Effects Of Bushen Huatan Recipe On The AKT-GLUT4 Insulin Signal Pathway Of Ovarian Granular Cells In Polycystic Ovarian Syndrome And IVF Outcomes In These Infertile Patients

Objective: To investigate the effect of Kidney-Tonifying and Phlegm-Resolving Method on the key molecules(AKT,p-AKT and GLUT4)of the AKT-GLUT4 insulin signal pathway in ovarian granular cells(OGC)and its effect on oocyte quality,embryo development and pregnancy outcomes of these infertile patients with polycystic ovary syndrome.Methods: Sixty-six PCOS patients with Kidney-deficiency and phlegm-dampness treated by in vitro fertilization-embryo transfer(IVF-ET)were randomly and equally(33 patients per group)divided into two groups: the Erzhi Tiangui combined with Qigong Keli group(treatment group)and placebo(control group).Two groups of patients were treated with double-drop program(GnRH-a+Diane 35),the treatment group of patients taking the Diane 35 at the same time to giving the above traditional Chinese medicine,until HCG injection day.Patients in the placebo group were given placebo granules as described above.Score changes of Kidney-deficiency and phlegm-dampness symptom before and after treatment were measured,other outcomes including HOMA-IR,high-quality oocytes rate,high-quality embryos rate,clinical pregnancy rate,and the expression of AKT,p-AKT and GLUT4 in ovarian granulosa cells on the day of retrieval were measured.Results: Compared to the placebo group,the Kidney-deficiency and phlegmdampness symptoms significantly is improved in the chinese treatment group after treatment.In addition,the treatment group take a turn for the better in the HOMA-IR,high-quality oocytes ratio,high-quality embryos ratio and clinical pregnancy rate(P<0.05 respectively).Compared with the other treatment group,the placebo group showed significantly high-regulated p-AKT levels and GLUT4 protein contents(P<0.05 respectively).Conclusion: The Erzhi Tiangui combined with Qigong Keli could significantly improve Kidney-deficiency and phlegm-dampness status in infertile patients,reduce HOMA-IR and increase their high-quality oocytes ratio,high-quality embryos ratio,and clinical pregnancy rate.Bushen Huatan Recipe might improve the insulin resistance status of ovary in PCOS patients through improving the expression of p-AKT and GLUT4 protein in ovarian granular cells,and then provide sufficient energy for oocyte biological function,so as to improve the IVF outcome in these infertile patients.