Effect of Chitosan-assisted Combination of Laparoscope and Hysteroscope on the Levels of IFN-γ and ICAM-1 in Treatment of Infertility Caused by Obstruction of Fallopian Tubes.

This experiment was carried out to investigate the effect of combined treatment of tubal obstruction infertility with deacetylated chitosan and two microscopes on the levels of IFN-γ and ICAM-1. In this study, 100 infertile patients with fallopian tube obstruction who were treated in Jiangbei District Hospital of traditional Chinese medicine from January to August 2019 were divided into two groups according to the alternating grouping method, group A (50 cases) received combined surgery, and Group B (50 cases) received combined surgery and chitosan. The curative effect and postoperative pelvic adhesion of the two groups were analyzed, and the levels of IFN-γ, ICAM-1 and IL6(IL-6), laminin (LN), Transforming growth factor beta 1(TGF-ß1) and fibronectin (FN) were observed before and after treatment. Results showed that the total effective rate of Group B was higher than that of Group A (92. 00% vs 76. 00%). The incidence of pelvic adhesion was lower in Group A (4. 00% vs 16. 00%) (P < 0.05). The levels of IFN-γ, ICAM-1, IL-6, LN, FN and TGF-ß1 in Group B were significantly lower than those in group A (P < 0.05). In conclusion, the treatment of tubal obstruction infertility with combined deacetylated chitosan and biendoscopy is effective, which can reduce the levels of IFN-γ and ICAM-1, improve the expression of adhesion-related factors and reduce the occurrence of pelvic adhesion.

Comparative efficacy and safety of complementary and alternative therapies for tubal obstructive infertility: A protocol for network meta-analysis.

BACKGROUND: Infertility is a kind of global disease. Fallopian tubal obstruction is one of the most important causes of female infertility. Complementary and alternative therapies are effective in treating tubal obstructive infertility, but there is no study on a comprehensive comparison among them. So, the purpose of this paper is to evaluate the efficacy and safety of different complementary and alternative therapies for tubal obstructive infertility. METHODS: We will search for randomized controlled trials (RCTs) from the following databases: PubMed, Cochrane Library, EMBASE, Web of Science, Chinese Biomedical Literature Database (SinoMed), Chinese National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database. We will assess the risk of bias of the included studies with the Cochrane tool, and the strength of evidence with the GRADE approach. Both pairwise meta-analyses and network meta-analyses will be performed to examine the relative efficacy and safety of complementary and alternative therapies in the treatment of tubal obstructive infertility. CONCLUSION: Our findings will provide clear evidence based on current available studies, which may lead to some proposals for both patients and researchers. INPLASY REGISTRATION NUMBER: INPLASY202110076.

Successful pregnancy in a woman with bilateral fallopian tube obstruction and diminished ovarian reserve treated with electroacupuncture: A case report.

RATIONALE: Fallopian tube obstruction and diminished ovarian reserve (DOR) are main factors including female infertility. Acupuncture might be effective in the treatment of the disease. PATIENT CONCERNS: A 39-year-old woman diagnosed with fallopian tube obstruction and DOR has been unable to conceive in the past 5 years, despite of receiving various treatments and 3-time in vitro fertilization (IVF) in different countries. DIAGNOSES: Under comprehensive consideration of clinical manifestations and hysterosalpingography examinations results, the patient was diagnosed as female infertility due to fallopian tube obstruction and DOR. INTERVENTION: Electroacupuncture treatment was performed 3 times per week for about 3 months. OUTCOMES: After 2-months of electroacupuncture treatment, the patient's menstrual cycle was back to normal, and she conceived after 3-month treatment and gave birth to a healthy baby boy finally. LESSONS: Electroacupuncture might be a complementary or alternative treatment for female infertility, particularly for women with fallopian tube obstruction and DOR.

Management of hydrosalpinx before IVF: a literature review.

Hydrosalpinx has a detrimental effect on the outcome of in vitro fertilization (IVF). Surgical intervention such as salpingectomy or tubal occlusion before IVF improves the outcome of IVF, but these procedures are often contraindicated in women with dense pelvic adhesions. Thus, it is worthwhile to search minimally invasive alternative therapies. The main objective of this review is to assess and compare the value of all the therapeutic options for hydrosalpinx before IVF. The results of the following procedures were compared: the laparoscopic treatments (salpingectomy/proximal tubal occlusion), the hysteroscopic insertion of device achieving tubal occlusion, the tuberous sclerosis and the aspiration of hydrosalpingeal fluid at the time of IVF procedure. Laparoscopic surgical treatment should be considered for all women with hydrosalpinx before IVF. Whenever laparoscopy is not recommended, hysteroscopic insertion of device seems the most effective option for management of hydrosalpinx before IVF.

[Effect of bushen tiaojing recipe on growth differentiation factor-9 in tubal infertility patients undergoing in vitro fertilization-embryo transfer].

OBJECTIVE: To study the effect and mechanism of Bushen Tiaojing Recipe on improving oocyte and embryo qualities in patients undergoing in vitro fertilization-embryo transfer (IVF-ET) at the super-ovulatory cycle. METHODS: Fifty-eight tubal infertility patients undergoing IVF-ET were randomly assigned to two groups. Thirty patients in the treatment group were treated with Bushen Tiaojing Recipe and GnRHa/FSH/hCG, and twenty-eight patients in the control group were treated with GnRHa/FSH/hCG. Contents of GDF-9 in the mature follicular fluid were detected by Western blot. The expressions of GDF-9 in granulose cells were detected by Real-time PCR. The dose of gonadotropin (Gn), the number of oocytes obtained, the fertilization rate, the oocyte cleavage rate, the high quality embryo rate, and the pregnancy rate were compared. RESULTS: The contents of GDF-9 in the follicular fluid and its expression in granulosa cells were significantly higher in the treatment group than in the control group (P<0.05). The number of oocytes obtained, the fertilization rate, the high quality embryo rate, and the pregnancy rate were significantly higher in the treatment group than in the control group. There was no significant difference in the dose of Gn or the oocyte cleavage rate. CONCLUSIONS: Bushen Tiaojing Recipe could improve the pregnancy rate of IVF-ET. Its mechanism might be possibly through regulating the GDF-9 contents in the follicular fluid and granulosa cells.

Conception in unilateral right tubal blockage with herbomineral formulations: a case report.

BACKGROUND AND OBJECTIVES: Infertility is a state of inability to conceive after unprotected intercourse for 1 year; it involves 1 in 6 couples in England. It is a complex problem with an incidence of 10%-15% and of these, 14% of infertilities are due to a tubal factor. The incidence of unilateral tubal blockage is 33%. Pregnancy can occur in unilateral tubal blockage. In the Unani system of medicine, many herbal drugs are used empirically for enhancing fertility. This case report was an effort to understand the role of Unani formulations in conception. This patient had unilateral tubal blockage and she was also resistant to clomiphene citrate. LOCATION: This study was performed in the Outpatient Department of the National Institute of Unani Medicine, Bangalore, India. INTERVENTIONS: A 25-year-old female patient with primary infertility for 2½ years was diagnosed with unilateral tubal blockage. She was given Unani treatment with Hab hamal 1 tablet t.i.d. for 5 days from the seventh day of the menstrual cycle, Majoon hamal amberi alvi khani 5 g, and Majoon supari pak 5 g b.i.d. for 1 month from the seventh day of menstrual cycle for two consecutive cycles. OUTCOME MEASURES: The main outcome measure was to observe the conception in the patient. RESULTS AND CONCLUSIONS: The patient conceived within 2 months of the treatment. These formulations might have assisted in conception as they are considered to have uterine tonic, vitalizer, and aphrodisiac properties in Unani medicine. Some of these drugs have been pharmacologically proved to assist in conception, such as Crocus sativus Linn, which is reported to improve fertility that may be attributed to crocetin and/or flavonoids. It is also reported that oysters, which contain zinc and calcium, might have been helped in enhancing fertility.

Treating fallopian tube occlusion with a manual pelvic physical therapy.

OBJECTIVE: To determine the efficacy of a non-invasive, manual soft-tissue physical therapy in opening completely blocked fallopian tubes in infertile women with confirmed bilateral occlusion and a history indicative of abdominopelvic adhesions. DESIGN: Retrospective analysis. SETTING: Clear Passage Therapies, Inc, clinic, Gainesville, Florida. PATIENTS: 28 infertile women (mean age = 35.2) with diagnosed complete tubal occlusion (proximal, midtubal, distal, or combination). The patients were being treated for various types of abdominopelvic pain and dysfunction (eg, intercourse and/or pelvic pain, menstrual cramps, endometriosis pain). INTERVENTION: A 20-hour series of manual physical therapy treatments (mean duration = 1 week) designed to address pain and restricted soft tissue mobility due to adhesions and micro-adhesions. The therapists accessed some of the deeper structures (such as the fallopian tubes) indirectly by manipulating the peritoneum, uterine and ovarian ligaments, and neighboring structures. MAIN OUTCOME MEASURES: (1) Unilateral or bilateral tubal patency confirmed by diagnostic test or natural intrauterine pregnancy; (2) natural intrauterine pregnancy rate achieved by patent patients within the 2-year follow-up period. RESULTS: Of the 28 patients, 17 (61%, 95% exact CI 41%-78%) demonstrated post-treatment unilateral or bilateral patency, as measured by hysterosalpingography or natural intrauterine pregnancy. The median interval between the last treatment date and patency confirmation was 1 month. Nine of the 17 (53%) patent patients reported a subsequent natural intrauterine pregnancy. CONCLUSION: Since truly occluded tubes are not known to reopen spontaneously, the results suggest this non-invasive therapy might be considered as an adjuvant to standard gynecological procedures in treating tubal occlusion.

[Effects of combined therapy of salpingostomy and Bushen Huoxue drugs on fallopian tube obstructive infertility].

OBJECTIVE: To compare the effect of treatment of fallopian tube obstructive infertility by salpingostomy alone and in combination with TCM drugs for Bushen Huoxue (invigorating Shen and promoting blood circulation). METHODS: To all the patients, salpingostomy was performed 3 to 7 days after menstruation and hydrotubation with Xiangdan Injection (XI) was applied once in the next menstrual cycle. Bushen Huoxue Decoction (BHD) was administrated additionally to patients in the treated group, 1 dose every day starting from the 5th day of menstrual cycle for 14 days. Three months' treatment was taken as one therapeutic course and the observation lasted for 4 courses. RESULTS: The condition of follicular development, thickness of endometrium and level of serum estradiol in the preovulatory phase after treatment were all significantly increased in the two groups (P < 0.05 and P < 0.01); but the improvement in the treated group was significantly superior to that in the control group, showing significant difference. Moreover, the pregnancy rate was also higher in the former than in the latter (P < 0.05). CONCLUSION: The combined therapy of salpingostomy and TCM drugs for invigorating Shen and promoting blood circulation is an effective therapy for fallopian tube obstructive infertility, it has the effect of enhancing follicular development and increasing thickness of endometrium, and could elevate the pregnancy rate in patients.

External application of chinese drugs on acupoint Shenque combined with salpingostomy for treatment of sterility caused by obstruction of the fallopian tube--a clinical report of 45 cases.

OBJECTIVE: To observe the therapeutic effect of external application of Chinese drugs on acupoint Shenque (CV 8) combined with salpingostomy for treatment of sterility caused by obstruction of the fallopian tube. METHOD: 75 cases were randomly divided into the following 2 groups. Forty-five patients in the treatment group were treated with external application of Chinese drugs on acupoint Shenque (CV 8) combined with salpingostomy, while 30 patients in the control group were treated with salpingostomy only. RESULTS: The results showed that in the treatment group, 26 cases were cured, 11 cases improved, and 8 cases failed, with a total effective rate of 82.22%; while in the control group, 14 cases were cured, 7 cases improved, and 9 cases failed, with a total effective rate of 70.00%. There is a significant difference in the total effective rate between the two groups (P<0.05). CONCLUSION: The therapeutic effect of external application of Chinese drugs on acupoint Shenque combined with salpingostomy is better than that of salpingostomy only.

Application of traditional Chinese medicine in the treatment of infertility.

The philosophy and practice of traditional Chinese medicine (TCM) have been evolving for thousands of years in China, Japan and other Asian countries. TCM is now generating popular interest worldwide for reproductive health care and disease prevention, including applications for treating infertility and improving sexual function. This review focuses on the application of TCM for infertility patients, and provides a critical reflection on the efficacy and safety of selected Chinese herbal formulas. It has been claimed that some formulas produce high clinical pregnancy rates with few or no side effects, as well as improving the general well-being of patients. The need for randomized control trials and research into possible mechanisms of action, effective doses, contra-indications and toxicity is self-evident. However, the task is enormous in view of the number of herbal products currently available on the market; yet among these products are undoubtedly some that will prove to be safe and beneficial.

A comparative study of hysterosalpingography and endoscopy/laparotomy in infertile patients.

A comparison of hysterosalpingography (HSG), using Lipiodol ultrafluid as contrast medium, with endoscopy/laparotomy in the evaluation of the tubal function in 124 infertile women is presented. There was agreement between the results of both methods in 73.4% of the patients. The false-negative rate was 2.4% and the false-positive rate was 8.9%. Complications in the form of intravasation were seen in three patients but none of them had any symptoms. The conception rate was 35% in the subgroup of patients with normal HSG. The authors recommend the continuous use of HSG in the overall evaluation of infertile patients. It is recommended to use oil-soluble contrast media because of its high diagnostic accuracy, low frequency of complications and its therapeutic advantages.

In vitro fertilization as an out-patient procedure.

A new, non invasive method for IVF/ET is discussed. Twenty infertile patients were involved in an outpatient procedure; less risk for them, because of local anaesthesia and low costs for the clinic are the most remarkable advantages of this procedure. Four normal ongoing pregnancies followed this treatment.