Objective To observe the clinical effect of acupuncture plus medication in the treatment of poor ovarian response(POR)patients and to explore its mechanisms in assisting pregnancy.Methods A total of 100 volunteer POR women undergoing in vitro fertilization-embryo transplantation(IVF-ET)were recruited in the present study. On the 1 stcycle of IVF-ET

these POR women received microstimulation of ovulation program(oral administration of Clomiphene

muscular injection of Menotrophin

Chorionic Gonadotrophin triggering

etc.). Before receiving the 2 ndperiod of IVF-ET

these patients were equally and randomly divided into control

medication(Climen

composed of estradiol valerate and cyproterone acetate)

acupuncture and acupuncture+medication(combined treatment) groups according to the random number table. Patients of the medication group were asked to orally take Climen(1 tablet/d for 21 days)beginning from the 3 rdday of the menstruation

which was repeated for 3 menstrual cycles. Patients of the acupuncture group received manual acupuncture stimulation of Guanyuan(CV4)

and bilateral Taixi(KI3)

Sanyinjiao(SP6)of and Taichong(LR3)from day 8 to 15 of menstruation(follicular phase)

once daily for 3 menstrual cycles. On the 2 ndday of menstruation of the 1 stand 2 ndIVF-ET cycle

the ovarian reserve function was detected

including measurement of serum follicle-stimulating hormone(FSH)

luteinizing hormone(LH)

and estradiol(E2)contents by using radioimmunoassay

and serum anti-mullerian hormone(AMH)level by using ELISA

and the antral follicles count(AFC)of the ovaries by using a color Doppler ultrasonic diagnosis apparatus. At the end of ovulation induction

the assisted pregnancy indexes and outcomes were detected

including administration of dosage and days of gonadotropin(Gn)

the diameter of dominant oocyte

level of E2 on the trigger day

the numbers of ultrasound-guided-retrieved oocyte and the cultivated highquality embryo(grade 1 and 2).Results After the treatment

the contents of serum FSH

LH and E2 in the medication

acupuncture and combined treatment groups were significantly reduced(P<0. 05)

and the content of serum AMH and ovary AFC in the medication

acupuncture and combined treatment groups were obviously increased(P<0. 05)in comparison with their own pre-treatment(P<0. 05). Compared with the control group

the levels of FSH

LH and E2 contents were notably decreased

and the AMH content and AFC significantly increased in the medication

acupuncture and combined treatment groups(P<0. 05). Comparison among the three treatment groups showed that the levels of FSH

LH and E2 were notably lower in the combined treatment group than in the acupuncture group(P<0. 05)

and the AFC was markedly more in the combined treatment group than in the acupuncture group(P<0. 05)

and LH content was also significantly lower in the combined treatment group than in the medication group(P<0. 05). Regarding the pregnancy-assistant indexes and outcomes

the dosage of Gn in the combined treatment group and the number of Gn administration days in the acupuncture and combined treatment groups were significantly fewer(P<0. 05)

serum E2 levels on the trigger day in the medication

acupuncture and combined treatment groups

and the high-quality embryo number in the combined treatment group were considerably higher in comparison with their own levels of the 1 stIVF-ET cycle in each group(P<0. 05). Comparison among the three groups showed that the dosage and number of administration days of Gn in the combined treatment group were fewer than those in the medication group(P<0. 05)

and the dosage of Gn in the combined treatment group were significantly lower than that in the acupuncture group(P<0. 05)

E2 content of the combined treatment group was markedly higher than that of the medication and acupuncture groups(P<0. 05). The highquality embryo number in the combined treatment group was obviously larger than that of the medication group(P<0. 05). No significant differences were found between the 2 ndand 1 stIVF-ET cycles in the number of the obtained oocyte

between the acupuncture and medication groups in the E2 content at the trigger day

and the numbers of Gn administration days and the high-quality embryo(P>0. 05).Conclusion Acupuncture combined with medication improves the level of endocrinal hormones and ovarian reservation function in POR women undergoing IVF-ET

benefiting the ovary environment of pregnancy.