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

BACKGROUND: Diminished ovarian reserve (DOR) is a condition in which the ovary loses its normal reproductive potential, compromising fertility. Although the prevalence and incidence of DOR is increasing, there are currently no effective treatments for this condition. Acupuncture has been reported as an alternative therapy for female infertility. The purpose of this study is to investigate the effect of acupuncture for women with DOR. METHODS/DESIGN: In this randomized controlled trial, a total of 120 women with DOR will be randomly assigned to receive either acupuncture or sham acupuncture for 12 weeks. The primary outcome will be determined by the mean change from baseline in the antral follicle count (AFC) at week 12. Secondary outcomes include serum levels of FSH, LH, E2, and AMH, the length of menstrual cycle, and the score of Self-Rating Anxiety Scale (SAS). DISCUSSION: This study is expected to investigate the effectiveness of acupuncture versus sham acupuncture in improving ovarian reserve for women with DOR. TRIAL REGISTRATION: Acupuncture-Moxibustion Clinical Trial Registry ChiCTR1800014988 . Registered on 6 February 2018.

Effect of acupuncture on women with poor ovarian response: a study protocol for a multicenter randomized controlled trial.

BACKGROUND: Poor ovarian response (POR), a manifestation of low ovarian reserve and ovarian aging, leads to a significant reduction in the pregnancy rate after in vitro fertilization-embryo transfer. Acupuncture has increasingly been used to improve the ovarian reserve. The purpose of this study will be to evaluate the effect of acupuncture on increasing the number of retrieved oocytes after controlled ovarian hyperstimulation in women with POR. METHODS: This will be a multicenter randomized controlled trial. A total of 140 women with POR will be randomly assigned to receive acupuncture or nontreatment for 12 weeks before controlled ovarian hyperstimulation. The primary outcome will be the number of retrieved oocytes. The secondary outcomes will be antral follicle counts, serum levels of anti-Müllerian hormone, basal serum levels of follicle stimulating hormone, luteinizing hormone and estradiol levels, scores from the self-rating anxiety scale, fertilization rates, cleavage rates, available embryo rates, and high-quality embryo rates. The safety of acupuncture will also be assessed. DISCUSSION: The results of this trial will help to determine the effectiveness of acupuncture in the treatment of POR. This may provide a new treatment option for patients with POR and their physicians. TRIAL REGISTRATION: AMCTR-IPR-18000198 . Registered on 10 August 2018.

Half-precessional cycle of thermocline temperature in the western equatorial Pacific and its bihemispheric dynamics.

The El Niño-Southern Oscillation (ENSO), which is tightly coupled to the equatorial thermocline in the Pacific, is the dominant source of interannual climate variability, but its long-term evolution in response to climate change remains highly uncertain. This study uses Mg/Ca in planktonic foraminiferal shells to reconstruct sea surface and thermocline water temperatures (SST and TWT) for the past 142 ky in a western equatorial Pacific (WEP) core MD01-2386. Unlike the dominant 100-ky glacial-interglacial cycle recorded by SST and δ18O, which echoes the pattern seen in other WEP sites, the upper ocean thermal gradient shows a clear half-precessional (9.4 ky or 12.7 ky) cycle as indicated by the reconstructed and simulated temperature (ΔT) and δ18O differences between the surface and thermocline waters. This phenomenon is attributed to the interplay of subtropical-to-tropical thermocline anomalies forced by the antiphased meridional insolation gradients in the two hemispheres at the precessional band. In particular, the TWT shows greater variability than SST, and dominates the ΔT changes which couple with the west-east SST difference in the equatorial Pacific at the half-precessional band, implying a decisive role of the tropical thermocline in orbital-scale climate change.

[Comments on "Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro Fertilization: A Randomized Clinical Trial " from Journal of the American Medical Association].

In recent years, acupuncture has been used widely as an adjuvant treatment for the in vitro fertilization (IVF). "Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro Fertilization: A Randomized Clinical Trial " published in Journal of the American Medical Association (JAMA) on May 15, 2018, the research findings do not support the use of acupuncture to improve the rate of live births among the women undergoing IVF. In order to avoid the misunderstanding of the scholars at home and abroad for the clinical effects of acupuncture on IVF assistance, the authors put forward the doubts after the analysis from the following 3 aspects, including the acupuncture scheme, outcomes and result explanation. Additionally, the thinking and suggestions are proposed for the future development of the clinical trials of acupuncture IVF assistance in terms of selecting the proper participants, being abided by the standards of the evidence-based medicine, designing multi-acupuncture schemes and setting up the rational control, as well as conducting the overall analysis of the trial data.