益气养阴方联合体外受精-胚胎移植对卵巢低反应患者卵细胞质量及妊娠结局的影响

发布时间：2018-09-18 08:44

【摘要】：目的观察益气养阴方在卵巢低反应(POR)患者体外受精-胚胎移植(IVF-ET)过程中对卵细胞质量及妊娠结局的影响,并探讨其可能作用机制。方法将既往曾行体外受精(IVF)治疗并诊断为POR的59例患者随机分为治疗组28例和对照组31例。两组均采用微刺激方案,治疗组从促超排卵当月月经第2天开始至人绒毛膜促性腺激素(HCG)注射日给予益气养阴方,每日1剂。比较两组患者获卵及妊娠结局情况,观察促超排卵过程中促性腺激素(Gn)使用情况、性激素水平及子宫内膜厚度,并检测患者卵泡液颗粒细胞生长分化因子-9(GDF-9)、骨形态发生蛋白-15(BMP-15)表达。结果治疗组平均获卵数、受精率、优胚率、取卵周期临床妊娠率分别为(4.51±2.49)个、51.93%、47.19%、23.81%,对照组分别为(2.02±1.98)个、46.90%、42.42%、10.42%,治疗组获卵数、取卵周期临床妊娠率均明显高于对照组(P0.05),受精率、优胚率两组比较差异无统计学意义(P0.05)。与对照组比较,治疗组Gn使用量显著降低,雌二醇水平、子宫内膜厚度均显著升高,颗粒细胞GDF-9、BMP-15表达显著升高,差异均具有统计学意义(P0.05)。结论益气养阴方可改善POR患者IVF-ET过程中的卵巢反应性,提高获卵数并增加患者妊娠率,其作用机制可能与调控卵巢颗粒GDF-9、BMP-15表达有关。
[Abstract]:Objective to observe the effect of Yiqi Yangyin recipe on egg cell quality and pregnancy outcome during in vitro fertilization and embryo transfer (IVF-ET) in patients with ovarian hyporesponse (POR) and to explore its possible mechanism. Methods 59 patients who had been treated with in vitro fertilization (IVF) and diagnosed as POR were randomly divided into treatment group (n = 28) and control group (n = 31). Both groups were treated with micro-stimulation regimen. The treatment group received Yiqi Yangyin recipe once a day from the second day of menstrual cycle of hyperstimulation month to the day of (HCG) injection of human chorionic gonadotropin. To compare the oocyte acquisition and pregnancy outcome between the two groups, to observe the use of gonadotropin (Gn), the level of gonadotropin and the thickness of endometrium during superovulation. The expression of growth and differentiation factor-9 (GDF-9) and bone morphogenetic protein-15 (BMP-15) in granulosa cells of follicular fluid were detected. Results the average number of eggs acquired, fertilization rate, excellent embryo rate and clinical pregnancy rate in the oocyte extraction cycle were (4.51 卤2.49) and 47.193.31 respectively in the treatment group and (2.02 卤1.98) 46.90,42.42% in the control group. The clinical pregnancy rate in the treatment group was significantly higher than that in the control group (P0.05), the fertilization rate was higher than that in the control group (P0.05), and the fertilization rate was significantly higher in the treatment group than in the control group (P0.05), and the fertilization rate was significantly higher in the treatment group than in the control group (P0.05), the fertilization rate was significantly higher in the treatment group than in the control group. There was no significant difference in the rate of excellent embryo between the two groups (P0.05). Compared with the control group, the amount of Gn in the treatment group decreased significantly, the level of estradiol and endometrial thickness increased significantly, and the expression of GDF-9,BMP-15 in granulosa cells increased significantly (P0.05). Conclusion Yiqi Yangyin decoction can improve ovarian reactivity, increase the number of oocytes and increase pregnancy rate during IVF-ET in POR patients. The mechanism of YQNY may be related to regulating the expression of GDF-9,BMP-15 in ovary granules.
【作者单位】：南京中医药大学第一临床医学院;
【基金】：江苏省高校自然科学研究面上项目(13KJB360004)
【分类号】：R714.8

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