Clinical Research On Effect Of Kidney-tonilying Traditional Chinese Herbs To Improve The Female Reproductive Potential In Late-reproductive Age

Background of theoryThe ability to conceive of the normal femal reproductive system, known as reproductive potential. Diminished ovarian reserve (DOR) means that the amount of ovarian eggs in the retention dropped to the threshold value, or the diminished capacity of the ovaries to produce eggs, and the quality of follices is decline. All these phenomena led to women’s fertility decline and lack of sex hormones. This type of patients account for about10%of infertility patients. Many factors can affect ovarian reserve,such as living enviroment and living habits, age, the level of endocrine, ovarian factors, ovarian iatrogenic injury, genetic factors,et al.Age is an irreversible physiological factors leading in women with ovarian functional reserve. Ovarian reserve declined with the age increased, especially after35-year-old. Thus how to improve the elderly infertile women with ovarian reserve has become a hot and difficult issues in recent years. In Western medicine, the main treatment methods include:Hormone replacement in order to promote the recovery of ovarian function;the use of ovulation induction drugs in order to achieve the purpose of assisted reproduction, these drugs can contribute to the mild DOR patients who have ovulatory dysfunction with ovulation; Oral dehydroepiandrosterone (DHEA) supplementation, in order to improve the ovarian microenvironment and the ovarian reserve. But Western medicine in those treatment should have many aspects of adverse drug reactions. The common adverse reactions include nausea, vomiting,dizziness,fatigue,et al. by using sex hormone, all of these may caused liver, kidney metabolic abnormalities and the formation of tiny blood clots by long-term use;using of ovulation induction drugs could lead to that endometrial and follicular development are not synchronized which could affect the pregnancy rate. In addition, excessive use can cause ovarian hyperstimulation, even the possibility of ovarian hyperstimulation syndrome.So far, although the DHEA supplementation found no significant side effects and adverse drug reactions, but an overdose might cause androgen role, like facial acne, hair strong,et al.The price of DHEA is more expensive and difficult to purchase, too. Chinese medicine treatment of DOR has unique efficacy and advantages. Chinese medicine consider DOR mainly related to kidney, its treatment-based is Chinese herbs for tonifying kidney. Capsule YiZhen I, II that made in Guangdong Provincial Hospital can regulate reproductive endocrine.It achieved good clinical efficacy by using in the treatment of the elderly infertile female patients. And the proprietary Chinese medicines are relatively cheaper, easier to take, so that patients have better compliance.ObjectivesIn this study, all patients with DOR were divided into two groups:Treatment Group with kidney-tonilying Traditional Chinese Herbs and Control group with DHEA randomly. To observe the changes in menstrual cycle and menstrual flow, the antral follicle count (AFC) in Day3during the menstrual cycle by transvaginal sonography(TVS). Basal follicle stimulating hormone(bFSH), Luteinzing hormone(LH), estradiol(E2), anti-Mtillerian hormone(AMH), inhibinB(INH-B) and the improved Kupperman Score of the two groups were monitored before and after treatments.To study the effect of kidney-tonilying Traditional Chinese Herbs to improve the female reproductive potential in Late-reproductive age.So as to clarify improtant clinical value and its possible mechauism in treatment of infertility by using kidney-tonilying Traditional Chinese Herbs, and to provide a basis for further clinical applications.MethodsAll patients with DOR were divided into two groups:Treatment Group with kidney-tonilying Traditional Chinese Herbs and Control group with DHEA by respecting DME priciples and methods via randomized controlled trials. Treatment Group:the patients agreed to the treatment, and took capsules YiZhen I, Ⅱ;Control Group:the patients agreed to the treatment, and took DHEA supplementation. To observe the targets and the clinical efficacy. The relevant data would be input SPSS17.0to establish a database and be analyzed statistically.Result The rate of pregnancy was23.5%in Treatment Group, and11.8%in Control Goup, there was no significant difference(P>0.05). The rate of overall symptoms and signs was94.1%, which is higher than Control Group’s76.5%, there was no significant difference (P>0.05) between these two groups. The bFSH, E2levels after treatment between two groups had no statistically significant difference (P>0.05). But the bFSH levels in the Treatment Group had a downward trend after treatment. After treatment, the score of menstrual cycle(0.176+0.393)in Treatment Group was significantly lower than Control Group(0.706±0.470), there was a significant difference (P<0.01). The score of menstrual flow(0.118±0.332)was significantly lower than Control Group(0.471+0.514), there was a significant difference (P<0.01). The score of cervical mucus (0.294±0.470) was lower than Control Group (0.824±0.529), there was a significant difference (P<0.01). There was no significant difference between two groups in the scroe of the degree of hot flushes and sweeating or the other symptoms and signs (P>0.05). The number of AFC between two groups was significantly increased, but there was no significantly difference (P>0.05). The AMH levels was significantly increased between two groups, there was no significant difference(P>0.05). The INH-B levels in Treatment Group was significantly increased, and there was no changes in Control Group, but there was no significant difference (P>0.05).ConclusionThe kidney-tonilying Traditional Chinese Herbs can significantly decrease the bFSH levels. It always can respectively reduce the scroe of the menstrual cycle, menstrual flow, cervical mucus, the degree of hot flushes and sweating, other symptoms and signs;increase the number of AFC, AMH and INH-B levels.The effect of kidney-tonilying Traditional Chinese Herbs was better than DHEA supplementation in decreased the menstrual cycle, menstrual flow and cervical mucus.Treatment Group and Control Group had similar efficacy in changed sex hormone levels, increased the number of AFC, AMH level and INH-B level. Generally speaking, the kidney-tonilying Traditional Chinese Herbs can improve the elderly female’s ovarian reserve at the Late-reproductive age and increase the fertility potential.