Effectiveness of Herb-partitioned Moxibustion on the Navel for Pregnancy Outcomes in Patients With Recurrent Implantation Failure Undergoing in Vitro Fertilization and Embryo Transfer: A Study Protocol for a Randomized Controlled Trial

Abstract

BackgroundRecurrent implantation failure (RIF) in the majority of patients undergoing in vitro fertilization and embryo transfer (IVF-ET) is caused by various factors such as maternal age, embryo quality, endometrial receptivity (ER) and immunity. The incidence of RIF is usually between 5and 10%. Previous studies have shown that herb-partitioned moxibustion on the navel is one of the treatment methods of acupuncture with a positive effect on pregnancy. However, its application in the treatment of RIF has not been reported. Therefore, this study aimed to explore the effectiveness of herb-partitioned moxibustion on the navel in improving the outcome of frozen embryo transfer (FET) in patients with RIF. MethodsThis study conducted a randomized controlled trial (RCT). It is planned to recruit 210 patients undergoing RIF for FET from Affiliated Hospital of Shandong University of Traditional Chinese Medicine and randomly divide them into the treatment group and the control group in a ratio of 1:1. The patient of the treatment group will be treated with herb-partitioned moxibustion on the navel once a week for three consecutive menstrual cycles. During the fourth menstrual cycle, will be induced to prepare the endometrium before embryo transfer. No intervention will be used in the control group for 3 menstrual cycles. However, in the fourth menstrual cycle, an artificial cycle will be induced to prepare the endometrium before embryo transfer. The conception outcome will be recorded after a 3-months follow-up. Primary outcome will be assessed as the ongoing pregnancy rate compared with the control group. Secondary outcomes include the endometrial type, resistance index (RI), pulsatility index (PI) of the bilateral uterine artery, endometrial blood flow, serum estradiol (E2), progesterone (P), biochemical pregnancy rate, implantation rate and clinical pregnancy rate. DiscussionIf the results confirm that the herb-partitioned moxibustion on the navel can improve IVF-ET outcomes in patients with RIF, it will be recommended for application in clinical practice.Trial registration:Chinese clinical trial registry (ChiCTR). Trial registration number: ChiCTR2100043954. Registered on 8 July 2021.