Electroacupuncture Enhances Number of Mature Oocytes and Fertility Rates for In Vitro Fertilization

MEDICAL ACUPUNCTURE
Volume 31, Number 5, 2019
© Mary Ann Liebert, Inc.
DOT: 10.1089/acu.2019.1368

Electroacupuncture Enhances Number of Mature Oocytes and Fertility Rates for In Vitro Fertilization

Ayu Cintani Kusuma,¹ Nadia Oktari,¹ Hasan Mihardja,¹ Adiningsih Srilestari,¹ Christina L. Simadibrata,¹ Andon Hestiantoro,² Budi Wiweko,² and Naylah Muna,³

ABSTRACT

Objective: The increasing prevalence of infertility every year is in line with the increasing need for in vitro fertilization (IVF) programs. Failure of oocyte maturation is an obstacle that often causes low success in IVF. According to several studies, controlled ovarian stimulation (COS) has been reported to increase the risk of granulosa-cell apoptosis associated with inhibition of oocyte maturation. This study was conducted to determine the effect of electroacupuncture (EA) on oocyte maturation; rate of fertilization; granulosa-cell apoptosis; and levels of growth-differentiation factor 9 (GDF9) and bone morphogenetic protein 15 (BMP15) an IVF program.

Materials and Methods: A randomized controlled trial was conducted with 24 subjects who were in the IVF program. Subjects were randomly allocated into verum-EA (n= 12) and sham-EA groups (n= 12). Microscopic assessment of oocyte maturation and rate of fertilization was performed by embryologists, and examinations of granulosa-cell apoptosis index (Bax/Bcl-2 ratio), GDF9, and BMP15 were performed, using real-time quantitative polymerase chain reaction and messenger-RNA techniques.

Results: There were significant differences in oocyte maturation (P =0.02) and fertilization rates (P= 0.03) between the verum-EA and sham-EA groups. There were differences in granulosa-cell apoptosis index between the verum-EA and sham-EA groups (P<0.001). There were significant differences in Bax-protein expression (P=0.04) and Bcl-2 (P=0.03) granulosa cells between the verum-EA and sham-EA groups. There was no significant difference in GDF levels (P=0.34) and BMP15 (p=0.47) between the verum-EA and sham-EA groups.

Conclusions: EA can enhance oocyte maturation and fertilization rate, and reduce the granulosa-cell apoptosis index in an IVF program.

Keywords: Bax, Bcl-2, BMP15, GDF9, granulosa-cell apoptosis, oocyte maturation

INTRODUCTION

CONTROLLED OVARIAN STIMULATION (COS) was introduced in the early 1980s as part of atherapeutic method in in vitro fertilization (IVF) to improve multifollicle development, thereby increasing the number of oocytes at the time of retrieval, which can then provide 1 or more embryos to be transferred. This would eventually increase the pregnancy rate.' One factor that has an important influence on good embryo development is oocyte quality. The development and maturation of oocytes is potentially a key success factor for IVF.

Departments of ¹Medical Acupuncture and ²Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
³Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute, Universitas Indonesia, Jakarta, Indonesia.