Female Infertility and Obesity across the United States—A Geographic Cross-Sectional Analysis

This cross-sectional study investigates a connection between female infertility and obesity across various regions of the United States, utilizing data from the NIH’s “All of Us” Researcher Workbench. Analysis suggested that the Southern region exhibited the highest percentage of concurrently infertile and obese females at 32.3%, in contrast to the lowest in the Western region at 28.7%. The findings underscore the significant regional disparities in obesity-related infertility, particularly in medically underserved areas where healthcare access is limited. The study highlights the urgent need for targeted public health interventions, particularly in the Southern United States, to address the rising prevalence of obesity and its impact on infertility. Further, these results advocate for enhanced public health education and policies aimed at improving healthcare accessibility, with the goal of mitigating the adverse effects of obesity on reproductive health.

Place of Selective Tubal Catheterization in the Management of Female Infertility in Togo

Objective: To determine the effectiveness of selective tubal catheterization in the management of female infertility due to proximal tubal obstruction. Method: This was a longitudinal descriptive study, conducted over a period of 24 months, which included 73 patients presenting with objectified bilateral proximal tubal obstruction after standard HSG. The intervention was performed on an outpatient basis, during the follicular phase with negative β-hCG assay the day before, in the interventional radiology room and under antibiotic coverage. Confirmatory hysterosalpingography was performed as the first step followed by selective tubal catheterization after the failure of spontaneous tubal opacification. The parameters studied related to socio-epidemiological, clinical and radiological data. Results: The age of our patients was between 24 and 42 years with an average of 33.97 years. The average duration of infertility was 3.95 years, with a predominance of primary infertility in 83.56% of cases. Voluntary termination of pregnancy (38.89%) and fibromyomas (33.33%) were the most represented gynecological-obstetrical antecedents. Selective tubal catheterization was successful in 92.14% of cases (129/140 tubes). It was possible bilaterally in 93.02% of cases and unilaterally in 6.98% of cases. The confirmatory HSG allowed a spontaneous opacification of 4.10% of the fallopian tubes. At the end of the procedure, all the recanalized tubes were opacified;62.01% of them were normal, against 37.99% pathological with a preponderance of inflammatory tubes 26.61% followed by hydrosalpinx in 5.03% of cases. No major complications were encountered. The fertility rate was 23.29%. Conclusion: Selective tubal catheterization is a simple technique, without major complications with an efficiency close to natural fertility. It should be proposed as the first intention before any other procedure in the treatment of infertility by proximal tubal obstruction.

Ultrasound Causes of Female Infertility at the Fertilia Medical Clinic in Bamako

Aims: Infertility is a major problem in our current societies and the Fertilia medical clinic in Bamako is a center for medical assistance in procreation (MAP) where there is an increasingly growing demand for ultrasound. The objective of our study was to investigate the ultrasound causes likely to prevent the occurrence of pregnancy in a group of infertile and subfertile women. Subjects and Methods: This was a 5-year cross-sectional and prospective study, between January 2017 and January 2022, which involved 250 women wishing to become pregnant (infertile or subfertile), who came for pelvic ultrasound or follicular monitoring and who agreed to participate in our study. The parameters used were ultrasound reports including uterine, ovarian and tubal pathologies. It should be noted that in some cases no ultrasound cause of infertility was found. Data were entered and analyzed in SPSS. Results: 250 women were recruited into our. The average age was 32 years with extremes ranging from 17 to 51 years. 179 patients or 71.6% were between 17 and 35 years old. 139 patients or 55.6% had secondary infertility against 44.4% primary infertility. 202 patients or 80.8% had at least one ultrasound lesion and 48 patients or 19.2% had no significant ultrasound abnormality. The most represented ultrasound lesions were of uterine origin with 72.20%, 23.7% ovarian lesions and 04% tubal lesions. Uterine lesions were dominated by myomas, adenomyosis, endometrial polyps, uterine malformations and synechiae. As for ovarian lesions we noted cysts, polycystic ovary syndrome (PCOS), ovarian endometriosis, non-follicular ovaries and tubal ultrasound lesions showed unilateral or bilateral hydrosalpinx. Conclusion: In our study, ultrasound was an invaluable contribution to the diagnosis of the causes likely to explain subfertility and infertility in our respondents. She highlighted uterine, ovarian and tubal lesions, some of which could be corrected and pregnancies ensued.

Aetiological Diagnosis of Infertility at Conakry University Hospital: Role of Hysterosalpingography and Pelvic Ultrasound

Objective: The objective of this study was to investigate the etiologies of infertility and to determine the contribution of hysterosalpingography coupled with ultrasound in the exploration of female infertility at Donka University Hospital. Methodology: This was a prospective descriptive cross-sectional study carried out in the Radiology Department of Donka National Hospital over a period of ten (10) months. It involved 78 women who came to the department for hysterosalpingography and/or pelvic ultrasound examinations, as part of the exploration of infertility. Data collection involved the use of pre-established survey forms to gather information on the parameters studied. Sociodemographic parameters, ultrasound and hysterosalpingography results were studied. A correlation was made between age at marriage and infertility to determine whether early marriage has an impact on primary infertility, with a statically significant result for p value greater than 0.05. Results: The mean age of our patients was 33.7 ± 5.6 years, with extremes of 18 and 35 years. The 18-35 age group was the most represented, with a frequency of 80.7%. The 34% of our patients were married before the age of 18, with a marriage duration ranging from 6 months to 15 years. The indication for investigations was dominated by secondary infertility, with a frequency of 65%, followed by primary infertility (35%). All our women underwent ultrasound-hysterosalpingography, i.e. 100%, in search of the cause of infertility. Ultrasound was pathological in 35.8%. The most common ultrasound lesions were myomas and ovarian dystrophies, with 12.8% each. However, hysterosalpingography was pathological in 35%. Tubal obstructions affected almost a third of our women (29.5%), followed by phimosis and tubo-peritoneal adhesions. Conclusion: Diagnostic evaluation of infertility requires a multidisciplinary approach, including collaboration between infertility gynecologists, radiologists and other infertility specialists. Medical imaging remains indispensable in the evaluation of female infertility.

Traditional Chinese Medicine Compound Mianbu Mixfang Is Effective in Treating Immunological Infertility: a Female Mice

Objective To study the therapeutic effectivess of Traditional Chinese Medicine compound mixture Mianbu Fang (Immunological infertility therapy) on immunological infertility caused by antisperm antibody (AsAb) in female mice. Materials & Methods Forty-two female Kunming mice were evenly divided into 7 groups by weight. Group A was control group; Group B was model of infertility. Group C, D and E were fed with normal, half and double dosage of Mianbu I respectively. Group F and G were fed with Mianbu II and prednisone Acetates respectively. Animal model of immunological infertility were set up by injecting mice sperm to the other 36 Kunming female mice except Group A. The AsAb levels in serum, cervical mucus were measured, the histological and immunohistochemistry changes in ovary and endometrium were observed, and the pregnancy indexes were compared in different groups. Results Compared with the infertility model group, the AsAb level in serum and cervical mucus in treatment group was lower. Less immune compounds in ovary and endometrium and atretic follicle of ovary was found in treatment group than in model and control group. The immune compounds in ovary and endometrium were less in the treatment group than that in the model and control group. Conclusion By regulating immunological system, Traditional Chinese Medicine compound mixfang Mianbu Fang lowers AsAb in the circulation system and special organs, eliminates immunological compound, repairs tissue impairment and increases pregnancy of female mice.

Interference with the C-terminal structure of MARF1 causes defective oocyte meiotic division and female infertility in mice

Meiosis-arrest female 1（MARF1） is a recently identified key oogenic regulator essential for the maintenance of female fertility and genome integrity in mice. However, the detailed functions and the underlying mechanisms of MARF1 remain elusive. Here, in an attempt to create a mouse model expressing fluorescent protein-tagged MARF1 to facilitate further exploration of the roles of MARF1 in oocytes, we produced a Marf1-eGFP knockin（KI） mouse line in which the C-terminal structure and function of MARF1 were interfered by its fusing eGFP peptide. Using these Marfl-eGFP-KI mice, we revealed, unexpectedly, the functions of MARF1 in the control of oocyte meiotic division.We found that the Marfl-eGFP-KI females ovulated mature oocytes with severe meiotic and developmental defects,and thus were infertile. Moreover, meiotic reinitiation was delayed while meiotic completion was accelerated in the KI-oocytes, which was coincident with the increased incidence of oocyte aneuploidy. Therefore, MARF1 is indispensable for maintaining the fidelity of homolog segregation during oocyte maturation, and this function relies on its C-terminal domains.

An evaluation of methods for the test of tubal patency in female infertility

ＡｎｅｖａｌｕａｔｉｏｎｏｆｍｅｔｈｏｄｓｆｏｒｔｈｅｔｅｓｔｏｆｔｕｂａｌｐａｔｅｎｃｙｉｎｆｅｍａｌｅｉｎｆｅｒｔｉｌｉｔｙＨｅＦａｎｇｆａｎｇ（何方方），ＸｕＬｉｎｇ（徐苓），ＧｅＱｉｎｓｈｅｎｇ（葛秦生）Ａｎｅｖａｌｕａｔｉｏｎｏｆｍｅｔｈｏ...

A Retrospective Study of the Prevalence of Female Infertility in the Southwest Region, Cameroon

Background: Infertility is a major reproductive health care problem that affects the wellbeing of women. Although views vary between cultures, infertility is seen almost exclusively as a woman’s problem in Africa with secondary infertility being the most prevalent while sexually transmitted infections the most investigated cause of infertility. Objective: The aim of this study was to determine the prevalence of female infertility in the Limbe and Buea Regional hospitals of the Southwest region of Cameroon from 2015-2019. Materials and Methods: A retrospective descriptive design was used which involved studying clinical files of women within the reproductive age group (15 - 49) with infertility problems, at the gynaecological and maternity units of the selected hospitals in the Southwest region of Cameroon over a period of five years (2015-2019). Data were collected from all files included in the study. Results: A total of 4609 females visited the two hospitals for investigation and 1111 files were identified with infertility giving prevalence of 24 %. Three hundred and forty-three (343;31%) presented with primary infertility while seven hundred and sixty-eight (768;69%) had secondary infertility. The average age of affected female was 31.5 making age the predisposing factor of infertility because after the peak of 25 years, infertility started decreasing. Employment with salary and the association between diagnosis and age had a p-value < 0.005 which was considered significant in this study. Conclusion: This study found that the prevalence of infertility in Southwest Cameroon is high with secondary infertility being most predominant among infertile women with a prevalence of 69% caused principally by sexually transmitted infection (STIs). Age and occupation were significantly associated with infertility. Routine laboratory screening of women of reproductive age may reduce the high prevalence of infertility in the study area.

Hysterosalpingographic Findings among Patients Undergoing Infertility Work-Up in Kisangani, Democratic Republic of the Congo

Introduction: Hysterosalpingography is an important tool in the investigation of the causes of female infertility. In developing countries such as the Democratic Republic of Congo, the HSG is the basic tool for performing first-line anatomical (pelvic) assessment. The aim of this study is to determine the prevalence of the different lesions observed in hysterosalpingography carried out during the assessment of infertile women monitored in Kisangani. The study set also out to look for differences in these lesions according to the type of infertility. Methods: This cross-sectional study was conducted in Kisangani from June 2016 to December 2018. The 130 cases of hysterosalpingography performed for female infertility assessment during the study period were included, of which 33.07% for primary infertility and 66.93% for secondary infertility. Results: The mean age of the patients was 33.52 ± 6.01 years;the history of pelvic inflammatory disease was noted with a predominance for secondary infertility (11% vs. 4.65%). Using hysterosalpingography, 7 (5.38%) patients had a normal result;94 (72.31%) had tubal obstruction;25 (19.23%) had hydrosalpinx;11 (8.46%) had uterine fibroids;pelvic adhesions were suspected in 12.64% of cases. There was no obvious association between all these lesions and the type of infertility. Conclusion: We found that tubal obstructions were the most prevalent lesions in this study, regardless of the type of infertility. These lesions would reflect the high prevalence of septic abortions and sexually transmitted infections in developing countries such as the Democratic Republic of the Congo.

116 CASES OF TUBAL OBSTRUCTIVE INFERTILITY TREATED BY ACUPUNCTURE AND POINT-APPLICATION OF DRUGS

Tubal obstructive in fertility is often due to insufficiency of kidney-Qi, dysfunction andvascular obstruction of the uterine collaterals, in view of these pahogenetic characteristics, we havetreated 116 cases of tubal obstructive in fertility based on .differentiation of symptoms and signs byacupuncture at Guanyuan(CV4 ), Shuidao (ST 26), Guilai (ST 29 ), Diji (SP 8 ), Sanyinjiao (SP 6 ),Taixi(KI 3), Taichong(LR 3) which have functions of removing obstruction in collaterals by warmingkidney, regulating functions of the Chongmai and removing obstruction of the Renmai, increasihg levelsof female sex hormones, activating ovarian function, and external application to Guanyuan(CV 4) pointwith fresh Radix Aconiti Praeparata, Herb of Garden Balsam, Radix Salviae Miltiorrhizae, Fructus Evodiae, Fructus Foeniculi, Mirabilitum, Ramulus Cinnamomi, Fructus Liguidambaris, etc., which have thefunction of softening and resolving hard masses, subduing swelling and disintegrating masses, improvingblood circulation of the pelvic cavity, promoting absorption of the obstructed focus. AInong them 83cases were cured (pregnancy) accounting for 71. 6 %. The effective rate reached 90. 5 %. Clinically, itis proved that the combination of acupuncture with drugs has satis factory effects.

Management of Women Infertility in Tropical Africa: The Experience of the Gynecology Department of University and Hospital Center of Treichville (Abidjan-Cote d’Ivoire)

Objectives: This study aimed to clarify the etiology of women infertility and describe their management in our service with limited technical equipment. Methodology: We conducted a retrospective and descriptive study on 175 women treated for infertility and followed in the gynecology services of the university Hospital center of Treichville from 1st January 2012 to 31st December 2014. Results: During the study, we recorded 12072 consultations in gynecology including 1582 (13.1%) cases of infertility, but only 175 cases were selected for this study. The patients had an average age of 31.3 years and an average socio-economic level in general (78.9%). The etiologies were found in 79.4% of patients, dominated by classical abnormalities: uterine (fibroids: 41.8%), hormonal, tubo peritoneal (5%). We also found some unusual pathologies related to cultural practices (female genital mutilation, caustic stenosis of the vagina). The surgery was performed in several patients, including myomectomy by laparotomy (46.6%), laparoscopy, hysteroscopy and vaginal surgeries. As to drug treatment, they were various combinations, and the ovarian stimulation practices (62.3%) and induction of ovulation (47.2%) were common. The result of this support has been marked by the occurrence of 74 pregnancies (42.3%), with the birth of healthy children in the majority of cases (95.9%). Conclusion: The management of infertile women was frequent and yielded encouraging results despite our limited technical equipment.

Assessment of the Microbiome Collected from the Reproductive Tracts of Women from Saudi Arabia and Its Potential Influence on Infertility

Background and Objective: Female infertility may be attributed to several causes that are fundamentally related to the health status of women. The main objective of this project was to correlate the abundance of the microbiota in cervicovaginal fluid to infertility. Materials & Methods: A total of 36 married women who voluntarily came to the hospital in Riyadh for a routine visit participated in the study. To collect the cervicovaginal liquid, a SoftcupTM menstrual device was used by the participant;the cup was then transported in a liquid nitrogen box to the laboratory for analysis. Results: The mean vaginal pH in normal women and infertile women was 3.96 and 5.06, respectively, and the difference between the two cohorts was significant (p 5.5, is primarily composed of G. vaginalis, P. anaerobius, Mycoplasma hominis, Mobiluncus species and Atopobium vaginae. The protein content and viscosity of the cervicovaginal liquid were significantly lower in infertile women compared to normal women (p < 0.05).

Detection of <i>Chlamydia trachomatis</i>and <i>Neisseria gonorrhoeae</i>in Egyptian Women Suffering from Infertility

Chlamydial and gonococcal infections are recognized as two of the major causes of sexually transmissible human bacterial infection which may lead to infertility. In this cross sectional study, we aimed to determine the prevalence of Neisseria gonorrhoeae, Chlamydia trachomatis among Egyptian women using different microbiological methods. One hundred and fifty cervical swabs were collected, of which 100 were from infertile women. Culture and ELISA technique were used for screening of Neisseria gonorrhoeae and Chlamydia trachomatis individually. In addition, PCR was used for all examined samples. For C. trachomatis, 3 cases were positive for antigen detection by ELISA. Moreover, in obtained results of PCR, DNA was detected in 4 samples, and three of them from infertile group. So based on PCR results, the sensitivity and specificity of ELISA were 75% and 100% respectively. Furthermore, 3 samples were positive for gonococcal infections by PCR, and two of them were taken from infertile women. Positive results of two samples were verified by culture. The estimated sensitivity and specificity of culture method were 66.7% and 100% respectively. Results of this study indicate that PCR is a valuable method for detection of gonococcal and chlamydial infection and it is suitable for the confirmation of ELISA results for C. trachomatis diagnosis. Culture method is less sensitive than PCR for detection of N. gonorrhoeae. The prevalence of such infections is higher among infertile women.

The Endometrium Biopsy and Hystero-Laparoscopy in Evaluation of Women’s Infertility. A Prospective Study in Algeria

Female infertility is considered as a real obstacle to the development of a couple who cannot conceive in a natural way. The aim of this study is to evaluate female infertility using two complementary methods of exploration: hystero-laparoscopy and endometrial biopsy, to compare histopathological data with those of hystero-laparoscopy findings in the same patients, and finally assess the interest to couple both methods to detect a greater number of pathologies. Our prospective study included 64 patients aged 20 - 43 years with primary or secondary infertility for a period of 3 years ranging from 2012 to 2015 at obstetrics and gynecology department in which all patients were admitted to a hysteroscopy followed by laparoscopy. Endometrial biopsy curettage was performed and sent to the Pathological Anatomy Department for a histopathological study. On 64 infertile women explored, no pathologies were findings in 20 patients (31.3%) to the biopsy and 27 patients (42.2%) by hysteroscopy-laparoscopy. Histopathological study was in favor of dysfunctional endometrium (50%) followed by hyperplasia (10.9%). The lesions findings in the hystero-laparoscopy were in the first place uterine (18.8%) followed by equally between tubal and endometrial pathologies (10.9%). Associated diseases affecting the same organs or more were recorded with a percentage of 7.8%. The two methods have been shown effective and the most of common pathologies findings were uterine and endometrial. We concluded that the endometrial biopsy was more decisive in the exploration of endometrium pathologies while hystero-laparoscopy is more sensitive for the exploration of uterine, tubal and ovarian pathologies. Each method taken individually was revealed incomplete. It is more interesting to systematically couple the histology with endoscopic examination in order to detect a greater number of pathologies.

Chinese Medicine as Complementary Therapy for Female Infertility

Chinese medicine (CM) has been used in clinical treatment for thousands of years in China, Japan, Korea, and other countries. CM is at present attracting many attentions around the world for reproductive health care and disease prevention, including treatment of female infertility. This review focuses on the CM treatment for female infertility patients, and supplies a summary on the efficacy, safety, and mechanism of some Chinese herbal medicines, herbal medicine-derived active compounds, and acupuncture. A large number of researches have reported that CM could alleviate or even cure female infertility by regulating hormone, improving reproductive outcome of in vivo fertilization, affecting embryonic implantation, curing polycystic ovarian syndrome, endometriosis, pelvic inflammatory disease, relieving mental stress, and regulating immune system. Meanwhile, a few studies claimed that there was little adverse reaction of CM in randomized controlled trials. However, up to present there is a lack of adequate evidences with molecular mechanistic researches and randomized controlled trials to prove the CM as an effective and safe treatment for infertility. Thus, utility of CM as a complementary medicine will be a feasible method to improve the outcome of female infertility treatment.

Transcriptomic analysis of granulosa cells in patients with endometriosis-related infertility:identification of potential molecular mechanisms

Objective:To investigate the impact of endometriosis(EMS)on granulosa cell function and elucidate the molecular mechanisms involved.Methods:RNA sequencing,differential expression analysis,Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis,gene set enrichment analysis,protein–protein interaction analysis,and RT-qPCR were employed to assess the effects of EMS on granulosa cell function.Results:The results revealed significant differences in gene expression between the EMS and control groups,including genes related to immune regulatory functions and ferroptosis.Hub gene modules and hub genes were identified,including those related to cell cycle and immune and inflammatory pathways.RT-qPCR revealed significant upregulation of the hub genesCCL3 andIL1B in granulosa cells of patients with EMS.Conclusion:The results of RNA sequencing demonstrated that EMS induces significant transcriptional alterations in granulosa cells of affected patients.These findings provide important insights into the diagnosis and treatment of EMS and highlight the importance of further investigation ofCCL3 andIL1B as potential biomarkers for EMS.

Female Sexual Dysfunction and Timed Intercourse: A Prospective Study of 105 Infertile Women

Introduction: Timed intercourse (TI) based on ovulation monitoring is an effective and common choice for treatment of infertility. However, TI related female sexual dysfunction remains to be elucidated. Method and Material: This was a prospective study and 105 infertile women were included using the Female Sexual Function Index (FSFI) to assess their sexual function in general sexual life (GSL) and TI cycle. Results: The mean age of the patients was 29.4 ± 3.4 years and the duration of infertility was 1.8 ± 0.5 years. The mean score of FSFI was 25.2 in GSL cycle and 24.5 in TI cycle (p = 0.008). Scores of 5 out of 6 domains of FSFI during GSL cycle were significantly higher than the counterparts during TI cycle. Female sexual function was related to stress, which mostly came from patients themselves and parents. The stronger the stress was, the more domains of FSFI were affected. Conclusion: Infertility is an important factor affecting female sexual function, especially TI condition reduced FSFI score in several domains, and this may be related to infertile stress.

Effects of electro-acupuncture on embryo implanted potential of patients with infertility of different syndromes

Objective To explore the impacts of electro-acupuncture on embryo implanted potential and its molecular mechanism in patients with infertility of different syndromes. Methods Among infertile patients treated with in vitro fertilization and embryo transplantation （IVF-ET） combined with electro-acupuncture, 82 cases of kidney deficiency syndrome （group A）, 74 cases of liver qi stagnation syndrome （group B） and 54 cases of phlegm dampness syndrome （group C） were selected. Patients in three groups all received a long program of ovarian hyperstimulation. Additionally, electro-acupuncture was applied before controlled ovarian hyperstimulation （COH） and in the process of ovarian hyperstimulation. Contents of human leukocyte antigen G （HLA-G） in the serum were determined in three groups respectively on the 2nd day of menstruation （M2） and the day of human Chorionic Gonadotropin （hCG） injection. Content of HLA-G in the culture solution of three groups was examined separately on the day of embryo transplantation. The fertilization rate, implantation rate and clinical pregnancy rate were observed for patients in three groups. Results Contents of HLA-G in the serum on the day of hCG injection and in the culture solution on the day of embryo transplantation in group A and B were significantly higher than those in group C （all P0.05）. However, there was no significant difference with contents of HLA-G in serum on M2 day among three groups. The high quality embryo rate in either group A （73.6%, 352/478） or group B （70.6%, 379/537） was significantly higher than that in group C （54.2%, 208/384） with significantly statistical difference （all P0.01）. But there were no significant differences in clinical pregnancy rate, fertilization rate and cleavage rate among three groups. Conclusion Electro-acupuncture combined could increase contents of HLA-G in the body and the level of HLA-G secreted from embryos of patients in the process of IVF-ET. Eventually, the pregnancy outcome and the pregnancy rate are improved. It showed better clinical effects of electro-acupuncture for patients with kidney deficiency and liver qi stagnation syndromes than those of phlegm dampness syndome.

Heyan Kuntai capsule versus dehydroepiandrosterone in treating Chinese patients with infertility caused by diminished ovarian reserve： a multicenter, randomized controlled trial

OBJECTIVE: To evaluate the clinical efficacy and safety of Heyan Kuntai capsule(HYKT) in treating women with infertility caused by diminished ovarian reserve(DOR).METHODS: One hundred eight eligible patientsfrom three Chinese hospitals were randomly divided into an HYKT treatment group(n = 55) or a dehydroepiandrosterone(DHEA) treatment group(n =53). Patients in the HYKT group were treated orally with four 0.5 g HYKT three times a day; patients in the DHEA group were treated with one 25.0 mg DHEA capsule three times a day. All patients were treated for 3 months and followed up over a3-month period.RESULTS: Of 108 patients, 12 dropped out: six from the HYKT group, and six from the DHEA group. Eleven patients got pregnant during the treatment. Serum anti-Müllerian hormone levels and antral follicle counts increased significantly in both groups after treatment(P < 0.05) especially in the HYKT group(P < 0.05). Serum follicle stimulating hormone(FSH) levels and FSH/luteinizing hormone ratios decreased(P < 0.05) with no significant difference between the two groups. Estradiol levels in the HYKT group and DHEA-sulfate levels in the DHEA group both increased(P < 0.05). The spontaneous pregnancy rates were 12% and 11% in the HYKT and DHEA groups, respectively(not significant). During the follow-up period, 16 patients in the HYKT group underwent in vitro fertilization-embryo transfer(IVF-ET) and the number of retrieved oocytes was(5.1 ± 1.8). In DHEA group, 20 patients underwent IVF-ET and the number of retrieved oocyte was(4.2 ± 1.9)(not significant); clinical pregnancy rates were 38% in the HYKT group and 20%in DHEA group(not significant). No significant adverse reactions were observed.CONCLUSION: HYKT can improve the ovarian re-serve and hormone levels in patients with infertility caused by DOR. Pregnancy rates after HYKT treatment were similar to those of DHEA treatment.HYKT might be an alternative to the treatment of infertility caused by DOR.

Treatment of Tubal Infertility Mainly by Acupoint-injection in 64 Cases

Sixty-four patients with tubal infertility were treated with a complex therapy of injection on Zigong （Ex-CA 1） and Ciliao （BL 32） and acupuncture on Qichong （ST 30）, Guilai （ST 29）,Chongmen （SP 12） and Dahe （KI 12）, and ginger-partitioned moxibustion on the lower abdomen. As a result, 31 cases were cured, 20 cases got marked effectiveness, 8 cases improved and 5 cases failed,and the total effective rate was 92.2%.