Impact of Transcutaneous Electrical Acupoint Stimulation on BDNF Expression and IVF Outcomes in Patients with Infertility

Figures & data

Table 1 Characteristics of the Participants

Characteristics	TEAS Group	Placebo Group	P
Overall population	n=510	n=518
Age (years)	31.9±3.5	32.1±3.5	0.248
Duration of infertility (years)	4.4±2.6	4.7± 2.8	0.164
BMI (kg/m^2)	24.1±3.8	24.2±4.2	0.586
Basal FSH (mIU/mL)	7.39±1.77	7.51±1.68	0.234
Basal LH (mIU/mL)	4.68±2.35	4.75±2.44	0.640
Basal E2 (pmol/l)	169.72±60.88	171.18±66.57	0.712
Basal P (nmol/l)	1.69±0.88	1.74±0.65	0.388
Basal T (nmol/l)	1.19±0.46	1.22±0.44	0.184
Val/Val genotype	n=240	n=243
Age (years)	31.8±3.3	32.2±3.4	0.189
Duration of infertility (years)	4.6±2.7	4.8± 2.8	0.370
BMI (kg/m^2)	23.9±4.0	24.1±4.2	0.502
Basal FSH (mIU/mL)	7.35±1.75	7.50±1.67	0.349
Basal LH (mIU/mL)	4.50±2.16	4.69±2.41	0.367
Basal E2 (pmol/l)	169.38±61.34	176.54±61.97	0.203
Basal P (nmol/l)	1.70±0.87	1.76±0.70	0.224
Basal T (nmol/l)	1.19±0.46	1.24±0.38	0.203
Val/Met genotype	n=165	n=174
Age (years)	32.3±3.6	32.0±3.5	0.449
Duration of infertility (years)	4.3±2.6	4.4±2.7	0.747
BMI (kg/m^2)	24.6±3.6	24.6±4.2	0.923
Basal FSH (mIU/mL)	7.52±1.82	7.57±1.71	0.792
Basal LH (mIU/mL)	4.94±2.53	4.93±2.62	0.977
Basal E2 (pmol/l)	165.86±55.28	163.93±69.57	0.779
Basal P (nmol/l)	1.72±0.89	1.73±0.60	0.877
Basal T (nmol/l)	1.18±0.50	1.28±0.49	0.087
Met/Met genotype	n=105	n=101
Age (years)	31.5±3.6	32.3±3.4	0.122
Duration of infertility (years)	4.2±2.5	4.7±3.0	0.187
BMI (kg/m^2)	23.6±3.6	23.7±4.2	0.843
Basal FSH (mIU/mL)	7.26±1.73	7.46±1.64	0.391
Basal LH (mIU/mL)	4.66±2.47	4.56±2.15	0.759
Basal E2 (pmol/l)	176.54±67.85	170.80±71.29	0.554
Basal P (nmol/l)	1.71±0.89	1.69±0.61	0.852
Basal T (nmol/l)	1.18±0.41	1.09±0.44	0.156

Note: Continuous variables are presented as mean±SD.

Abbreviations: TEAS, transcutaneous electrical acupoint stimulation; BMI, body mass index; FSH, follicle-stimulating hormone; LH, luteinizing hormone; E₂, estradiol; P, progesterone; T, testosterone.

Figure 1 Study flowchart.

Table 2 Primary Outcomes

Characteristics	TEAS Group	Placebo Group	PGroup	PTime	PInteraction
Overall population	n=510	n=518
Serum BDNF			<0.001	<0.001	<0.001
3rd day of menstruation before treatment	559.47±217.55	570.68±212.27
3rd day of menstruation after treatment	699.99±245.75	566.12±212.64
HCG day	830.15±225.38	790.36±207.59
Follicular-fluid BDNF level during OPU	768.36±246.68	714.50±221.67	<0.001
Val/Val genotype	n=240	n=243
Serum BDNF			<0.001	<0.001	<0.001
3^rd day of menstruation before treatment	576.32±227.42	584.53±224.17
3^rd day of menstruation after treatment	830.49±216.81	573.60±212.67
HCG day	867.28±232.06	798.91±222.38
Follicular-fluid BDNF level during OPU	847.99±252.33	784.79±214.27	0.003
Val/Met genotype	n=165	n=174
Serum BDNF			0.546	<0.001	0.027
3rd day of menstruation before treatment	545.96±210.00	565.67±203.79
3rd day of menstruation after treatment	602.16±205.33	569.37±213.75
HCG day	811.48±204.72	790.17±195.96
Follicular-fluid BDNF level during OPU	759.04±217.20	697.02±212.78	0.008
Met/Met genotype	n=105	n=101
Serum BDNF			0.856	<0.001	0.806
3rd day of menstruation before treatment	542.21±204.89	545.99±195.89
3rd day of menstruation after treatment	555.41±213.25	542.53±211.10
HCG day	774.61±227.86	770.11±189.97
Follicular-fluid BDNF level during OPU	601.01±184.57	575.50±180.46	0.317

Note: Continuous variables are presented as mean±SD.

Abbreviations: TEAS, transcutaneous electrical acupoint stimulation; BDNF, brain-derived neurotrophic factor; HCG, human chorionic gonadotropin.

Table 3 IVF Outcomes Patients Between TEAS and Placebo Group

Characteristics	TEAS Group	Placebo Group	P
Overall population	n=510	n=518
Total dose of gonadotropins (IU)	2146.35±693.00	2267.18±730.10	0.007
Days of stimulation	9.4±1.5	9.4±1.7	0.493
No. of mature oocytes	15.0±7.5	14.1±7.1	0.055
Fertilization rate (%)	71.5±20.1	67.9 ±22.5	0.006
High-quality embryo rate (%)	55.3±25.0	51.3±26.4	0.013
Pregnancy rate per ET (%)	54.5 (199/365)	46.3 (167/361)	0.031
Implantation rate (%)	38.3 (271/708)	33.3 (230/690)	0.058
Val/Val genotype	n=240	n=243
Total dose of gonadotropins (IU)	2019.74±644.43	2149.95±696.45	0.034
Days of stimulation	9.4±1.5	9.3±1.4	0.265
No. of mature oocytes	12.6±6.4	11.5±6.2	0.048
Fertilization rate (%)	74.8±18.0	70.1±22.4	0.012
High-quality embryo rate (%)	59.0±25.7	54.1±26.3	0.039
Pregnancy rate per ET (%)	61.2 (109/178)	51.2 (86/168)	0.066
Implantation rate (%)	43.6 (149/342)	35.4 (113/319)	0.038
Val/Met genotype	n=165	n=174
Total dose of gonadotropins (IU)	2185.68±726.11	2302.01±788.91	0.164
Days of stimulation	9.5±1.6	9.5±1.7	0.602
No. of mature oocytes	11.2±6.6	11.3±6.4	0.982
Fertilization rate (%)	70.8±20.6	67.4±21.9	0.119
High-quality embryo rate (%)	54.4±25.1	50.9±26.1	0.208
Pregnancy rate per ET (%)	50.4 (59/117)	43.9 (54/123)	0.365
Implantation rate (%)	34.9 (80/229)	33.05 (78/236)	0.696
Met/Met genotype	n=105	n=101
Total dose of gonadotropins (IU)	2373.93±687.67	2489.23±648.08	0.167
Days of stimulation	9.4±1.5	9.5±1.8	0.967
No. of mature oocytes	10.1±5.8	9.6±6.1	0.627
Fertilization rate (%)	65.1±22.3	63.2±23.0	0.754
High-quality embryo rate (%)	48.04 ± 21.37	45.01 ± 26.20	0.632
Pregnancy rate per ET (%)	44.29 (31/70)	38.57 (27/70)	0.607
Implantation rate (%)	30.77 (42/137)	28.89 (39/135)	0.792

Notes: Continuous variables are presented as mean±SD. Categorical variables are presented as a percentage. P_Group, P_Time, and P_Interaction represent P values associated with group effect, time effect, and interaction of group and time effect indicated by repeated analysis of variance, respectively.

Abbreviations: TEAS, transcutaneous electrical acupoint stimulation; ET, embryo transfer.