Effect Of Kidney-Invigorating And Chong-Vessel-Regulating Therapy On TNF-α And IL-6 In PCOS Serum And Follicular Fluid And Correlation Study Between The Therapy And Oocyte Quality In PCOS

Objective: To investigate the mechanism of Kidney-Invigorating and Chong-Vessel-Regulating (KICR) therapy on the quality of PCOS oocyte by studying the effect of this therapy on the levels of TNF-αand IL-6 in serum and follicular fluid of sterile patients with polycystic ovarian syndrome (PCOS) patients during in vitro fertilization and embryo transfer (IVF-ET), relationship between KICR and oocyte quality, and the impact of KICR on endocrine and levels of cytokines in the rat model of PCO. Methods: 1. Clinical Study: Sixty-six infertile patients with PCOS undergoing IVF-ET were divided into two groups at random, 33 cases in the test group treated with Erzhi Tiangui Granules and western medicine, and 33 cases in the control group only treated with western medicine. The differences of improvement of kidney deficiency and blood stasis syndrome, accounts of harvested oocytes, high-quality oocyte rate, fertilization rate, cleavage rate, good embryo rate and pregnancy rate and discrepancies of levels of TNF-αand IL-6 in serum and follicular fluid in the two groups were observed respectively. Correlation test was proceeded between the levels of TNF-αand IL-6 in serum and follicular fluid and the rates of high-quality oocyte and good embryo. Correlation analysis was also made for the level of TNF-αand IL-6 in serum and follicular fluid in the two groups. 2. Animal Experimental Study: After successful PCO modeling,the PCO model rats were randomly divided into 2 groups: PCO treated group, PCO control group, 10 rats contained in each group, another 10 rats were normal group. The treatment group was given Erzhi Tiangui Granules gavage, while the control group and the normal group were given with the same dose of distilled water. The level of TNF-α, IL-6, testosterone and insulin were detected after 10 days. After finishing vaginal cells smear, bilateral ovaries were stained with HE staining and observed under light microscopic. Results: 1. Compared with the control group, the experimental group had obvious improvement of kidney deficiency and blood stasis syndrome, high-quality oocyte rate, fertilization rate, cleavage rate, good embryo rate and clinical pregnancy rate. 2. The dose of r-FSH, applying time and RI and PI of thecoma flow were decreased greatly. 3. The levels of TNF-αand IL-6 in follicular fluid were correlated positively, and their levels were also related negatively with high-quality oocyte rate and good embryo rate. Both the levels of TNF-αand IL-6 in serum and follicular fluid in the experimental were greatly lower than those in the control group. 4. The levels of TNF-α, IL-6, testosterone and insulin in serum from rats of the PCO treatment group were significantly lower than those in the PCO model group, and had no significant differences from those in the normal group. 5. 50% of rat vaginal epithelial cells smears of PCO treatment group showed regular estrous cycle and marked improvement in ovary histology. Conclusion: 1. TNF-αand IL-6 in human serum and follicular fluid take part in regulation of ovarian paracrine and autocrine, improve the oocyte quality and embryo development potential of patient with PCOS. 2. KICR therapy can significantly increase oocyte and embryo quality and clinical pregnancy rate of IVF-ET, restore estrous cycle and improve ovarian histological changes of PCO model rats. 3. The mechanism of KICR therapy improving oocyte quality of the patients with PCOS is relative with its action of regulating the levels of TNF-αand IL-6 in serum and follicular fluid and of androgen and insulin, improving pathophysiological changes and activating follicular microenvironment. The interactive mechanism needs further research.