Clinical Observation On Sequential Therapy Of Nourishing Yin And Tonifying Yang Prescription Combined With ART In Infertility Due To DOR

OBJECTIVE:The thesis is designed to observe the outcome of assisted reproductive technology(ART)under the treatment of nourishing Yin and tonifying Yang sequential therapy on patients with Diminished Ovarian Reserve(DOR),and explore the feasibility and effectiveness of combination treatment of nourishing yin and tonifying yang sequential therapy in ART.METHODS:1.From January 2016 to April 2020 in Affiliated Hospital of Nanjing University of Chinese Medicine,92 intrauterine insemination(IUI)cases who met the criteria are divided into two groups according to treatment plan.One is observation group:under the treatment of nourishing Yin and tonifying Yang sequential therapy combined with ovulation induction(OI)+IUI,the other is control group:under the treatment of OI+IUI.Comparing two groups,basic sex hormone,anti mullerian hormone(AMH),antral follicle count(AFC),volume dose of gonadotropin(Gn),ovulation number,endometrium on the day of injection of human chorionic gonadotropin(HCG),pregnancy rate and pregnant results will be observed to explore the feasibility and effectiveness of combination treatment of nourishing Yin and tonifying Yang sequential therapy on patients with DOR in IUI.2.From January 2016 to April 2020 in Affiliated Hospital of Nanjing University of Chinese Medicine,193 in vitro fertilization(IVF)cases who met the criteria are divided into two groups according to treatment plan.One is observation group:under the treatment of nourishing Yin and tonifying Yang sequential therapy combined with gonadotropin-releasing hormone antagonist(GnRH-ant)protocol,the other is control group:under the treatment of GnRH-ant protocol.Comparing two groups,basic sex hormone,anti mullerian hormone(AMH),antral follicle count(AFC),volume dose of gonadotropin(Gn),Gn days,estradiol(E2)level on the day of injection of human chorionic gonadotropin(HCG),the number of retrieved oocytes,oocytes,M II oocytes,M II oocytes fertilization rate,cleavage rate,number of embryos,the number of high quality embryos,high quality embryo rate,transplantation rate and clinical pregnancy rate and pregnant results will be observed to explore the feasibility and effectiveness of combination treatment of nourishing Yin and tonifying Yang sequential therapy on patients with DOR in IVF(GnRH-ant protocol).RESULT:1.The effectiveness of nourishing Yin and tonifying Yang sequential therapy on patients with DOR in IUI:Volume dose of Gn was less than that of the control group while endometrium shape,the number of ovulation,pregnancy rate and pregnant results were better than those of the control group.The difference was statistically significant(P<0.05).There was no significant difference in endometrial thickness between the two groups(P>0.05).2.The effectiveness of nourishing Yin and tonifying Yang sequential therapy on patients with DOR in IVF(GnRH-ant protocol):E2 level on the day of injection,the number of retrieved oocytes,oocytes,M II oocytes,cleavage rate,number of embryos,the number of high quality embryos were better than those of the control group.The difference was statistically significant(P<0.05).Transplantation rate,clinical pregnancy rate and pregnant results were better than those of the control group,but the difference was not statistically significant(P>0.05).There was no significant difference in volume dose of Gn,days of Gn and oocytes fertilization rate between the two groups(P>0.05).CONCLUSION:Nourishing Yin and tonifying Yang sequential therapy could reduce the Volume dose of Gn,increase the number of ovulation,improve endometrium shape and pregnancy rate in IUI.Nourishing Yin and tonifying Yang sequential therapy could increase E2 level on the day of injection,the number of retrieved oocytes,oocytes,M Ⅱ oocytes,cleavage rate,number of embryos,number of high quality embryos in GnRH-ant protocol.In conclusion nourishing Yin and tonifying Yang sequential therapy is worthy of wide clinical use.