A Randomized Controlled Trial Of Acupuncture In The Treatment Of IVF-ET In Patients With DOR Infertility

Objective To observe whether acupuncture treatment can contribute to IVF-ET outcomes in patients with DOR infertility,and to explore the possible mechanism of the effect of acupuncture treatment on oocyte development in patients with DOR infertility by comparing the levels of beta-EP,BMP-4,Cx43,ICAM-1 and COX-2 in the follicular fluid between the two groups.Methods A prospective randomized controlled study was conducted on 51 patients with diminished ovarian reserve who met the rejection criteria during in vitro fertilization and embryo transfer from October 2017 to December 2018 in the Reproductive Medicine Special Hospital of the 1st hospital of Lanzhou University.They were randomly divided into the acupuncture group and the blank control group.The number of target follicles,the number of captured oocytes,the number of MII oocytes,the number of 2PN oocytes,the number of high-quality embryos,the number of transplantable embryos,the rate of MII oocytes,the rate of fertilization,the rate of oocyte output and the rate of clinical pregnancy were observed and compared between the two groups.Follicular fluid was collected and the levels of beta-EP,BMP-4,Cx43,ICAM-1 and COX-2 in follicular fluid were analyzed.Results There was no significant difference in the number of target follicles,the number of oocytes obtained and the number of MII oocytes between the two groups(P>0.05).The number of 2PN in the acupuncture group was significantly higher than that in the control group(P<0.05);There was no significant difference in the number of high-quality embryos and transplantable embryos between the two groups(P>0.05).There was no statistical difference in the oocyte output rate between the two groups(P>0.05);the MII oocyte rate and fertilization rate in the acupuncture group were significantly higher than those in the control group(P<0.05).There was nosignificant difference in the concentration of beta-EP,BMP-4 and Cx43 in the follicular fluid between the two groups(P>0.05),the follicular fluid ICAM-1 and COX-2 in the acupuncture group were significantly lower than those in the control group(P<0.05).The concentration of BMP-4,Cx43,ICAM-1 and COX-2 in follicular fluid of the two groups were correlated with the concentration of beta-EP(P<0.05).Conclusion Acupuncture treatment can improve the M II oocyte rate and in vitro fertilization rate of DOR patients,and may be beneficial to IVF-ET outcomes of DOR patients.Acupuncture treatment may promote oocyte development of DOR patients by reducing ICAM-1 and COX-2 in follicular fluid.