标题：经皮穴位电刺激对 IVF中POI患者卵母细胞质量及FSHR表达的影响

      作者：帅振虹 1，李雪梅 1，张婉菁 1，杨卓欣 2    1.南方医科大学附属深圳妇幼保健院生殖医学中心，广东 深圳 518017；2.深圳市中医院，广东 深圳 518021

      卷次： 2019年30卷8期

      【摘要】 目的 观察经皮穴位电刺激(TEAS)对体外受精-胚胎移植(IVF-ET)中早发性卵巢功能不全(POI)患者卵母细胞质量及卵泡刺激素受体(FSHR)表达的影响。方法 选取2018年5~10月在南方医科大学附属深圳妇幼保健院生殖医学中心接受 IVF治疗的POI妇女66例，采用随机数表法分为TEAS组和对照组，每组33例。TEAS组自促性腺激素(Gn)启动日至绒促性素(hCG)注射日给予电子针疗仪治疗，隔日1次，对照组自Gn启动日起给予安慰针治疗，治疗时间、疗程及穴位选择均与TEAS组相同。比较两组患者的获卵数、受精率、优质胚胎率及临床妊娠率的差异，采用Western blot法检测取卵日颗粒细胞FSHR蛋白的表达。结果 TEAS组患者的临床妊娠率为51.52%，明显高于对照组的27.28%，差异有统计学意义(P<0.05)；治疗后，TEAS组和对照组的获卵数分别为(3.33±1.05)个、(2.73±1.21)个，优质胚胎率分别为54.29%和34.15%，颗粒细胞FSHR蛋白表达分别为0.75±0.17、0.55±0.12，两组上述指标比较差异均有统计学意义(P<0.05)；TEAS组和对照组的受精率分别为75.79%和73.23%，两组比较差异无统计学意义(P>0.05)。结论 TEAS疗法可能通过调控卵巢颗粒细胞FSHR的表达，促进卵母细胞发育，提高卵母细胞质量，改善 IVF中POI患者的妊娠结局。
      【关键词】 经皮穴位电刺激；体外受精-胚胎移植；早发性卵巢功能不全；卵母细胞质量；卵泡刺激素受体
      【中图分类号】 R711.75 【文献标识码】 A 【文章编号】 1003—6350（2019）08—0960—03

Effect of transcutaneous electric acupoint stimulation on oocyte quality and follicle-stimulating hormonereceptor expression in patients undergoing in vitro fertilization with premature ovarian insufficiency.
SHUAIZhen-hong 1, LI Xue-mei 1, ZHANG Wan-jing 1, YANG Zhuo-xin 2. 1. Center for Reproductive Health, Shenzhen Maternity andChild Healthcare Hospital Affiliated to Southern Medical University, Shenzhen 518017, Guangdong, CHINA; 2. ShenzhenTraditional Chinese Medicine Hospital, Shenzhen 518021, Guangdong, CHINA
【Abstract】 Objective To observe the effects of transcutaneous electric acupoint stimulation (TEAS) on oocytequality and follicle-stimulating hormone receptor (FSHR) expression of premature ovarian insufficiency (POI) patientsundergoing in vitro fertilization-embryo transfer (IVF-ET). Methods A total of 66 POI women receiving IVF treatmentat Center for Reproductive Health of Shenzhen Maternity and Child Healthcare Hospital Affiliated to Southern MedicalUniversity from May 2018 to October 2018 were selected and randomly divided into the TEAS group and the controlgroup, with 33 cases in each group. The patients in the TEAS group were treated by electronic acupuncture once everyother day from the day of gonadotropin (Gn) injection to the day of hCG injection. The patients in the control groupwere treated with placebo as from the day of Gn injection to the day of hCG injection. The time, course of treatment andacupoint selection were the same as those in the TEAS group. The number of oocytes retrieved, rate of fertilization,high-quality embryos, and the clinical pregnancy between the two groups were observed and compared, and the expres-sion of FSHR protein in the granulosa cells was detected by Western blot. Results The clinical pregnancy rate of theTEAS group was 51.52%, which was significantly higher 27.28% of the control group (P<0.05). After the treatment, thenumber of oocytes retrieved, rate of high-quality embryos, FSHR protein expression in granulosa cells of the TEASgroup were 3.33±1.05, 54.29%, 0.75±0.17, versus 2.73±1.21, 34.15%, 0.55±0.12 of the control group (all P<0.05). Thefertilization rates in the TEAS group and control group were 75.79% and 73.23%, respectively. There was no significantdifference in the rate of fertilization between the two groups (P>0.05). Conclusion TEAS can regulate the expressionof FSHR in granulosa cells, promote oocyte development, improve oocyte quality, and then improve the pregnancy out-come in IVF patients with POI.
      【Key words】 Transcutaneous electric acupoint stimulation (TEAS); In vitro fertilization-embryo transfer(IVF-ET); Premature ovarian insufficiency (POI); Oocyte quality; Follicle-stimulating hormone receptor (FSHR)