电针干预对多囊卵巢综合征患者纺锤体及卵子质量的影响  

Effect of Electro-acupuncture on the Spindle and Oocytes Quality in Patients with PCOS

作　　者：李静[1] 崔薇[1] 孙伟[1] 张琪瑶[1] 管群[1] 

机构地区：[1]山东中医药大学第二附属医院生殖科,济南250001

出　　处：《中国中西医结合杂志》2015年第3期304-309,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.30973790)

摘　　要：目的观察超促排卵过程中加电针干预对行体外受精——胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者卵子质量的影响。方法选择217例行IVF-ET的PCOS患者,按随机数字表分为电针组(119例)和对照组(98例),均给予长方案超促排卵,降调节及促排卵过程中电针组加用电针干预,直至取卵日。观察两组患者纺锤体(纺锤体与极体的位置关系)、获卵数、受精率、卵裂率、优质胚胎率、卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)发生率、临床妊娠率、早期自然流产率、促性腺激素(gonadotropins,Gn)用量、时间、绒促性素(human chorionic gonadotropin,HCG)日E2、孕酮(progesterone,P)、促黄体生成素(luteinizing hormone,LH)水平。结果电针组纺锤体位于极体11点至1点的卵子数占卵子数的比例明显高于对照组(P<0.05)。纺锤体位于极体11点至1点的卵子数与HCG日E2水平及优胚率呈正相关(r=0.19,P<0.01)。与对照组比较,电针组优质胚胎率明显升高(P<0.05),电针组Gn用量与用药时间减少(P<0.05),临床妊娠率提高8.36%。结论纺锤体与卵子质量呈正相关;电针干预可以提高卵子质量,改善PCOS患者临床妊娠率。Objective To observe the effect of electro-acupuncture （EA） treatment on the oo- cyte quality in polycystic ovarian syndrome （PCOS） patients undergoing in vitro fertilization-embryo transfer （IVF-ET）. Methods Totally 217 PCOS patients undergoing IVF-ET were assigned to two groups by random digit table, the EA group （119 cases） and the control group （98 cases）. All patients received long program ovarian hyperstimulation with gonadotropin-releasing hormone agonist. Patients in the EA group received EA treatment in the process of controlled ovarian hyperstimulation till the oocyte retrieval day. The position relation of the spindle to the polocyte, the number of retrieved oocytes, the fertilization rate,the cleavage rate,the high quality embryo rate,the ovarian hyperstimulation syndrome （OHSS） inci- dence rate, the clinical pregnancy rate, the early abortion rate,the gonadotropins （Gn） dose and time, levels of estradiol （ E_2 ）, progesterone （P） ,and luteinizing hormone （LH） on the day of human chorionic gonadotropin （HCG） were observed between the two groups. Results The ratio of oocytes in which the meiotic spindle deviation angle was 〈60 degrees to the all oocytes was obviously higher in the EA group than in the control group （P 〈0.05）. The oocytes in which the meiotic spindle deviation angle was 〈60 de- grees was positively related to level of E_2 on the HCG day and the high quality embryo rate （r =0.19,P 〈 0.01 ）. Compared with the control group, the high quality embryo rate increased significantly （P 〈0.05）, the dose and days of Gn decreased significantly （P 〈0.05）in the EA group. The clinical pregnancy rate was improved by 8.36%. Conclusions The spindle was positively correlated with the oocyte quality. EA could improve the quality of oocytes and the clinical pregnancy rate in PCOS patients undergoing IVF-ET.

关 键 词：纺锤体 卵子质量 电针 多囊卵巢综合征 体外受精——胚胎移植 

分 类 号：R246.3[医药卫生—针灸推拿学]