ABSTRACT
OBJECTIVE: To observe the clinical effect of acupuncture plus medication in the treatment of poor ovarian response (POR) patients and to explore its mechanisms in assisting pregnancy. METHODS: A total of 100 volunteer POR women undergoing in vitro fertilization-embryo transplantation (IVF-ET) were recruited in the present study. On the 1st cycle of IVF-ET, these POR women received microstimulation of ovulation program (oral administration of Clomiphene, muscular injection of Menotrophin, Chorionic Gonadotrophin triggering, etc.). Before receiving the 2nd period of IVF-ET, these patients were equally and randomly divided into control, medication (Climen, composed of estradiol valerate and cyproterone acetate), acupuncture and acupuncture+medication (combined treatment) groups according to the random number table. Patients of the medication group were asked to orally take Climen (1 tablet/d for 21 days) beginning from the 3rd day of the menstruation, which was repeated for 3 menstrual cycles. Patients of the acupuncture group received manual acupuncture stimulation of Guanyuan (CV4), and bilateral Taixi (KI3), Sanyinjiao (SP6) of and Tai-chong (LR3) from day 8 to 15 of menstruation (follicular phase), once daily for 3 menstrual cycles. On the 2nd day of menstruation of the 1st and 2nd IVF-ET cycle, the ovarian reserve function was detected, including measurement of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) contents by using radioimmunoassay, and serum anti-mullerian hormone (AMH) level by using ELISA, and the antral follicles count (AFC) of the ovaries by using a color Doppler ultrasonic diagnosis apparatus. At the end of ovulation induction, the assisted pregnancy indexes and outcomes were detected, including administration of dosage and days of gonadotropin (Gn), the diameter of dominant oocyte, level of E2 on the trigger day, the numbers of ultrasound-guided-retrieved oocyte and the cultivated high-quality embryo (grade 1 and 2). RESULTS: After the treatment, the contents of serum FSH, LH and E2 in the medication, acupuncture and combined treatment groups were significantly reduced (P0.05). CONCLUSION: Acupuncture combined with medication improves the level of endocrinal hormones and ovarian reservation function in POR women undergoing IVF-ET, benefiting the ovary environment of pregnancy.
ABSTRACT
Objective; To investigate the influence of high-purity human menopausal gonadotrophin (HP-hMG) added in different periods of antagonist program COH in the pregnancy outcom of in vitro fertilization-embryo transplantation (IVF-ET) of the patients with normal ovarian function reserve, and to clarify the possible mechanism. Methods; A totol of 142 patients aged from 25 to 40 years old with normal ovarian function underwent IVF treatment were selected. According to the timing of HP-hMG addition, they were divided into early addition group (HP-hMG was added on the first day) and middel and latel addition group (HP-hMG was added on the 6th day). The pregnancy outcomes of the patients were analyzed. Results; Compared with early addition group, the estradiol (E2) level on the day of human chorimic gonadotropin (HCG) injection in middle and late addition group was significantly increased (P = 0.042) and the progesterone (P) level on the day of HCG injection was significantly decreased (P=0. 016), the number of follicles with diameter> 16 mm (P=0. 035) and the number of follicles with diameter >18 mm (P= 0. 026) were increased. Compared with early addition group, the rate of mature follicles in middle and late addition group was increased (P=0. 006), the rate of high quality embroy was increased (P=0. 001), and the cumulative pregnancy rate was increased (P=0. 040). Conclusion: The addition of HP-hMG at middle and late follicular phase can improve the pregnancy outcome in the patients with normal ovarition function reserve under went antagonist program COH.
ABSTRACT
Objective To observe the effect of the reinforcing kidney,nourishing and activating blood on promoting ovulation and improving the endometrium thickness and pregnancy rate in the process of in vitro fertilization-embryo transplantation(IVF-ET).Methods The 63 cases receiving IVF-ET were randomly divided into two groups: the treatment group(n=31) treated with GnRHa/r-FSH/HMG/HCG combined with the herbs of kidney-reinforcing,blood-nourishing and blood-activating in different periods of IVF-ET,and the control group(n=32) with GnRHa/ r-FSH/HMG/HCG alone.The dose of gonadotropin(Gn),endometrium thickness,follicular oocyte number,high-quality oocyte rate,fertilization rate,high-quality embryo rate and pregnancy rate of both groups were observed.Results In the treatment group,Gn dose was significantly lower(P