{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T02:07:46Z","timestamp":1770343666525,"version":"3.49.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Diminished ovarian reserve (DOR) is known to reduce the likelihood of achieving pregnancy or live births in women undergoing\n                      <jats:italic>in vitro<\/jats:italic>\n                      fertilization and embryo transfer (IVF-ET). Acupuncture maybe effective for DOR, but current evidence remains limited and inconclusive.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This study is a multicenter, randomized, placebo-controlled trial conducted on a large scale. A total of 300 women with DOR preparing for IVF-ET will be randomized 1:1 to acupuncture or placebo acupuncture. Interventions will be administered from the second menstrual cycle preceding the IVF cycle until the day of oocyte retrieval. The primary outcome is the clinical pregnancy rate (CPR) following the first embryo transfer. Secondary outcomes include various IVF-ET indicators, such as the number of follicles \u2265 14 mm, estradiol (E2) levels, and endometrial thickness on the day of human chorionic gonadotropin (hCG) administration; the number of retrieved oocytes, metaphase II (MII) oocytes, and two pronuclei (2PN) fertilizations; as well as the rates of 2PN fertilization, available embryos, high-quality embryos, implantation, cycle cancellation, biochemical pregnancy, pregnancy loss, sustained pregnancy, and live birth. Additionally, ovarian reserve indicators\u2014including antral follicle count (AFC), basal serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and E2, and anti-M\u00fcllerian hormone (AMH)\u2014along with scores from the Self-Rating Anxiety Scale (SAS) will also be evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The trial has been approved by the ethics committees of all participating centers. The results will be disseminated in academic journals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>http:\/\/itmctr.ccebtcm.org.cn\/<\/jats:ext-link>\n                      , identifier ID: ITMCTR2024000021.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1723278","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T12:44:36Z","timestamp":1770295476000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of acupuncture pretreatment on clinical pregnancy rate in women with diminished ovarian reserve undergoing IVF-ET: study protocol for a multicenter randomized controlled trial"],"prefix":"10.3389","volume":"17","author":[{"given":"Xin","family":"Liu","sequence":"first","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenchen","family":"Su","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junmin","family":"Li","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, The Third Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Chen","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, General Hospital of Eastern Theater Command","place":["Nanjing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinhua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, Shanghai University of Traditional Chinese Medicine Affiliated Shuguang Hospital","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Sun","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, Fujian Maternal and Child Health Hospital","place":["Fuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinbang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, Fujian Maternal and Child Health Hospital","place":["Fuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cuilian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, Henan Provincial People's Hospital","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinjie","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Henan Provincial People's Hospital","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuemei","family":"Li","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, Shenzhen Maternal and Child Health Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huisheng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and moxibustion Massage, Shenzhen Maternal and Child Health Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yicong","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Yang","sequence":"additional","affiliation":[{"name":"Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]},{"name":"Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Sichuan Jinxin Xinan Women and Children Hospital","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Zhu","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, Reproductive and Genetic Hospital of China International Trust and Investment Corporation (CITIC)-Xiangya","place":["Changsha, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiying","family":"Lu","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, Hainan Women and Children's Medical Center","place":["Haikou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tongsheng","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Acupuncture, Shaanxi Provincial Hospital of Chinese Medicine","place":["Xian, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Shang","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, The Seventh Medical Center of the Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qun","family":"Lu","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, Beijing Chaoyang Hospital of Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Yang","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiashan","family":"Li","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian","family":"Hang","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingyu","family":"Qi","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiwei","family":"Xiao","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weixin","family":"Li","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Gao","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyan","family":"Wang","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pengfei","family":"Du","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongxue","family":"An","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huanfang","family":"Xu","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yigong","family":"Fang","sequence":"additional","affiliation":[{"name":"The Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2020.09.134","article-title":"Testing and interpreting measures of ovarian reserve: a committee opinion","volume":"114","year":"2020","journal-title":"Fertil Steril"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1004-3845.2022.04.001","article-title":"Expert consensus on clinical diagnosis and treatment of diminished ovarian reserve","volume":"31","year":"2022","journal-title":"J Reprod Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1016\/j.fertnstert.2015.05.017","article-title":"Diminished ovarian reserve in the United States assisted reproductive technology population: diagnostic trends among 181,536 cycles from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System","volume":"104","author":"Devine","year":"2015","journal-title":"Fertil Steril"},{"key":"B4","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1016\/j.fertnstert.2020.02.112","article-title":"Perinatal outcome in young patients with diminished ovarian reserve undergoing assisted reproductive technology","volume":"114","author":"Hu","year":"2020","journal-title":"Fertil Steril"},{"key":"B5","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/s12905-024-03039-6","article-title":"Effect of diminished ovarian reserve on the outcome of fresh embryo transfer in IVF\/ICSI cycles among young women: A retrospective cohort study","volume":"24","author":"Zhu","year":"2024","journal-title":"BMC Womens Health"},{"key":"B6","doi-asserted-by":"publisher","first-page":"101982","DOI":"10.1016\/j.jogoh.2020.101982","article-title":"The effect of growth hormone adjuvant therapy on assisted reproductive technologies outcomes in patients with diminished ovarian reserve or poor ovarian response","volume":"50","author":"Dogan","year":"2021","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"B7","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/1477-7827-11-44","article-title":"Efficacy of dehydroepiandrosterone to improve ovarian response in women with diminished ovarian reserve: a meta-analysis","volume":"11","author":"Narkwichean","year":"2013","journal-title":"Reprod Biol Endocrinol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jgyn.2016.01.002","article-title":"The effect of dehydroepiandrosterone (DHEA) supplementation on women with diminished ovarian reserve (DOR) in IVF cycle: Evidence from a meta-analysis","volume":"46","author":"Qin","year":"2017","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1136\/acupmed-2015-011014","article-title":"Electroacupuncture for reproductive hormone levels in patients with diminished ovarian reserve: a prospective observational study","volume":"34","author":"Wang","year":"2016","journal-title":"Acupunct Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.13703\/j.0255-2930.2017.10.009","article-title":"Acupuncture with regulating menstruation to promote pregnancy for diminished ovarian reverse: a prospective case series study","volume":"37","author":"Li","year":"2017","journal-title":"Zhongguo Zhen Jiu"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.13703\/j.0255-2930.20190925-k0001","article-title":"\u201cThirteen acupoints for regulating menstruation and promoting pregnancy\u201d for diminished ovarian reserve: a prospective cohort study","volume":"40","author":"Yang","year":"2020","journal-title":"Zhongguo Zhen Jiu"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1136\/acupmed-2011-010064","article-title":"Effect of acupuncture on symptoms of anxiety in women undergoing in vitro fertilisation: a prospective randomised controlled study","volume":"30","author":"Isoyama","year":"2012","journal-title":"Acupunct Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.02.005","article-title":"A new more detailed stratification of low responders to ovarian stimulation: from a poor ovarian response to a low prognosis concept","volume":"105","author":"Alviggi","year":"2016","journal-title":"Fertil Steril"},{"key":"B14","volume-title":"WHO Standard Acupuncture Point Locations in the Western Pacific Region","year":"2008"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1089\/acm.2010.0652","article-title":"Characterization of de qi with electroacupuncture at acupoints with different properties","volume":"17","author":"Zhou","year":"2011","journal-title":"J Altern Complement Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.7220","article-title":"Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence: A randomized clinical trial","volume":"317","author":"Liu","year":"2017","journal-title":"JAMA"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/der037","article-title":"The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting","volume":"26","year":"2011","journal-title":"Hum Reprod"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/gaw057","article-title":"Assessment of human embryo development using morphological criteria in an era of time-lapse, algorithms and \u2018OMICS\u2019: is looking good still important","volume":"22","author":"Gardner","year":"2016","journal-title":"Mol Hum Reprod"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1973.04200030026004","article-title":"From art to science: the diagnosis and treatment of depression","volume":"29","author":"Zung","year":"1973","journal-title":"Arch Gen Psychiatry"},{"key":"B20","volume-title":"Record specification on adverse event in clinical trials of acupuncture and moxibustion (Standard No. T\/CAAM 0002-2022)","year":"2022"},{"key":"B21","doi-asserted-by":"publisher","first-page":"100395","DOI":"10.1016\/j.imr.2020.02.003","article-title":"Acupuncture for in vitro fertilization in women with poor ovarian response: a systematic review","volume":"9","author":"Jang","year":"2020","journal-title":"Integr Med Res"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12810","article-title":"Effects of transcutaneous electrical acupoint stimulation on ovarian reserve of patients with diminished ovarian reserve in in vitro fertilization and embryo transfer cycles","volume":"41","author":"Zheng","year":"2015","journal-title":"J Obstet Gynaecol Res"},{"key":"B23","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1093\/humupd\/dml034","article-title":"A systematic review of tests predicting ovarian reserve and IVF outcome","volume":"12","author":"Broekmans","year":"2006","journal-title":"Hum Reprod Update"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)60615-5","article-title":"Follicle-stimulating hormone levels on cycle day 3 are predictive of in vitro fertilization outcome","volume":"51","author":"Scott","year":"1989","journal-title":"Fertil Steril"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.02.027","article-title":"Ovarian reserve testing: a user\u2019s guide","volume":"217","author":"Tal","year":"2017","journal-title":"Am J Obstet Gynecol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh119","article-title":"Intercycle variability of ovarian reserve tests: results of a prospective randomized study","volume":"19","author":"Kwee","year":"2004","journal-title":"Hum Reprod"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa513","article-title":"Anti-m\u00fcllerian hormone and ovarian reserve: update on assessing ovarian function","volume":"105","author":"Moolhuijsen","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.5653\/cerm.2016.43.3.139","article-title":"The meaning of anti-M\u00fcllerian hormone levels in patients at a high risk of poor ovarian response","volume":"43","author":"Park","year":"2016","journal-title":"Clin Exp Reprod Med"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000445","article-title":"Ovarian reserve testing: A review of the options, their applications, and their limitations","volume":"62","author":"Ulrich","year":"2019","journal-title":"Clin Obstet Gynecol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3182(71)71479-0","article-title":"A rating instrument for anxiety disorders","volume":"12","author":"Zung","year":"1971","journal-title":"Psychosomatics"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.13703\/j.0255-2930.2016.01.007","article-title":"Effects of \u201cmenstrual cycle-based acupuncture therapy\u201d on IVF-ET in patients with decline in ovarian reserve","volume":"36","author":"Zhou","year":"2016","journal-title":"Zhongguo Zhen Jiu"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.13703\/j.0255-2930.2015.04.001","article-title":"Impacts on pregnancy outcome treated with acupuncture and moxibustion in IVF-ET patients","volume":"35","author":"Chen","year":"2015","journal-title":"Zhongguo Zhen Jiu"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1723278\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T12:44:42Z","timestamp":1770295482000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1723278\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,5]]},"references-count":32,"alternative-id":["10.3389\/fendo.2026.1723278"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1723278","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,5]]},"article-number":"1723278"}}