二至益真胶囊对改善高龄妇女胚胎质量的效果

The effects of Chinese herbal medicine Erzhiyizhen capsule on the quality improvement of embryo in women of advanced age

目的:应用时差成像技术观察二至益真胶囊在改善高龄妇女胚胎质量中的作用.方法:回顾性分析2019年5月至12月于广州中医药大学第二附属医院生殖医学科行体外受精-胚胎移植(IVF-ET)助孕的肾阴虚高龄妇女,根据治疗情况分为中药治疗组和对照组,对照组65例直接进行IVF-ET治疗,中药治疗组62例先行二至益真胶囊中药治疗,然后进行IVF-ET治疗.比较两组患者的胚胎动力学参数及异常卵裂事件发生情况;同时观察两组患者获卵数、正常受精率、可利用胚胎数、优质胚胎数、临床妊娠率、着床率等情况.结果:中药治疗组平均获卵数显著多于对照组(P<0.05);两组患者的可利用胚胎数和优质胚胎数无统计学差异(P>0.05),但中药治疗组有增多的趋势.两组患者的正常受精率、临床妊娠率和着床率无统计学差异(P>0.05);在原核消失时间(tPNF)、2细胞出现时间(t2)、3细胞出现时间(t3)、4细胞出现时间(t4)、5细胞出现时间(t5)时段中,中药治疗组胚胎发育速度显著快于对照组(P<0.05),中药治疗组的s2(从3细胞分裂为4细胞的持续时间)显著短于对照组,有统计学差异(P<0.05),两组患者胚胎的异常分裂发生率无统计学差异(P>0.05),但中药治疗组胚胎异常分裂发生率有降低的趋势.结论:应用二至益真胶囊,可有效改善高龄IVF-ET患者的早期胚胎发育迟缓,同时对异常卵裂的发生有一定的改善作用,最终可能通过提高胚胎质量而改善高龄女性的生育力.

Objective:To examine the effect of Chinese herbal medicine Erzhiyizheng capsule on embryo quality in women of advanced age by leveraging time-lapse imaging technique Methods:A retrospective study was carried out on women of advanced age,who had kidney-yin deficiency syndrome and also received in vitro fertilisation-embryo transfer(IVF-ET)assisted reproduction in Department of Reproductive Medicine,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from May to December 2019.By comparing 65 women(control group)who only received IVF-ET assisted reproduction with 62 women(traditional Chinese medicine treatment group,TCM group)who treated with the Erzhiyizheng capsule prior to the IVF-ET assisted reproduction,the kinetics of embryo development and the occurrence of abnormal cleavage were assessed,as well as the number of retrieved oocytes,the rate of normal fertilization,the number of available embryos,the number of high-quality embryos,the implantation rate,and the clinical pregnancy rate for each individual.Results:TCM group had significantly higher average number of retrieved oocytes than the control group(P<0.05).The number of available embryos and the number of high-quality embryos between two groups were not significantly different(P>0.05),but those in the TCM group tend to be increased.In addition,the rate of normal fertilization,the clinical pregnancy rate,and implantation rate were not different statistically between two groups(P>0.05).Notably,the embryos at the times of tPNF,t2,t3,t4,t5 in the TCM group developed faster significantly than those in the control group(P<0.05),while s2 in the TCM group was significantly shorter than that in control group(P<0.05).At last,compared with the control group,the TCM group did not shown significant difference in the occurrence of abnormal cleavage(P>0.05),whose incidence of abnormal cleavage events tended to be decreased.Conclusion:The Chinese herbal medicine Erzhiyizheng capsule can improve the early embryo development but also decrease the occurrence of abnormal cleavage in women of advanced age who received IVF-ET assisted reproduction.These results suggest that the fertility of the women of advanced age could be restored by improving the embryo quality.