滋阴补阳方序贯联合拮抗剂方案对卵巢低反应体外受精结局的影响
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摘要
目的:观察滋阴补阳方序贯联合拮抗剂对卵巢低反应(POR)患者体外受精-胚胎移植(IVF-ET)临床疗效的影响,探讨中药对POR卵巢反应性、卵母细胞质量、妊娠率的影响及其在辅助生殖中应用的思路。方法:将进入IVF-ET周期符合POR患者64例分为治疗组(滋阴补阳方序贯+拮抗剂)32例及对照组(拮抗剂)32例。比较两组在促性腺激素(Gn)天数、总量、注射人绒毛膜促性腺激素(HCG)日雌二醇(E2)、取卵数、获卵数、MⅡ卵数、MⅡ卵受精率、可移植胚胎数、优质胚胎数、优质胚胎率、移植率、生化妊娠率和临床妊娠率。结果:治疗后治疗组获卵数、MⅡ卵数、可移植胚胎数、优质胚胎数优于对照组(P<0.05,P<0.01),治疗组Gn总量、Gn天数、HCG日E2、取卵数、MⅡ卵受精率、移植率、生化妊娠率、临床妊娠率优于对照组,但差异无统计学意义。结论:滋阴补阳方序贯能增加POR患者拮抗剂周期的获卵数,提高卵子质量,增加优质胚胎数,从而提高妊娠率。
Objective: To observe the effect of the Ziyin Buyang Sequential Formula combined with antagonist on the clinical efficacy of poor ovarian response(POR) in the period of in vitro fertilization and embryo transfer(IVF-ET) and to investigate the effect of Ziyin Buyang Sequential Formula on ovarian responsiveness, oocyte quality and pregnancy rate in POR patients and the thoughts on the application of traditional Chinese medicine in auxiliary reproductive technology. Methods: A total of 64 patients with POR infertility who need to enter the IVF-ET cycle were randomly divided into the treatment group(Ziyin Buyang Sequential Formula with antagonist), control group(antagonist), 32 cases in each group. Between the two groups in gonadotropin(Gn) days, Gn dosage, estradiol(E2) level on the day of injection of human chorionic gonadotropin(HCG), and the number of retrieved oocytes, oocytes, MⅡoocytes, MⅡ oocytes fertilization rate, number of embryos, the number of high quality embryos, high quality embryo rate, transplantation rate, biochemical pregnancy rate and clinical pregnancy rate. Results:After treatment, the number of oocytes, the number of MⅡoocytes, the number of transplantable embryos and the number of high quality embryos were better than those of the control group, the difference was statistically significant(P<0.05, P<0.01). The Gn dosage, Gn days, E2 level on the HCG day, oocyte count, MⅡfertilization rate, transplant rate, biochemical pregnancy rate and clinical pregnancy rate in the treatment group were better than those in the control group, but the difference was not statistically significant. Conclusion: Ziyin Buyang Sequential Formula could increase the number of oocyte in the cycle of POR antagonist,improve the quality of oocyte, increase the number of high quality embryos, and increase the pregnancy rate.
Objective: To observe the effect of the Ziyin Buyang Sequential Formula combined with antagonist on the clinical efficacy of poor ovarian response(POR) in the period of in vitro fertilization and embryo transfer(IVF-ET) and to investigate the effect of Ziyin Buyang Sequential Formula on ovarian responsiveness, oocyte quality and pregnancy rate in POR patients and the thoughts on the application of traditional Chinese medicine in auxiliary reproductive technology. Methods: A total of 64 patients with POR infertility who need to enter the IVF-ET cycle were randomly divided into the treatment group(Ziyin Buyang Sequential Formula with antagonist), control group(antagonist), 32 cases in each group. Between the two groups in gonadotropin(Gn) days, Gn dosage, estradiol(E2) level on the day of injection of human chorionic gonadotropin(HCG), and the number of retrieved oocytes, oocytes, MⅡoocytes, MⅡ oocytes fertilization rate, number of embryos, the number of high quality embryos, high quality embryo rate, transplantation rate, biochemical pregnancy rate and clinical pregnancy rate. Results:After treatment, the number of oocytes, the number of MⅡoocytes, the number of transplantable embryos and the number of high quality embryos were better than those of the control group, the difference was statistically significant(P<0.05, P<0.01). The Gn dosage, Gn days, E2 level on the HCG day, oocyte count, MⅡfertilization rate, transplant rate, biochemical pregnancy rate and clinical pregnancy rate in the treatment group were better than those in the control group, but the difference was not statistically significant. Conclusion: Ziyin Buyang Sequential Formula could increase the number of oocyte in the cycle of POR antagonist,improve the quality of oocyte, increase the number of high quality embryos, and increase the pregnancy rate.
引文
[1]武学清,孔蕊,田莉,等.卵巢低反应专家共识.生殖与避孕,2015,35(2):71-79
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[3]杨茜,腊晓琳,党鑫.卵巢低反应研究进展.淮海医药,2017,35(3):371-373
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[5]戴雪,李晓荣,郝莹莹,等.滋阴/补阳方对多囊卵巢综合征大鼠IL-6、TNF-α基因表达的影响.中华中医药杂志,2018,33(7):2823-2826
[6]赵娟,童星丽,谈勇,等.滋阴补阳序贯法对多囊卵巢综合征大鼠颗粒细胞分泌功能及干细胞因子基因表达的调控.中华中医药杂志,2013,28(4):963-967
[2]Ferraretti A P,La Marca A,Fauser B C,et al.ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization:the Bologna criteria.Hum Reprod,2011,26(7):1616-1624
[3]杨茜,腊晓琳,党鑫.卵巢低反应研究进展.淮海医药,2017,35(3):371-373
[4]SbraciaM,FarinaA,PoveriniR,etal.Shortversus longgonadotropin-releasing hormone analogue suppression protocols for superovulation in patients≥40 years oldundergoing intracytoplasmic sperm injection.Fertil Steril,2005,84(3):644-648
[5]戴雪,李晓荣,郝莹莹,等.滋阴/补阳方对多囊卵巢综合征大鼠IL-6、TNF-α基因表达的影响.中华中医药杂志,2018,33(7):2823-2826
[6]赵娟,童星丽,谈勇,等.滋阴补阳序贯法对多囊卵巢综合征大鼠颗粒细胞分泌功能及干细胞因子基因表达的调控.中华中医药杂志,2013,28(4):963-967