Effects Of Yougui Keli On The Mitochondrial Apoptotic Pathway Of Ovarian Granulosa Cells And IVF Outcomes In Infertile Patients With Kidney Yang Deficiency

Objective: To explore the effect of Yougui Keli(YK) on the key molecules(Bax, cytochrome-c(Cyt-c), and caspase-3) of mitochondrial apoptotic pathway in ovarian granulosa cells(OGC) and on oocyte quality and pregnancy outcomes of infertile patients with kidney yang deficiency.Methods: Seventy patients with kidney yang deficiency who underwent in vitro fertilization and embryo transfer(IVF-ET) due to tubal factor were included, which were randomly and equally(35 patients per group) divided into the Yougui Keli group(treatment group) and placebo group(control group). Another 35 patients who underwent IVF due to male factor were included as the normal control group. The treatment group started to receive YK combined with conventional IVF treatment in follicular phase, whereas the other two groups were given placebo instead of YK. Score changes of kidney deficiency symptom before and after treatment were measured, other outcomes including high-quality oocytes rate, high-quality embryos rate, clinical pregnancy rate, and the expression of Bax, Cyt-c, and caspase-3 in ovarian granulosa cells on the day of retrieval were measured.Results: Compared to the placebo group, the kidney deficiency symptoms significantly improved in the YK group after treatment. In addition, the treatment group showed a significant increase in the high-quality oocytes ratio, high-quality embryos ratio, and clinical pregnancy rate(P<0.05 respectively). Compared with the other two gourps, the placebo group showed significantly high-regulated Bax m RNA levels and Cyt-c and caspase-3 protein contents(P<0.05 respectively).Conclusion: YK could significantly improve the kidney yang deficiency status in infertile patients, and increase their high-quality oocytes ratio, high-quality embryos ratio, and clinical pregnancy rate. YK might inhibit granulosa cell apoptosis by suppressing the mitochondrial apoptotic pathway(i.e., down-regulating Bax expression, inhibiting Cyt-c release and down-regulating caspase-3 expression), so as to improve the IVF outcome in infertile patients with kidney yang deficiency.