OBJECTIVETo observe the efficacy differences between acupuncture combined with medication and medication alone for infertility patients with polycystic ovary syndrome (PCOS).

METHODSAccording to random number table, a total of 60 infertility patients with PCOS were randomly assigned into an observation group and a control group, 30 cases in each one. The patients in the control group were treated with diane-35 from the 3rd day into menstruation, and one menstrual cycle was taken as a session of treatment. At the same time of using diane-35, the patients in the observation group were treated with acupuncture at Guanyuan (CV 4), Qihai (CV 6), Sanyinjiao (SP 6), Zusanli (ST 36), Zigong (EX-CA 1), Shenshu (BL 23), Pishu (BL 20), Weishu (BL 21) and Ganshu (BL 18) during non-menstruation period; the acupuncture was given once every two days, three treatments per week. The patients in both groups were treated for two sessions. The basic sex hormone and body mass index (BMI) were compared between the two groups before and after treatment. After ovulation induction treatment, the endometrial thickness, amount of mature follicle, ovulation rate, clinical pregnancy rate, occurrence rate of ovarian hyperstimulation syndrome (OHSS) and the number of early spontaneous abortion were compared between the two groups during ovulation.

RESULTSAfter treatment, the luteinizing hormone (LH), testosterone (T) and BMI reduced in the observation group (all <0.05), while only LH reduced in the control group (<0.05). The reducing of estradiol (E), T and BMI in the observation group was more significant than that in the control group (all <0.05). The ovulation rate was 93.3% (28/30) in the observation group, which was higher than 80.0% (24/30) in the control group (<0.05). The rate of clinical pregnancy was 43.3% (13/30) in the observation group, which was higher than 33.3% (10/30) in the control group (<0.05). The differences of endometrial thickness, amount of mature follicle, occurrence rate of OHSS and number of early spontaneous abortion were not significant between the two groups (all >0.05).

CONCLUSIONAcupuncture as adjunctive treatment could improve BMI, reduce the levels of LH, E and T, increase ovulation reaction and effectively shorten reproduction cycles in infertility patients with PCOS.

Acupuncture Therapy ; Body Mass Index ; Combined Modality Therapy ; Cyproterone Acetate ; therapeutic use ; Drug Combinations ; Estradiol ; blood ; Ethinyl Estradiol ; therapeutic use ; Female ; Humans ; Infertility, Female ; therapy ; Luteinizing Hormone ; blood ; Ovulation Induction ; Polycystic Ovary Syndrome ; therapy ; Pregnancy ; Pregnancy Rate ; Testosterone ; blood

CYP2D6 is primarily responsible for the metabolism of clomiphene citrate (CC). The purpose of the present study was to investigate the relationship between CYP2D6 genotypes, concentrations of CC and its major metabolites and drug response in infertility patients. We studied 42 patients with ovulatory dysfunction treated with only CC. Patients received a dose of 100 mg/day CC on days 3-7 of the menstrual cycle. CYP2D6 genotyping and measurement of CC and the major metabolite concentrations were performed. Patients were categorized into CC responders or non-responders according to one cycle response for the ovulation. Thirty-two patients were CC responders and 10 patients were non-responders with 1 cycle treatment. The CC concentrations were highly variable within the same group, but non-responders revealed significantly lower (E)-clomiphene concentration and a trend of decreased concentrations of active metabolites compared to the responders. Nine patients with intermediate metabolizer phenotype were all responders. We confirmed that the CC and the metabolite concentrations were different according to the ovulation status. However, our results do not provide evidence for the contribution of CYP2D6 polymorphism to either drug response or CC concentrations.
Adult ; Chromatography, High Pressure Liquid ; Clomiphene/blood/metabolism/*therapeutic use ; Cytochrome P-450 CYP2D6/*genetics ; Estrogen Antagonists/analysis/metabolism/therapeutic use ; Female ; Genotype ; Humans ; Infertility/*drug therapy/genetics ; Ovulation Induction ; Phenotype ; *Polymorphism, Genetic ; Republic of Korea ; Tandem Mass Spectrometry

OBJECTIVETo investigate changes of serum total oxidation status (TOS) and total antioxidant status (TAS) and their association with apolipoprotein (a) [Apo(a)] in patients with polycystic ovary syndrome (PCOS) combined with infertility.

MWTHODSNinety patients with PCOS and infertility were selected as the study group, including 45 patients treated with antioxidants combined with Diane-35(group A) and 45 with Diane-35 therapy only (group B), with 45 healthy volunteers with normal menstruation and normal dual phase basic body temperatures as the control group. Serum TOS of the participants was determined by dual xylenol orange method, and serum TAS was determined with ABTS method; plasma Apo(a) level was determined by dual wavelength immune transmission turbidity method.

RESULTSBefore treatment, serum TOS, OSI, and Apo(a) levels were significantly higher and TAS level was significantly lower in the study group than in the control group (P<0.05). Serum TOS, OSI, and Apo (a) were significantly lowered and TAS was significantly increased in group A after the therapy as compared with the levels before therapy and the levels in group B. The rate of natural recovery of menstruation was significantly higher and the incidence of cardiovascular disease was significantly lower in group A than in group B (P<0.05). Pearson correlation analysis showed that serum TOS and OSI were positively correlated with plasma Apo(a) (r=0.524 and 0.531, P<0.05), and serum TAS was negatively correlated with plasma Apo(a) (r=-0.519, P<0.05).

CONCLUSIONAntioxidant therapy can lower TOS, OSI and Apo(a) levels and increase TAS level to lessen oxidative stress, improve the prognosis, and reduce the risks of cardiovascular disease in patients with PCOS and infertility.

Antioxidants ; metabolism ; Apoprotein(a) ; blood ; Cyproterone Acetate ; therapeutic use ; Drug Combinations ; Ethinyl Estradiol ; therapeutic use ; Female ; Humans ; Infertility, Female ; blood ; Oxidative Stress ; Polycystic Ovary Syndrome ; blood ; drug therapy

OBJECTIVETo evaluate the effect of serum luteinizing hormone (LH) variation on clinical outcomes in patients with polycystic ovarian syndrome (PCOS) undergoing in vitro fertilization-embryo transfer (IVF-ET).

METHODSA retrospective analysis was conducted in 314 patients with PCOS undergoing their first IVF cycle using standard long protocol. On the basis of LH concentrations on early-, mid- and late-follicular phase, the patients were divided into decreased LH (LH ratio≤1, group A) and increased LH (group B, LH ratio>1) groups in early- to mid-follicular phase, decreased LH (group C) and increased LH (group D) groups in mid- to late-follicular phase, and decreased LH (group E) and increased LH (group F, LH ratio>1) in early- to late-follicular phase. The clinical outcomes were compared between groups A and B, groups C and D, and between groups E and F.

RESULTSNo significant differences were found in the clinical outcomes between group A and B (P>0.05). The number of oocytes retrieved and the early abortion rate were significantly lower, but the normal fertilization rate, implantation rate, clinical pregnancy rate and ongoing pregnancy rate were significantly higher in group D than in group C (P<0.05). In group F, the early abortion rate was significantly lower and the ongoing pregnancy rate was significantly higher than those in group E (P<0.05), and no significant differences were found in other clinical outcomes between the two groups (P>0.05).

CONCLUSIONAn increase in LH level from early- or mid- to late-follicular phase has a positive effect on the clinical outcomes, but this LH variation in early- to mid-follicular phase does not affect the clinical outcomes.

Embryo Transfer ; methods ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; therapy ; Luteinizing Hormone ; blood ; Oocytes ; Polycystic Ovary Syndrome ; blood ; Pregnancy ; Pregnancy Rate ; Retrospective Studies

PURPOSE: This study attempted to derive an objective and sophisticated definition of poor ovarian response (POR). MATERIALS AND METHODS: A total of 176 consecutive in vitro fertilization (IVF) cycles (137 patients) with conventional ovarian stimulation during 2009 to 2012 were studied by retrospective analysis. Optimal oocyte number (total or mature) was determined by statistics-based (distribution of oocyte number) and prognosis-based approaches (prediction for IVF outcome). Receiver operating characteristics curve analysis was used to show what number of oocytes could predict IVF pregnancy and whether clinical and laboratory variables could predict newly defined POR. RESULTS: The 25th percentile of the distribution corresponded to total oocytes < or =2 and mature oocyte < or =1. The cut-off values for the prediction of IVF outcomes were total oocytes >5 and mature oocyte >1. Considering the incidence of POR (34.1%), a reasonable definition of POR was decided as total oocytes < or =2 or mature oocyte < or =1. For the prediction of this new definition, the extreme cut-off value (by setting a false positive rate of 5%) of serum anti-Mullerian hormone (AMH) was < or =0.76 ng/mL, which was better than serum follicle stimulating hormone or age. A new simple definition of POR was derived as total oocytes < or =2 or mature oocyte < or =1 in a previous cycle or a serum AMH level of < or =0.76 ng/mL. When this simple criterion was re-applied to our data, the predictive performance was similar to the Bologna criteria. CONCLUSION: We here propose a new definition of POR, which is simple and supported by statistical and prognostic analyses.
Adult ; Anti-Mullerian Hormone/blood ; Female ; Fertilization in Vitro ; Follicle Stimulating Hormone/blood ; Humans ; Infertility, Female/blood/*therapy ; *Oocytes ; *Ovulation Induction ; Pregnancy ; Prognosis ; ROC Curve ; Retrospective Studies ; *Sperm Injections, Intracytoplasmic ; Treatment Outcome

PURPOSE: This study attempted to derive an objective and sophisticated definition of poor ovarian response (POR). MATERIALS AND METHODS: A total of 176 consecutive in vitro fertilization (IVF) cycles (137 patients) with conventional ovarian stimulation during 2009 to 2012 were studied by retrospective analysis. Optimal oocyte number (total or mature) was determined by statistics-based (distribution of oocyte number) and prognosis-based approaches (prediction for IVF outcome). Receiver operating characteristics curve analysis was used to show what number of oocytes could predict IVF pregnancy and whether clinical and laboratory variables could predict newly defined POR. RESULTS: The 25th percentile of the distribution corresponded to total oocytes < or =2 and mature oocyte < or =1. The cut-off values for the prediction of IVF outcomes were total oocytes >5 and mature oocyte >1. Considering the incidence of POR (34.1%), a reasonable definition of POR was decided as total oocytes < or =2 or mature oocyte < or =1. For the prediction of this new definition, the extreme cut-off value (by setting a false positive rate of 5%) of serum anti-Mullerian hormone (AMH) was < or =0.76 ng/mL, which was better than serum follicle stimulating hormone or age. A new simple definition of POR was derived as total oocytes < or =2 or mature oocyte < or =1 in a previous cycle or a serum AMH level of < or =0.76 ng/mL. When this simple criterion was re-applied to our data, the predictive performance was similar to the Bologna criteria. CONCLUSION: We here propose a new definition of POR, which is simple and supported by statistical and prognostic analyses.
Adult ; Anti-Mullerian Hormone/blood ; Female ; Fertilization in Vitro ; Follicle Stimulating Hormone/blood ; Humans ; Infertility, Female/blood/*therapy ; *Oocytes ; *Ovulation Induction ; Pregnancy ; Prognosis ; ROC Curve ; Retrospective Studies ; *Sperm Injections, Intracytoplasmic ; Treatment Outcome

High quality of fertility and pregancy is a specific presentation of family planning in this new historic environment. Our country adopted two-child policy from November, 2013. This symbolized an adjustive stage of reproduction policy in 21st century. It is a major adjustment in the development of national population. As a contry of tremendous population, it is very important to have a high- quality fertility and pregancy for the future of the whole nation, which would improve population quality and restrict development of population. The morbidity of infertility has increased significantly, which brings a huge crisis for national population. Under the guidance of high-quality fertility and pregancy in Chinese medicine theory, improving fertile women's ability of high-quality fertility and pregancy, and follow-up studying is of vital importance for evaluating the treatment of abortion prevention by traditional Chinese medicine and human health of high-quality fertility and pregancy.
Adult ; Blood Circulation ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Infertility, Female ; drug therapy ; physiopathology ; Kidney ; drug effects ; physiopathology ; Medicine, Chinese Traditional ; Pregnancy ; Pregnancy Outcome ; Reproduction

INTRODUCTIONIntrauterine insemination (IUI) after controlled ovarian hyperstimulation (COH) was applied to selected infertile patients to determine the effect of gonadotropin-releasing hormone (GnRH) antagonists in IUI cycles, in which recombinant follicle-stimulating hormone (rFSH) had been used for COH.

METHODSThis study was conducted between April 1, 2009 and June 10, 2009, and involved a total of 108 patients. These patients had primary or secondary infertility, which resulted in an indication for IUI, and they each received two cycles of ovarian stimulation treatment with clomiphene citrate. The patients were randomised into two groups--patients in group A received rFSH + GnRH antagonist (n = 45), while those in group B received only rFSH (n = 63).

RESULTSThe mean age of the patients was 31.84 ± 3.73 years and the mean body mass index (BMI) was 24.40 ± 1.88 kg/m(2). The mean age and BMI of the patients in groups A and B were not significantly different. There was no significant difference in the mean total rFSH dose administered (988.33 IU in group A and 871.83 IU in group B). When compared to group B, the mean number of follicles that were > 16 mm on the human chorionic gonadotropin (HCG) trigger day was significantly higher in group A (1.58 and 1.86, respectively; p < 0.05). When the two groups were compared, there were no statistically significant differences in the number of cancelled cycles due to premature luteinisation (none in group A vs. two in group B) and the rate of clinical pregnancy (8.9% in group A vs. 7.9% in group B).

CONCLUSIONNo significant improvement in the clinical pregnancy rates was observed when GnRH antagonists were used in COH + IUI cycles, despite the significant increase in the number of follicles that were > 16 mm on HCG trigger day.

Adult ; Body Mass Index ; Chorionic Gonadotropin ; blood ; Clomiphene ; therapeutic use ; Endometrium ; pathology ; Female ; Follicle Stimulating Hormone ; therapeutic use ; Gonadotropin-Releasing Hormone ; antagonists & inhibitors ; Hormone Antagonists ; therapeutic use ; Humans ; Infertility, Female ; therapy ; Insemination, Artificial ; methods ; Ovulation Induction ; methods ; Pregnancy ; Pregnancy Rate ; Young Adult

OBJECTIVETo observe the effect of Bushen Tiaojing Recipe (BTR) and Xiaoyao Pill (XYP) on the morphology and sex hormones secretion of adenohypophysis and ovaries in androgen-induced sterile rats (ASR).

METHODSFifty 9-day old SD female rats randomly recruited from total 60 rats were subcutaneously injected with testosterone propionate to establish the ASR model. And the rest 10 rats were recruited as the normal group. Thirty successfully modeled rats were recruited and randomly divided into the model group, the BTR group (administered with BTR suspension), and the XYP group (administered with XYP suspension), 10 in each group. Five weeks later, rats were decapitated in the proestrus. Serum levels of estradiol (E2), progesterone (P), testosterone (T), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were detected by radioimmunoassay. The morphologies of adenohypophysis and ovary were observed after HE staining.

RESULTSCompared with the normal group, serum E2 and T levels increased, while FSH and LH levels decreased in the model group (all P < 0.01). The morphology of adenohypophysis and ovary was abnormal in the model group. Compared with the model group, serum E2 and T levels decreased, while FSH and LH levels increased in the BTR group and the XYP group (P < 0.05, P < 0.01). Besides, E2 and T levels in the BTR group and FSH levels in the XYP group restored to normal (all P > 0.05). The damaged structure of adenohypophysis and ovary got restored to different degrees.

CONCLUSIONBTR and XYP both could improve ovulation failure.

Androgens ; adverse effects ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Infertility, Female ; chemically induced ; drug therapy ; Luteinizing Hormone ; blood ; Ovary ; drug effects ; Ovulation ; Pituitary Gland, Anterior ; drug effects ; Progesterone ; blood ; Rats ; Rats, Sprague-Dawley ; Testosterone ; blood

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