Add-on bioelectrical stimulation and ultrasound acupuncture to letrozole for improving pregnancy outcomes in PCOS-related anovulatory infertility: A clinical trial

Purpose This clinical research aimed to evaluate the clinical efficacy of a combined regimen involving biomimetic electrical stimulation-ultrasound acupuncture and letrozole on follicular development and clinical pregnancy outcomes in women suffering from PCOS-associated anovulatory infertility. Methods In this non-randomized controlled trial,130 patients with PCOS-related anovulatory infertility admitted from May 2025 and May 2026, participants were stratified by treatment modality into a control group (n = 66), and the observation group (n = 64). The primary outcome was clinical pregnancy rate.All patients had needed to ingest letrozole (Jiangsu Henrui Medicine) at daily dosages ranging from 2.5 mg to 7.5 mg for five consecutive days, initiated between days 2 and 5 of the menstrual cycle. For the observation group, patients were augmented with total 30-min sessions of biomimetic electrical stimulation and ultrasound acupuncture administered daily for 7 consecutive days following the conclusion of menstruation, maintained over 3 successive cycles. The ovulation frequency, pregnancy rates, endometrial morphological characteristics, subendometrial vascular resistance indices (PI, RI, S/D), endocrine profiles (LH, E2, P), and pregnancy loss rates were systematically evaluated and compared. Results General characteristics were comparable across both groups, with no statistically significant discrepancies observed (P > 0.05). Regarding endometrial morphology, the distribution differed significantly between groups. And the variance in ovulation rates between the two treatment arms did not reach statistical significance, the observation group demonstrated a superior clinical pregnancy rate (P < 0.05). Furthermore, The clinical pregnancy rate in the control group was 28.79%, while that in the observation group was 43.75%. Conclusion Bioelectrical stimulation-ultrasound acupuncture combined with letrozole has a adjunctive efficacy in facilitating follicular maturation and improving clinical pregnancy outcomes for patients experiencing PCOS-related anovulatory infertility.