Electroacupuncture to Improve Endometrial Receptivity and Folliculogenesis in Polycystic Ovary Syndrome

Objective: Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting folliculogenesis and endometrial receptivity. PCOS causes low fertility due to failures in folliculogenesis and ovulation. Electroacupuncture (EA) may help improve folliculogenesis and endometrial receptivity. EA can decrease tonic activity in the sympathetic vasoconstrictor pathway to the uterus. This study was conducted to determine the effect of the addition of EA therapy on folliculogenesis and endometrial receptivity in women with PCOS.Materials and Methods: This case-control study was conducted at the Dr. Moewardi General Hospital, in Jawa Tengah, Indonesia. The subjects were women with PCOS, ages 20-45, who were infertile. They were divided into a control group (17 women) and an experimental group (17 women). The control group received letrozole therapy, and the experimental group received EA + letrozole therapy. Folliculogenesis is determined by measuring the growth of follicle diameter on days 2, 6, 8, 10, and 12 of the menstrual cycle. Endometrial receptivity is determined by resistance index (RI) and pulsatility index (PI) examinations on days 19 and 21; endometrial thickness is measured on day 12.Results: There was a significant difference in folliculogenesis on days 2, 6, 8, 10, and 12. Folliculogenesis with letrozole versus EA + letrozole, respectively, were: day 2 = 5.59 +/- 1.06 versus 7.01 +/- 1.53, P = 0.004; day 6 = 6.71 +/- 1.59 versus 9.11 +/- 1.23, P < 0.001; day 8 = 9.51 +/- 2.68 versus 12.44 +/- 1.49, P < 0.001; day 10 = 11.30 +/- 3.08 versus 15.53 +/- 2.34, P < 0.001; and day 12 = 13.92 +/- 3.61 versus 19.86 +/- 0.75, P < 0.001. RI value with letrozole versus EA + letrozole were, respectively, day 19 = 0.91 +/- 0.07 versus 0.88 +/- 0.07, P = 0.150; day 21 = 0.88 +/- 0.07 versus 0.79 +/- 0.09, P < 0.001. PI value with letrozole versus EA + letrozole were respectively, day 19 = 3.00 +/- 0.89 versus 2.30 +/- 0.65, P = 0.009; and day 21 = 2.72 +/- 0.88 versus 2.02 +/- 0.55, P = 0.009. Endometrial thickness with letrozole versus EA + letrozole were, respectively, day 12 = 6.95 +/- 1.82 versus 8.22 +/- 1.76, P = 0.005.Conclusions: The addition of EA to letrozole therapy improved folliculogenesis, RI, PI, and endometrial thickness in patients with PCOS. Further studies are needed to gain a better understanding of the dosage and timing of this therapy and its potential synergy with other current treatments.