OBJECTIVETo study the effect of Chinese medical herbs for Shen tonifying, blood nourishing and activating (CMHSTBNA) on the cycle of controlled ovarian hyperstimulation (COH) of assisted reproductive technique (ART).

METHODSA large sample randomized control trial was performed. Infertility women patients, younger than 42 years (infertility due to tubal factor and/or male factor) were randomly assigned to the CMHSTBNA intervention group (abbreviated as the treated group) and the control group, 184 cases in each group. All underwent COH. Those in the treated group received assist therapy of CMHSTBNA from the menstrual period day 2 -3 of COH to the day of oocytes retrieved. The serum hormone level [including estrogen (E2), progesterone(P), luteal hormone (LH) on the day of human chorionic gonadotrophin (hCG) administration], the medication days and dosage of gonadotropin (Gn), the number of oocytes retrieved, the fertilization rate, and the good-quality embryo rate were observed and compared with the control group.

RESULTSThe endometrial thickness on the day of oocytes retrieved was 10.85 +/- 1.63 mm in the treated group, larger than that in the control group (10.50 +/- 1.49 mm) (P <0.05). The good-quality embryo rate and the frozen rate were 48. 9% and 39. 7% respectively in the treated group, superior to those of the control group (45. 4% and 35. 8% respectively), showing statistical difference (P < 0.05). On the day of hCG administration, favorable tendency was shown in the serum levels of estradial (E2), progesterone (P), luteinizing hormone (LH), the medication days and dosage of Gn, the number of oocytes retrieved, the fertilization rate, and the cleavage rate, showing no statistical difference when compared with the control group (P >0.05).

CONCLUSIONThe combined application of CMHSTBNA and gonado-trophic hormones in COH cycle could elevate the embryo quality, improve the endometrial state, thus laying foundation for successful in vitro fertilization/intracytoplasmic sperm embryo transfer.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; drug therapy ; Ovulation Induction ; methods ; Pregnancy ; Pregnancy Rate ; Superovulation ; drug effects

OBJECTIVETo evaluate the effect of superovulation with recombinant follicle stimulating hormone (r-FSH) therapy and intrauterine insemination in the treatment of idiopathic infertility.

METHODSSuperovulation with r-FSH therapy and intrauterine insemination were used in 202 cycles of 88 couples in the Department of Obstetrics and Gynecology of Monash Medical Centre.

RESULTSThe per cycle ovulation rate and in-ovulation rate were 95.7% and 4.3% respectively, and the per cycle pregnancy rate was 11.6% with no cases of hyperstimulation. The cancelling rate was 7.4% because of the development of multiple follicles. The overall cumulative conception rate was 22.7% per patient, with 15% of twin pregnancies. There were no differences between pregnancy group and non-pregnancy group in age, BMI, treatment days, number of mature follicles, endometrial thickness and number of treatment cycles. The only significant parameter observed between the two groups was infertility time (P < 0.05), which was longer in non-pregnancy group [(30.52 +/- 13.08) months] than in pregnancy group [(24.25 +/- 6.45) months].

CONCLUSIONSSuperovulation and intrauterine insemination is a safe and more cost-effective method in treatment of idiopathic infertility.

Adult ; Female ; Follicle Stimulating Hormone, Human ; biosynthesis ; genetics ; therapeutic use ; Humans ; Infertility, Female ; therapy ; Insemination, Artificial, Homologous ; methods ; Recombinant Proteins ; biosynthesis ; genetics ; therapeutic use ; Superovulation ; drug effects

Echinomycin is a small-molecule inhibitor of hypoxia-inducible factor-1 DNA-binding activity, which plays a crucial role in ovarian ovulation in mammalians. The present study was designed to test the hypothesis that hypoxia-inducible factor (HIF)-1alpha-mediated endothelin (ET)-2 expressions contributed to ovarian ovulation in response to human chorionic gonadotropin (hCG) during gonadotropin-induced superuvulation. By real-time RT-PCR analysis, ET-2 mRNA level was found to significantly decrease in the ovaries after echinomycin treatment, while HIF-1alpha mRNA and protein expression was not obviously changed. Further analysis also showed that these changes of ET-2 mRNA were consistent with HIF-1 activity in the ovaires, which is similar with HIF-1alpha and ET-2 expression in the granulosa cells with gonadotropin and echinomycin treatments. The results of HIF-1alpha and ET-2 expression in the granulosa cells transfected with cis-element oligodeoxynucleotide (dsODN) under gonadotropin treatment further indicated HIF-1alpha directly mediated the transcriptional activation of ET-2 during gonadotropin-induced superuvulation. Taken together, these results demonstrated that HIF-1alpha-mediated ET-2 transcriptional activation is one of the important mechanisms regulating gonadotropin-induced mammalian ovulatory precess in vivo.
Animals ; Cells, Cultured ; Chorionic Gonadotropin/*pharmacology ; Echinomycin/*pharmacology ; Endothelin-2/genetics/*metabolism ; Female ; Gonadotropins, Equine/*pharmacology ; Granulosa Cells/drug effects/metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit/*antagonists & inhibitors/genetics/metabolism/physiology ; Oligonucleotides/genetics ; Ovary/cytology/drug effects/physiology ; Rats ; Rats, Sprague-Dawley ; Superovulation/*drug effects ; Transcriptional Activation