Objective:

2

To observe the effects of electroacupuncture (EA) on reproductive outcomes in women with Shen (Kidndy) deficiency syndrome after in vitro fertilization-embryo transfer (IVF-ET)

and explore the underlying molecular mechanism.

Methods:

2

Sixty-six infertile patients with Shen deficiency syndrome undergoing IVF-ET were divided into EA or control groups according to a random table

33 cases in each group. Before undergoing IVF

patients in the EA and control groups received EA therapy and placebo needle puncture

respectively

for 3 menstrual cycles. Shen deficiency syndrome scores were assessed. Other outcome measures included the number of retrieved oocytes and fertilization

high-quality embryo and clinical pregnancy rates. Follicular fluid was collected on the day of oocyte retrieval

and granulosa cell expression of phosphatidylinositide 3-kinases (PI3K)

serine-threonine kinase (Akt) and forkhead box O3 (Foxo3a) mRNA were measured by reverse transcribed and quantitative real-time polymerase chain reaction.

Results:

2

Syndrome scores for pre- versus post-treatments decreased significantly (16.53±1.75 to 8.67±1.61) in the EA group (

P

<

0.05)

but showed no significant change in the control group (17.18±1.58 to 14.74±1.58). A significant difference in score change was found between the EA and control groups (

P

<

0.05). High-quality embryo and clinical pregnancy rates were both increased in the EA group compared with the control group [69.15% (195/282) vs. 60.27% (176/292) and 66.67% (22/33) vs. 42.42% (14/33)

respectively

P

<

0.05]. The fertilization rate was equivalent in EA and control groups. No difference was found in the number of retrieved oocytes between the two groups. Granulosa cell expression levels of PI3K and Akt mRNA were significantly increased in the EA group compared with the control group

while the expression of Foxo3a was reduced (all

P

<

0.05).

Conclusions:

2

For infertile patients with Shen deficiency syndrome undergoing IVF

EA for tonifying Shen as an adjunct treatment may alleviate clinical symptoms and improve the high-quality embryo rate. The EA-induced mechanism may involve regulation of PI3K/Akt/Foxo3a expression in granulosa cells to improve the developmental microenvironment of oocytes and inhibit granulosa cell apoptosis

possibly contributing to the improved clinical pregnancy rate (Registration No. ChiCTR 1800016217).