【作者】 何晓霞；

【导师】 张学红；

【作者基本信息】 兰州大学 ， 妇产科学， 2011， 硕士

【摘要】 目的探讨针刺治疗对体外受精-胚胎移植术(IVF-ET)治疗期的作用及其可能产生影响的机理。方法将进行IVF-ET/ICSI治疗的304例不孕症患者随机分为针刺治疗组(实验组)和空白对照组(对照组)两组。两组患者均采用促性腺激素释放激素激动剂(GnRH-a)长方案治疗,实验组从控制性超排卵第一天开始接受针刺治疗,直至胚胎移植日停止(取卵当天不进行针刺治疗),观察两组GnRH-a用量、促性腺激素(Gn)用量、治疗天数等方面的差异,通过化学发光法检测血清雌二醇(E2)、孕酮(P)水平,对比两组的获卵数、MⅡ卵率、临床妊娠率、流产率和OHSS发生率。结果1.实验组临床妊娠率为52.90%,对照组临床妊娠率为50.74%,两组间没有统计学意义(p>0.05)；实验组的流产率与对照组相比也没有显著性差异(10.96% vs.10.14%,p>0.05)；2.实验组>16mm的卵泡数较对照组少(p<0.05),但MII率高于对照组(p<0.05)；3.胚胎移植日实验组血清E2水平低于对照组(p<0.05)；4,实验组OHSS的发生率较对照组明显降低(2.03% vs.7.33%,p=0.030<0.05),有统计学意义。结论针刺辅助治疗对IVF-ET治疗过程中卵母细胞的进一步成熟具有一定的促进作用,针刺治疗可以调节血清中E2含量是影响OHSS发生的机理之一。更多还原

【Abstract】 Objective This study aimed to investigate the effects of acupuncture on in vitro fertilization-embryo transfer (IVF-ET) treatment and the possible influencing mechanism.Methods 304 patients under the treatment of IVF-ET/ICSI were randomly allocated to acupuncture group or control group. Both groups were treated with long protocol of gonadotropin releasing hormone agonist (GnRH-a). The patients in acupuncture group received acupuncture from the first day of controlled ovarian hyperstimulation to embryo transfer day (exclude the day of oocyte retrieval). Dose of GnRH-a and gonadotropin (Gn), days of treatment were observed. Levels of serum estradiol (E2) and progesterone (P) were detected by chemiluminescence. Compared the number of oocytes, the rate of MⅡoocytes, clinical pregnancy rate, miscarriage rate and incidence of OHSS.Results 1. The clinical pregnancy rate of acupuncture group showed no difference with control group (52.90% versus 50.74%, respectively, p>0.05); No significant differences were found in miscarriage rate between the two groups (10.96 % versus 10.14%, respectively, p>0.05);2. The number of follicles (>16mm) was higher in the control group than that in acupuncture group (p<0.05). But the rate of MⅡoocytes was opposite, acupuncture group higher than control group (p<0.05); 3. Serum E2 of the embryo transfer day was significantly lower in the acupuncture group than that in the control group (p<0.05); 4. Compared with the control group, the incidence of OHSS significantly reduced in acupuncture group (7.33% versus 2.03%, respectively, p=0.030<0.05).Conclusion Acupuncture used during IVF treatment may promote the maturation of oocytes, and acupuncture for the role of regulating the serum E2 might be one of the mechanism of reducing OHSS.更多还原