Objective

2

To observe the effects of acupuncture combined with Chinese herbal medication on pregnancy outcomes in patients with recurrent implantation failure (RIF) infertility of kidney deficiency and blood stasis

and to explore its effects on the protein expression of serum p38MAPK and JAK/STAT.

Methods

2

Sixty-two patients with RIF infertility of kidney deficiency and blood stasis who were scheduled for artificial cycle frozen-thawed embryo transfer

were randomly divided into an observation group (31 cases

4 cases dropped out) and a control group (31 cases

3 cases were eliminated). The patients in the control group were treated with conventional artificial cycle frozen-thawed embryo transfer. On the basis of the control group

the patients in the observation group were treated with acupuncture combined with Chinese herbal medication. Acupuncture was applied at Baihui (GV 20)

Guanyuan (CV 4) and bilateral Neiguan (PC 6)

Zigong (EX-CA 1)

Guilai (ST 29)

Zusanli (ST 36)

Taichong (LR 3)

Shenshu (BL 23)

Ciliao (BL 32)

with each session lasting for 30 minutes

once every other day. Chinese herbal medication was administered to

Bushen Huoxue

(tonifing the kidney and activating blood circulation) decoction

with one dose per day

starting from the 3rd to 5th day of the menstrual cycle and continuing until 1 day before embryo transfer. Clinical pregnancy rate

embryo implantation rate

live birth rate

and biochemical pregnancy rate were compared between the two groups. TCM symptom score

platelet count (PLT)

and plasma D-dimer level were assessed before treatment and 1 day before embryo transfer. Western blot method was used to detect the expression of serum P38MAPK

JAK

and STAT proteins before treatment and 1 day before embryo transfer.

Results

2

In the observation group

the clinical pregnancy rate

embryo implantation rate

and live birth rate were higher (

P

<

0.05)

while the biochemical pregnancy rate was lower (

P

<

0.05) than those in the control group. One day before embryo transfer

both groups showed a decrease in TCM symptom scores

PLT

and plasma D-dimer levels compared to those before treatment (

P

<

0.05)

and the observation group had lower TCM symptom scores and plasma D-dimer levels than the control group (

P

<

0.05). One day before embryo transfer

the expression levels of serum p38MAPK

JAK

and STAT proteins in both gro

ups were lower than those before treatment (

P

<

0.05)

and the observation group had lower serum p38MAPK protein expression than the control group (

P

<

0.05).

Conclusion

2

Acupuncture combined with Chinese herbal medication can improve the clinical pregnancy rate

embryo implantation rate

live birth rate

and reduce the biochemical pregnancy rate in RIF infertility patients of kidney deficiency and blood stasis. Its mechanism of action may be related to down-regulating plasma D-dimer level and protein expression of serum p38MAPK.