Clinical observation of Kuntai capsule combined with Fenmotong in treatment of decline of ovarian reserve function

BACKGROUND Decreased ovarian reserve function is an ovarian hypofunction disease that occurs in women before 40 years of age,leading to a decline in fertility and perimeno-pausal symptoms,such as irregular menstruation,amenorrhea,infertility,de-creased libido,and autonomic nervous dysfunction.Fenmatong(FMT)is a com-pound mixture of estradiol tablets and estradiol didroxyprogesterone tablets,which can improve ovarian reserve function by supplementation of exogenous estrogen.However,this treatment has also been shown to cause breast pain,gastrointestinal discomfort,irregular vaginal bleeding,and changes in sexual desire.In severe cases,FMT can promote the development of breast cancer,endometrial cancer,and venous embolic disease.AIM To observe the effects of Kuntai capsules and FMT on endocrine indexes and uterine artery blood circulation in patients with decreased ovarian reserve func-tion.METHODS Patients(130)with decreased ovarian reserve function,who were treated in our hospital from May 2018 to May 2020,were divided into two groups:The FMT group,in which patients were treated with FMT,and the observation group,in which patients were treated with Kuntai capsules.Chinese medicine symptom scores,uterine artery blood flow parameters,ovarian ultrasound test indexes,pictorial blood loss assessment chart(PBAC)scores,and hormone levels were recorded,and total effective rates were calculated for both groups.RESULTS The total effective rate in the observation group was higher than that in the FMT group(P<0.05).After treatment,primary symptoms,including low menstrual volume,delayed menstruation,red color and thick consistency of menses,di-zziness,palpitation,weakness at the waist and knee,insomnia and excessive dreaming,irritability,and dryness and astringency of the pudendal canal in the observation group decreased,and scores for primary and secondary symptoms in the observation group were significantly lower than those in the FMT group(P<0.05).The systolic peak flow rate(PSV),end-diastolic flow rate(EDV),ovarian diameter,sinus follicle count,and resistance index(RI)of the uterine arteries in the observation group and FMT group increased after treatment.Notably,the PSV,EDV,ovarian diameter,and antral follicle count in the observation group were higher than those in the FMT group,whereas the RI in the observation group was lower than that in the FMT group(P<0.05).The PBAC scores in the observation and FMT groups increased after treatment,with that in the ob-servation group becoming significantly higher than that in the FMT group(P<0.05).After treatment,estradiol(E2)and anti-Mullerian hormone(AMH)levels increased,whereas follicle-stimulating hormone(FSH)levels decreased in the observation group and FMT group;E2 and AMH levels became significantly higher and FSH levels became significantly lower in the observation group than in the FMT group(P<0.05).CONCLUSION Compared with FMT,Kuntai capsules promoted uterine artery blood circulation,improved menstruation,relieved symptoms,regulated endocrine function,and improved curative effects.

Hydrogen-rich Water Exerting a Protective Effect on Ovarian Reserve Function in a Mouse Model of Immune Premature Ovarian Failure Induced by Zona Pellucida 3

Background：Premature ovarian failure （POF） is a disease that affects female fertility but has few effective treatments.Ovarian reserve function plays an important role in female fertility.Recent studies have reported that hydrogen can protect male fertility.Therefore,we explored the potential protective effect of hydrogen-rich water on ovarian reserve function through a mouse immune POF model.Methods：To set up immune POF model,fifty female BALB/c mice were randomly divided into four groups：Control （mice consumed normal water,n =10）,hydrogen （mice consumed hydrogen-rich water,n =10）,model （mice were immunized with zona pellucida glycoprotein 3 [ZP3] and consumed normal water,n =15）,and model-hydrogen （mice were immunized with ZP3 and consumed hydrogen-rich water,n =15） groups.After 5 weeks,mice were sacrificed.Serum anti-M＆#252;llerian hormone （AMH） levels,granulosa cell （GC） apoptotic index （AI）,B-cell leukemia/lymphoma 2 （Bcl-2）,and BCL2-associated X protein （Bax） expression were examined.Analyses were performed using SPSS 17.0 （SPSS Inc.,Chicago,IL,USA） software.Results：Immune POF model,model group exhibited markedly reduced serum AMH levels compared with those of the control group （5.41 ± 0.91 ng/ml vs.16.23 ± 1.97 ng/ml,P =0.033） and the hydrogen group （19.65 ± 7.82 ng/ml,P =0.006）.The model-hydrogen group displayed significantly higher AMH concentrations compared with that of the model group （15.03 ± 2.75 ng/ml vs.5.41 ± 0.91 ng/ml,P =0.021）.The GC AI was significantly higher in the model group （21.30 ± 1.74%） than those in the control （7.06 ± 0.27%）,hydrogen （5.17 ± 0.41%）,and model-hydrogen groups （11.24 ± 0.58%） （all P 〈 0.001）.The GC AI was significantly higher in the model-hydrogen group compared with that of the hydrogen group （1 1.24 ± 0.58% vs.5.1 7 ± 0.41%,P =0.021）.Compared with those of the model group,ovarian tissue Bcl-2 levels increased （2.18 ± 0.30 vs.3.01 ± 0.33,P =0.045） and the Bax/Bcl-2 ratio decreased in the model-hydrogen group.Conclusions：Hydrogen-rich water may improve serum AMH levels and reduce ovarian GC apoptosis in a mouse immune POF model induced by ZP3.