养卵方治疗IVF-ET中肾虚型卵巢低反应患者临床疗效观察

Clinical Observaion on Effects of Yangluanfang on Treatment of Patients with Poor Ovarian Response and Kidney Deficiency in IVF-ET

目的:观察养卵方对行IVF-ET中肾虚型卵巢低反应患者的临床疗效。方法:选取70例符合肾虚型卵巢低反应诊断的患者,随机分为两组:观察组和对照组,每组各35例。两组患者均在行IVF-ET治疗之前给予西药人工周期治疗,即月经第5天口服戊酸雌二醇片,每日1次,每次2 mg,连服21 d停药;第26天开始每天肌注黄体酮注射液20 mg,连用5 d,停药待月经来潮,共治疗3个月经周期。观察组联合服用养卵方治疗。检测两组治疗前后月经第2天内分泌水平,包括卵泡刺激素(FSH)、雌二醇(E2)、血清黄体生成素(LH)及窦卵泡数。两组患者均给予拮抗剂方案超促排卵治疗,观察两组获卵数、受精率、妊娠率。结果:(1)观察组的基础FSH水平治疗后比治疗前下降,有统计学差异(P<0.05);窦卵泡数增多,有统计学差异(P<0.05)。(2)观察组促性腺激素(Gn)用量低于对照组(P<0.05),获卵数、妊娠率高于对照组(P<0.05)。结论:在行IVF-ET前采用养卵方中药干预可以改善肾虚型卵巢低反应患者的妊娠结局。

Objectives ： To observe the effects of Yangluanfang on treatment of patients with poor ovarianresponse and kidney deficiency in IVF-ET. Methods ： Seventy patients with poor ovarian response wererandomly divided into two groups ： the observation group （ n=35 ） and the control group （ n=35 ）. Bothgroups were given artificial menstrual cycle treatment, that was, estradiol valerate once a day on the fifthday of the menstrual cycle,2 mg one time. 21 days later, al! patients were injected progesterone （20 mgone day ） for 5 days. After three courses of treatment, all of them got IVF-ET procedure. The patients inthe observation group were given Yangluanfang and the same time for 3 months. The changes of endocrinehormone levels （ including FSH, E2 and LH ） and the number of antral follicle were observed before andafter the treatment. And then the patients in the two groups underwent IVF-ET adopted GnRH-ant protocol.The number of retrieved ooeytes, the rate of fertilization and pregnancy rate were observed. Results ： （ 1 ）The FSH level decreased significantly （ P〈0.05 ） and the number of antral follicle increased significantly（ P〈0.05 ） as compared with the patients in the control group. （ 2 ） The Gn dose of the observation group wassignificantly lower, and the number of retrieved ooeyte and pregnancy rate was significantly bighe （ P〈0.05 ）than those in the control group. Conclusions： Yangluanfang could modulate the hypothalamus-pituitary-ovary axis of the patients with ovarian poor response, improve ovarian reaction, and finally increase theoutcomes of patients with poor ovarian response and kidney deficiency in IVF-ET.