Electroacupuncture for Diminished Ovarian Reserve: Clinical Evidence, Mechanisms, and Future Perspectives

Diminished ovarian reserve (DOR) is a major cause of reduced female fertility. In recent years, electroacupuncture (EA), as an important branch of traditional manual acupuncture, has gained widespread attention in both clinical intervention and mechanistic research on DOR. Clinical studies have demonstrated that EA alone or in combination with medication and assisted reproductive technology can significantly increase anti-Müllerian hormone (AMH) levels, increase the antral follicle count (AFC), reduce follicle-stimulating hormone (FSH) levels, optimize ovarian blood perfusion and endometrial receptivity, and show potential to improve pregnancy-related outcomes. Mechanistic studies indicate that EA may preserve ovarian reserve through multiple pathways, including restoring hypothalamic gonadotropin-releasing hormone (GnRH) levels, alleviating oxidative stress, and regulating the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway. Focusing on EA as the core intervention, this article reviews the clinical evidence for EA in treating DOR and the molecular mechanisms by which it improves ovarian function. In addition, key parameters of EA (e.g., stimulation settings) and acupoint combination rules are analyzed, and methodological limitations of current studies as well as future research directions are discussed.