Clinical Study On Pregnancy Outcome Of Patients With Repeated Implantation Failure Of Thin Endometrium Treated With Tongyuan Acupuncture By Stages

Objective:The purpose of this study was to observe the effect of "Tongyuan Acupuncture" on endometrial receptivity and pregnancy outcome in patients with recurrent endometrial implantation failure.Methods:In this study,from January 2020 to December 2020,the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine and the people’s Hospital of Guangdong Province were diagnosed as patients with repeated planting failure and meeting the research criteria,Guided by DME principles and methods,A prospective clinical randomized controlled study,The 74 subjects who met the criteria were divided into two groups: Tongyuan acupuncture combined with estradiol valerate(EV)and EV group,37 cases per group,EV group started taking estradiol valerate tablets 2mg/d;Tongyuan acupuncture combined with EV group on the basis of EV group on the fifth day of menstruation started universal acupuncture,The basic prescriptions were divided into A and B groups: A group was mainly composed of Baihui,Dazhui and bladder meridian acupoints to dispel disease and evil,to calm the viscera and to warm up the uterus,B group was composed of Qihai,Guanyuan and other Renmai and stomach meridian acupoints,Alternate abdominal and dorsal stimulation,Combined with local points,dialectical points,points by stages,With flying needles,Give me 30 min.after you get angry Once every other day,Until the day before the transplant,Two days after the transplant,Then continue acupuncture until the day of pregnancy(or menstruation),Both groups were treated for 3menstrual cycles.To observe the improvement of clinical pregnancy rate,embryo implantation rate,endometrial thickness,A endometrial ratio,endometrial blood flow index PI、RI and adverse reactions in the two groups,And a trimester follow-up.Results:1.Baseline comparison: There was no significant difference between the two groups in age,infertility years,transplant history,gestation history,adverse gestation history,basic hormone level,type of infertility(P>0.05),and the baseline level was comparable.2.Endometrial tolerance comparison : before treatment,The endometrial thickness and type of both groups had no statistical significance,Compar ability(P>0.05,P>0.05);The endometrial thickness compared with EV,compared with treatment and EV,The differences are statis tically significant(P<0.01,P<0.01);Endome trial thickness increased significantly in group EV compared to that prior to treatment,Statistical significance of the difference(P<0.01);The endometrial thickness difference before and after treatment between the two groups(P<0.01).The proportion of type A in group EV was 64.9 %(24/37),Before treatment,13.5 %(5/37),Group EV is 48.7 %(13/37),The proportion of A type in endometrial type combined with group EV was significantly increased compared with before treatment and EV group,The differences are statis tically significant(P<0.01,P<0.05);Before the treatment,Neither group of endometrial blood flow parameters PI 、 RI,Compar ability(P>0.05,P>0.05);Pre-transplantation 1 through injection combined with EV group PI 、 RI was significantly lower compared with pre-treatment,The differences are statis tically significant(P<0.01,P<0.01);Significant decrease in EV group PI、RI compared with pre-treatment,The differences are statis tically significant(P<0.01,P<0.01),Combined with PI、RI compared With EV group,The differences are statis tically significant(P<0.01,P<0.05).Two sets of PI、RI difference comparisons have statistical significance(P<0.05,P<0.01).3.Comparison of pregnancy rates : The clinical pregnancy rate of Tongyuan acupuncture combined with EV group was 37.8%(14/37)higher than that of EV group(16.2%(6/37),difference was statistically significant(P <0.05),Embryo implantation rates of 26.3 per cent(21/81)were higher than those of the EV group of 17.7 per cent(14/79),But there was no significant difference(P>0.05).4.Comparison of adverse reactions :There were 6 cases of breast pain,stomach pain,dizziness,nausea and other discomfort in the EV group,and no adverse drug reaction occurred in the Tongyuan acupuncture combined with the EV group.It shows that acupuncture can reduce the adverse reactions caused by drugs.Conclusion:Based on conventional western medicine,adding "Tongyuan acupuncture" can significantly increase the thickness of endometrium in patients with thin endometrium RIF,improve endometrial receptivity and improve pregnancy outcome.