The Clinical Intervention On The Effect Of The Treatment Of Nourishing Yin And Tonifying Yang To Stimulate Ovarian Cycles In Anovulation Infertility

Objective:With the clinical study of Nourishing Yin and tonifying Yang combined with Clomiphene/Letrozole treatment and low-dose step-up protocol of Recombinant human follitropin alfa for injection(rhFSH) to anovulatory infertility, to analyzing the mechanism of nourishing yin and tonifying Yang combined with COS on follicular development mature^ovulation and gestation.Record the rhFSH use hours and doses^endometrial thickness and form on HCG day and the incidence of complications in follicular development process.Try to find an effective treatment to infertility patients by Chinese medicine,and then recover normal female reproductive rhythm, we can see the clinical pregnancy rate be improved.Methods:60patients who have been diagnosed with anovulatory infertility are divided into2groups randomly.From December,2012to December,2013,two groups were treated in the Reproductive Center of Affiliated Hospital of Nanjing University of Chinese Medicine The one group is called experimental group,which is consisted of33patients,35cycles,by the nourishing yin and tonifying Yang combined with Clomiphene/Letrozole treatment and low-dose step-up protocol of rhFSH.The other group is called control group,which is consisted of27patients,35cycles,by the traditional Chinese medicine of diagnosis and associated with Letrozole/Clomiphene citrate treatment and low-dose step-up protocol of rhFSH.The following variables of two groups in stimulated cycles are compared:the dosage of rhFSH, stimulation time, endometrial thickness and form on HCG days, FORT index,and the ending of cycle.Results:The cycle ovulation rate of the experimental group and the control group is91.43%and85.71%,clinical pregnancy rate is34.29%and22.85%,there are no statistically significant differences (P>0.05).But experimental group is relatively high.The rhFSH use hours and the doses of two groups on stimulation cycle have statistically significant differences (P<0.05), The rhFSH use hours and the doses of experimental group is significantly lower than control group.Endometrial thickness on HCG days have statistically significant differences (P<0.05),but its form have no statistically significant differences (P>0.05).FORT index has a statistically significant difference (P<0.05), the experimental group is significantly higher than control group.In35cycles of the experimental group,one cycle is the tendency of OHSS,one is no-response,one is concel-cycle;While in35cycles of the control group,two cycle is the tendency of OHSS,two are no-response,one is LUF-cycle,two are concel-cycle;No statistically significant differences (P>0.05) in two groups,probably associated with the small-sized sample,but the experimental group highlight the advantages.Conclusion:We have acquired satisfied rate of ovulation and pregnancy by the the nourishing yin and tonifying Yang combined with Clomiphene/Letrozole treatment and low-dose step-up protocol of rhFSH on anovulatory infertility.In the meantime,the rhFSH use hours and the doses have been reduced,Ovarian response have been improved.the incidence of Ovarian hyperstimulation syndrome(OHSS) and Multiple pregnancy have been reduced,the incidence of no-response cycle、the LUF-cycle、cancel-cycle have aslo been reduced.This therapy not only improves the economic retures but aslo improve the rate of pregnancy.