Xue Hui, Dong Juan, Xu Huijun, Huang Xin, Dai Huangguan, Hao Cuifang
Department of Gynecology, The Affiliated Qingdao Hiser Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China.
Department of Preventive Treatment of Disease, Shandong Qingdao Hospital of Integrated Traditional and Western Medicine, Qingdao, Shandong 266000, P.R. China.
Exp Ther Med. 2017 Oct;14(4):3935-3941. doi: 10.3892/etm.2017.4948. Epub 2017 Aug 16.
The present study aimed to explore the therapeutic effects of the Tiaogeng Yijing decoction on patients with poor ovarian response (POR) undergoing fertilization-embryo transfer (IVF-ET), in addition to the underlying molecular mechanisms of these effects. A total of 40 patients were randomly and equally assigned to the treatment or control group. Patients in the treatment group received the Tiaogeng Yijing decoction continuously for three menstrual cycles in addition to microstimulation, while patients in the control group underwent microstimulation only. The following molecules were measured following treatment: Serum levels of sex hormones, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and anti-mullerian hormone (AMH); follicular fluid levels of cytokines, including growth differentiation factor (GDF)-9, transforming growth factor (TGF)-β1, leukemia inhibitory factor (LIF), granulocyte-colony stimulating factor (G-CSF) and vascular endothelial growth factor (VEGF); and endometrial levels of cytokines, including integrin αVβ3, TGF-β1, LIF, G-CSF and VEGF. In addition, the antral follicle count (AFC), mean ovarian diameter (MOD) and pregnancy outcomes were measured. The results revealed that the Tiaogeng Yijing decoction significantly decreased serum levels of FSH and E2, and significantly increased serum AMH levels, the AFC, follicular fluid levels of GDF-9, TGF-β1 and VEGF, and endometrial levels of integrin αVβ3, TGF-β1 and VEGF, in addition to pregnancy outcomes (all P<0.05 vs. the control group). However, no significant differences were found in the MOD or levels of LH, LIF and G-CSF. In conclusion, the present study demonstrated that the Tiaogeng Yijing decoction promotes pregnancy outcomes in patients with POR undergoing IVF-ET, and that this effect may be associated with the upregulation of TGF-β1 and VEGF in the follicular fluid and endometrium.
本研究旨在探讨调更益精汤对接受体外受精-胚胎移植（IVF-ET）的卵巢反应不良（POR）患者的治疗效果及其潜在分子机制。总共40例患者被随机等分为治疗组或对照组。治疗组患者在微刺激基础上连续三个月经周期服用调更益精汤，而对照组患者仅接受微刺激。治疗后检测以下分子：性激素血清水平，包括促卵泡生成素（FSH）、促黄体生成素（LH）、雌二醇（E2）和抗苗勒管激素（AMH）；卵泡液细胞因子水平，包括生长分化因子（GDF）-9、转化生长因子（TGF）-β1、白血病抑制因子（LIF）、粒细胞集落刺激因子（G-CSF）和血管内皮生长因子（VEGF）；以及子宫内膜细胞因子水平，包括整合素αVβ3、TGF-β1、LIF、G-CSF和VEGF。此外，测量窦卵泡计数（AFC）、平均卵巢直径（MOD）和妊娠结局。结果显示，调更益精汤显著降低血清FSH和E2水平，显著提高血清AMH水平、AFC、卵泡液中GDF-9、TGF-β1和VEGF水平以及子宫内膜中整合素αVβ3、TGF-β1和VEGF水平，同时提高妊娠结局（与对照组相比，均P<0.05）。然而，MOD或LH、LIF和G-CSF水平未发现显著差异。总之，本研究表明调更益精汤可提高接受IVF-ET的POR患者的妊娠结局，且这种作用可能与卵泡液和子宫内膜中TGF-β1和VEGF的上调有关。
