To Explore The Effect Of Brain-derived Neurotrophic Factor(BDNF) On Transcutaneous Electrical Acupoint Stimulation(TEAS) To Improve The Pregnancy Outcome Of IVF

Objective:To observe the effect of TEAS on the level of BDNF in the whole body and ovary of infertile female patients,and to explore the effect of BDNF on the improvement of IVF pregnancy outcome by TEAS,so as to provide theoretical support and experimental basis for the universal application of TEAS therapy in infertility treatment.Methods:A total of 240 infertility patients treated with IVF-ET were randomly divided into two groups:TEAS treatment group（observation group）and placebo stimulation treatment group（control group）.Among them,120 cases in the TEAS treatment group were given TEAS for 2 menstrual cycles every day before the IVF cycle.The specific acupoints were Guanyuan,Zhongji,Sanyinjiao,Uterus,Tianshu,Shenshu,Yaoyangguan and Mingmen.The 120 patients in the placebo stimulation group were treated with placebo electrical stimulation for 2 menstrual cycles every day before IVF cycle,and the acupoints were the same as those in the TEAS group.In order to observe the effect of BDNFmet gene on the treatment effect of TEAS,the enrolled patients were divided into 3subgroups according to the detected BDNF genotype:BDNFval/val,BDNFval/met,and BDNFmet/met,a total of 6 groups.Observation,6 groups of patients before and after the intervention period the 3rd serum,serum HCG day and take eggs,concentration of BDNF in follicular fluid,intervention before and after the intervention period the 3rd ovarian blood flow S/D,PI,RI values,intervention before and after the intervention period.3 day serum E₂,P,LH,FSH level and HCG serum E₂,P,LH levels,6 groups of IVF outcome.Results were processed with SPSS22.0 statistical software.Results:1.TEAS could improve the serum BDNF concentration on the 3rd day of menstruation,the serum BDNF concentration on HCG day and the BDNF concentration in follicular fluid in patients with BDNFval/val genotype,and the differences were statistically significant（P<0.01）.2.BDNFval/val,BDNFval/met,BDNFmet/met had no difference in serum BDNF concentration on the3rd day of menstruation and HCG day（P>0.05）.BDNF concentration in follicular fluid:BDNFval/val>BDNFval/met>BDNFmet/met（P<0.01）;3.TEAS can reduce the S/D,PI and RI values of ovarian artery on the 3rd day of menstruation in patients with BDNFval/val and BDNFval/met genotypes,and the differences in BDNFval/val group and BDNFval/met group were statistically significant（P<0.01）and statistically significant（P<0.05）;4.After TEAS treatment,the serum FSH level of patients with BDNFval/val genotype decreased（P<0.01）and the serum E₂ level increased（P<0.05）.5.After TEAS treatment,the amount of Gn in BDNFval/val genotype patients decreased,and the fertilization rate and embryo excellent rate increased（P≤0.05）;6.The values of S/D and PI in the ovarian artery on the third day of menstruation were negatively correlated with the serum BDNF concentration on the third day of menstruation in group A（P<0.01）.The serum FSH level was negatively correlated with the serum BDNF concentration on the 3rd day of menstruation（P<0.01）,and the serum E₂ level was positively correlated with the serum BDNF concentration on the 3rd day of menstruation（P<0.01）.Serum E₂ level was positively correlated with serum BDNF concentration on HCG day（P<0.05）.7.The amount of Gn required by IVF-ET and the number of days of Gn were negatively correlated with the concentration of BDNF in the follicular fluid（P<0.05）,while the rate of fertilization and the rate of excellent embryo were positively correlated with the concentration of BDNF in the follicular fluid（P<0.01）.8.TEAS has no obvious effect on patients carrying BDNFmet gene,especially BDNFmet/met patients.Conclusion:TEAS can improve the ovarian blood perfusion by reducing the S/D,RI and PI values of the ovarian artery.This can promote the proliferation of granulocyte cells,increase the content of BDNF,and then play the role of BDNF in regulating the reproduction-endocrine axis to improve the ovarian function,promote the development and maturation of follicles,improve the quality of IVF eggs,and improve the fertilization rate and optimal embryo rate.In this way,the outcome of IVF pregnancy can be improved.BDNFmet mutant gene inhibited the effect of TEAS on improving BDNF content and expression,and also inhibited the effect of TEAS on improving IVF pregnancy outcome.