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The mechanistic study was a single-center RCT.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Interventions<\/jats:title>\n                <jats:p>The participants received TEAS vs. no TEAS treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Main outcome measures<\/jats:title>\n                <jats:p>In the efficacy study, the primary outcomes were the rates of clinical pregnancy, embryo implantation, and live birth. In the mechanistic study, sex hormones and endometrial protein expression were examined.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Ultimately, 739 participants were enrolled (367 and 372 in the TEAS and control groups, respectively). The clinical pregnancy rate was higher in the TEAS group than in the controls (55.1% vs. 46.7%, <jats:italic>P<\/jats:italic>\u2009=\u20090.03). There were no significant differences in embryo implantation, biochemical pregnancy, and live birth rates between the two groups (all <jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05) in the study population. In women\u2009&gt;\u200935\u00a0years, the clinical pregnancy rates, embryo implantation rates and live birth rates in the TEAS and control groups were 48.9% vs. 23.7% (<jats:italic>P<\/jats:italic>\u2009=\u20090.004),30.8 vs. 13.9% (<jats:italic>P<\/jats:italic>\u2009=\u20090.001) and 34.0% vs. 19.7% (<jats:italic>P<\/jats:italic>\u2009=\u20090.06) respectively. In the mechanistic study with 120 participants, on the theoretical embryo implantation day, better developed endometrial pinopodes, elevated endometrial integrin \u03b11\u03b21\/\u03b1V\u03b23, leukemia inhibitory factor, and elevated serum progesterone levels were found in the TEAS group compared with controls.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>TEAS significantly improved the clinical pregnancy rate in women undergoing IVF-ET, especially in women of older age. It might be due to improved endometrial receptivity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>ChiCTR-TRC-13003950.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12958-022-00997-0","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T12:09:36Z","timestamp":1661170176000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Transcutaneous electrical acupoint stimulation improves endometrial receptivity resulting in improved IVF-ET pregnancy outcomes in older women: a multicenter, randomized, controlled clinical trial"],"prefix":"10.1186","volume":"20","author":[{"given":"Xiaojun","family":"Feng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songping","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jisheng","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"997_CR1","doi-asserted-by":"publisher","first-page":"f650","DOI":"10.1136\/bmj.f650","volume":"346","author":"E Fields","year":"2013","unstructured":"Fields E, Chard J, James D, Treasure T, Guideline Development G. 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It was approved by the Peking University Institutional Review Board (Approval No. IRB00001052-13011, IRB00001052-10060).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"JSH is the inventor of the transcutaneous electrical nerve stimulator used in the present study. Other authors have no conflicts of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"127"}}