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Journal of Integrative Medicine ›› 2022, Vol. 20 ›› Issue (2): 163-172.doi: 10.1016/j.joim.2022.01.007

• Original Experimental Research • Previous Articles     Next Articles

Moxibustion alleviates decreased ovarian reserve in rats by restoring the PI3K/AKT signaling pathway

Hong-xiao Lia,b, Ling Shia,b, Shang-jie Lianga,b, Chen-chen Fanga,b, Qian-qian Xuc, Ge Lua,b, Qian Wanga,b, Jie Chenga,b, Jie Shena,b, Mei-hong Shena,b   

  1. a. College of Acupuncture, Moxibustion and Tuina, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
    b. Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
    c. School of Traditional Chinese Medicine & School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China

  • Online:2022-03-25 Published:2022-02-27
  • Contact: Mei-hong Shen; E-mail address:


Moxibustion, a common therapy in traditional Chinese medicine, has potential benefits for treating decreased ovarian reserve (DOR). The present study investigates the protective effect of moxibustion in a rat model of DOR and explores the possible mechanisms.


Sixty-four female Sprague-Dawley rats were randomly divided into four groups: control, DOR, moxibustion (MOX), and hormone replacement therapy (HRT). The DOR rat model was established by intragastric administration of 50 mg/kg Tripterygium glycoside suspension (TGS), once daily for 14 days. MOX and HRT treatments were given from the day TGS administration was initiated. The ovarian reserve function was evaluated by monitoring the estrus cycle, morphological changes in ovaries, levels of serum estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and anti-Mullerian hormone (AMH), pregnancy rate and embryo numbers. Terminal-deoxynucleotidyl transferase-mediated nick-end-labeling staining was used to identify ovarian granulosa cell apoptosis, while the protein and mRNA expressions of Bax, B-cell lymphoma-2 (Bcl-2), phosphatidylinositol 3-kinase (PI3K) and protein kinase B (AKT) in ovarian tissues were examined by immunohistochemistry, Western blot and quantitative reverse transcription-polymerase chain reaction.


Compared with the DOR group, MOX improved the disordered estrous cycle, promoted follicular growth, reduced the number of atresia follicles, increased the concentrations of serum E2 and AMH, and decreased serum FSH and LH concentrations. More importantly, the pregnancy rate and embryo numbers in DOR rats were both upregulated in the MOX treatment group, compared to the untreated DOR model. Further, we found that the MOX group had reduced apoptosis of ovarian granulosa cells, increased Bcl-2 expression and reduced expression of Bax. Furthermore, the PI3K/AKT signaling pathway was triggered by the moxibustion treatment.


Moxibustion improved ovarian function and suppressed apoptosis of ovarian granulosa cells in a rat model of DOR induced by TGS, and the mechanism may involve the PI3K/AKT signaling pathway.

Key words: Decreased ovarian reserve, Moxibustion, Phosphatidylinositol 3-kinase, Protein kinase B, Apoptosis, Infertility

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