电针对高龄不孕IVF患者卵细胞质量影响的研究

Study on Effect of Electro-acupuncture on Oocyte Quality in Elderly Infertile IVF Patients

目的:研究电针对高龄不孕患者体外受精-胚胎移植(IVF-ET)的疗效,以及其对卵巢颗粒细胞P53、Bax基因表达的影响。方法:选取高龄肾气虚证接受体外受精(IVF)助孕的患者66例,按照随机数字表法分为治疗组即电针组33例(电针加拮抗剂方案),对照组即伪针组33例(伪针加拮抗剂方案)。两组患者均采用拮抗剂方案治疗,并于控制性超促排卵的前一周期经净后行电针治疗,每周2次,直至取卵日。收集两组患者取卵日颗粒细胞,采用反转录-聚合酶链反应(RT-PCR)技术检测患者P53、Bax基因的表达变化,同时对比治疗前后肾气虚证候积分、优质卵率、优质胚胎率、临床妊娠率。结果:①治疗组自身前后比较,治疗后肾气虚证候积分低于治疗前;与对照组比较,治疗组肾气虚证候积分低于对照组(P<0.05);②治疗组临床妊娠率提高,与对照组比较差异无统计学意义(P>0.05),但治疗组优胚率明显优于对照组(P<0.05);③治疗组P53mRNA、Bax mRNA的表达与对照组比较均下降(P<0.05)。结论:电针可能是通过下调P53和Bax基因的表达,抑制了颗粒细胞凋亡,进而提高了高龄不孕患者IVF卵细胞质量。

Objective:To study the curative efficacy of electro-acupuncture on in vitro fertilization and embryo transfer(IVF-ET)in elderly infertile patients and its effect on p53 and Bax gene expression in ovarian granulosa cells.Methods:Sixty-six elderly patients with kidney-qi deficiency syndrome who received IVF-assisted pregnancy were divided into the treatment group(electro-acupuncture group,electro-acupuncture combined with antagonist regimen,n=33)and the control group(pseudo-acupuncture group,pseudoacupuncture combined with antagonist regimen,n=33).Patients in both groups were treated with antagonist regimen,and electro-acupuncture was performed twice a week until the day of egg extraction in the previous cycle of controlled superovulation.The granulosa cells of the two groups were collected on the day of egg extraction,and the expression changes of p53 and Bax genes were detected by RT-PCR technique.At the same time,the score of kidney qi deficiency syndrome,high quality egg rate,high quality embryo rate and clinical pregnancy rate were compared before and after treatment.Results:①After treatment,the score of kidney qi deficiency syndrome in the treatment group was lower than that before treatment,and the score of kidney qi deficiency syndrome in the treatment group was lower than that in the control group(P<0.05).②The clinical pregnancy rate of the treatment group was improved,and there was no statistically significant difference between the treatment group and the control group,but the high quality embryo rate of the treatment group was significantly better than that of the control group(P<0.05).③The expression of p53 mRNA and Bax mRNA in the treatment group was significantly lower than that in the control group(P<0.05).Conclusions:Electro-acupuncture may reduce the expression of p53 and Bax genes,inhibit the apoptosis of granulosa cells,and then improve the quality of IVF oocytes in elderly patients.