二至天癸颗粒对体外受精-胚胎移植周期人卵泡液白血病抑制因子和卵细胞质量的影响

Clinical Study on Effect of Erzhi Tiangui Granule in Improving the Quality of Oocytes and Leukemia Inhibitory Factor in Follicular Fluid of Women Undergoing in vitro Fertilization and Embryo Transfer

目的探讨二至天癸颗粒对体外受精-胚胎移植(IVF-ET)周期人卵泡液中白血病抑制因子(LIF)和卵细胞质量的影响。方法入选患者随机分为两组,分别用二至天癸颗粒合西药(治疗组,42例)和单用西药(对照组,38例)治疗,观察患者取卵日肾虚证候较垂体降调节后的改善情况,比较两组获卵数、优质卵率、受精率、卵裂率、优质胚胎率、妊娠率和卵泡液LIF水平的差异;对卵泡液LIF水平与优质卵率、优质胚胎率的关系分别进行相关性检验。结果与对照组比较,治疗组肾虚证候改善程度、优质卵率、受精率、卵裂率、优质胚胎率及临床妊娠率均显著提高;卵泡液LIF水平明显高于对照组;卵泡液中LIF水平与优质卵率、优质胚胎率及妊娠结局均呈正相关。结论二至天癸颗粒能显著提高卵细胞数、胚胎质量和IVF-ET成功率,其机理与增加卵泡液LIF水平、激活卵泡微环境LIF活性充分表达有关。

Objective To investigate the effects of Erzhi Tiangui Granule （ETG） on the concentration of leukemia inhibitory factor （LIF） in follicular fluid （FF） and quality of oocytes/embryos after in vitro fertiliza- tion and embryo transfer （IVF-ET）. Methods Women undergoing IVF-ET were randomly assigned to two groups： the treated group （42 cases） treated with ETG combined with Western medicine and the control group （38 cases） treated with Western medicine alone. Syndrome of Shen-deficiency, amount of oocytes, rates of ma- ture oocytes, fertilization, cleavage, high-quallty embryos and pregnancy, as well as LIF level in FF were ob- served and compared between the two groups. The relationship of LIF level with mature oocyte rate and high- quality embryo rate was analyzed, respectively. Results In the treated group after treatment, the syndrome of Shen-deficiency and the above-mentioned indexes tested were improved better than those in the control group, respectively. Correlation analysis showed that the LIF level in FF was positively correlated with the rate of ma- ture oocyte, high-quality embryo and the outcome of pregnancy. Conclusion ETG can distinctively increase the amount of oocyte, elevate the quality of embryo and raise the successful rate of IVF-ET. The mechanism maybe correlated to the increase of LIF level in FF and the activating of microenvironment for its full expression.