电针对不同证型不孕症患者胚胎种植潜能的影响

Effects of electroacupuncture on embryo implanted potential for patients with infertility of different symptom complex

目的:探讨电针对不同证型不孕症患者胚胎种植潜能的影响,并研究其作用的分子机制。方法:在配合电针进行体外受精-胚胎移植(IVF-ET)的不孕症患者中选取肾虚型(A组)82例、肝郁型(B组)74例、痰湿型(C组)54例,3组患者均为长方案超促排卵,在控制性超排卵前及超排卵过程中配合电针,测定3组患者月经第2日(M2)、绒促腺素(hCG)注射日血清和胚胎移植日培养基中人类白细胞抗原G(HLA-G)的含量,观察3组患者的受精率、种植率和临床妊娠率。结果:A、B两组hCG日血清HLA-G含量和移植日培养基HLA-G含量均显著高于C组(均P<0.05),但3组M2日血清HLA-G含量差异无统计学意义。A、B两组优质胚胎率为73.6%(352/478)、70.6%(379/537),显著高于C组的54.2%(208/384),差异均有统计学意义(均P<0.01);3组的临床妊娠率、受精率和卵裂率差异均无统计学意义。结论:在IVF-ET过程中配合电针治疗可通过促进患者体内HLA-G含量升高,提高胚胎分泌的HLA-G的水平,进而改善患者的妊娠情况,提高妊娠率。肾虚型和肝郁型两种不孕症患者经电针治疗后其临床结局较痰湿型效果好。

Objective To explore the impacts of electroacupuncture on embryo implanted potential and its molecular mechanism in the patients with infertility of different symptom complex.Methods Among the patients with infertility treated with electroacupuncture and in vitro fertilization and embryo transplantation（IVF-ET）,82 cases of kidney deficiency（group A）,74 cases of liver qi stagnation（group B） and 54 cases of phlegm dampness（group C） were selected.All of the patients in three groups received long-program ovarian hyper-stimulation.Additionally,electroacupuncturecan was applied before controlled ovarian hyper-stimulation（COH） and in the process of ovarian hyper-stimulation.The levels of human leukocyte antigen-G（HLA-G） in the serum were determined on the 2nd day of the menstruation（M2）,on the day of human Chorionic Gonadotropin（hCG） injection and on the day of embryo transplantation in the culture solution in three groups separately.The fertilization rate,implantation rate and clinical pregnancy rate were observed for the patients in three groups.Results The levels of HLA-G in the serum on hCG injection day and in the culture solution on embryo transplantation day in group A and B were significantly higher than those in group C（all P0.05）.But,there was no significant diffe-rence in serum HLA-G levels on M2 day among three groups.The high-quality embryo rate in either group A（73.6%,352/478） or group B（70.6%,379/537） was higher significantly than that in group C（54.2%,208/384） separately,pre-senting statistical significant difference（all P0.01）.But there were no significant differences in clinical pregnancy rate,fertilization rate and cleavage rate among three groups.Conclusion Electroacupuncture can increase the contents of HLA-G in the body and the level of HLA-G secreted in embryos for the patients in the process of IVF-ET.Eventually,the pregnancy outcome and the pregnancy rate are improved.The clinical effects of electroacupuncture for the patients of kidney deficiency and liver qi stagnation are better than those for the patients of phlegm dampness.