The Research Of The Effect Of The Smoothing Liver And Reinforcing Kidney Recipe On The Patients With Diminished Ovarian Reserve In IVF-ET And Its Mechanism

Objective:To investigate the effect of the smoothing liver and reinforcing kidney recipe on the patients with diminished ovarian reserve (DOR) in IVF-ET and its mechanism.Method:The patients with DOR who would receive IVF-ET treatment were divided into experimental group (traditional Chinese medicine auxiliary treatment group) and control group (blank control group) randomly. According to the treatment stage of the patients in experimental group, they received smoothing liver and reinforcing kidney recipe from three weeks before down-regulation (A group),down-regulation (B group) and ovulation induction (C group) until the day when the human chorionic gonadotropin (HCG) was injected. The duration of gonadotropin (Gn),the total dose of Gn,estradiol(E2),progesterone(P) level of HCG day in serum and E2level of the ovum pick up (OPU)day in serum were compared between two groups.The total number of oocyte retrieved, the number of MⅡ oocyte,2PN,embryo and top quality embryo,the ratio of MⅡ oocyte,normal fertilization rate and top quality embryo rate were also compared as the laboratory index.The E2,melatonin(MT) and advanced oxidation protein products(AOPPs) level in follicular fluid were all measured by the method of ELISA and the three were compared between two groups. Besides, the above parameters were compared among A group.B group and C group to analyze whether they were related to the time of taking medicine.Results:1. The total dose of Gn in experimental group was fewer than in control group, but the difference had no statistical significance, P>0.05.2.The E2、P level in serum of HCG day and the E2level in serum of OPU day in experimental group were all higher than in control group and the difference had statistical significance, P<0.05.3.The normal fertilization rate,top quality embryo rate and clinical pregnancy rate were all higher in experimental group than in control group,but there were no statistical significance,P>0.05.4. The E2and MT level in follicular fluid of experimental group was higher than control group and AOPPs level was lower than control group, there were no significant difference, P>0.05. 5.The Gn doses of Group A was lower than Group B and Group C,P<0.05;the number of oocyte obtained,M II oocyte,embryo and top quality embryo of Group A were all higher than Group B and Group C,P>0.05;the level of MT,E2and AOPPs in follicular fluid had no significant differences among the three groups, P>0.05.Conclusion:Smoothing liver and reinforcing kidney recipe could improve the outcome of the patients with DOR in IVF-ET, which could increase the number of oocyte obtained,M II oocyte,embryo and top quality embryo and it might be related to the reduction of oxidative damage in ovary. Treatment from three weeks before down-regulation got the most significant effect.