加味左归丸方预治疗对控制性超排卵治疗中卵巢低反应患者临床结局的影响

Influence of Pretreatment with Modified Zuogui Pills on Clinical Outcomes of Poor Ovarian Response Women in Controlled Ovarian Hyperstimulation

【目的】探讨加味左归丸方预治疗对体外受精—胚胎移植(IVF-ET)控制性超排卵(COH)治疗中卵巢低反应患者再次IVF临床结局的影响。【方法】IVF第1个周期COH治疗中卵巢低反应的不孕症患者45例,其中治疗组30例在拟行再次IVF周期治疗前予加味左归丸方预治疗3个周期,对照组15例在再次IVF前未行任何干预。检测2组第1次COH后和第2次COH前患者基础血清卵泡刺激素(bFSH),基础雌二醇(bE2)的浓度(化学发光法),比较2组两次IVF周期中患者促性腺激素(gonadotropin,Gn)使用天数和剂量、获卵数、受精率、优质胚胎数、优质胚胎率。【结果】治疗组治疗后较治疗前bFSH水平显著降低(P<0.01),且显著高于对照组(P<0.01)。治疗组第2次获卵数、优质胚胎数均显著多于第1次(P<0.01),受精率、优质胚胎率均显著高于第1次(P<0.05或P<0.01);与对照组第2次比较,Gn使用量显著低于对照组(P<0.05),受精率、优质胚胎数、优质胚胎率则显著高于对照组(P<0.05或P<0.01)。【结论】加味左归丸方预治疗可以改善卵巢功能,提高COH中卵巢反应性,提升获卵数量和质量,提高受精率,最终获得更多的优质胚胎。

Objective To investigate the influence of pretreatment with modified Zuogui pills （MZP） on clinical outcomes of poor ovarian response women during the first controlled ovarian hyperstimulation （COH） of in-vitro fertilization and embryo transfer （IVF-ET） when receiving IVF again. Methods Forty-five women diagnosed as poor ovarian response in the first IVF cycle were divided into treatment group and control group. Thirty women in the treatment group were pretreated with MZP for 3 cycles before the second IVF, and 15 women in the control group only received IVF. The serum concentrations of basic follicle-stimulating hormone （FSH） and estradiol （E2） after the first COH and before the second COH were detected by chemiluminescence analysis in both groups. And then the medication days and dosage of gonadotropin （Gn）, number of retrieved oocytes, fertility rate, number of high-quality embryo, and rate of high-quality embryo were compared between the first IVF cycle and the second 1VF cycle in both groups. Results In the treatment group, the serum concentration of basic FSH was decreased significantly after treatment （P〈O.01 compared with that before treatment） and was higher than that in the control group （P〈0.01）, the number of retrieved oocytes and high-quality embryo, fertility rate, and rate of high-quality embryo in the second IVF cycle were increased when compared with those in the first IVF cycle （P〈0.05 or P〈0.01） . When compared with the second IVF of the control group, the medication dosage of Gn was less （P〈0.05） , and fertility rate, number of high-quality embryo and rate of high-quality embryo were higher in the second IVF cycle of the treatment group （P〈0.05 or P〈0.01） . Conclusion Pretreatment with modified Zuogui pills can improve the ovarian function, enhance ovarian response in COH, and increase the number of retrieved oocytes and high-quality embryo as well as fertility rate, thus to obtain high-quality embryo for the poor ovarian response women during the first COH of IVF-ET when receiving the second IVF.