraditionalChinese medicine from October2012to November2013. Patients were randomly dividedinto the observation group (n=40) and the control group (n=40).The observation groupwere given pelvic floor muscle massage combined with artificial cycle treatment bywestern medicine. Pelvic floor muscle massage were given after menstrual bleeding for20minutes with the frequency50HZ once a day until the next menstrual cycle. Acupointsincluding Huiyin, Huiyang, Changqiang, Yaoshu, Baliao. Artificial cycle treatment bywestern medicine was formed by the use of complex Packing Estradiol Tablets/Estradioland Dydrogesterone Tablets. One white pill, once a day, from the third day of menstrualcycle, for14days, and then followed by one grey pill, once a day, for14days. And menseswill coming.The control group were only given artificial cycle by western medicine. Bothof the two groups were treated for3menstrual cycles. The endocrine level, ovarian arterypulsatility index (PI), resistance index (RI), systolic/diastolic blood flow index (S/D) andantral follicle count were compared before and after treatment on the second day ofmenstrual cycle. Both of the two groups patients were given improvement of ultrashortscheme, at the same time the observation group were given pelvic floor muscle massageuntil HCG day. Gn dosage, duration, endometrial thickness, LH E2, P levels on HCG day, the number of retrieved oocytes, fertilization, cleavage, the number of good qualityembyos, the number of frozen embryos, embryo implantation rate, pregnancy rate andcycle cancellation rate were compared between the two groups.Results: There were no significant difference between the two groups beforetreatment (P>0.05). No significant difference was find between the two groups beforeCOH (P>0.05).After3menstrual cycles:Comparison in the group:1.The level of bFSH、PI、RI and S/D in the observationgroup were significantly decreased(P＜0.05),while AMH was significantly increased(P＜0.05).The number of antral follicle count was significantly increased(P＜0.05).2. Thelevel of bFSH in the control group was significantly decreased(P＜0.05),while AMH wassignificantly increased(P＜0.05).Comparison between groups:1.The level of bFSH in the observation group decreasedby10%compared with the control group(P＜0.05), while AMH increased by15%compared with the control group(P＜0.05), while the number of antral follicle countincreased by11%compared with the control group(P＜0.05).PI、RI、SD were decreasedsignificantly(P＜0.05).2. The E2level and endometrial thickness in observation group weresignificantly higher than control group (P<0.05).3. The number of retrieved oocytes, goodquality embryo and frozen embryo were significantly higher in observation group thanthose in control group(P<0.05).4. Clinical pregnancy rate were significantly higher in theobservation than those in the control group (P<0.05).Conclusion: Through stimulate the Acupuncture points in the Pelvic floor, pelvicfloor muscle massage can increase ovarian perfusion by improving the Pelvic floorperfusion, improve the ovarian reserve, increasing the number of oocytes retrieved andincrease pregnancy rate.