Study On TCM Constitutions,Syndrome Types And Their Influencing Factors Of 321 Ovarian Patients With Different Ovarian Reactivity

Objective:this paper explore the TCM constitutions and syndromes of IVF-ET patients with high,poor and normal ovarian responses The distribution characteristics and its influencing factors through clinical investigation and analysis of TCM constitutions,syndromes and their influencing factors of different ovarian responsiveness in IVF-ET patients,which provide a reference for the clinical application of the idea of "treating the disease".Methods: From January 2019 to January 2020,this paper collect 321 IVF-ET patients meeting the inclusion criteria from the Reproductive Maternal and Child Hospital of Chengdu University of Traditional Chinese Medicine and the Reproductive Center of Sichuan Provincial People's Hospital.Questionnaires were used to collect the general situation of the selected patients,including their age.,BMI,history of pelvic surgery,history of miscarriage,history of fertility,history of ectopic pregnancy,years of infertility,type of infertility,AMH,AFC,FSH,etc.The patient fill out the physical fitness questionnaire and TCM syndrome questionnaire.Investigator use Excel software to establish a survey database and perform statistical analysis with SPSS 25.0 statistical analysis software package.Results: 1.A total of 321 patients with IVF-ET were collected,including 97 patients with high ovarian response,120 patients with low ovarian response,and 104 patients with normal ovarian response.2.Among 321 patients with IVF-ET,different ovarian responses were statistically significant with age,history of miscarriage,history of ectopic pregnancy,years of infertility,AMH,AFC,and FSH(P <0.05).while it were not statistically significant with BMI,fertility history,type of infertility,pelvic surgery history,and so on.(P> 0.05).3.Among the 321 patients with IVF-ET,the most were Yang Deficiency(20.2%),followed by Yin Deficiency(15.3%),Qi Deficiency(15.3%),Qi Deficiency(15.0%),Phlegm(13.1%).),Peace Quality(8.7%),Damp Heat Quality(6.5%),Blood Stasis Quality(5.9%),Which were statistically significant with age,history of pelvic surgery,history of miscarriage,history of ectopic pregnancy,type of infertility,AMH,FSH(P <0.05),There were no significant differences with BMI,fertility history,infertility years,and AFC(P> 0.05).The most common syndromes were Kidney-Yang Deficiency Syndrome(21.2%),followed by Liver-Stagnation-Qi Stagnation Syndrome(16.5%),Kidney Yin Deficiency Syndrome(15.6%),Kidney Qi Deficiency Syndrome(13.7%),Stagnation Dampness Syndrome(10.9%),Damp Heat Accumulation Syndrome(10.0%),Stasis Blockage Syndrome(8.7%),Cold Coagulation and Stasis Syndrome(1.6%),and were statistically significant with pelvic surgery history,ectopic pregnancy history,fertility history,infertility type,AMH,AFC(P <0.05).While were not statistically significant with age,abortion history,BMI,infertility years,FSH(P> 0.05)).4.Among patients with ovarian hyperresponsiveness,Qi Deficiency was the most common(25.8%),followed by Phlegm Dampness(17.5%),Qi Depression(14.4%),Yang Deficiency(11.3%),and Blood Stasis(9.3%),Yin Deficiency(8.2%),Peacefulness(8.2%),Dampness(5.2%).There were not statistically significant with Age,BMI,Pelvic surgery history,Abortion history,Ectopic pregnancy history,Fertility history,Infertility type,The infertility years,AMH,AFC,FSH and so on(P> 0.05).the syndrome type was the most common type of deficiency of Kidney Qi(28.9%),followed by the Syndrome of Internal Phlegm Dampness(20.6%),Liver Stagnation and Qi Stagnation Syndrome(15.5%),Kidney Yang Deficiency Syndrome(11.3%),Kidney Yin Deficiency Syndrome(8.2%),Stasis Blocking Syndrome(8.2%),Damp Heat Syndrome(6.2%),which were statistically significant with abortion history(P <0.05).There was no significant difference with age,history of pelvic surgery,BMI,ectopic pregnancy history,reproductive history,type of infertility,years of infertility,AMH,AFC,FSH(P> 0.05).5.Among patients with poor ovarian responsiveness,the constitution is most of Yin Deficiency(26.7%),followed by Qi Depression(17.5%),Yang Deficiency(15.8%),Phlegm and Wetness(14.2%),Qi Deficiency(10.0%),Damp Heat Quality(9.2%),Blood Stasis Quality(4.2%),and it was statistically significant with BMI and AMH(P <0.05),while it was not statistically significant with age,history of pelvic surgery,history of abortion,history of ectopic pregnancy,birth history,Infertility type,infertility years,AFC,FSH(P> 0.05).the syndrome type was the most Kidney Yin Deficiency(27.5%),followed by Liver Stagnation and Qi Stagnation Syndrome(19.2%),Damp Heat Accumulation syndrome(17.5%),Kidney Yang Deficiency Syndrome(12.5%),Blood Stasis Blocking Syndrome(6.7%),Phlegm Dampness Internal Resistance Syndrome(5.8%),Kidney Qi Deficiency Syndrome(4.2%),Cold Coagulation and Stasis Syndrome(4.2%),Qi and Blood Deficiency Syndrome(2.5%),which were statistically significant with history of pelvic surgery and type of infertility(P <0.05).But it was not statistically significant with age,BMI,history of miscarriage,history of ectopic pregnancy,birth history,age of infertility,AMH,AFC,FSH and other factors(P> 0.05).6.Among the patients with normal ovarian response,the constitution of Yang was most deficient(33.7%),followed by the Balance(16.3%),Qi Depression(13.5%),Qi Deficiency(10.6%),and Yin Deficiency(8.7 %),Phlegm Moisture Quality(7.7%),Damp Heat Quality(4.8%),Blood Stasis Quality(4.8%),which were statistically significant with the history of pelvic surgery and AFC(P <0.05).while it was not statistically significant with age,BMI,history of abortion,Ectopic pregnancy history,reproductive history,infertility type,infertility years,AMH,FSH and other factors(P> 0.05).The syndrome type was the most with Kidney-Yang Deficiency(40.4%),followed by Liver Depression Stagnation Syndrome(14.4%),Blood Stasis Syndrome(11.5%),Kidney Deficiency Syndrome(10.6%),Kidney Yin Deficiency Syndrome(8.7%),Phlegm Dampness Internal Resistance Syndrome(7.7%),Damp Heat Accumulation Syndrome(4.8 %),Qi and Blood Deficiency Syndrome(1.9%),which were statistically significant with pelvic surgery history(P <0.05).it was not statistically significant with age,BMI,abortion history,ectopic pregnancy history,reproductive history,type of infertility,age of infertility,AMH,AFC,FSH and other factors(P> 0.05).Conclusions:1.The ovarian reactivity in IVF-ET patients is related to age,AFC,AMH,and FSH.AMH,AFC and ovarian reactivity are positively correlated,while age and FSH is negatively correlated.In addition,ovarian response also was a certain affected by the history of previous miscarriages,ectopic pregnancy,and infertility years.2.The constitution of patients with IVF-ET is mainly Yang Deficiency.The constitution is related to the distribution of age,history of pelvic surgery,history of miscarriage,history of ectopic pregnancy,type of infertility,AMH,FSH.It's syndrome type is Mainly Kidney Yang Deficiency Syndrome,which is related to the history of pelvic surgery,the history of ectopic pregnancy,the history of fertility,the type of infertility,AMH,AFC.3.Ovarian hyperresponsiveness is mainly Qi deficiency.It's syndrome type is mainly Kidney Qi Deficiency Syndrome,which is related to the history of abortion.4.The poor ovarian response is mainly Yin Deficiency,which is related to the distribution of BMI and AMH.It's the syndrome type is mainly Kidney Yin Deficiency Syndrome,and the syndrome type is related to the history of pelvic surgery and the type of infertility.5.The normal ovarian response constitution is mainly Yang Deficiency,which is related to the history of pelvic surgery and AFC distribution.The syndrome type is mainly Kidney Yang deficiency,which is related to the history of pelvic surgery.6.The TCM constitution of patients with IVF-ET can affect the syndrome types of this disease,and the TCM constitution and syndrome types have multiple corresponding relationships.