| Objective:To study the effect of Erzhitiangui Granule on IVF oocyte quality,ovarian response and pregnancy outcome in elderly patients with decreased ovarian reserve function(DOR),and to explore the mechanism of the effect of Erzhitiangui Granule on the elderly patients with DOR of kidney qi deficiency from the perspective of oxidative stress.Furthermore,the theory of kidney dominating reproduction and ovary reserving and discharging was supplementedMethods:66 elderly patients with DOR infertility of kidney qi deficiency type treated by IVF-ET were divided into kidney tonifying traditional Chinese medicine treatment group(experimental group)and placebo control group(33 cases respectively)according to the method of complete random number table;another 33 elderly patients with normal ovarian reserve function were selected as the elderly normal control group.The treatment group took Erzhitiangui granules for three cycles before taking eggs,and all patients in the three groups took the antagonistic scheme.The treatment group took Erzhitiangui granules on the start day of GN,and the control group and the normal control group were given placebo granules at the same time.Before and after treatment,the changes of the integral of kidney qi deficiency syndrome,the dosage and days of Gn,the number of oocytes obtained by HCG injection,the rate of normal fertilization,the rate of available embryos,the rate of high-quality embryos,the rate of clinical pregnancy,and the expression of 8-iso-pgf2α,superoxide dismutase(SOD)and advanced oxidation protein products(AOPP)in ovarian follicular fluid and serum were observed.Results:1.After treatment,the symptoms of kidney deficiency in the experimental group were significantly improved(P<0.01).Compared with the control group,the Gn dosage was decreased,and the normal fertilization rate and available embryo rate were significantly increased(P<0.05).2.Comparing the expression of 8-iso-PGF2α,SOD and AOPP in the follicular fluid and serum of the three groups,it was found that the level of 8-iso-PGF2α and AOPP in the serum and follicular fluid of the experimental group was significantly lower than that of the control group,but significantly higher than that of the normal control group,the difference was statistically significant(P<0.01);the level of SOD in the serum of the experimental group was significantly higher,but significantly lower than that of the normal control group,the difference was statistically significant(P<0.01),The level of SOD in the follicular fluid of the experimental group was significantly higher than that of the control group(P<0.01),and there was no significant difference between the experimental group and the normal control group(P>0.05);3.Comparison of 8-iso-PGF2α,SOD and AOPP in serum and follicular fluid between each groups,Serum level of 8-iso-PGF2α in DOR patients was significantly higher than that in follicular fluid(P<0.01).There was no significant difference between the levels of 8-iso-PGF2α in serum and follicular fluid of patients with normal control group(P>0.05).Between the three groups,the levels of SOD and AOPP in serum were higher than those in follicular fluid,and the difference was statistically significant(P<0.01)Conclusion:1.Traditional Chinese medicine for tonifying the kidney can significantly improve the kidney deficiency state of DOR infertility patients with kidney deficiency,reduce the dosage of Gn,and improve the normal fertilization rate and the available embryo rate;2.Kidney tonifying Chinese medicine may promote the differentiation of germ cells and improve the quality of oocytes and the potential of embryo development by regulating the oxidative stress in vivo;3.Based on the level of 8-iso-PGF2α,SOD and AOPP,the theoretical system of "kidney dominating reproduction" and "ovary storing and discharging" in traditional Chinese medicine was enriched and improved from the perspective of oxidative stress. |
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