Transcutaneous electrical acupoint stimulation improves endometrial receptivity resulting in improved IVF-ET pregnancy outcomes in older women: a multicenter, randomized, controlled clinical trial

Abstract

Objective To examine the effects and mechanisms of transcutaneous electrical acupoint stimulation (TEAS) on pregnancy outcomes in women undergoing in vitro fertilization (IVF)-embryo transfer (ET). Design, setting, and participants This efficacy study was a multicenter, randomized, controlled clinical trial (RCT) in women receiving IVF-ET. The mechanistic study was a single-center RCT. Interventions The participants received TEAS vs. no TEAS treatment. Main outcome measures In the efficacy study, the primary outcomes were the rates of clinical pregnancy, embryo implantation, and live birth. In the mechanistic study, sex hormones and endometrial protein expression were examined. Results Ultimately, 739 participants were enrolled (367 and 372 in the TEAS and control groups, respectively). The clinical pregnancy rate was higher in the TEAS group than in the controls (55.1% vs. 46.7%, P = 0.03). There were no significant differences in embryo implantation, biochemical pregnancy, and live birth rates between the two groups (all P > 0.05) in the study population. In women > 35 years, the clinical pregnancy rates, embryo implantation rates and live birth rates in the TEAS and control groups were 48.9% vs. 23.7% (P = 0.004),30.8 vs. 13.9% (P = 0.001) and 34.0% vs. 19.7% (P = 0.06) respectively. In the mechanistic study with 120 participants, on the theoretical embryo implantation day, better developed endometrial pinopodes, elevated endometrial integrin α1β1/αVβ3, leukemia inhibitory factor, and elevated serum progesterone levels were found in the TEAS group compared with controls. Conclusion TEAS significantly improved the clinical pregnancy rate in women undergoing IVF-ET, especially in women of older age. It might be due to improved endometrial receptivity. Trial registration ChiCTR-TRC-13003950.

Review of transcutaneous electrical acupoint stimulation and related devices

“…By reviewing the available studies, we summarized the therapeutic parameters of transcutaneous electrical acupoint stimulators. The stimulators achieved satisfactory clinical efficacy in the treatment of various conditions including postoperative neuralgia, infertility, insomnia, hypertension, respiratory diseases, and other neurological-endocrine disorders, [11–31] which is shown in Table 2. Acupoints on the chest, abdomen, trunk, upper limbs, and lower limbs were often used for clinical diagnosis and treatment of diseases.…”

“…30 min 18 Zhang et al [28] 3 Wang et al [30] 0. Feng et al [31] The stimulation intensity was set to trial for the treatment of acute pain after total knee joint replacement.…”

“…Shuai et al [21] conducted TEAS (9-25 mA, 2 Hz) at the acupoints Sanyinjiao (SP6), Zhongji (RN3), Guanyuan (RN4), and Zigong (EX-CA1) for 30 minutes, which significantly improved the clinical outcomes of subsequent in vitro fertilization cycles among women who had experienced recurrent implantation failure. Feng et al [31] found that TEAS can enhance endometrial receptivity by stimulating Diji (SP8), Guilai (ST29), Zigong (RN19), and Xuehai (SP10) at the frequency of 2 Hz and current intensity of 10-20 mA before embryo transfer and stimulating Zusanli (ST36), Taixi (KI3), Shenshu (BL23), Guanyuan (RN4), and Zhongwan (RN12) after embryo transfer. The results indicated that the treatment significantly improved the clinical pregnancy rate, embryo transfer success rate, and live birth rate.…”

Establishment and validation of a nomogram model for predicting ovulation in the PCOS women

“…[6] Previous clinical trials conducted across various countries suggest a potential benefit of acupuncture in enhancing reproductive function. [7][8][9][10] However, these acupuncture trials lack sufficient evidence to determine the efficacy of acupuncture in treating ovulation disorders in women with PCOS. [11] Additionally, female infertility in PCOS is negatively affected by factors such as being overweight, hyperandrogenism, and increased serum luteinizing hormone (LH) levels.…”