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目的研究疏肝补肾法辅助治疗在卵巢储备功能不良(diminished ovarian reserve,DOR)患者体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)周期低反应中应用的临床疗效。方法将接受IVF-ET治疗的84例DOR患者按随机数字表法分为中药辅助治疗组和对照组,每组42例。对照组采用控制性超促排卵治疗,并进行IVF-ET。中药辅助治疗组在对照组治疗基础上给予疏肝补肾法的基础方,每日1剂。促排卵过程中记录基因重组人促卵泡素(recombinant follicle-stimulating hormone,r-FSH)使用时间及用量,化学发光法测定人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)注射日、取卵日血清雌二醇(estradiol,E_2);ELISA法检测取卵日卵泡液E_2含量。记录IVF-ET过程中获卵数、成熟卵数(metaphaseⅡ,MⅡ)、正常受精数(two pronucleus,2PN)、可移植胚胎数及优质胚胎数。观察中药辅助治疗与上述指标之间的相关性。比较两组患者临床妊娠率及流产率。结果 r-FSH用量、HCG注射目E_2水平、取卵日血清E_2水平、获卵数、MⅡ卵数、2PN数、可移植胚胎数及优质胚胎数均与中药辅助治疗存在显著正相关关系(P<0.05,P<0.01);与对照组比较,中药辅助治疗组HCG注射日及取卵日血清E_2明显升高,获卵数、MⅡ卵数及可移植胚胎数亦多于对照组,差异有统计学意义(P<0.05,P<0.01)。两组临床妊娠率及流产率比较,差异无统计学意义(P>0.05)。结论疏肝补肾法中药辅助治疗可改善DOR患者IVF-ET治疗卵巢反应性,增加获卵数,提高卵子质量、胚胎数。
Objective To study the clinical effects of Shugan Bushen Method in low cycle response of in vitro fertilization and embryo transfer (IVF-ET) patients with diminished ovarian reserve (DOR). Methods Eighty-four patients with DOR treated with IVF-ET were divided into two groups according to random number table: control group and control group, 42 cases in each group. Control group using controlled ovarian hyperstimulation and IVF-ET. Chinese medicine adjuvant therapy group given in the control group based on the method of Shugan kidney method, a day. During ovulation induction, the time and dosage of recombinant human follicle-stimulating hormone (r-FSH) were recorded. The levels of human chorionic gonadotropin (HCG) on the day of injection, Estradiol (E_2) was detected by enzyme-linked immunosorbent assay (ELISA). The number of oocytes retrieved, the number of mature eggs (metaphaseⅡ, MⅡ), two pronucleus (2PN), the number of transplanted embryos and the number of high quality embryos in IVF-ET were recorded. Observed the adjuvant treatment of traditional Chinese medicine and the above indicators of the correlation. Clinical pregnancy rates and abortion rates were compared between the two groups. Results There was a significant positive correlation between the amount of r-FSH, the level of E_2 HCG, the level of E_2 on ovulation day, the number of oocytes retrieved, the number of MⅡ oocytes, the numbers of 2PN, the number of embryos transferred and the number of high quality embryos (P <0.05, P <0.01). Compared with the control group, serum E 2 on HCG injection day and ovulation day of Chinese medicine adjuvant therapy group was significantly increased, and the number of oocytes retrieved, the number of M Ⅱ oocytes and the number of transplantable embryos were also more than those of the control group, Statistical significance (P <0.05, P <0.01). There was no significant difference in clinical pregnancy rate and abortion rate between the two groups (P> 0.05). Conclusion Shugan Bushen Method can improve IVF-ET ovarian response in DOR patients, increase the number of oocytes and increase the egg quality and embryo number.