A Comparison About The Advantages Of Different Treatments To Induced Ovulation By Chinese Medicines

Objective:The incidence of infertility is increasing year by year, and one of the major factors leading to infertility is ovulation disorders. Ovulation disorder is divided into 2 parts:a mature follicle barrier and discharge barrier of mature follicles. Currently, follicle-stimulating treatment methods vary with stable clinical efficacy, while the discharge method of inducing mature follicles is single, and its treatment is more difficult with highly concurrent unruptured follicle syndrome, ovarian hyperstimulation syndrome and multiple pregnancy, such as iatrogenic disease. Chinese medicine has a long history of infertility treatment, especially with a variety of methods to induce ovulation and an obvious clinical efficacy. In this study, by comparing oral decoction, TCM herbs, acupuncture points, and four scenarios intramuscular medicine HCG ovulation induced advantage; explore more clinically safe, effective and simple method to induce ovulation, with an increasing rate of ovulation and clinical pregnancy; and elaborate the characteristics and advantages of the medical treatment of ovulatory disorder infertility.Methods:Put the 149 cases of patients in the treatment of intended ovulation drugs and traditional Chinese medicine diagnosis using conventional pretreatment in the follicular phase, the menstrual cycle of 11 to 13 days from the next day of follicular B-exploration growth. When follicular diameter is≥18mm, it is randomly divided into four treatment groups:A group (decoction group) 39 cases, a total of 112 menstrual cycles, B group (TCM herbs group) 35 cases, a total of 94 of the menstrual cycle, C group (acupoint acupuncture group) 36 cases, a total of 65 of the menstrual cycle, and D group (HCG medicine group) 39 cases, a total of 262 menstrual cycles. Observe in all groups the differences of the ovulation rate, mid-luteal estrogen and progesterone levels, clinical pregnancy, biochemical pregnancy, ectopic pregnancy, luteinizing unruptured follicle syndrome (LUFS), and ovarian hyperstimulation syndrome (OHSS) incidence.Results:(1) Comparison of ovulation in each group:A group of 112 observation period,80 cycles of ovulation, ovulation rate is 71.43%; group B of a total of 94 observation period,73 cycles of ovulation, ovulation rate is 77.66%; C Group of a total of 65 observation period,53 cycles of ovulation, ovulation rate is 81.54%; D group of 262 observation period,175 ovulatory cycles, ovulation rate is 66.79%. Group B, group C and group D, respectively, a significant difference (P<0.05). (2) Mid-luteal the serum estrogen and progesterone comparison:A Group E2:459.10±348.11 pg/mL, P:20.74±8.95 ng/mL; B Group E2:394.94±251.66 pg/mL, P: 35 ng/mL; C Group E2:514.89±269.05 pg/mL, P:25.69±14.61ng/l Group E2:354.65±216.32 pg/mL, P:16.44±7.04ng/mL; estrogen aspect of Group C and Group D, with statistical significance (P<0.01), A Group and D Group, with statistical significance (P<0.05). In the aspects of Progesterone, there are significant differences (P<0.01) among Group A, B, C and D groups.(3) Comparison of pregnancy outcomes in each group:A group of 14 cases of clinical pregnancies (35.90%), ectopic pregnancy,0 cases (0%), biochemical pregnancy one case (2.56%); group B,19 cases of clinical pregnancies (54.29%),0 cases of ectopic pregnancy (0%), biochemical pregnancy 0 cases (0%); group C clinical pregnancy 21 cases (58.33%), ectopic pregnancy,0 cases (0%), biochemical pregnancy 3 cases (8.33%); D group of clinical pregnancy 12 cases (30.77%), two cases of ectopic pregnancy (5.13%), biochemical pregnancy three cases (7.69%). In Group B, C and D, respectively, concerning clinical pregnancy rate, there is a statistically significant difference (P<0.05); each group is not statistically significant in terms of biochemical pregnancy and ectopic pregnancy (P> 0.05). (4) Comparison of the incidence of complications in each group:A group LUFS 13 cycles (11.61%), OHSS mild three cycles (2.68%), no moderate, no severe OHSS; group B LUFS 9 cycles (9.57%), OHSS mild two cycles (2.13%), no moderate, no severe OHSS; group C LUFS 5 cycles (7.69%), OHSS mild two cycles (3.08%), no moderate, no severe OHSS; D group LUFS 60 cycles (22.90%), OHSS mild 6 cycles (2.29%), moderate a period (0.38%); no severe OHSS. Group B, group C in LUFS compare the incidence of group D, respectively, a significant difference (P<0.01); A Group and D Group have a statistically significant difference (P<0.05). In terms of the incidence of OHSS, there is no significant difference (P> 0.05) between the groups.Conclusion:The positive effect of clinical Chinese medicine to induce ovulation assures us that, the rates of three different programs of ovulation induction are as follows:acupuncture points rate 81.54%, topical medicine77.66%, oral medicine 71.43%, and the three different programs to induce ovulation can increase the mid-luteal estrogen and progesterone level, and improve the clinical pregnancy rate of infertility treatment. After the ovulation induction treatment by using Chinese medical technology, the rates of unruptured follicle syndrome, ovarian hyperstimulation syndrome & biochemical pregnancy, and ectopic pregnancy are significantly lower than that of the HCG program, showing its safe, effective, convenient features and advantages, worthy of clinical application.