Abstract: Background　In vitro fertilization-embryo transfer（IVF-ET） is one of the main technologies to treat infertility.The treatment of infertility has rapidly improved since IVF-ET appeared.The clinical pregnancy rate of IVF-ET at home and abroad has reached 30%-40% at present.However，many patients still fail after transferring high-quality embryos.It is generally believed that the reason lies in the uterine environment.Endometrial polyps（EPs） are an important cause of uterine environment deterioration.Low endometrial receptivity（ER） after transhysteroscopic resection of polyps（TCRP） will prolong the treatment cycle and reduce the success rate of IVF-ET.How to improve the endometrial receptivity of these patients and make them get pregnant is an urgent problem to be solved now.Objective　To observe the clinical effect of warming acupuncture combined with acupoint injection on low ER of patients undergoing frozen-thawed embryo transfer（FET） after TCRP，and to explore the mechanism of ER improvement by warming acupuncture combined with acupoint injection.Methods　Twenty-seven female patients with low ER after TCRP due to EPs during IVF-ET pregnancy cycle were enrolled from Traditional Chinese Medicine Department，Foshan Maternal and Child Health Hospital from January 2015 to July 2018.They were divided into observation group（13 cases） and control group（14 cases） by random table method.Both groups were given the Progynova after menstruation.In the control group，patients could received FET after ER recovery.In the observation group，patients were treated with warming acupuncture combined with acupoint injection（human placenta tissue fluid），and they could receive FET after ER recovery.The rate of endometrial type a，rate of endometrial and subendometrial blood flow type A，number of high-quality embryos transferred，time spent on FET and clinical pregnancy rate were compared.Results　There were no significant differences in type a rate of endometrium，type A rate of endometrial and subendometrial blood flow between the observation group and the control group after treatment（P>0.05）．There were no significant differences in the number of high-quality embryos transferred and the clinical pregnancy rate between the two groups（P>0.05）．The time spent on FET in observation group was shorter than that in control group（P<0.05）．Conclusion　Warming acupuncture combined with acupoint injection can shorten time spent on FET of patients with low ER after TCRP.The mechanism may enhance the uterine blood flow perfusion，give ER sufficient energy，improve repairing ability after endometrial injury，thus optimizing the uterine environment，reversing the low ER status，and creating good conditions for embryo implantation.

Key words: Fertilization in vitro, Embryo transfer, Endometrium, Needle warming therapy, Acupoint therapy, Polyps, Pregnancy

摘要： 背景　体外受精—胚胎移植（IVF-ET）是治疗不孕症的主要手段之一，自该技术诞生以来不孕症的治疗效果迅速提高，目前国内外IVF-ET的临床妊娠率已达30%~40%，但仍有不少患者移植优质胚胎出现失败，医学界普遍认为原因在于宫腔环境。子宫内膜息肉（EPs）是导致宫腔环境变差的重要原因，经宫腔镜治疗后息肉虽被切除，但出现子宫内膜容受性（ER）低下将延长治疗周期、降低IVF-ET成功率。如何改善此类人群ER，使他们成功妊娠是当前迫切需要解决的问题。目的　观察温针灸结合穴位注射治疗冻融胚胎移植（FET）者经宫腔镜子宫内膜息肉电切术（TCRP）后ER低下的临床疗效，探讨温针灸结合穴位注射调节ER的作用机制。方法　选取2015年1月—2018年7月于佛山市妇幼保健院中医科就诊，在IVF-ET助孕周期中因EPs行TCRP，术后出现低ER患者27例。按随机数字表法将患者分为观察组13例和对照组14例。对照组在月经干净后口服戊酸雌二醇片治疗，直至ER恢复行FET；观察组在对照组基础上进行温针灸结合穴位注射（人胎盘组织液）治疗，直至ER恢复行FET。观察比较两组患者子宫内膜类型a型率、子宫内膜及内膜下血流类型A型率、移植优质胚胎数、行FET所需时间、临床妊娠率。结果　治疗后观察组子宫内膜类型a型率、子宫内膜及内膜下血流类型A型率与对照组比较，差异无统计学意义（P>0.05）。两组移植优质胚胎数、临床妊娠率比较，差异无统计学意义（P>0.05）。观察组行FET所需时间较对照组短（P<0.05）。结论　温针灸结合穴位注射可缩短TCRP后低ER患者行FET所需时间；机制可能为通过增强TCRP后低ER患者宫腔血流灌注，提高内膜损伤后再修复能力，从而优化宫腔环境、逆转低ER状态，为胚胎着床创造良好条件。

关键词: 体外受精, 胚胎移植, 子宫内膜, 温针疗法, 穴位疗法, 息肉, 妊娠