JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):79
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263658

P-67. Effect Of Acupunture On Endometrial Characteristics In Cycles Preparing For Cryopreserved Embryo Transfer

Karla Meira Castro Zepponi¹, Julia Castro Zepponi de Mello Horta², Lucca Salineiro Gomes de Carvalho³, Rui Alberto Ferriani¹, Ana Carolina Japur de Sá Rosa e Silva¹

¹ Universidade de São Paulo - Ribeirão Preto - SP - Brasil
² Universidade Anhembi Morumbi - São Paulo - SP – Brasil
³ Independent - Araçatuba - SP – Brasil

Objective: To evaluate the impact of electroacupuncture (EA) combined with auriculotherapy, applied during endometrial preparation and before embryo transfer, on implantation and pregnancy rates in women undergoing frozen embryo transfer (FET) cycles.
Methods: A prospective, randomized, controlled clinical trial, approved by the Institutional Ethics Committee, was conducted in compliance with all regulations, including informed consent. At the first appointment of the endometrial preparation cycle, eligible participants were invited to join the study and informed about the possibility of allocation to either the control (sham) or intervention group. Inclusion criteria were women aged 18 to 40 years, with at least one previous fresh or cryopreserved embryo transfer without achieving pregnancy. Exclusion criteria included daily use of anti-inflammatory drugs or muscle relaxants or current psychiatric treatment, except for anxiety. Participants were randomized into two groups. The intervention group (GEAA) received EA combined with auriculotherapy using specific acupuncture points and electrical stimulation according to protocol. The control group (CG) underwent sham procedures with needles placed at non-therapeutic points and no real electrical stimulation. Both groups received three treatment or sham sessions at predetermined points in the cycle. Evaluations included endometrial characteristics before progesterone initiation, implantation and clinical pregnancy rates, anxiety (Beck Anxiety Inventory), and quality of life (WHOQOL-Bref) before and after interventions.
Results: Of the 65 initially recruited participants, 12 were excluded due to cycle cancellation, leaving 53 women: 22 in GEAA and 31 in CG. The groups were homogeneous regarding age (GEAA: 36.7±3.2 years; GC: 36.4±3.5 years), body mass index (BMI), oocyte retrieval age, embryo transfer age, initial endometrial thickness, and number of embryos transferred (p>0.05). Embryo stages at transfer ranged from D2 to D7, with no significant difference between groups (p=0.3227), suggesting similar embryo quality. Causes of infertility such as polycystic ovary syndrome, endometriosis, low ovarian reserve, tubal obstruction, uterine fibroids, adenomyosis, genital tract infections, and male factors, were also comparable (p>0.05). Endometrial preparation protocols, natural or stimulated, were monitored through serial ultrasound evaluations. Endometrial pattern was assessed in the previous cycle, at the beginning of the preparation, and on the day of progesterone initiation. A trilaminar pattern, considered ideal for implantation, was predominant and similar between groups. Biochemical pregnancy rates were significantly higher in GEAA (59.09%) compared with CG (21.74%) (p=0.0106). Clinical pregnancy rates, confirmed by ultrasound visualization of a gestational sac, were also higher in the GEAA (p=0.0092). Early miscarriage rates did not differ between groups. Anxiety scores, assessed using the Beck Anxiety Inventory, improved significantly in GEAA, particularly in women with moderate to severe baseline levels, who shifted to mild or normal levels after treatment. No significant clinical improvement was observed in CG. Quality of life assessment showed impairment in psychological and environmental domains in both groups, with no significant difference between GEAA and CG after intervention (p=0.35).
Conclusion: EA combined with auriculotherapy showed a positive impact on clinical outcomes, with higher biochemical and clinical pregnancy rates compared to sham controls. Anxiety levels improved, and there was a trend toward better perceived quality of life, supporting the potential of integrative therapies as adjuncts in assisted reproduction. Beyond enhancing clinical outcomes, these therapies may contribute to emotional well-being, an essential yet often overlooked component in fertility treatment. Larger studies with longer follow-up are recommended to confirm these findings.