| PurposeInfertility is a common gynaecological problem of reproductive disturbance that involved by many diseases and multiple factors. It relates to high aging, multiple abortions, psychological stress and environmental air pollutants. Rising infertility rates around the world have had a profound impact on human development and female reproductive health, nowadays it is considered as a worldwide public problem. This is a prospective clinical observation research, our aim is to study the effects of endometrium during proliferative phase after medication in women with infertility.Methods60 participants from the Taipei United Hospital, department of Chinese medicine were recruited, they were divided into two groups:30 of them were in controlled group, they received Chinese herbal medicine Jia Wey Guei Shuoh Dih Hwang Tang alone, and the other 30 participants in experimental group, they received Jia Wey Guei Shuoh Dih Hwang Tang with Clomiphene Citrate together, we observed the changes of endometrium before and after medication, making self compared firstly, and then compared the difference between these two groups. Our investigation time was one or two days before ovulation. Transvaginal ultrasound-color flow Doppler was the investigative tool. We measured the thickness of endometrium, observing endometrial triple line, and measured the Doppler flow indices (resistance index (RI),pulsatility index (PI) and systolic/diastolic (S/D) ratio) of uterine and spiral arteries. The number and size of follicles were measued and we also observed the amount of cervical mucus. The fertility rate was counted after medication.ResultsThe average age of participants was 35.7±3.5, most of them are high age. The average weight was 55.0±5.4, BMI (kg/m2) was 21.4±2.0. They came for treatment due to unable to conceive for many years, high age, hypomenorrhea, high stress of infertility, no sexual desire etc.The findings of the controlled group, that received only the Chinese herbal medicine Jia Wey Guei Shuoh Dih Hwang Tang, only one mature follicle was found before and after medication, but the size of follicle is bigger after medication. The average size was 1.92±0.3cm. The endometrium became thicker, the average thickness was 0.92±0.21cm. Triple line was found in 80% of endometrium. The fertility rate of this group is 67%. In the experimental group, they received Jia Wey Guei Shuoh Dih Hwang Tang and Clomiphene Citrate together.1-3 mature follicles were found, The average size was 1.80±0.39cm. The endometrium also became thicker, the average thickness was 0.89±0.23cm. Triple line was found in76.7% of endometrium. The fertility rate of this group is 33%.Concerning the Doppler effect, the controlled group had a significance change before and after medication, the RI, PI, S/D ratio of uterine and spiral arteries were lower (P＜0.001). The RI, PI, S/D of uterine and spiral arteries in the experimental group were also became lower (P＜0.01).Both of these two groups have good effects in the endometrium, but the controlled group is better. Jia Wey Guei Shuoh Dih Hwang Tang can decrease the Doppler flow indices, improve blood perfusion of uterus, regulate uterine receptivity and implantation and increase the outcome of pregnancy.Conclusions1. Jia Wey Guei Shuoh Dih Hwang Tang can improve the growth of endometrial thickness and triple line, it can decrease the RI of uterine and spiral arteries, improve blood perfusion of uterus,regulate uterine receptivity and implantation of embryo.2. Jia Wey Guei Shuoh Dih Hwang Tang can improve the growth of follicle, increase ovulatary cervical mucus that benefits the motility of sperms, this condition will increase the chance of pregnancy.3. For the patients who are disturbed by anovulation, inducing ovulation by using clomiphene citrate is effective but it may adversely affect the endometrium and impair formation of cervical mucus and so reduce the chance of conception. In this study, we found out that using Jia Wey Guei Shuoh Dih Hwang Tang and clomiphene citrate together could decrease the side effects of clomiphene citrate and raise the outcome of pregnancy.
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