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Chen YQ, Shen T, Lv Y, Shen MH. Feasibility of acupuncture as an adjunct intervention for ovulatory disorder infertility: A systematic review and meta-analysis. World J Clin Cases 2024; 12:5108-5123. [DOI: 10.12998/wjcc.v12.i22.5108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/27/2024] [Accepted: 06/14/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Acupuncture (AT) is widely used in treatment of ovulatory disorder infertility (ODI), but the safety and efficacy of AT for ODI still lack an evidence-based basis.
AIM To evaluate the feasibility and effectiveness of AT as an adjunct intervention for ODI.
METHODS The Cochrane Library, Embase, PubMed, VIP, China National Knowledge Infrastructure, WanFang Data, and Chinese biomedical literature databases were searched from inception to January 20, 2024. Two reviewers independently selected studies, collected data, and evaluated methodological quality through the Cochrane Risk of Bias tool. Revman 5.4 was used for meta-analysis, and the Grade system was performed to evaluate the level of evidence for the outcomes of the meta-analysis.
RESULTS A total of 20 randomized controlled trials with 1677 ODI patients were included. Compared with the clomiphene citrate (CC) group, the AT plus CC group exhibited significant improvement of the pregnancy rate [relative risk (RR) = 1.68, 95% confidence interval (CI): 1.45-1.95, P < 0.00001, I2 = 23%], ovulation rate (RR = 1.34, 95%CI: 1.22-1.47, P < 0.00001, I2 = 32%), serum E2 level [mean difference (MD) = 31.36, 95%CI: 21.83-40.88, P < 0.00001, I2 = 97%], thickness of endometrium (MD = 1.76, 95%CI: 0.71-2.81, P = 0.001, I2 = 98%) and decreasing miscarriage rate (RR = 0.25, 95%CI: 0.09-0.65, P = 0.005, I2 = 0%), serum follicle-stimulating hormone level (MD = -2.10, 95%CI: -3.27 to -0.94, P = 0.0004, I2 = 99%), serum luteinizing hormone level (MD = -6.94, 95%CI: -9.89 to -4.00, P < 0.00001, I2 = 100%), and serum progesterone level (MD = -1.66, 95%CI: -2.98 to -0.34, P = 0.01, I2 = 96%). The AT group had a more favorable effect than CC group for improving pregnancy rate (RR = 1.52, 95%CI: 1.33-1.73, P < 0.00001, I2 = 0%), thickness of endometrium (MD = 2.48, 95%CI: 2.15-2.81, P < 0.00001, I2 = 0%) and reducing miscarriage rate (RR = 0.23, 95%CI: 0.13-0.44, P < 0.00001, I2 = 0%), serum follicle-stimulating hormone level (MD = -0.55, 95%CI: -0.86 to -0.24, P = 0.0005, I2 = 0%), and serum progesterone level (MD = -0.24, 95%CI: -0.28 to -0.20, P < 0.00001). However, the level of evidence was predominantly assessed as very low to moderate.
CONCLUSION AT can improve the pregnancy outcomes and sex hormone levels for patients with ODI. However, further studies are needed to confirm these findings.
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Affiliation(s)
- Yu-Qi Chen
- Department of Acupuncture and Tuina Rehabilitation, Kunshan Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Kunshan 210023, Jiangsu Province, China
- School of Acupuncture-Moxibustion and Tuina, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Tao Shen
- Department of Traditional, Chinese Medicine Kunshan Rehabilitation Hospital, Kunshan 215300, Jiangsu Province, China
| | - Ying Lv
- Department of Acupuncture and Tuina Rehabilitation, Kunshan Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Kunshan 210023, Jiangsu Province, China
| | - Mei-Hong Shen
- School of Acupuncture-Moxibustion and Tuina, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, Jiangsu Province, China
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2
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Xie X, Ao X, Xu R, Lv H, Tan S, Wu J, Zhao L, Wang Y. Injectable, stable, and biodegradable hydrogel with platelet-rich plasma induced by l-serine and sodium alginate for effective treatment of intrauterine adhesions. Int J Biol Macromol 2024; 270:132363. [PMID: 38754675 DOI: 10.1016/j.ijbiomac.2024.132363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/16/2024] [Accepted: 05/11/2024] [Indexed: 05/18/2024]
Abstract
The combination of pharmacological and physical barrier therapy is a highly promising strategy for treating intrauterine adhesions (IUAs), but there lacks a suitable scaffold that integrates good injectability, proper mechanical stability and degradability, excellent biocompatibility, and non-toxic, non-rejection therapeutic agents. To address this, a novel injectable, degradable hydrogel composed of poly(ethylene glycol) diacrylate (PEGDA), sodium alginate (SA), and l-serine, and loaded with platelet-rich plasma (PRP) (referred to as PSL-PRP) is developed for treating IUAs. l-Serine induces rapid gelation within 1 min and enhances the mechanical properties of the hydrogel, while degradable SA provides the hydrogel with strength, toughness, and appropriate degradation capabilities. As a result, the hydrogel exhibits an excellent scaffold for sustained release of growth factors in PRP and serves as an effective physical barrier. In vivo testing using a rat model of IUAs demonstrates that in situ injection of the PSL-PRP hydrogel significantly reduces fibrosis and promotes endometrial regeneration, ultimately leading to fertility restoration. The combined advantages make the PSL-PRP hydrogel very promising in IUAs therapy and in preventing adhesions in other internal tissue wounds.
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Affiliation(s)
- Xiangyan Xie
- College of Chemistry and Materials Science, Sichuan Normal University, Chengdu 610068, China
| | - Xue Ao
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Ruijuan Xu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Hongyi Lv
- College of Chemistry and Materials Science, Sichuan Normal University, Chengdu 610068, China
| | - Shiqiao Tan
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Jinrong Wu
- State Key Laboratory of Polymer Materials Engineering, College of Polymer Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Lijuan Zhao
- College of Chemistry and Materials Science, Sichuan Normal University, Chengdu 610068, China.
| | - Yi Wang
- College of Chemistry and Materials Science, Sichuan Normal University, Chengdu 610068, China.
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Lai YY, Liu LY, Wu YN, Huang L, Zheng XY, Gan D, Yu SY, Zhong Y, Liang FR, Zhou Y, Yang J. Immediate Effect of Electro-acupuncture on Endometrial Blood Flow in Patients with Recurrent Implantation Failure: A Randomized Controlled Trial. Chin J Integr Med 2024; 30:291-298. [PMID: 38433155 DOI: 10.1007/s11655-024-3758-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To investigate the immediate effects of electro-acupuncture (EA) on endometrial blood flow among recurrent implantation failure (RIF) patients. METHODS Eighty RIF patients, enrolled from March 2022 to December 2022, were randomly allocated into either the EA group (40 cases) or the waiting-list (WL) group (40 cases) by using a random number table. The EA group underwent acupuncture at points of Shenting (GV 24), Baihui (GV 4), Benshen (GB 13), bilateral Zigong (EX-CA 1), Huangshu (KI 16), Sanyinjiao (SP 6) and Xuehai (SP10), and electric acupuncture apparatus was connected to EX-CA 1, KI 16, SP 6, and SP 10 with disperse-dense waves at 4/20 Hz frequencies for 30 min after transvaginal ultrasound, while the WL group received no intervention. The primary outcome measured was the endometrial volume blood flow. The secondary outcomes included the bilateral uterine artery index, endometrial volume, endometrial blood flow type, vascular distribution index (VIMV) for endometrial and ovary, clinical pregnancy rate, and embryo implantation rate. RESULTS In the EA group, there was a notable decrease in the bilateral pulsatility index and a significant improvement in the endometrial blood flow type post-EA (P<0.05). Both the endometrial blood flow type and VIMV for the endometrium and right ovary were markedly higher in the EA group compared to the WL group post-treatment (P<0.05). Conversely, no significant disparities were observed in vascular index, flow index, vascular blood flow index, uterine arterial blood flow indices, endometrial volume, clinical pregnancy rate and embryo implantation rate between the two groups after treatment (P>0.05). Besides, no adverse events related to EA were observed. CONCLUSIONS EA can promptly ameliorate VIMV for the endometrial and right ovary, and endometrial blood flow type. Future randomized controlled trials are warranted to investigate the long-term effects of EA on blood flow of RIF patients and its implications for pregnancy outcomes. (Trial registration No. ChiCTR2200057377).
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Affiliation(s)
- Yuan-Yuan Lai
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Li-Ying Liu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Yong-Na Wu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Lei Huang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Xiao-Yan Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Di Gan
- Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, 610032, China
| | - Si-Yi Yu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Ying Zhong
- Yuan TCM Wellness Pte. Ltd., 999002, Pulse TCM Singapore, Singapore
| | - Fan-Rong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Ying Zhou
- Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, 610032, China
| | - Jie Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China.
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Xia Q, Lv S, Xu H, Wang X, Xie Z, Lin R, Zhang J, Shu C, Chen Z, Gong X. Non-invasive evaluation of endometrial microvessels via in vivo intrauterine photoacoustic endoscopy. PHOTOACOUSTICS 2024; 36:100589. [PMID: 38318428 PMCID: PMC10839775 DOI: 10.1016/j.pacs.2024.100589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/09/2024] [Accepted: 01/17/2024] [Indexed: 02/07/2024]
Abstract
The endometrium microvessel system, responsible for supplying oxygen and nutrients to the embryo, holds significant importance in evaluating endometrial receptivity (ER). Visualizing this system directly can significantly enhance ER evaluation. Currently, clinical methods like Narrow-band hysteroscopy and Color Doppler ultrasound are commonly used for uterine blood vessel examination, but they have limitations in depth or resolution. Endoscopic Photoacoustic Imaging (PAE) has proven effective in visualizing microvessels in the digestive tract, while its adaptation to uterine imaging faces challenges due to the uterus's unique physiological characteristics. This paper for the first time that uses high-resolution PAE in vivo to capture a comprehensive network of endometrial microvessels non-invasively. Followed by continuous observation and quantitative analysis in the endometrial injury model, we further corroborated that PAE detection of endometrial microvessels stands as a valuable indicator for evaluating ER. The PAE system showcases its promising potential for integration into reproductive health assessments.
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Affiliation(s)
- Qingrong Xia
- Institute of Medical Imaging, University of South China, Hengyang 421001, China
- Affiliated Nanhua Hospital, University of South China, Hengyang 421002, China
- Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
- Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
| | - Shengmiao Lv
- Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
- Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
| | - Haoxing Xu
- Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
- Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
| | - Xiatian Wang
- Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
- Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
| | - Zhihua Xie
- Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
- Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
| | - Riqiang Lin
- Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
- Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
- Department of Electrical and Electronic Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Jinke Zhang
- Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
- Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
| | - Chengyou Shu
- Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
- Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
| | - Zhiyi Chen
- Institute of Medical Imaging, University of South China, Hengyang 421001, China
- Institution of Medical Imaging, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha 410000, China
| | - Xiaojing Gong
- Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
- Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518055, China
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Hu X, Wu H, Yong X, Wang Y, Yang S, Fan D, Xiao Y, Che L, Shi K, Li K, Xiong C, Zhu H, Qian Z. Cyclical endometrial repair and regeneration: Molecular mechanisms, diseases, and therapeutic interventions. MedComm (Beijing) 2023; 4:e425. [PMID: 38045828 PMCID: PMC10691302 DOI: 10.1002/mco2.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/21/2023] [Accepted: 10/27/2023] [Indexed: 12/05/2023] Open
Abstract
The endometrium is a unique human tissue with an extraordinary ability to undergo a hormone-regulated cycle encompassing shedding, bleeding, scarless repair, and regeneration throughout the female reproductive cycle. The cyclical repair and regeneration of the endometrium manifest as changes in endometrial epithelialization, glandular regeneration, and vascularization. The mechanisms encompass inflammation, coagulation, and fibrinolytic system balance. However, specific conditions such as endometriosis or TCRA treatment can disrupt the process of cyclical endometrial repair and regeneration. There is uncertainty about traditional clinical treatments' efficacy and side effects, and finding new therapeutic interventions is essential. Researchers have made substantial progress in the perspective of regenerative medicine toward maintaining cyclical endometrial repair and regeneration in recent years. Such progress encompasses the integration of biomaterials, tissue-engineered scaffolds, stem cell therapies, and 3D printing. This review analyzes the mechanisms, diseases, and interventions associated with cyclical endometrial repair and regeneration. The review discusses the advantages and disadvantages of the regenerative interventions currently employed in clinical practice. Additionally, it highlights the significant advantages of regenerative medicine in this domain. Finally, we review stem cells and biologics among the available interventions in regenerative medicine, providing insights into future therapeutic strategies.
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Affiliation(s)
- Xulin Hu
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
- Department of BiotherapyCancer Center and State Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduSichuanChina
| | - Haoming Wu
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Xin Yong
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Department of Paediatrics, West China Second University Hospital, State Key Laboratory of Biotherapy and Collaborative Innovation Center of BiotherapySichuan UniversityChengduSichuanChina
| | - Yao Wang
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Shuhao Yang
- Department of OrthopedicsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Diyi Fan
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Yibo Xiao
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Lanyu Che
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Kun Shi
- Department of BiotherapyCancer Center and State Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduSichuanChina
| | - Kainan Li
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | | | - Huili Zhu
- Department of Reproductive Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of EducationWest China Second University Hospital of Sichuan UniversityChengduSichuanChina
| | - Zhiyong Qian
- Department of BiotherapyCancer Center and State Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduSichuanChina
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Jiang M, Huang L, Wang Y, Wang Y, Kang Q, Chen C, Hu Y, Li J, Wang T. Yueliang Yin Ameliorates Endometrial Receptivity in Mice with Embryo Implantation Failure by Reducing Pyroptosis and Activating BDNF/TrkB Pathway. Mol Nutr Food Res 2023; 67:e2300339. [PMID: 37797178 DOI: 10.1002/mnfr.202300339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/16/2023] [Indexed: 10/07/2023]
Abstract
SCOPE Endometrial receptivity plays a vital role in embryonic implantation. Yueliang Yin is a marketed solid drink in China, also known as Bushen Cuyun Recipe (BCR), that is, assumed to have a therapeutic effect on infertility by improving endometrial receptivity. This study investigates the effects and mechanisms of BCR in protecting the endometrium. METHODS AND RESULTS Mice with mifepristone-induced embryo implantation failure that exhibited a decreased implantation sites number, thinner endometrium, reduced endometrial glands number, and poor pinopode expression levels are treated with BCR, and these mentioned conditions significantly improves afterward. Molecular docking shows that the main active components kaempferol, quercetin, and hesperetin of BCR stably bound to gasdermin D (GSDMD). Experimental results demonstrate that levels of GSDMD, cleaved caspase-1 and leucine-rich repeat, and pyrin domain-containing 3 and IL-1β levels in model mice are significantly decreased and expressions of brain-derived neurotrophic factor (BDNF) and tyrosine protein kinase B (TrkB) expression levels are significantly elevated after BCR treatments, and that the DNA damage is significantly reversed in BCR-treated mice. CONCLUSIONS BCR is potent and effective in ameliorating endometrial receptivity. The potential mechanisms of BCR on endometrial receptivity may mediate by activating BDNF/TrkB pathway activation and protecting endometrial cells' protection against pyroptosis.
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Affiliation(s)
- Mei Jiang
- Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Ling Huang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yuxi Wang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yao Wang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 100029, China
- National Key Laboratory of Efficacy and Mechanism on Chinese Medicine for Metabolic Diseases, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Qianjun Kang
- Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Cong Chen
- Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yujie Hu
- Ziqiang Vocational School of Shaanxi Province, Shaanxi Province, 721000, China
| | - Jialin Li
- Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Ting Wang
- Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
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7
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Liu J, Zhu Q, Pan Y, Hao S, Wang Z, Cui C, Li J, Huang Y, Xia L, Xu T, Cheng J, Shen J, Xia Y. Electroacupuncture alleviates intrauterine adhesion through regulating autophagy in rats. Mol Hum Reprod 2023; 29:gaad037. [PMID: 37935442 DOI: 10.1093/molehr/gaad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/16/2023] [Indexed: 11/09/2023] Open
Abstract
Autophagy is a well-conserved metabolic system that maintains homeostasis by relying on lysosomal breakdown. The endometrium of patients with intrauterine adhesion (IUA) and an animal model exhibits impaired autophagy. Autophagy is negatively correlated with inflammation. Activation of autophagy can inhibit the inflammatory response, while defects in autophagy will activate the inflammatory response. Here, we studied whether electroacupuncture (EA) inhibits inflammation and promotes endometrial injury repair by activating endometrial autophagy. The IUA animal model was established by mechanical injury plus lipopolysaccharide infection. EA stimulation was applied to the acupoints Guanyuan (CV4), bilateral Sanyinjiao (SP6), and Zusanli (ST36). The results indicated that EA could improve endometrial morphology, attenuate endometrial fibers, and enhance endometrial receptivity in the rat. EA could increase the autophagosomes of endometrial epithelial cells, increase the levels of LC3 and Beclin1, and decrease the level of p62. Additionally, EA may also suppress the nuclear factor kappa-B (NF-κB) signaling pathway and reduce the release of inflammatory factors. Additionally, the effect of EA was comparable to that of the autophagy agonist rapamycin, and the autophagy inhibitor 3-methyladenine reversed the therapeutic effect of EA. Therefore, we assume that EA may facilitate endometrial healing by activating autophagy and reducing NF-κB signal pathway-mediated inflammation.
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Affiliation(s)
- Jingyu Liu
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qian Zhu
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Pan
- Department of Acupuncture and Moxibustion, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Sainan Hao
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhaoxian Wang
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chuting Cui
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Junwei Li
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yueying Huang
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
| | - Liangjun Xia
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Tiancheng Xu
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Cheng
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Shen
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Youbing Xia
- Acupuncture and Moxibustion and Massage College, Health Preservation and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
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8
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Li Q, Gong M, Shen J, Jin X, Mu Y, Xia L, Cheng J, Xia Y. The transcriptome expression levels related to ovulation induction and acupuncture protection therapy in rats through gene microarray. ALL LIFE 2022. [DOI: 10.1080/26895293.2022.2117245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Qian Li
- Key Laboratory of Acupuncture and Medicine Research of Minister of Education, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Meirong Gong
- Key Laboratory of Acupuncture and Medicine Research of Minister of Education, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Jie Shen
- College of Acupuncture and Tuina, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Xun Jin
- College of Acupuncture and Tuina, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Yanyun Mu
- College of Acupuncture and Tuina, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Liangjun Xia
- College of Acupuncture and Tuina, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Jie Cheng
- College of Acupuncture and Tuina, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Youbing Xia
- College of Acupuncture and Tuina, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
- The Affiliated Hospital, School of medical information & engineering of Xuzhou Medical University, Xuzhou, People’s Republic of China
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9
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The Application of Complementary and Alternative Medicine in Polycystic Ovary Syndrome Infertility. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5076306. [PMID: 36248406 PMCID: PMC9568292 DOI: 10.1155/2022/5076306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/07/2022] [Accepted: 09/12/2022] [Indexed: 11/05/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a lifelong reproductive endocrine disease, which is the most common cause of anovular infertility. Modern medicine mainly treats infertile patients with PCOS by improving living habits, ovulation induction therapy, and assisted reproductive technology (ART), but the effect is not satisfied. Complementary alternative medicine (CAM) has conspicuous advantages in the treatment of PCOS infertility due to its good clinical efficacy, wide mechanism of action, and no obvious adverse reactions, but its safety and effectiveness in the treatment of PCOS infertility have not been proved. Based on the existing clinical and experimental studies, this paper looks for the therapeutic effect and the mechanism behind it, and explores the safety and effectiveness of its treatment in PCOS infertility, in order to provide reference for future clinical treatment and experimental research.
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10
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Zhu C, Xia W, Huang J, Zhang X, Li F, Yu X, Ma J, Zeng Q. Effects of acupuncture on the pregnancy outcomes of frozen-thawed embryo transfer: A systematic review and meta-analysis. Front Public Health 2022; 10:987276. [PMID: 36159230 PMCID: PMC9501879 DOI: 10.3389/fpubh.2022.987276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/16/2022] [Indexed: 01/26/2023] Open
Abstract
Background Acupuncture is increasingly used as adjuvant therapy for infertile women undergoing frozen-thawed embryo transfer (FET); however, its effects and safety are highly controversial. This study aimed to evaluate the pooled effects of adjuvant acupuncture on FET pregnancy outcomes. Methods We considered only randomized controlled trials (RCTs) that compared acupuncture with sham acupuncture or no adjuvant treatment during FET and the primary outcome was clinical pregnancy rate. Two authors separately selected studies, extracted data, and performed a risk of bias assessment. Pooled data were expressed as risk ratio (RR) or mean difference (MD), with a 95% confidence interval (CI). In addition, we conducted subgroup and sensitivity analyses to investigate the sources of heterogeneity, and we also constructed funnel plots to assess the likelihood of publication bias. Finally, Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) was applied to evaluate the quality of evidence. Results A total of 14 RCTs with a total of 1,130 participants were included in the study. We found significant effects of acupuncture adjuvant to FET on the outcomes of clinical pregnancy rate (RR = 1.54, 95% CI [1.28, 1.85], I 2 = 34%; 14 trials), biochemical pregnancy rate (RR = 1.51, 95% CI [1.21, 1.89]; 5 trials), endometrial thickness (MD = 0.97, 95% CI [0.43, 1.51]; 12 trials), and endometrial pattern (RR = 1.41, 95% CI [1.13, 1.75]; 7 trials). For live birth rate (RR = 1.48, 95% CI [0.90, 2.43], 4 trials), there were no statistical effectiveness. For subgroup analyses, most variables had tolerable heterogeneity (I 2 = 0%) except for trials that were sham-controlled, performed acupuncture only after FET, or <5 times, which appeared to interpret most of the heterogeneity. Additionally, the quality of evidence of all outcomes in this review ranged from low to moderate. Conclusion Acupuncture could be instrumental in the pregnancy outcomes of FET, and has very few risks of severe adverse events; however, the quality of evidence is unsatisfactory. Further research with rigorous methodological quality should be considered, and the protocols of acupuncture also need more investigations (e.g., appropriate control groups, sessions, and times).
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Affiliation(s)
- Can Zhu
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China,School of Basic Medical Sciences, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Wanting Xia
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jinzhu Huang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xuan Zhang
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fangyuan Li
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaorun Yu
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiamin Ma
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qian Zeng
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China,*Correspondence: Qian Zeng
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11
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The Treatment of Complementary and Alternative Medicine on Female Infertility Caused by Endometrial Factors. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:4624311. [PMID: 36118081 PMCID: PMC9473886 DOI: 10.1155/2022/4624311] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/02/2022] [Accepted: 08/08/2022] [Indexed: 12/02/2022]
Abstract
Recently, with the development of the social economy, the incidence of infertility has increased year by year. With its complex etiology and diversified syndromes, infertility has become one of the most important diseases that plague the physical and mental health of women of childbearing age worldwide. Endometrial factors as an important part affecting female reproductive capacity, due to which induced repeated abortion and multiple uterine cavity operations occur, can destruct endometrium, failing to provide a normal implantation environment for zygote, thus resulting in infertility. Many patients failed to achieve expected results after receiving conventional treatments such as hormone therapy, assisted reproductive technology (ART), granulocyte colony-stimulating factor (G-CSF) therapy, and cell therapy, then turn to complementary and alternative medicine (CAM) therapies for help. Aiming at clarifying the effectiveness and mechanisms of CAM therapy in the treatment of infertility caused by endometrial factors, our paper systematically searched and studied present related literature on the PubMed, CNKI, and other databases, focusing on the aspects of clinical application and mechanism explorations and highlighting the therapeutic effects of Chinese herbal medicine (CHM), acupuncture, and moxibustion on such diseases. Moreover, this paper also introduces the CAM treatments of traditional Chinese medicine (TCM) retention enema, neuromuscular electrical stimulation (NMES), photobiomodulation therapy, dietary intervention, and other measures for infertility caused by endometrial factors, in order to provide a reference for subsequent basic research and clinical work.
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12
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Zheng X, Yu S, Liu L, Yang H, Wang F, Yang H, Lv X, Yang J. The Dose-Related Efficacy of Acupuncture on Endometrial Receptivity in Infertile Women: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:858587. [PMID: 35570887 PMCID: PMC9095926 DOI: 10.3389/fpubh.2022.858587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Progress has been achieved by using acupuncture widely for poor endometrial receptivity (PER). However, different acupuncture dosages may lead to controversy over efficacy. Objective To evaluate the evidence-based conclusions of dose-related acupuncture on infertile women with PER. Method References were retrieved from nine databases from inception to 26 February 2022. This meta-analysis included randomized controlled trials (RCTs) that investigated the dose-related efficacy of acupuncture for PER with outcomes of endometrium receptivity (ER) parameters by transvaginal sonography (TVS) and the subsequent pregnancy outcomes in three acupuncture-dose groups: the high-dosage group (three menstrual cycles), the moderate-dosage group (one menstrual cycle), and the low-dosage group (two or four days). Since there remained sufficient heterogeneity among the three subsets, we prespecified seven subgroup variables (four clinical and three methodological) to investigate the heterogeneities. Results A total of 14 RCTs (1,564 women) of moderate or low overall quality were included. The results were different when the dosage of acupuncture was restricted. For the moderate or high-dosage group, CPR and part of ER parameters were improved in the acupuncture group (i.e., CPR: OR = 2.00, 95% CI [1.24, 3.22], p = 0.004, I 2 = 0% in one menstrual cycle; OR = 2.49, 95%CI [1.67, 3.72], p < 0.05, I 2 = 0% in three menstrual cycles). However, for the low-dosage group, no statistical difference was observed in CPR (OR = 0.07, 95% CI [-0.10, 0.23], p = 0.44, I 2 = 82%) and a part of the ER parameters. In subgroup analysis, four subgroup variables (the routine treatment, risk of performance bias, duration of acupuncture treatment, and the age of participants) could explain some of the heterogeneities across all trials. Conclusion The finding indicated that the trend of relatively more acupuncture dosage showed better effects for poor endometrial receptivity among PER women. It remains a potential heterogeneity in our studies. Further high-quality trials with a homogeneity trial design need to be conducted.
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Affiliation(s)
- Xiaoyan Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu Xi'nan Gynecological Hospital, Chengdu, China
| | - Siyi Yu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liying Liu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Han Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fangge Wang
- Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu Xi'nan Gynecological Hospital, Chengdu, China
| | - Hongmei Yang
- Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu Xi'nan Gynecological Hospital, Chengdu, China
| | - Xingyu Lv
- Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu Xi'nan Gynecological Hospital, Chengdu, China
| | - Jie Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu Xi'nan Gynecological Hospital, Chengdu, China
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13
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Casale M. Improving the health and treatment success rates of in vitro fertilization patients with traditional Chinese medicine: Need for more robust evidence and innovative approaches. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:187-192. [PMID: 35216931 DOI: 10.1016/j.joim.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
Maximising access to and the success of fertility treatments should be a priority for global reproductive health, as should overall patient well-being. The demand for in vitro fertilization (IVF) and other assisted fertility treatments has increased over the past decade and is likely to further increase in years to come. Nevertheless, there is still considerable unmet demand for infertility support worldwide. Moreover, the high emotional, physical and financial burden experienced by individuals undergoing IVF cycles can be a risk for their mental and physical health, which in turn can influence treatment continuation and the likelihood of IVF success. Studies from various parts of the world show that most individuals undergoing IVF also use adjunct alternative medicines and procedures, the most common being traditional Chinese medicine (TCM). The complementary and synergistic role of TCM for individuals undergoing IVF is an area that merits further attention and research, both for its potential positive effects on IVF success rates and for its broader physical and mental health benefits. However, much of the existing evidence is not sufficiently robust or consistent for findings to be adopted with confidence. This commentary argues that much work must be done to understand the efficacy and clinical best practices for these integrated approaches. This can be achieved in part by developing more robust and clinically relevant randomized controlled trial protocols, collecting and triangulating evidence through a variety of study designs and methods, and strengthening the collection and pooling of clinic-level data.
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Affiliation(s)
- Marisa Casale
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa.
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14
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You F, Du X, Zhang T, Wang Y, Lv Y, Zeng L. Electroacupuncture improves endometrial receptivity through miRNA-223-3p-mediated regulation of leukemia inhibitory factor / signal transducer and activator of transcription 3 signaling pathway. Bioengineered 2022; 13:10298-10312. [PMID: 35435116 PMCID: PMC9161864 DOI: 10.1080/21655979.2022.2062524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- Fang You
- Department of Obstetrics and Gynaecology, The Second Clinical College, Guizhou University of Chinese Medicine, Guiyang, Guizhou, China
| | - Xin Du
- Reproductive Centre, Women and Children’s Hospital, Qingdao University, Qingdao, Shandong, China
| | - Taiwei Zhang
- Department of Obstetrics and Gynaecology, The First Clinical College, Guizhou University of Chinese Medicine, Guiyang, Guizhou, China
| | - Yang Wang
- Reproductive Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Guizhou, China
| | - Yuxia Lv
- Department of Obstetrics, Maternal and Child Hospital of Hubei Province, Wuhan, Guizhou, China
| | - Li Zeng
- Department of Obstetrics and Gynaecology, The Second Clinical College, Guizhou University of Chinese Medicine, Guiyang, Guizhou, China
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15
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Effects of Acupuncture on Endometrium and Pregnancy Outcomes in Patients with Polycystic Ovarian Syndrome Undergoing In Vitro Fertilization-Embryo Transfer: A Randomized Clinical Trial. Chin J Integr Med 2022; 28:736-742. [PMID: 35419725 DOI: 10.1007/s11655-022-3498-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To observe the effect of acupuncture on endometrium and pregnancy outcomes in patients with polycystic ovary syndrome (PCOS) infertility undergoing in vitro fertilization-embryo transfer (IVF-ET). METHODS Eighty-three patients were randomly assigned to observation group (40 cases) and control group (43 cases) according to the random numbers generated by SPSS software. The patients of the two groups received GnRH agonist long protocol as a routine treatment. In the observation group, acupuncture was given at two acupoint groups for 30 min once every other day. Group 1 included Guanyuan (CV 4), Qihai (CV 6), Zhongji (CV 3), bilateral acupoints Zigong (EX-CA1). Group 2 included Mingmen (GV 4), Yaoyangguan (GV 3), bilateral Shenshu (BL 23) and Ciliao (BL 32). The two groups of acupoints were used alternately. The whole needling process was performed at the time of ovulation induction until the transplantation day and consisted of 3 courses, while the control group did not receive acupuncture interventions. The Gn dosage and Gn stimulation time, endometrial thickness and type (A, B, and C), serum oestradiol (E2) and progesterone (P) levels on the day of injection of human chorionic gonadotropin (hCG), clinical pregnancy rate, as well as live birth rate were observed. Adverse reactions were also be recorded. All patients were followed up for the pregnant rate 14 days after IVF-ET and live birth rate after pregnancy. All adverse reactions (AEs) of acupuncture were recorded during the trial. RESULTS The Gn dosage and Gn stimulation time in the observation group were lower in the observation group than in the control group (P<0.01). The proportion of type A endometrium in the observation group were higher than that in the control group (P<0.05). The serum E2 and P levels on the day of hCG injection was lower and the clinical pregnancy rate was higher in the observation group compared to those in the control group (P<0.05). There was no serious AEs during this trial. CONCLUSION Acupuncture can improve the proportion of type A endometrium, regulate the levels of serum E2 and P on the day of hCG injection, and improve the pregnancy rate in patients with PCOS infertility undergoing IVF-ET.
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16
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Budihastuti UR, Melinawati E, Anggraini NWP, Anggraeni A, Yuliantara EE, Sulistyowati S, Hadi C, Nurwati I, Yulyanti, Octavia DE, Wesliaprilius TA, Murti B. Electroacupuncture to Improve Endometrial Receptivity and Folliculogenesis in Polycystic Ovary Syndrome. Med Acupunct 2021; 33:428-434. [PMID: 34976276 DOI: 10.1089/acu.2020.1503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting folliculogenesis and endometrial receptivity. PCOS causes low fertility due to failures in folliculogenesis and ovulation. Electroacupuncture (EA) may help improve folliculogenesis and endometrial receptivity. EA can decrease tonic activity in the sympathetic vasoconstrictor pathway to the uterus. This study was conducted to determine the effect of the addition of EA therapy on folliculogenesis and endometrial receptivity in women with PCOS. Materials and Methods: This case-control study was conducted at the Dr. Moewardi General Hospital, in Jawa Tengah, Indonesia. The subjects were women with PCOS, ages 20-45, who were infertile. They were divided into a control group (17 women) and an experimental group (17 women). The control group received letrozole therapy, and the experimental group received EA + letrozole therapy. Folliculogenesis is determined by measuring the growth of follicle diameter on days 2, 6, 8, 10, and 12 of the menstrual cycle. Endometrial receptivity is determined by resistance index (RI) and pulsatility index (PI) examinations on days 19 and 21; endometrial thickness is measured on day 12. Results: There was a significant difference in folliculogenesis on days 2, 6, 8, 10, and 12. Folliculogenesis with letrozole versus EA + letrozole, respectively, were: day 2 = 5.59 ± 1.06 versus 7.01 ± 1.53, P = 0.004; day 6 = 6.71 ± 1.59 versus 9.11 ± 1.23, P < 0.001; day 8 = 9.51 ± 2.68 versus 12.44 ± 1.49, P < 0.001; day 10 = 11.30 ± 3.08 versus 15.53 ± 2.34, P < 0.001; and day 12 = 13.92 ± 3.61 versus 19.86 ± 0.75, P < 0.001. RI value with letrozole versus EA + letrozole were, respectively, day 19 = 0.91 ± 0.07 versus 0.88 ± 0.07, P = 0.150; day 21 = 0.88 ± 0.07 versus 0.79 ± 0.09, P < 0.001. PI value with letrozole versus EA + letrozole were respectively, day 19 = 3.00 ± 0.89 versus 2.30 ± 0.65, P = 0.009; and day 21 = 2.72 ± 0.88 versus 2.02 ± 0.55, P = 0.009. Endometrial thickness with letrozole versus EA + letrozole were, respectively, day 12 = 6.95 ± 1.82 versus 8.22 ± 1.76, P = 0.005. Conclusions: The addition of EA to letrozole therapy improved folliculogenesis, RI, PI, and endometrial thickness in patients with PCOS. Further studies are needed to gain a better understanding of the dosage and timing of this therapy and its potential synergy with other current treatments.
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Affiliation(s)
- Uki Retno Budihastuti
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia.,Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Public Health Science Study Program, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Doctoral Program in Medical Science, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Eriana Melinawati
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia.,Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Nutria Widya Purnama Anggraini
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia.,Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Asih Anggraeni
- Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Universitas Sebelas Maret Hospital, Jawa Tengah, Indonesia
| | - Eric Edwin Yuliantara
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia.,Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Sri Sulistyowati
- Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Doctoral Program in Medical Science, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Universitas Sebelas Maret Hospital, Jawa Tengah, Indonesia
| | - Cahyono Hadi
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
| | - Ida Nurwati
- Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Doctoral Program in Medical Science, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Yulyanti
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
| | - Dhamayanti Eka Octavia
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
| | - Todung Antony Wesliaprilius
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
| | - Bhisma Murti
- Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Public Health Science Study Program, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Doctoral Program in Medical Science, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
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17
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Ma J, Zhan H, Li W, Zhang L, Yun F, Wu R, Lin J, Li Y. Recent trends in therapeutic strategies for repairing endometrial tissue in intrauterine adhesion. Biomater Res 2021; 25:40. [PMID: 34819167 PMCID: PMC8611984 DOI: 10.1186/s40824-021-00242-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/31/2021] [Indexed: 12/25/2022] Open
Abstract
Intrauterine adhesion (IUA) is a common gynaecological disease that develops from infection or trauma. IUA disease may seriously affect the physical and mental health of women of childbearing age, which may lead to symptoms such as hypomenorrhea or infertility. Presently, hysteroscopic transcervical resection of adhesion (TCRA) is the principal therapy for IUAs, although its function in preventing the recurrence of adhesion and preserving fertility is limited. Pharmaceuticals such as hormones and vasoactive agents and the placement of nondegradable stents are the most common postoperative adjuvant therapy methods. However, the repair of injured endometrium is relatively restricted due to the different anatomical structures of the endometrium. Recently, the treatment outcome of IUAs has improved with the advancement of hysteroscopic techniques. In particular, the application of bioactive scaffolds combined with tissue engineering technology has proven to have high therapeutic potential or endometrial repair in IUA treatment. Herein, this review has summarized past therapeutic strategies, including postoperative adjuvant therapy, cell or therapeutic molecular delivery therapy methods and bioactive scaffold-based tissue engineering methods. Therefore, this review presented the recent therapeutic strategies for repairing endometrium treatment and pointed out the issues of clinical concern to provide alternative methods for the management of IUAs.
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Affiliation(s)
- Junyan Ma
- Zhejiang Provincial Key Laboratory for Precision Diagnosis & Treatment of Major Gynecological Diseases, Hangzhou, 310006, Zhejiang Province, China
| | - Hong Zhan
- Department of Gynecology and Obstetrics, Women' s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang Province, China
| | - Wen Li
- Department of Gynecology and Obstetrics, Women' s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang Province, China
| | - Liqi Zhang
- Department of Gynecology and Obstetrics, Women' s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang Province, China
| | - Feng Yun
- Department of Gynecology and Obstetrics, Women' s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang Province, China
| | - Ruijin Wu
- Department of Gynecology and Obstetrics, Women' s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang Province, China.
| | - Jun Lin
- Department of Gynecology and Obstetrics, Women' s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang Province, China.
| | - Yangyang Li
- Zhejiang Provincial Key Laboratory for Precision Diagnosis & Treatment of Major Gynecological Diseases, Hangzhou, 310006, Zhejiang Province, China.
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18
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Song L, Zhang Q, Zhu S, Shan X. Granulocyte Colony-Stimulating Factor Combined With Transcutaneous Electrical Acupoint Stimulation in Treatment of Unresponsive Thin Endometrium in Frozen Embryo Transfer Cycles. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:647336. [PMID: 36304049 PMCID: PMC9580712 DOI: 10.3389/frph.2021.647336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This trial was designed to assess the treatment effects of granulocyte colony-stimulating factor (G-CSF) and transcutaneous electrical acupoint stimulation (TEAS) on thin endometrium in frozen-thawed embryo transfer (FET) cycles. Methods: Ninety-nine patients with previous cancellations of embryo transfer were included, 56 of whom were prospectively treated with intrauterine perfusion of G-CSF in subsequent FET cycles. The selected patients were randomized into the G-CSF perfusion only group and the G-CSF perfusion combined with TEAS group. The other 43 patients were retrospectively included as controls. Results: Compared to previous cycles, endometrial thickness was statistically significantly increased in the two treatment groups (5.97 ± 0.60, 7.52 ± 0.56, 6.14 ± 0.52, and 7.66 ± 0.44; P = 0.00 and 0.00, respectively). The increases in endometrial thickness suggested that no statistically significant difference was found between the two treatment groups. The G-CSF with TEAS group suggested a higher embryo implantation rate than the G-CSF perfusion only and control groups (33.33 and 29.1% and 33.33 and 17.39%; P = 0.412 and 0.091, respectively). The G-CSF combined with TEAS group demonstrated nominally higher clinical and ongoing pregnancy rates than the G-CSF perfusion-only group and controls, though, the difference was not statistically significant. Conclusion: G-CSF has a potential role in improving endometrium thickness in patients with thin unresponsive endometrium in FET treatment cycles. In addition, when combined with TEAS, G-CSF perfusion treatment also improves the embryo implantation rate; however, randomized controlled trials are highly demanded to provide high-grade evidence regarding clinical pregnancy rate after G-CSF perfusion treatment.
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19
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Keyhanvar N, Zarghami N, Bleisinger N, Hajipour H, Fattahi A, Nouri M, Dittrich R. Cell-based endometrial regeneration: current status and future perspectives. Cell Tissue Res 2021; 384:241-254. [PMID: 33650018 DOI: 10.1007/s00441-021-03419-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/18/2021] [Indexed: 02/08/2023]
Abstract
Endometrial-related disorders including Asherman's syndrome, thin endometrium, pelvic organ prolapse, and cesarean scar pregnancies can be accompanied by different symptoms such as amenorrhea, infertility, abnormal placental implantation and recurrent miscarriage. Different methods have been introduced to overcome these problems such as surgery and hormonal therapy but none of them has shown promising outcomes. On the other hand, the development of novel regenerative therapeutic strategies has opened new avenues for the treatment of endometrial-related deficiencies. In this regard, different types of scaffolds, acellular matrices and also cell therapy with adult or stem cells have been investigated for the treatment of endometrial-related deficiencies. In this paper, we review the current status of cell-based endometrium regeneration using scaffold dependent and scaffold-free methods and future perspectives in this field. Moreover, we discuss the endometrial diseases that can be candidates for cell-based treatments. Also, the cells with the potential for endometrial regeneration are explained.
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Affiliation(s)
- Neda Keyhanvar
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nosratollah Zarghami
- Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nathalie Bleisinger
- University Hospital Erlangen, OB/GYN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Hamed Hajipour
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Fattahi
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammad Nouri
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Ralf Dittrich
- University Hospital Erlangen, OB/GYN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Xi J, Cheng J, Jin CC, Liu JY, Shen ZR, Xia LJ, Li Q, Shen J, Xia YB, Xu B. Electroacupuncture Improves Pregnancy Outcomes in Rats with Thin Endometrium by Promoting the Expression of Pinopode-Related Molecules. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6658321. [PMID: 33937407 PMCID: PMC8062184 DOI: 10.1155/2021/6658321] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/27/2021] [Accepted: 04/03/2021] [Indexed: 11/21/2022]
Abstract
A thin endometrium affects the success of assisted reproduction due to low endometrial receptivity. Acupuncture improves endometrial receptivity and promotes the formation of pinopodes, the ultrastructure marker implantation window. However, the specific underlying mechanisms remain unclear. In this study, the efficacy of acupuncture treatment and its underlying mechanism were investigated by analyzing pregnancy rate, pinopode formation, and related molecular markers in thin endometrium model rats. Absolute ethanol (95%) was injected into the uteruses of female Sprague-Dawley rats to construct a thin endometrium model. In this model, acupuncture stimulation at EX-CA1, SP6, and CV4 ameliorated the pregnancy rate. Significantly increased embryo implantation, endometrial thickness, numbers of glands, and blood vessels were observed in the electroacupuncture (EA) group compared to the model group. The number of pinopodes in the EA group was abundant, with a shape similar to that of the control group. Additionally, significantly higher expression levels of pinopode-related markers, including integrin αvβ3, homeobox A10 (HOXA10), heparin-binding EGF-like growth factor (HBEGF), estrogen receptor alpha (ERα), and progesterone receptor (PR), were observed in the EA group than those in the model group. In conclusion, EA had a positive effect on the endometrial receptivity of thin endometrium model rats by improving pinopode formation through multiple molecular targets.
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Affiliation(s)
- Jin Xi
- Acupuncture and Tuina College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
| | - Jie Cheng
- Acupuncture and Tuina College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
| | - Chun-chun Jin
- Acupuncture and Tuina College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
| | - Jing-yu Liu
- Acupuncture and Tuina College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
| | - Zhen-ru Shen
- Acupuncture and Tuina College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
| | - Liang-jun Xia
- Acupuncture and Tuina College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
| | - Qian Li
- Acupuncture and Tuina College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
| | - Jie Shen
- Acupuncture and Tuina College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
| | - You-bing Xia
- Acupuncture and Tuina College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
- Xuzhou Medical University, Xuzhou 221004, China
| | - Bin Xu
- Acupuncture and Tuina College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
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21
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Li F, Lu H, Wang X, Zhang Q, Liu Q, Wang T. Effectiveness of electroacupuncture for thin endometrium in infertile women: study protocol for a single-blind, randomized controlled trial. Trials 2021; 22:73. [PMID: 33478562 PMCID: PMC7818916 DOI: 10.1186/s13063-021-05029-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 01/06/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Thin endometrium negatively impacts the reproductive function. Current treatments for thin endometrium do not always improve endometrial receptivity. Preliminary evidence suggests that electroacupuncture could have potential therapy for thin endometrium in infertile women. Thus, this randomized controlled trial was designed to test whether electroacupuncture can improve endometrial receptivity in infertile women with thin endometrium. METHODS This study is a randomized, single-blinded, controlled, clinical trial. A total of 142 eligible patients will be recruited and randomly assigned to the electroacupuncture (EA) group or the sham electroacupuncture (SEA) group in a 1:1 ratio. Participants will receive 36 sessions over three menstrual cycles (12 weeks in total), with the same acupoint prescription. The primary outcome of this trial is endometrial thickness in the midluteal phase. The secondary outcomes include endometrial pattern, resistance index (RI) and pulsatility index (PI) of bilateral uterine artery and endometrium blood flow, serum estradiol (E2) and progesterone (P), and pregnancy rate. The pregnancy rate will be evaluated during a 6-month follow-up after completion of the trial. All other outcomes will be evaluated before treatment, during the treatment of 1st, 2nd, and 3rd menstrual cycle, and 6 months after treatment. DISCUSSION If the outcome confirms the effectiveness of electroacupuncture for thin endometrium in infertile women, this treatment will be proposed for application in clinical practice. TRIAL REGISTRATION Chinese Clinical Trials Registry ChiCTR2 000029983. Registered on 18 February 2020.
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Affiliation(s)
- Fangyuan Li
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, NO.37 Shi-er-qiao Road, Chengdu, 610075 Sichuan Province People’s Republic of China
- Hospital of Chengdu University of Traditional Chinese Medicine, NO.39 Shi-er-qiao Road, Chengdu, 610075 Sichuan Province People’s Republic of China
| | - Hua Lu
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, NO.37 Shi-er-qiao Road, Chengdu, 610075 Sichuan Province People’s Republic of China
- Hospital of Chengdu University of Traditional Chinese Medicine, NO.39 Shi-er-qiao Road, Chengdu, 610075 Sichuan Province People’s Republic of China
| | - Xinxin Wang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, NO.37 Shi-er-qiao Road, Chengdu, 610075 Sichuan Province People’s Republic of China
| | - Qi Zhang
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, NO.37 Shi-er-qiao Road, Chengdu, 610075 Sichuan Province People’s Republic of China
- Hospital of Chengdu University of Traditional Chinese Medicine, NO.39 Shi-er-qiao Road, Chengdu, 610075 Sichuan Province People’s Republic of China
| | - Qianchen Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, NO.39 Shi-er-qiao Road, Chengdu, 610075 Sichuan Province People’s Republic of China
| | - Tong Wang
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, NO.37 Shi-er-qiao Road, Chengdu, 610075 Sichuan Province People’s Republic of China
- Hospital of Chengdu University of Traditional Chinese Medicine, NO.39 Shi-er-qiao Road, Chengdu, 610075 Sichuan Province People’s Republic of China
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22
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Effects of Erbuzhuyu Decoction Combined with Acupuncture on Endometrial Receptivity Are Associated with the Expression of miR-494-3p. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:9739672. [PMID: 33299465 PMCID: PMC7710412 DOI: 10.1155/2020/9739672] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/23/2020] [Accepted: 11/09/2020] [Indexed: 11/17/2022]
Abstract
Background/Aim Erbuzhuyu decoction (EBZYD) is a traditional Chinese medicine (TCM) formula and has been used in infertility treatment. Meanwhile, acupuncture is also used to treat female infertility. However, it is unclear whether EBZYD combined with acupuncture has better therapeutic effect. The aim of this study was to explore the effect of EBZYD combined with acupuncture and investigate its mechanism in superovulation mice. Methods The mice received the treatment of EBZYD, acupuncture, EBZYD combined with acupuncture, or miR-494-3p agomir combined with EBZYD and acupuncture. The blastocysts' number, endometrial microstructure, and endometrial thickness were observed, followed by the detection of endometrial receptivity-related factors, PI3K/Akt/mTOR pathway-related proteins, and miR-494-3p expression using quantitative real-time polymerase chain reaction (qRT-PCR) or western blot. Luciferase reporter assay was performed to confirm the targeting relationship between HOXA10 and miR-494-3p. Results EBZYD combined with acupuncture treatment could increase the number of blastocysts, pinopodes, endometrial thickness, and the expression of endometrial receptivity-related factors, and the treatment effect of EBZYD combined with acupuncture was better than EBZYD or acupuncture alone. In addition, EBZYD combined with acupuncture treatment activated PI3K/Akt/mTOR pathway and inhibited the expression of miR-494-3p. HOXA10 is one of the target genes of miR-494-3p. Overexpression of miR-494-3p reversed the therapeutic effect of EBZYD combined with acupuncture and suppressed the expression of HOXA10 and the activity of PI3K/Akt/mTOR pathway. Conclusion This study suggests that EBZYD combined with acupuncture could improve endometrial receptivity in superovulation mice via miR-494-3p/HOXA10 axis.
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23
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Effectiveness of different acupuncture for infertility: Overview of systematic reviews and network meta-analysis. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Liu X, Shi W, Liu Z, Shi S, Ke C, Zhang P, Tan Z, Zhang W. Effects of acupuncture on Luteinized Unruptured Follicle Syndrome: A meta-analysis of randomized controlled trials. Complement Ther Med 2020; 49:102319. [PMID: 32147029 DOI: 10.1016/j.ctim.2020.102319] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/14/2019] [Accepted: 01/14/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This meta-analysis aimed to evaluate the comprehensive efficiency and safety of acupuncture on Luteinized Unruptured Follicle Syndrome based on Randomized Controlled Trials (RCTs). METHODS Six electronic databases (i.e. Wanfang, VIP, China National Knowledge Infrastructure, Pubmed, Cochrane, and Embase) were searched from inception to July 2019. Randomized controlled trials were eligible to evaluate the effects of acupuncture alone or acupuncture as an adjunct. The primary outcomes were the ovulation rate and pregnancy rate. Two reviewers proceeded study selection and quality assessment of included trials and performed heterogeneity of included studies before meta-analysis.Trial Sequential Analysis was used to assess the risk of random error and estimate required information size. The Grading of Recommendations Assessment, Development and Evaluation was applied for assessing level of evidence. RESULTS 10 studies involving 715 participants were included Meta-analysis showed acupuncture alone and acupuncture as an adjunct both could significantly improve ovulation, which were confirmed by Trial Sequential Analysis. The evidence of acupuncture improving pregnancy rate was insufficient. Improved serum luteinizing hormone and estradiol levels, and decreased pulsatility index and resistance index of ovary artery were shown in both two subgroups. Level of evidence of most outcomes was "low" or "very low", so the results should be cautiously interpreted. CONCLUSIONS Acupuncture alone or be combined with drugs are effective on Luteinized Unruptured Follicle Syndrome especially for improving ovulation . While concurrent evidence is insufficient, and further studies of high quality are needed to strengthen the conclusion.
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Affiliation(s)
- Xiaojuan Liu
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Wenying Shi
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Zhifeng Liu
- College of Environmental Science and Engineering, Hunan University, Changsha, China; Key Laboratory of Environmental Biology and Pollution Control (Hunan University), Ministry of Education, Changsha, China
| | - Shuqing Shi
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Chao Ke
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Peiming Zhang
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Zhenyu Tan
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Wei Zhang
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China.
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Enhancement of Endometrial Receptivity by Cnidium officinale through Expressing LIF and Integrins. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:7560631. [PMID: 31827559 PMCID: PMC6885254 DOI: 10.1155/2019/7560631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/18/2019] [Accepted: 08/12/2019] [Indexed: 11/17/2022]
Abstract
Improvement of endometrial receptivity is necessary for successful embryo implantation, and its impairment is associated with female infertility. In this study, we investigated the effect of the roots of Cnidium officinale Makino (CoM) on endometrial receptivity in both in vitro and in vivo model of embryo implantation. We found that CoM enhanced the adhesion of JAr cells to Ishikawa cells by stimulating expression of leukemia inhibitory factor (LIF) and integrins. In addition, blocking of LIFR using hLA or neutralization of integrins αV, β3, and β5 using antibodies significantly reduced the enhanced adhesion between JAr cell and CoM-treated Ishikawa cells, indicating that LIF and integrin play an important role in trophoblast-endometrium adhesion for embryo implantation. Furthermore, we identified that CoM significantly improved the implantation rate of blastocysts in the mouse model of RU-induced implantation failure. By collecting these results, here, we suggest that CoM has a therapeutic potential against female infertility associated with decreased endometrial receptivity.
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Jiang M, Huang L, Gu X, Liu T, Kang J, Wang T. Traditional Chinese herb for low endometrial receptivity and its effect on pregnancy: Protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17841. [PMID: 31764781 PMCID: PMC6882586 DOI: 10.1097/md.0000000000017841] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 10/10/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Low endometrial receptivity is associated with infertility in women through multiple and complex mechanisms. Existing treatments are not always effective. Symptomatic drugs such as estradiol valerate and/or aspirin do not completely solve the problem. Traditional Chinese herbs have been widely used in infertility and uterine disease including low endometrial receptivity. However, their effectiveness and safety are still obscure and deserve further investigation. OBJECTIVE To assess the effect and safety of traditional Chinese herbs in treating low endometrial receptivity. METHODS We will summarize and meta-analyze randomized controlled trials (RCTs) of traditional Chinese herbs for the treatment of low endometrial receptivity. RCTs comparing traditional Chinese herbs with blank control, placebo, or conventional therapies will be included. RCTs comparing traditional Chinese herbs plus conventional therapies with conventional therapies alone will also be included. The following electronic databases will be searched: PubMed, Cochrane Library, EMBASE, CNKI, CBM, VIP, and WANFANG DATA. The methodological quality of RCTs will be assessed using the Cochrane risk assessment tool. All trials included will be analyzed according to the criteria of the Cochrane Handbook. Review Manager 5.3, R-3.5.1 software will be used for publication bias analysis. GRADE pro GDT web solution will be used for evidence evaluation. RESULTS This review will evaluate the effects of traditional Chinese herbs on estradiol, progesterone, thickness, volume, and perfusion index(PI) of the endometrium, pregnancy rate, and symptoms. CONCLUSIONS This review will provide clear evidence to assess the effectiveness and safety of traditional Chinese herbs for low endometrial receptivity. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/M85VT.
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Affiliation(s)
- Mei Jiang
- Beijing University of Chinese Medicine
| | | | | | | | - Jia Kang
- Gulou Hospital, Affiliated hospital of Capital Medical University, Beijing, China
| | - Ting Wang
- Beijing University of Chinese Medicine
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27
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Xi T, Liu Y, Bao X, Mi S. Effects of acupuncture on rates of ovulation and pregnancy in women with unruptured follicular luteinization syndrome: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17294. [PMID: 31626086 PMCID: PMC6824695 DOI: 10.1097/md.0000000000017294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND As a fabulous part of Oriental Medcine, acupuncture and moxibustion possesses the advantage of high safety, convenience and less adverse effects. Unruptured follicular luteinization syndrome is a common cause of infertility in women of reproductive age, which seriously affects the physical and mental health of patients. Certain studies have reported that acupuncture can improve the rate of pregnancy in women with unruptured follicular luteinization syndrome. In this protocol, the effects of acupuncture on rates of ovulation and pregnancy among women with unruptured follicular luteinization syndrome will be further explored. METHODS Electronic bibliographic databases such as: MEDLINE, EMBASE, PsycINFO, Global Health, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), Health Technology Assessment Database, and Web of Science (Science and Social Science Citation Index), PubMed, Chinese Biomedical Databaseare, Chinese VIP Information, Chinese National Knowledge Infrastructure (CNKI), all helpful to identify relevant randomized controlled trials (RCTs) of effects of acupuncture on rates of ovulation and pregnancy among women with unruptured follicular luteinization syndrome. The pooled odds ratio of achieving a clinical pregnancy, ongoing pregnancy, or live birth were used as the main outcome and the secondary outcome includes the changes of ovarian artery dynamics before and after treatment, so as to the adverse reactions of treatment. We will use RevMan 5.3 software to help us to analyze all data and use the Cochrane evaluation manual 5.1.0 to help us to assess the methodological quality for incorporated RCTs. RESULT This systematic review will provide evidence for assessing the effects of acupuncture on rates of ovulation and pregnancy in women with unruptured follicular luteinization syndrome. CONCLUSION The results of this study will be a useful reference for clinical treatment with acupuncture to improve rates of ovulation and pregnancy among women with unruptured follicular luteinization syndrome.
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