Mechanism Of Acupuncture On Decreasing The OHSS Incidence In IVF-ET Treatment

Objective This Study focused on the infertile patient with PCOS/PCO who had primary risk factors for predicting moderate or severe Ovarian Hyper-stimulation Syndrome (OHSS), aimed to these patient under in vitro fertilization-embryo transfer (IVF-ET) treatment with acupuncture treatment, to evaluate the efficacy and investigated the molecular biological mechanism of acupuncture in reducing the incidence of OHSS, and to observe the changes of follicular fluid metabonomics.Methods102PCOS/PCO patients under the treatment of IVF/ICSI-ET were randomized allocated to COH+Acupuncture group (experimental group) or Simply COH group (control group). The patients in each group were treated with the standard long protocol with GnRH-a. Especially the patients in experimental group received traditional acupuncture from the first day of controlled ovarian hyperstimulation to the drug withdrawal day.Levels of VEGF, IL-6, β-EP of follicular fluid were detected by ELSIA Kit, levels of follicular fluid metabonomics were detected by Biochemical Analyzer. And compare the drug of COH as Dose of GnRH-a, gonadotropin (Gn); and the outcome of IVF as the number of oocytes, Mlloocytes, clinical pregnancy rate, miscarriage rate; and the related data of OHSS as incidence of OHSS, the rate of moderate/severe OHSS, serum estradiol in COH process.Results1.Compared with the control group, the incidence of OHSS significantly reduced in acupuncture group (28.85%vs.48%, p<0.05), and no difference in pregnancy rate and miscarriage rate;2. Serum E2of the embryo transfer day was significantly lower in the acupuncture group (2452.66±642.76vs.2538.13±647.37, p<0.05);3.Serum WBC and GRA(granulocyte reckon absolute) was significantly lower in the acupuncture group (14.42±3.85vs.16.98±4.20,10.81±3.26vs.12.89±3.97, p<0.05);4.The levels of serum and follicular fluid(FF) β-EP was significantly higher in the acupuncture group (409.62±335.51vs.203.09±350.13,1311.1±416.2 vs.1046.6±458.3, p<0.05), and the levels of VEGF in FF was significantly lower in the acupuncture group (257.3±103.10vs.265.1±96.91, p<0.05);5.The concentration of Na+,K+in FF was significantly lower in the acupuncture group (3.75±0.15vs.3.83±0.23,136.68±3.51vs.138.47±3.87, p<0.05), and The concentration of Ca2’in FF was significantly higher in the acupuncture group (1.86±0.08vs.1.82±0.09, p<0.05).Conclusion Acupuncture is a safe and effective way to prevent OHSS in IVF/ICSI-ET treatment, acupuncture therapy may have a role in reducing the incidence of OHSS by:alleviating the inflammatory responses during the OHSS especially suppressing secretion levels of inflammatory cytokines; deceasing the concentrations of circulating estradiol to prevent the cardiovascular damage; modulating the microenvironment and metabolism platforms of ovary; facillitating the levels of β-EP related to GnRH secretion; Then cupuncture has a better effect in preventing OHSS incidence.