[Effect of Wenyang Huazhuo acupuncture therapy on endometrial receptivity and pregnancy outcomes in patients with repeated implantation failure of spleen and kidney yang deficiency pattern].

OBJECTIVES: To observe the effect of Wenyang Huazhuo (warming yang and resolving turbidity) acupuncture therapy on endometrial receptivity and the outcome of frozen-thawed embryo transfer in patients with repeated implantation failure (RIF) of spleen and kidney yang deficiency.

METHODS: A total of 80 patients with RIP of spleen and kidney yang deficiency were randomly divided into a control group (40 cases, 3 cases dropped out) and a treatment group (40 cases, 4 cases dropped out). In the control group, frozen embryo transfer (FET) was operated. In the treatment group, starting 2 months before FET and ending on the day of FET, Wenyang Huazhuo acupuncture therapy was given once every other day, 3 times a week and the needles were retained for 30 min in each treatment. Luteal support therapy was administered after FET in two groups. The comparison was conducted in clinical pregnancy rate, embryo implantation rate, sustained pregnancy rate and live birth rate between two groups. Using ultrasound, endometrial thickness and morphology, endometrial blood flow, uterine artery hemodynamic index (PI), resistance index (RI), and peak systolic velocity/end diastolic flow velocity (S/D) were detected on ovulation day/endometrial transformation day in FET cycle separately;and using Western blot method, the protein expressions of the mid-luteal endometrial homologous frame gene 10 (HOXA10), integrin β5 (ITGB5) and leukocyte inhibitory factor (LIF) in endometrial tissue were detected.

RESULTS: Compared with the control group, in the treatment group, clinical pregnancy rate, embryo implantation rate, sustained pregnancy rate and live birth rate increased (P<0.05, P<0.01);the endometrial thickness on the endometrial transformation day/ovulation day before FET was thickened (P<0.05), the rate of endometrial type A increased (P<0.01), and the RI of the uterine artery decreased (P<0.01);endometrial blood flow, PI, and S/D ratio showed no statistically significant differences. The protein expressions of the mid-luteal endometrial HOXA10, ITGB5 and LIF increased (P<0.05, P<0.001) in the treatment group.

CONCLUSIONS: Wenyang Huazhuo acupuncture therapy can increase the implantation rate, pregnancy rate and live birth rate in frozen-thawed embryo transfer cycle for the patients with RIF of spleen and kidney yang deficiency, and effectively improve the pregnancy outcome, which may be related to the up-regulation of the protein expressions of the mid-luteal endometrial HOXA10, ITGB5 and LIF and the improvement of endometrial receptivity.