Ma Ying-Jie, Yuan Li-Hua, Xiao Ji-Mei, Jiang Hua-Ying, Sa Yuan-Hong, Sun Hong-Qi, Song Jing-Yan, Sun Zhen-Gao
Shandong University of Traditional Chinese Medicine, Jinan 250014, China.
Reproductive and Genetic Center of Integrated Traditional and Western Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, China.
Evid Based Complement Alternat Med. 2021 Nov 10;2021:6696305. doi: 10.1155/2021/6696305. eCollection 2021.
To identify the biological function and metabolic pathway of differential metabolites in follicular fluid of senile patients with kidney qi deficiency undergoing in vitro fertilization-embryo transfer (IVF-ET) and observe the effect of kidney-invigorating herbs on IVF outcomes in senile patients.
A total of 95 women undergoing IVF treatment were recruited and divided into three groups, including 34 cases in the treatment group (the senile patients with kidney qi deficiency after the intervention of Chinese medicine), 31 cases in the experiment group (the senile patients with kidney qi deficiency of no intervention of Chinese medicine), and 30 cases in the control group (young women with infertility due to male factor). The three groups of women were treated with long protocol ovarian hyperstimulation; the treatment group was given Qi-Zi-Yu-Si decoction on the day of HCG downregulation. Their IVF clinical outcomes were observed. The metabolites changes of kidney qi deficiency syndrome were analyzed in follicular fluid metabolomics using liquid chromatography-mass spectrometry (UPLC-MS/MS).
The syndrome score of kidney qi deficiency syndrome in the treatment group was significantly improved after treatment ( < 0.01). Compared with the experiment group, the available embryo rate and implantation rate were increased, and the difference was statistically significant ( < 0.05). Progesterone, indoleacrylic acid, 2-propenyl 1-(1-propenylsulfinyl) propyl disulfide, N-acetyltryptophan, decanoylcarnitine, 20a-dihydroprogesterone, testosterone acetate, eicosatrienoic acid, 1H-indole-3-carboxaldehyde, choline, phosphorylcholine, and tryptophan were downregulated in the treatment group. Through pathway analysis, glycerophospholipid metabolism and steroid hormone biosynthesis were regulated in senile patients with kidney qi deficiency after Qi-Zi-Yu-Si decoction intervention.
Qi-Zi-Yu-Si decoction can effectively improve the IVF outcome and clinical symptoms of senile patients. Follicular fluid metabolites were significantly changed in senile infertile women with kidney qi deficiency, and the mechanism by which kidney-invigorating herbs improve IVF treatment outcomes may be related to glycerophospholipid metabolism and steroid hormone biosynthesis. This study was registered in the Chinese Clinical Trials Registry Platform (ChiCTR1800014422).
探讨体外受精-胚胎移植（IVF-ET）老年肾气亏虚患者卵泡液中差异代谢物的生物学功能及代谢途径，观察补肾中药对老年患者IVF结局的影响。
选取95例行IVF治疗的女性，分为三组，治疗组34例（老年肾气亏虚患者经中药干预后），实验组31例（老年肾气亏虚患者未进行中药干预），对照组30例（因男方因素不孕的年轻女性）。三组女性均采用长方案超促排卵；治疗组在HCG降调节日给予杞子毓麟汤。观察其IVF临床结局。采用液相色谱-质谱联用（UPLC-MS/MS）技术对卵泡液代谢组学进行分析，探讨肾气亏虚证的代谢物变化。
治疗组治疗后肾气亏虚证证候积分明显改善（<0.01）。与实验组比较，可用胚胎率及种植率升高，差异有统计学意义（<0.05）。治疗组中孕酮、吲哚丙烯酸、2-丙烯基 1-(1-丙烯基亚磺酰基)丙基二硫化物、N-乙酰色氨酸、癸酰肉碱、20α-二氢孕酮、醋酸睾酮、二十碳三烯酸、1H-吲哚-3-甲醛、胆碱、磷酸胆碱和色氨酸下调。通过通路分析，杞子毓麟汤干预后老年肾气亏虚患者的甘油磷脂代谢和类固醇激素生物合成受到调节。
杞子毓麟汤能有效改善老年患者的IVF结局及临床症状。老年肾气亏虚不孕女性卵泡液代谢物有明显变化，补肾中药改善IVF治疗结局的机制可能与甘油磷脂代谢和类固醇激素生物合成有关。本研究在中国临床试验注册平台注册（ChiCTR1800014422）。
