To observe the effect of the“Zhibian（BL54）-to-Shuidao（ST28）”acupuncture technique on key proteins involved in endoplasmic reticulum stress（ERS）pathway apoptosis in ovarian tissue of poor ovarian response（POR）mice and to explore the possible mechanism of acupuncture improving ovarian function in POR mice.

According to the random number table method，45 mice with normal estrous cycles were selected and divided into a blank group，a model group and an acupuncture group（n＝15）.The blank group was orally administered with an equal volume of 0.9% sodium chloride solution，while the model group and acupuncture group were orally administered with Leigongteng（Tripterygium wilfordii）suspension（50 mg·kg^-1·d^-1）for 14 consecutive days to prepare a POR mouse model.After the completion of modeling，the acupuncture group selected the“Zhibian（BL54）-to-Shuidao（ST28）”acupuncture method for intervention treatment，once a day，20 minutes for each time.After 14 days of continuous treatment，the ovulation induction was carried out，and the next day the samples were taken out.The changes in mouse estrous cycle were observed by using vaginal smear method.The ovarian indices of mice in each group were compared.ELISA method was used to detect the levels of follicle stimulating hormone（FSH），luteinizing hormone（LH），estradiol（E2）and anti Mullerian hormone（AMH）in mouse serum.HE staining method was used to detect the pathological morphology of ovarian tissue.Transmission electron microscopy was used to detect the ultrastructure of ovarian tissue.TUNEL staining was used to detect the apoptosis rate of positive cells in ovarian tissue.Immunohistochemistry was used to detect the positive expression of glucose regulated protein 78（GRP78）in ovarian tissue.Fluorescence quantitative PCR and Western blot were used to measure the changes in mRNA and protein expressions of protein kinase R-like endoplasmic reticulum kinase（PERK），eukaryotic initiation factor 2α（eIF2α），activating transcription factor 4（ATF4），C/EBP cyclic adenosine monophosphate response element binding transcription factor homolog protein（CHOP）and cysteine protease（Caspase）-3.

Compared with the blank group，the model group had an increased rate of estrous cycle disorder（P<0.01）.The number of eggs retrieved，ovarian wet weight and ovarian index decreased to varying degrees（P<0.01）.The expression levels of FSH and LH in serum increased（P<0.01），while the expression levels of E2 and AMH decreased（P<0.01）.There was destruction of ovarian tissue morphology and increased number of atresia follicles.Under electron microscopy，follicles deformed，mitochondria swelled and shrank，and mitochondrial cristae disappearred.The area of ovarian cell apoptosis increased（P<0.01）.The positive expression of ovarian GRP78 increased（P<0.01）.Ovarian tissue PERK，eIF2α，Elevated mRNA and protein expression levels of ATF4，CHOP，and Caspase-3（P<0.01）.Compared with the model group，the rate of estrus cycle disorder in the acupuncture group mice decreased（P<0.01）.The number of retrieved eggs，wet weight of ovaries，and ovarian index increased（P<0.01，P<0.05）.The expression levels of FSH and LH in serum decreased（P<0.01），while the expression levels of AMH and E2 increased（P<0.01，P<0.05）.Improvement in ovarian tissue morphology and reduction of atresia follicles.Under electron microscopy，the number of mitochondria in follicles increased，and the structure，shape，and arrangement improved to varying degrees.The area of ovarian cell apoptosis decreased（P<0.01）.The positive expression of ovarian GRP78 decreased（P<0.01）.the mRNA and protein expression levels of PERK，eIF2α，ATF4，CHOP and Caspase-3 in the ovarian tissue all decreased to varying degrees（P<0.01，P<0.05）.

The“Zhibian（BL54）-to-Shuidao（ST28）”acupuncture can improve ovarian function and reduce ovarian granulosa cell apoptosis in POR mice，and its mechanism may be related toregulating the key factors of endoplasmic reticulum apoptosis pathway.