Effect of acupuncture for diminished ovarian reserve: study protocol for a randomized controlled trial

Xu, Haiyan; Hao, Mingzhao; Zheng, Chensi; Yang, Huisheng; Yin, Yong; Li, Yang; Fang, Yigong

doi:10.1186/s13063-021-05684-w

Cited by 3 publications

(3 citation statements)

References 20 publications

(20 reference statements)

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“…But further randomized controlled trials with larger populations are needed to clarify the effects of DHEA supplementation on ovarian reserves and pregnancy outcomes in patients with POI. Recently, TCM has gained increasing attention, including Chinese medicinal compounds and acupuncture which have been reported to be effective treatment for POI 91,92. Nevertheless, specific immunological and nonimmunological mechanisms of these Chinese medicine remain unclear and require further exploration.…”

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confidence: 99%

Advances in the cellular immunological pathogenesis and related treatment of primary ovarian insufficiency

Gao

Wang

2022

American J Rep Immunol

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Purpose of review:To describe the immunological mechanism in the pathogenesis of premature ovarian insufficiency (POI), summarize the alternations in humoral immunity and cellular immunity in patients with POI, and review some associated treatment methods based on these immunological changes. Recent findings: Symptoms of patients with POI are similar to that of menopause, such as amenorrhea, anovulation, early depletion of the ovarian reserve, decreased estrogen, and elevated follicle-stimulating hormone (FSH) levels. Therefore, most previous research has focused on finding ovary-related antibodies. In recent years, advances in the field of immunology have increased our understanding of the pathogenic mechanism of POI, which includes changed levels of cytokines and immunological cells especially Tregs cells and Th17 cells. Based on these advances, many associatedtreatment methods including DHEA supplementation, Traditional Chinese Medicine, adoptive transfer of Treg cells and stem cell transplantation have become research hotspots.Summary: This review focuses on the current literature regarding alterations in cellular immunity in patients with POI, as well as the role in the pathogenesis of POI, and summarizes treatment methods based on these immunological alternations, which have a great application potential in the clinical practice.

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confidence: 99%

Advances in the cellular immunological pathogenesis and related treatment of primary ovarian insufficiency

Gao

Wang

2022

American J Rep Immunol

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“…A large number of studies have proved that acupuncture has multi-level and multi-target advantages in the treatment of DOR [11][12][13]. Acupuncture can regulate the function of reproductive endocrine system and improve the level of sex hormones [14,15] However, there are some shortcomings in the existing studies, such as the sample size is generally small, the results are not representative, and many clinical studies do not follow the principle of syndrome differentiation and treatment of traditional Chinese medicine for acupoint selection in acupuncture and moxibustion treatment.…”

Section: Discussionmentioning

confidence: 99%

Conception Vessels Acupuncture Research Regularity in the Treatment of Diminished Ovarian Reserve: a multi-center, large-sample prospective cohort study protocol

Zhang,

Sun,

Zhang

et al. 2024

Preprint

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Background: Diminished ovarian reserve (DOR) refers to a decrease in the number or quality of oocytes in the ovarian cortex, which is a degenerative disease of the reproductive system, and can further develop into premature ovarian failure. There are few studies on acupuncture and moxibustion for DOR, which are still in the exploratory stage. Methods/design: This study was a real-world case registry study. According to whether the subjects received conception vessel acupuncture or not, they were divided into the basic treatment combined with conception vessel acupuncture group and the basic treatment group. A total of 1221 patients with DOR were enrolled and treated for 12 weeks. The percentage of patients with ≥30% improvement in anti-Müllerian hormone (AMH) was evaluated at the end of week 12. Secondary outcomes included Antral follicle count (AFC), modified Kupperman scale, basal FSH level, LH level, FSH/LH ratio, positive pregnancy, clinical pregnancy, early spontaneous abortion, ongoing pregnancy, and ectopic pregnancy. Discussion: This study provides clinical evidence and theoretical support for the treatment of DOR with conception vessel acupuncture and moxibustion, so as to guide and improve the efficacy of acupuncture and moxibustion. Trial registration: Acupuncture-Moxibustion Clinical Trial Registry ChiCTR2400080471. Registered on 30 January 2024.

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“…E2, FSH, and LH are routine sex hormones, while AMH is gonadotropin‐independent. AMH is produced by granulosa cells of early follicles and can reflect the size of the original oocyte pool (Arat et al., 2020; Xu et al., 2021). In our study, treatment with EXD increased AMH levels in patients with DOR, indicating that EXD is beneficial for patients with DOR.…”

Section: Discussionmentioning

confidence: 99%

Kaempferol exerts antioxidant effects in age‐related diminished ovarian reserve by regulating the HSP90/NRF2 pathway

Hua,

Zhang,

Han

et al. 2023

Chem Biol Drug Des

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Kaempferol is the active ingredient of Er‐Xian decoction (EXD), a traditional Chinese medicine formula used clinically to treat ovarian dysfunction, but the mechanism of kaempferol relieving age‐related diminished ovarian reserve (AR‐DOR) is still unclear. In this study, 36 volunteers and 78 DOR patients (37 patients with EXD treatment) were enrolled in the clinical research. Meanwhile, 32‐week‐old female mice were used to establish the AR‐DOR model, and these model mice were intragastrically administered with 100 mg/kg kaempferol in the presence or absence of 200 mg/kg geranylgeranylacetone (GGA) or 1 mg/kg geldanamycin (GDA). The effects of kaempferol on serum hormone levels and oxidative stress‐related indexes were detected by enzyme‐linked immunosorbent assay. Antral follicle count (AFC) was determined by hematoxylin–eosin staining. The protein levels of HSP90 and nuclear factor erythroid 2‐related factor 2 (NRF2) were assayed by Western blot. This study displayed that the serum anti‐Mullerian hormone (AMH) level in DOR patients with EXD treatment was higher than that in DOR patients without EXD treatment. Kaempferol treatment reversed the low levels of AMH, estradiol (E2), AFC, superoxide dismutase (SOD), and catalase (CAT), as well as the high levels of follicle‐stimulating hormone (FSH), reactive oxygen species (ROS), and malonaldehyde (MDA). The results showed that HSP90 was predicted to have high affinity with kaempferol, and its expression was inhibited by kaempferol, while the expression of NRF2, the target of HSP90, was up‐regulated by kaempferol. However, the above effects of kaempferol were reversed by GGA. On the contrary, GDA enhanced the therapeutic effects of kaempferol on AR‐DOR mice. Moreover, the treatment of kaempferol resulted in a reduction in the phosphorylation level of heat shock factor 1 (HSF1), the transcription factor associated with HSP90, and an increase in the phosphorylation level of Src, a client protein of HSP90. In summary, kaempferol exerts an antioxidant effect on AR‐DOR by inhibiting HSP90 expression to up‐regulate NRF2 expression. This study provides a theoretical basis for the clinical application of kaempferol in AR‐DOR.

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Effect of acupuncture for diminished ovarian reserve: study protocol for a randomized controlled trial

Cited by 3 publications

References 20 publications

Advances in the cellular immunological pathogenesis and related treatment of primary ovarian insufficiency

Advances in the cellular immunological pathogenesis and related treatment of primary ovarian insufficiency

Conception Vessels Acupuncture Research Regularity in the Treatment of Diminished Ovarian Reserve: a multi-center, large-sample prospective cohort study protocol

Kaempferol exerts antioxidant effects in age‐related diminished ovarian reserve by regulating the HSP90/NRF2 pathway

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