Acupuncture and Bushen Quyu decoction improved endometrial receptivity, hormone secretion, and uterine artery blood flow for repeated implantation failure patients undergoing in vitro fertilization and embryo transfer

Acupuncture and traditional Chinese medicine (TCM) have shown certain benefits in assisted in vitro fertilization and embryo transfer (IVF-ET). In this study, we evaluated the efficacy and safety of the combination of acupuncture combined with the Bushen Quyu decoction in patients with failures of IVF-ET. This study was conducted at Shanghai Yangpu District Hospital of TCM from May to November of 2021. Patients with failed IVF-ET received either combined therapy or the routine procedure (control group). The main outcomes were implantation rate and clinical pregnancy rate. Radioimmunoassay was used to detect serum levels of estradiol (E2) and progesterone on the day of injection of human chorionic gonadotropin (hCG). The endometrial thickness, resistance index (RI), and pulsatility index (PI) of bilateral uterine arteries were measured by color Doppler ultrasound. Safety was assessed in all participants. After 3 months of treatment, the implantation rate (61.9% vs . 47.7%, P = 0.187) and clinical pregnancy rate (52.4% vs. 36.4%, P = 0.135) of patients with IVF-ET failure receiving acupuncture therapy combined with Bushen Quyu decoction appeared to be higher than those of the routine procedure group, although the increase was not statistically significant. However, the serum E2 level and endometrial thickness of patients in the combined therapy group increased significantly than those of the control group after hCG injection. The RI and PI values of bilateral uterine arteries in the combined therapy group were significantly lower than those in the control group after hCG injection. No difference of adverse events was observed between combined therapy group and control group (11.9% vs. 11.36%, P = 0.962). Acupuncture therapy combined with TCM treatment may improve endometrial receptivity and hormone secretion, and increase uterine artery blood flow.