Clinical And Experimental Research Of Kidney-reinforcing And Menstrual Cycle-regulating Decoction In Treating Embryos Implantation Failure

ObjectiveTo observe the treatment effect of Kidney-reinforcing and menstrual cycle-regulating Decoction (BSTZR) on patients with repeated IVF-ET failure, a further experiment was carried out to explore the effect of Bushenguhuang Decoction (BSGHD, a recipe of BSTZR) on endometrial receptivity of the mice with embryonic implantation dysfunction, aimed at providing experimental basis for clinical applying of BSTZR.Methods1. Clinical observations:14 patients with repeated IVF-ET failure in line with case selection criteria of this study were included. They were categorized to pre-treatment group and post-treatment group. After 2 months of BSTZR treatment, the 14 patients took IVF or ICSI-ET once again. The change of the kidney deficiency symptoms of the patients before and after the BSTZR treatment was observed; endometrial and subendometrial blood flow of the cases on the day of urinary LH surge were examined by transvaginal power doppler ultrasonography before and after the BSTZR treatment; endometrial thickness on the day of hCG administration, fertilization rate, cleavage rate, high-quality embryo rate (abbrevated as "excellent embryo rate"), and clinical pregancy rate of the pre-treatment group were compared with the indicators of the post-treatment group.2. Experimental research:120 female Kunming mice were randomly divided into 3 groups, traditional Chinese medicine group(TCM group), model group and normal group, with 40 mice in every group. TCM group was administered with BSGHD twice before pregnancy for preventation. After pregnacy, TCM group was treated with BSGHD daily, while the other two groups with salin solution of the same volume. On pregnancy day 4,7am, TCM group and model group were injected with Mifepristone solution subcutaneously once to establish models of embryonic implantation dysfunction. On pregnancy day 4,10pm, half mice of each group were sacrificed; on pregnancy day5,7pm, the rest mice of each group were sacrificed. Colleting the uteruses of all groups.The numbers of implanted embryos were counted. Endometrial morphological changes of the mice were observed by a optical microscope.Results1. Clinical observations showed that, the points of the patients'kidney deficiency symptoms after the treatment was significantly lower than the points before the treatment, the difference was significant (P<0.01). Calculated by the law of Nimodipine, kidney deficiency symptoms were alleviated: effective 8 cases and ineffective 5 cases, the total effective rate is 61.54%. After treatment of BSTZR, the thickness of the endometrium on the day of hCG administration was increased, but the difference was not significant (P>0.05); fertilization rate, cleavage rate, high-quality embryo rate was slightly higher than those in the previous cycle, but the difference was not significant (P> 0.05). After the treatment,4 cases achieved clinical pregnancy (1 natural pregnancy,2 IVF cycle pregnancy, 1 frozen embryo transfer cycle pregnancy),1 case got biochemical pregnancy. The follow-up showed 3 of the 4 pregnancy cases suffered early miscarriage, the other gave birth to a healthy baby boy.2.Experimental results showed that, the number of implanted embryos in normal group was higher than that in model group and TCM group, the difference was significant (P<0.01). Compared with the other two groups, the number of endome trial glands was decreased,and the glandular cavity smaller in model group, TCM group and normal group had similar manifestation.Conclusion1. BSTZR can significantly reduce the kidney deficiency symptoms points of the patients who suffered from repeated IVF-ET failure, alleviate or eliminate the kidney deficiency symptoms, improve the patients' quality of life.2. BSTZR can improve clinical pregnancy rate of patients with repeated IVF-ET failure. But to make sure the exact therapeutic effect and mechanisms of BSTZR, we need carry out a further study which should involve a larger number of cases, and should be randomized, controlled, double-blind.3. Endometrial thickness, endome trial and subendometrial blood flow of the patients before and after BSTZR treatment showed no significant difference, but the indicators after treatment all displayed an improving tendency, when compared with indicators before treatment, the exact effect remains need to be studied with a larger number of sample cases.4. BSGHD can improve the implanted embryo number of the mice with embryonic implantation dysfunction. The possible mechanism might be that BSGHD can improve the endometrial morphology of the model mice.