Abstract
A thin endometrium affects the success of assisted reproduction due to low endometrial receptivity. Acupuncture improves endometrial receptivity and promotes the formation of pinopodes, the ultrastructure marker implantation window. However, the specific underlying mechanisms remain unclear. In this study, the efficacy of acupuncture treatment and its underlying mechanism were investigated by analyzing pregnancy rate, pinopode formation, and related molecular markers in thin endometrium model rats. Absolute ethanol (95%) was injected into the uteruses of female Sprague-Dawley rats to construct a thin endometrium model. In this model, acupuncture stimulation at EX-CA1, SP6, and CV4 ameliorated the pregnancy rate. Significantly increased embryo implantation, endometrial thickness, numbers of glands, and blood vessels were observed in the electroacupuncture (EA) group compared to the model group. The number of pinopodes in the EA group was abundant, with a shape similar to that of the control group. Additionally, significantly higher expression levels of pinopode-related markers, including integrin αvβ3, homeobox A10 (HOXA10), heparin-binding EGF-like growth factor (HBEGF), estrogen receptor alpha (ERα), and progesterone receptor (PR), were observed in the EA group than those in the model group. In conclusion, EA had a positive effect on the endometrial receptivity of thin endometrium model rats by improving pinopode formation through multiple molecular targets.
Highlights
Thin endometrium is often defined as an endometrial thickness below 7 or 8 mm on the day of ovulation or human chorionic gonadotropin administration [1,2,3]
Embryo implantation failure caused by the thin endometrium is a serious challenge for assisted reproductive technology, especially since there is no established effective treatment for this condition
Acupuncture has been widely used around the world, and its positive effect on endometrial receptivity has been confirmed in many studies [20]
Summary
Thin endometrium is often defined as an endometrial thickness below 7 or 8 mm on the day of ovulation or human chorionic gonadotropin administration [1,2,3]. Based on certain improvements in endometrial receptivity, acupuncture promotes endometrial microcirculation and increases the clinical pregnancy rate of patients undergoing in vitro fertilization and embryo transfer [18,19,20]. A recent clinical trial showed that acupuncture increases the expression of endometrial pinopodes and improves endometrial receptivity [18]; the specific underlying mechanism remains unclear. Various adhesion molecules and cytokines related to embryo implantation, such as integrin alpha v beta 3 (αvβ3) and heparin-binding epidermal growth factor- (EGF-) like growth factor (HBEGF), are expressed on the surface of pinopodes [27, 28]. Synergistic changes in pinopodes and pinopode-related molecules were observed after acupuncture treatment in a thin endometrium rat model to preliminarily explore the mechanism and molecular targets of acupuncture regulating endometrial pinopodes
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