补肾活血调周法对反复体外受精-胚胎移植失败患者卵巢储备功能改善作用的临床研究

CLINICAL STUDY ON IMPROVEMENT EFFECT OF TONIFYING KINEY AND PROMOTING BLOOD CIRCULATION TO REGULATE MENSTRUAL CYCLE METHOD ON OVARIAN RESERVE FUNCTION OF PATIENTS WITH FERTILIZATION-EMBRYO TRANSFER FAILURE IN VITRO

目的:观察补肾活血调周法对反复体外受精-胚胎移植(IVF-ET)失败患者卵巢储备功能的改善作用,并探讨其作用机理。方法:将60例参加IVF-ET周期的反复IVF-ET失败患者随机分为中药+控制性超排组(观察组,30例)和控制性超排组(对照组,30例),观察治疗前后及两组临床症状、体征改善情况,比较促性腺激素的用量、血清雌激素水平、促卵泡生成素水平、血清抑制素B水平、抗苗勒激素水平、取卵数、优质卵率、受精率、优质胚胎率和妊娠率。结果:观察组患者临床症状得到有效改善,与对照组比较有显著性差异(P<0.05);观察组FSH用量明显低于对照组(P<0.05);观察组基础E2、血清抑制素B、抗苗勒激素水平明显高于对照组,而FSH水平明显低于对照组;观察组取卵数、优质卵率、受精率、优质胚胎率均明显高于对照组,差异有显著性(P<0.05)。结论:补肾活血调周法可改善IVF-ET失败患者卵巢储备功能,其机理可能与其提高抗苗勒激素、血清抑制素B水平,协调下丘脑-垂体-卵巢轴功能有关。

Objective:To observe the improvement effect of tonifying kidney and promoting blood circulation to regulate menstrual cycle method on ovarian reserve function of patients with repeated failure of fertilization-embryo transplant in vitro and explore the mechanism. Methods:60 Cases with repeated failure of fertilization-embryo transplant in vitro were divided into two groups randomly, observe group was given Chinese and western medicine, control group was given western medicine, each group contained 30 cases, the changes of clinical symptoms an signs were observed before and after treatment, dosage of gonadotropin was recorded, serum estrogen, FSH, inhibin-B and anti Mullerian hormone were determined by ELISA method, number of oocytes, good quality rate of follicle, fertization rate, good quality rate of embryo and pregnancy rate were observed. Results:The clinical symptoms and signs of patient with repeated failure of fertilization-embryo transplant in vitro were significantly improved, there was obvious difference between the two groups, the dosage of FSH in the observed group was less than that of control group, serum E2, inhibin-B and anti Mullerian hormone levels of observe group were significant higher than those in control group, serum FSH level was obviously lower than that of control, the number of oocytes, good quality rate of follicle, fertization rate, good quality rate of embryo and pregnancy rate in observed group were better than those in control, the differences were significantly. Conclusion:Tonifying kidney and promoting blood circulation to regulate menstrual cycle method can improve the ovarian reserve function of patients with repeated failure of fertilization-embryo transplant in vitro, its mechanism was related to raise anti Mullerian hormone and inhibin-B levels, regulate the function of hypothalamic-pituitary-gonadal axis.