In the context of the new era, paying attention to maternal and child health and advocating prenatal and postnatal care can effectively improve the quality of the birth population. Traditional Chinese medicine has a long history of prenatal and postnatal healthcare with rich content, which is the theoretical basis of modern related services. With the social development and the improvement of people's awareness of prenatal and postnatal healthcare, people have gradually shifted the focus of prenatal and postnatal healthcare to the peri-pregnancy stage at present, namely that couples of childbearing age are guided to prepare for pregnancy under the premise of solving their basic diseases. Infertility is a common and refractory disease for women of childbearing age. Ovulation disorder is one of its common pathological mechanisms. Traditional Chinese medicine believes that kidney deficiency is the main cause and pa-thogenesis of anovulation infertility and blood stasis is an important factor throughout the disease course. In clinical practice, therapies for invigorating kidney and activating blood are safe and reliable to treat anovulatory infertility mainly by adjusting the hypothalamus-pituitary-ovarian axis, improving ovarian function, uterine environment and gamete quality and increasing endometrial volume. Under the guidance of the thought of prenatal and postnatal healthcare, the authors tried to explore the effect of therapies for kidney-tonifying and blood-activating in the treatment of anovulatory infertility in eugenics, with the purpose of providing ideas and basis for subsequent relevant clinical studies and contributing to prenatal and postnatal healthcare services.
Anovulation ; Child ; Eugenics ; Female ; Humans ; Infertility, Female/drug therapy* ; Kidney ; Medicine, Chinese Traditional ; Ovulation ; Pregnancy

OBJECTIVES: This study explored the association between a history of oligomenorrhea and onset of menopause and metabolic parameters. METHODS: The study population was 605 postmenopausal women who were patients at the Menopause Clinic, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand between February 2015 and December 2015. A questionnaire was used to ask all women about their history of oligomenorrhea. The study also collected medical data, including weight, height, waist circumference, blood pressure, and blood glucose and lipid profile. RESULTS: Of the 231 postmenopausal women with a complete data record, 31 had a history of oligomenorrhea and 200 did not. The age of onset of menopause was around 48 years in both groups. Prevalence of metabolic syndrome was 12.1%. More women with a waist circumference larger than 80 cm had a history of oligomenorrhea at the interview than women who had not, but a history of oligomenorrhea did not relate to other metabolic parameters. The adjusted odds ratio of a history of oligomenorrhea to waist circumference was 3.69 (95% confidence interval, 1.17–11.64). CONCLUSIONS: A history of oligomenorrhea did not affect the age at menopause, but was associated with waist circumference during menopause.
Age of Onset ; Anovulation ; Asian Continental Ancestry Group ; Blood Glucose ; Blood Pressure ; Female ; Humans ; Menopause ; Odds Ratio ; Oligomenorrhea ; Polycystic Ovary Syndrome ; Prevalence ; Thailand ; Waist Circumference

PURPOSE: Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenic anovulation in women of reproductive age. We investigated the metabolic effects of lean and overweight adolescents with PCOS. METHODS: Anthropometric measurements and biochemical parameters were evaluated in 49 adolescents with PCOS and 40 age- and body mass index (BMI)-matched controls. We further divided both PCOS and control groups into those having BMI within the normal range of less than 85th percentile and those being overweight and obese with a BMI greater than 85th percentile. RESULTS: Hemoglobin, gamma-glutamyl transferase (r-GT), total cholesterol, low-density lipoprotein-cholesterol and 2-hour postglucose load plasma insulin levels were significantly elevated in the lean PCOS group than in the lean control group. In the overweight/obese PCOS group, hemoglobin and r-GT levels were significantly elevated than in the overweight/obese control group. In the normal weight group, none of the subjects had metabolic syndrome according to the Adult Treatment Panel III criteria, but the incidence of metabolic syndrome in the overweight/obese PCOS group was 8.3% and that in the overweight/obese control group was 6.7%. CONCLUSION: PCOS in adolescents causes metabolic abnormalities, underscoring the importance of early diagnosis of PCOS in oligomenorrheic adolescents.
Adolescent* ; Adult ; Anovulation ; Body Mass Index ; Cholesterol ; Early Diagnosis ; Female ; Humans ; Incidence ; Insulin ; Insulin Resistance ; Overweight ; Plasma ; Polycystic Ovary Syndrome* ; Reference Values ; Transferases

INTRODUCTIONThis retrospective study was conducted to perform an external validation of the in vitro fertilisation (IVF) predict model developed by Scott Nelson et al in an Asian population.

MATERIALS AND METHODSAll IVF cycles registered in the study centre from January 2005 to December 2010 were included. Observed and predicted values of at least 1 live birth per cycle were compared by discrimination, calibration. Hosmer-Lemeshow test was used to assess the goodness-of-fit of the model calibration and Brier score was used to assess overall model performance.

RESULTSAmong 634 IVF cycles, rate of at least 1 live birth was 30.6%. Causes of infertility were unexplained in 35.5% cases. Fifty-seven percent of women came for their first IVF treatment. First IVF cycle showed significantly higher success in comparison to subsequent cycles. The odds ratio of successful live birth was worse in women with endometriosis. Observed outcome was found to be more than the prediction of the model. The area under the curve (AUC) in this study was found to be 0.65 that was close to that of Nelson model (0.6335) done in internal validation. Brier score (average prediction error) of model was 0.2. Chi square goodness-of-fit test indicated that there was difference between the predicted and observed value (x² =18.28, df = 8, P = 0.019). Overall statistical findings indicated that the accuracy of the prediction model fitted poorly with the study population.

CONCLUSIONOvarian reserve, treatment centre and racial effect on predictability cannot be excluded. So it is important to make a good prediction model by considering the additional factors before using the model widely.

Adolescent ; Adult ; Anovulation ; complications ; Area Under Curve ; Asian Continental Ancestry Group ; Endometriosis ; complications ; Fallopian Tube Diseases ; complications ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; etiology ; therapy ; Infertility, Male ; therapy ; Live Birth ; Male ; Maternal Age ; Odds Ratio ; Pregnancy ; Pregnancy Rate ; Reproducibility of Results ; Reproductive History ; Retrospective Studies ; Singapore ; Treatment Outcome ; Young Adult

Polycystic ovary syndrome affects 6%-7% of reproductive-aged women, making it the most common endocrine disorder in this population. It is characterized by chronic anovulation and hyperandrogenism. Affected women may present with reproductive manifestations such as irregular menses or infertility, or cutaneous manifestations, including hirsutism, acne, or male-pattern hair loss. Over the past decade, several serious metabolic complications also have been associated with polycystic ovary syndrome including type 2 diabetes mellitus, metabolic syndrome, sleep apnea, and possibly cardiovascular disease and nonalcoholic fatty liver disease. In addition to treating symptoms by regulating menstrual cycles and improving hyperandrogenism, it is imperative that clinicians recognize and treat metabolic complications. Lifestyle therapies are first-line treatment in women with polycystic ovary syndrome, particularly if they are overweight. Pharmacological therapies are also available and should be tailored on an individual basis. This article reviews the diagnosis, clinical manifestations, metabolic complications, and treatment of the syndrome.
Acne Vulgaris ; Anovulation ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diagnosis ; Fatty Liver ; Female ; Hair ; Hirsutism ; Humans ; Hyperandrogenism ; Infertility ; Insulin Resistance ; Life Style ; Menstrual Cycle ; Overweight ; Polycystic Ovary Syndrome* ; Sleep Apnea Syndromes

OBJECTIVE: To investigate the prevalence of subclinical hypothyroidism (SH) diagnosed by thyrotropin-releasing hormone (TRH) stimulating test in infertile women with basal thyroid-stimulating hormone (TSH) levels of 2.5 to 5.0 mIU/L. METHODS: This study was performed in 39 infertile women with ovulatory disorders (group 1) and 27 infertile women with male infertility only (group 2, controls) who had basal serum TSH levels of 2.5 to 5.0 mIU/L and a TRH stimulating test. Serum TSH levels were measured before TRH injection (TSH0) and also measured at 20 minutes (TSH1) and 40 minutes (TSH2) following intravenous injection of 400 microg TRH. Exaggerated TSH response above 30 mIU/L following TRH injection was diagnosed as SH. Group 1 was composed of poor responders (subgroup A), patients with polycystic ovary syndrome (subgroup B) and patients with WHO group II anovulation except poor responder or polycystic ovary syndrome (subgroup C). RESULTS: The prevalence of SH was significantly higher in group 1 of 46.2% (18/39) compared with 7.4% (2/27) in group 2 (P=0.001). TSH0, TSH1, and TSH2 levels were significantly higher in group 1 than the corresponding values in group 2 (P<0.001, P<0.001, P<0.001). In group 1, TSH1 and TSH2 levels were significantly lower in subgroup C compared with those in subgroup A and B (P=0.008, P=0.006, respectively). CONCLUSION: TRH stimulation test had better be performed in infertile women with ovulatory disorders who have TSH levels between 2.5 and 5.0 mIU/L for early detection and appropriate treatment of SH.
Anovulation ; Female ; Humans ; Hypothyroidism* ; Infertility ; Infertility, Male ; Injections, Intravenous ; Male ; Polycystic Ovary Syndrome ; Prevalence ; Thyrotropin* ; Thyrotropin-Releasing Hormone*

OBJECTIVETo explore the laws of anovulatory infertility patients of Gan-yin deficiency syndrome (GYDS), and to analyze the correlation between GYDS and partial sex hormones and metabolic parameters.

METHODSRecruited were 103 anovulatory infertility patients, including 48 of GYDS and 55 of non-GYDS. At the same time, 20 healthy pluripara at the child-bearing period were recruited as the control group. The body mass index (BMI) and waist to hip ratio (WHR) were measured. Serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), prolactin (PRL), estradiol (E2), sex hormone binding globulin (SHBG), fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), and leptin were detected. The inter-group difference of the above indices was compared between the two groups.

RESULTSLevels of BMI, FINS, HOMA-IRI, leptin, TC, TG, LDL-C, T, PRL, and LH were higher in the GYDS group and the non-GDS group than in the control group (P < 0.01, P < 0.05), while SHBG was lower in the GYDS group and the non-GYDS group than in the control group (P < 0.01). Only the PRL level was higher in the GYDS group than in the non-GYDS group (P < 0.01).

CONCLUSIONSGan-yin deficiency is a predominant manifestation in anovulatory infertility patients. Partial disorder of some sex hormones and metabolic derangement might be common pathological factors for anovulatory infertility, while increased PRL levels was dominant in GYDS.

Adult ; Anovulation ; metabolism ; Body Mass Index ; Case-Control Studies ; Female ; Gonadal Steroid Hormones ; blood ; Humans ; Infertility, Female ; metabolism ; Lipids ; blood ; Prolactin ; blood ; Yin Deficiency

With the ascending attack rate of anovulatory infertility year by year, people also began to pay attention to its treat methods. According to Doctor Ma Kun,who are engaged in clinical work about the treatment for anovulatory infertility, kidney deficiency is the basic pathogenesis and blood stasis is an important factor that has been through. Flexible use of tonifying the kidney and promoting blood circulation treatment of anovulatory infertility in clinic, has achieved remarkable curative effect. Director Ma adjusts menstruation by the different periods, and regulates both patients' negative emotions and sleep quality. Through years of clinical experience accumulation, Director Ma gradually formes special treatment of anovulatory infertility by flexibly using of tonifying the kidney and promoting blood circulation individually.
Adult ; Anovulation ; drug therapy ; physiopathology ; Blood Circulation ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Infertility, Female ; drug therapy ; physiopathology ; Kidney ; drug effects ; physiopathology

OBJECTIVETo discuss the clinical efficacy of the activating renal blood circulation and ovarian stimulation formula in treating ovulation failure infertility.

METHODEighty-six cases were randomly divided into two groups: the treatment group and the control group. The treatment group is administered with the activating renal blood circulation and ovarian stimulation formula (composed of 15 g Cuscutae Semen, 15 g Dipsaci Asperoidis Radix, 15 g Lycii Fructus, 15 g Spatholobi Caulis, 10 g Ligustri Lucidi Fructus, 15 g Lycopi Herba, 10 g Typhae Polleu, 10 g Angelicae Sinensis Radix, 15 g Cyathulae Radix etc.), whereas the control group was given clomiphene.

RESULTThe treatment group showed a pregnancy rate of 58.14%, with an ovulation rate of 68.6%. While the control group showed a pregnancy rate of 36.67%, with an ovulation rate of 70%.

CONCLUSIONThe comparison between the two groups showed that the activating renal blood circulation and ovarian stimulation formula was significantly different from clomiphene in statistical analysis (P < 0.05), without notable difference in the ovulation rate. Before and after the treatment, there is no significant difference in diameter of dominant follicles between the two groups, with remarkable difference in endometrium (P < 0.05).

Adult ; Anovulation ; drug therapy ; physiopathology ; Blood Circulation ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Fertility Agents, Female ; administration & dosage ; Humans ; Infertility, Female ; drug therapy ; physiopathology ; Kidney ; blood supply ; drug effects ; Middle Aged ; Ovulation ; drug effects

OBJECTIVETo explore the therapeutic efficacy of combination of Compound Xuanju Capsule (CXC) and clomiphene citrate (CC) for ovulatory dysfunctional infertility (001) patients of Shen-yang deficiency syndrome (SYDS).

METHODSTotally 87 001 patients of SYDS were randomly assigned to 2 groups, the treatment group (44 cases, treated with CXC and CC) and the control group (43 cases, treated with CC alone). The post-treatment clinical symptoms, the cervical mucus, the endometrial thickness, the quality of follicles, the ovulation, and the pregnancy rate, and so on were observed.

RESULTSIn aspect of improving the patients' SYDS, the effective rate was 86.4% (38/44) in the treatment group and 25.6% (11/43) in the control group. It was better in the treatment group (P < 0.01). After treatment better effects on the cervical mucus, the endometrial thickness, and the pregnancy rate were obtained in the treatment group, showing statistical difference when compared with the control group (P < 0.05). There was no statistical difference in the rate of ovulation and mature follicular numbers between the two groups (P > 0.05).

CONCLUSIONCXC combined CC could ameliorate hypoestrinemia-like effects on the endometrium, increase the endometrial thickness, and be favorable to the pregnancy in treating ODI patients of SYDS.

Adult ; Anovulation ; complications ; drug therapy ; Clomiphene ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fertility Agents, Female ; therapeutic use ; Humans ; Infertility, Female ; drug therapy ; etiology ; Ovulation Induction ; methods ; Phytotherapy ; Pregnancy ; Pregnancy Rate ; Yang Deficiency