title: Effect of transcutaneous electrical acupuncture point stimulation on endometrial receptivity in women undergoing frozen-thawed embryo transfer: a single-blind prospective randomised controlled trial.
abstract: OBJECTIVE
  To evaluate the effect of transcutaneous electrical acupuncture point stimulation (TEAS) on endometrial HOXA10 protein expression and three-dimensional (3D) power Doppler ultrasound parameters as markers of endometrial receptivity in women undergoing frozen-thawed embryo transfer (FET).
  
  
  METHODS
  A total of 68 women undergoing FET were randomised to receive TEAS or mock TEAS at acupuncture points CV3, CV4 and SP6 and Zigong bilaterally. Both groups had six sessions per cycle for three menstrual cycles prior to the scheduled FET. Each session lasted 30 min and was repeated every other day. 3D power Doppler ultrasound parameters, HOXA10 protein expression and rates of embryo implantation, clinical pregnancy and live birth were compared.
  
  
  RESULTS
  There were no significant differences between the two groups in endometrial thickness or endometrial volume. The ultrasonographic endometrial triple-line pattern was present more often in the TEAS group (p=0.002). The TEAS group had a greater endometrial and subendometrial vascularisation index (VI) than the mock TEAS group (p=0.001 and p<0.001, respectively) on 3D ultrasound and increased endometrial HOXA10 expression (p=0.001) immediately prior to FET. Subsequently, the rates of embryo implantation, clinical pregnancy and live birth rates were all higher in the TEAS group than in the mock TEAS group (p=0.024, p=0.038 and p=0.033, respectively).
  
  
  CONCLUSIONS
  In patients undergoing FET, TEAS may have beneficial effects on endometrial HOXA10 expression and ultrasound markers of endometrial receptivity. These findings may explain the improvement in clinical outcome of FET associated with the use of TEAS.
  
  
  BACKGROUND
  ChiCTR-TRC-14004448.
authors.affiliation: Shandong University of Traditional Chinese Medicine, Jinan, China.
authors.forename: Zhenhong
authors.initials: Z
authors.lastname: Shuai
authors.affiliation: Integrative Medicine Research Centre of Reproduction and Heredity, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Lian
authors.affiliation: Department of Urology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Li
authors.affiliation: Integrative Medicine Research Centre of Reproduction and Heredity, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
authors.forename: Wenxiu
authors.initials: W
authors.lastname: Yang
mesh_terms: D015669:Acupuncture Points; D000328:Adult; D015671:Electroacupuncture; D010064:Embryo Implantation; D004624:Embryo Transfer; D004717:Endometrium / Q000098:blood supply / Q000000981:diagnostic imaging / Q000378:metabolism; D005260:Female; D000080905:Homeobox A10 Proteins; D018398:Homeodomain Proteins / Q000378:metabolism*; D006801:Humans; D050498:Live Birth; D011247:Pregnancy; D011446:Prospective Studies; D016037:Single-Blind Method; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D014463:Ultrasonography
chemical_list: D000080905:Homeobox A10 Proteins; D018398:Homeodomain Proteins; C069634:HOXA10 protein, human
keywords: COMPLEMENTARY MEDICINE; REPRODUCTIVE MEDICINE