Clinical Observation On Buxueyimu Keli Combined With Clomiphene For Treatment Of Unovulation Infertility

Objective:This clinical observation was designed to observe the influence of Buxue Yimu Keli combined with clomiphene on the treatment of unovulation infertility, through the examination of cervical mucus, observed the endometrial thickness, Uterine artery pulsatility index and the development of the follicle compared with the control group (clomiphene), statistics on the ovulation rate and pregnancy rate, to observe its clinical cura tive effect.Methods:1.Selected60outpatient cases from Department of Obstetr ic s and Gynecology in Women and Children Health Center of Wuhan City in june2009to september2010,all cases were in line with diagnostic standard from "Infertility and Steril ity" which edited by Luo Lilan,all cases were checked by ne cessarily tests,and reasons of fallopian tube,male infertil ity, immunity, unknown reasons,polycystic ovarian syndrome we re excluded, and diagnosed as unovulation infertility. Sixty cases of unovulation infertility were randomly divided into two group, there were30cases in each group,an observation group (Buxue Yimu Keli combined clomiphene) and a control g roup (clomiphene), the two groups in age,disease duration and disease aspects were no significant different and compa rable.2. The observation group was orally given a dose of12g of Buxue Yimu Keli in non-menstrual period and a dose of50mg of clomiphene over5days from the first five days of the menstrual period. The control group was given a dose of50mg of clomiphene over5days from the first five days of the menstrual period.after two cycles of treatment, there were10cases from the control group had no effect, the dosage of clomiphene should be ajusted to100mg daily over5days. after four cycles of treatment, there were8cases from the control group had no effect, the dosage of clomifene should be ajusted to150mg daily over5days. Every couple was orally administered a tablet of centrum at the same time, to improve the sperm motility and reduce the incidence of neural tube defects in embryos. use the siemens SEQUOIA-512type color Doppler ultrasound diagnostic apparatus and5.0MHz vaginal probe. From the day9of the menstrual cycle, the dynamic monitoring of follicle growth and ovulation the every other day. the follicle diameter≥15mm, to daily monitoring. when the follicle≥18mm:①observe the endometrial thickness and uterine artery pulsatility index;②one-time instramuscular injection of the two group HCG5000U-10000U. The two groups were guided the sexual life within24-48hours after ovulation and improved their chances of conceiving;③cervical mucus examination.The two groups have a menstrual cycle for an observation period, and treat continuously for5cycles, pregnancy was excluded. 3.Statistical analysis methods:use the SPSS13.0statistical software for analysis. the statistical analysis of ovulation rate and pregnancy rate use Tietze life table method. measurement data within the group use the t-test,count data use the X2test. Results:1. The number of participants:the two groups of30patients with good compliance had no exit numbers of cases, were observed in128、132cycles.2. Score of cervical mucus:the cervical mucus score according to the Insler score,0-3is divided into insufficiency,4-7is divided into good,11-12is divided into functional outstanding. Score greater than8points, after5cycles, two sets of cumulative cycles were90(70.3%),73(55.3%), the difference was statistically significant (P<0.05).3.Endometrial thickness,Uterine artery pulsatility index(PI): when the follicles≥18mm in diameter, endometrial thickness>8mm, after5cycles, two sets of cumulative cycle were103(80.5%),72(54.5%), the difference was statistically significant (P<0.01)., when the follicle diameter≥18mm. uterine artery pulsatility index (PI)<3.00, after5cycles, two sets of cumulative cycles w ere91(70.3%),75(56.8%), the difference was statistically sig nificant (P<0.05).4. Ovulation rate and pregnancy rate:in the end of the5cycles of treatment, the ovulation rate of the two groups were96(75.0%),84(63.6%) cycles. the difference was statistically significant (P<0.05).5cycles of two sets of cumulative pregnancy rates were respectively14(46.7%) cases,7(23.3%) cases, the difference was statistically significant (P<0.05). 5.The safety examination result:two patients of the control group experienced mild nausea and vomiting in the third cycle,w ithin half a day to relieve themselves,without treatment. the tw o group had no appearance of ovarian hyperstimulation syndrome and other adversereactions.Conclusion:This clinical observation show that Buxue Yimu Keli combined clomiphene can improve ovulation and pregnancy rates and reduce the follicular dysplasia and complications that bring by the separate use of clomifene. The mechanism may be related to the following aspects:1. improve the function of cervical mucus, which wi11help the sperm to go through;2.enhance uterine blood supply and endometrial thickness, improve the receptivity of the endometrium;3. promote the development of the follicle,conducive to the formation of the dominant follicle.