| Objective: To observe the effect of acupuncture combined with umbilical therapy on the outcome of in-vitro fertilization(IVF)assisted pregnancy in elderly infertile women,and explore the possible mechanism of action from the perspective of follicular fluid targeted metabolomics.Methods: 60 elderly women(35-42 years old)with kidney-qi deficiency who underwent IVF assisted pregnant women were randomly divided into an experimental group and an elderly control group according to a 1: 1 ratio;another 30 women 21-35 years old who underwent IVF due to simple fallopian tube factors Youth control group.The experimental group took conventional ovulation induction + umbilical therapy + acupuncture treatment,and the control group received conventional ovulation induction.Before and after treatment between the three groups,the scores of syndrome of deficiency of kidney qi,Gn dosage,endometrium of HCG day,blood hormone level of HCG day,number of eggs acquired,2PN fertilization rate,2PN cleavage rate,excellent embryo rate,cumulative pregnancy rate The difference between.At the same time,the targeted metabolomics analysis of follicular fluid on the day of oocyte retrieval was carried out by UPLC-MS / MS,using hierarchical cluster analysis,multivariate statistical analysis,and principal component analysis(PCA)and Partial Least Squares Discriminant Analysis(PLS-DA)to identify the target metabolites in follicular fluid,observe the changes in the content of different metabolites and find the corresponding metabolic pathways.Result:Clinical results: 1.There was no statistically significant difference between the three groups of Gn dosage,HCG day endometrial thickness and typing,and HCG day estrogen level(P>0.05).2.The experimental group and the elderly control group had statistically significant differences in the scores of kidney qi deficiency syndromes after treatment(P < 0.05),while the experimental groups also had statistically significant differences in the scores of kidney qi deficiency syndromes before and after treatment(P<0.05).3.The difference in the number of eggs harvested,2PN fertilization rate,2PN cleavage rate,excellent embryo rate and cumulative pregnancy rate among the three groups was statistically significant(P<0.05).Experimental results: 1.Compared with the elderly control group,a total of 28 metabolic markers were found to be up-regulated or down-regulated in the experimental group.The up-regulated metabolites were Retinyl palmitate,Sn-Glycero-3-phosphocholine,Lyso SM(18: 0),L-cysteine,Linoleic acid,Glycocholic acid,Docosahexaenoic acid,Dihomolinoleic acid,25-hydroxyvitamin D3,a total of 9 kinds;down-regulated metabolites are Methionyl-proline,Metanephrine,Glycine,Pyruvic acid,Uridine,Phytosphingosine,Progesterone,Retinol,Lyso PC(16: 1),Lipoamide,Indoleacetic acid,Indole,Hydroxy Retinoic acid,Guanidinoacetic acid,Decanoylcarnitine,Acetylcholine,3-Sulfopyruvic acid,4-Oxo-retinoic acid and 3-Carboxy-4-methyl-5-propyl,a total of 19 kinds.2.These metabolites involve three metabolic pathways that are closely related to the developmental potential of oocytes: Retinol metabolism;Glycine,serine and theonine metabolism;glycerin Glycerophospholipid metabolism.Conclusion: 1.Acupuncture combined with umbilical therapy can significantly improve the syndrome of kidney qi deficiency in elderly IVF patients and significantly increase the number of eggs,2PN fertilization rate,2PN cleavage rate,excellent embryo rate and cumulative pregnancy rate.2.Acupuncture may catalyze Retinyl palmitate,Glycine,Lyso PC in three metabolic pathways by regulating Retinol metabolism;Glycine,serine and theonine metabolism;Glycerophospholipid metabolism(16: 1)The activity of metabolic enzymes that produce other substances,regulate the content of metabolic markers,and then improve the quality of oocytes,improve the outcome of IVF assisted pregnancy in elderly patients with kidney-qi deficiency syndrome. |
PDF Full Text Request