Abstract:

Objective　To investigate the effect of Yiqixue Buganshen Recipe (YBR) on the pregnancy outcomes of repeated implantation failure (RIF) patients taking frozen-thawed embryo transfer (FET). Methods　The clinical data of 120 patients with RIF who underwent FET in Department of Reproductive Health and Infertility, Guangzhou First People's Hospital from January 2017 to June 2023 were retrospectively analyzed. The patients were 25-35 years old and had regular menstruation. The 120 patients were divided into a control group and a study group according to whether they took YBR before FET, with 60 cases in each group. Fifty-seven patients who took FET and had no history of embryo transfer during the same period were set as a normal group. All the three groups used hormone replacement therapy (HRT) protocol for endometrium preparation. The study group took YBR for three menstrual cycles before endometrial preparation (the proliferation recipe after menstruation: it was cooked to 20 ml, and made into 10 g granules per packet; the patients took 1 packet per day in the morning and at night from the menstruation was clean until ovulation. Luteinizing hormone recipe: it was cooked to 20 ml and made into 10 g granules per packet; the patients took 1 packet per day in the morning and at night from the ovulation until day 1-3 of menstruation). The endometrial thicknesses, pulsatility indexes (PI), resistance indexes (RI), implantation rates (IR), and pregnancy rates (PR) were compared between the 3 groups. One-way ANOVA and χ² test were used. Results　The endometrial thickness, PI, and RI were (10.33±2.27) mm, (1.86±0.52), and (0.56±0.10) in the normal group, were (10.24±1.81) mm, (1.96±0.21) and (0.58±0.90) in the study group, and were (9.03±1.41) mm, (1.97±0.20), and (0.62±0.09) in the control group, with statistical differences (F=8.40, 6.08, and 6.89; all P<0.05). The IR and PR in the normal group and the study group were higher than those in the control group [43.9% (43/98) vs. 38.8% (40/103) vs. 25.2% (26/103) and 57.9% (33/57) vs. 55.0% (33/60) vs. 35.0% (21/60); χ²=8.18 and 7.37; both P<0.05]. Conclusion　YBR can improve the pregnancy outcomes of RIF patients in FET cycles by reducing the uterine blood flow RI and PI, increasing endometrial thickness, and enhancing the embryo IR and clinical PR.

Key words:

Yiqixue Buganshen Recipe, Repeated implantation failure, Frozen-thawed embryo transfer, Pregnancy outcomes

摘要：

目的　探讨益气血补肝肾方对胚胎反复种植失败（RIF）患者冻融胚胎移植（FET）周期妊娠结局的影响。方法　回顾性分析2017年1月至2023年6月在广州市第一人民医院生殖健康与不孕症专科行FET的120例RIF患者临床资料。患者月经周期规律，年龄25～35岁，按照FET前是否接受益气血补肝肾方治疗分为对照组和研究组，各60例；另选取同时期57例既往无胚胎移植史的FET患者作为正常组。3组均采用激素替代（HRT）方案准备内膜。研究组在准备内膜前先给予益气血补肝肾方3个月经周期（经后增殖方：煎成20 ml，制成颗粒剂10 g，1包/d，早晚分2次服用，月经干净后开始服用至排卵期；促黄体方：煎成20 ml，制成颗粒剂10 g，1包/d，早晚分2次服用，自排卵后开始服用至月经第1～3天停药）。比较3组患者内膜转化日子宫内膜厚度、血流搏动指数（PI）、动脉阻力指数（RI）、胚胎着床率和临床妊娠率。统计学方法采用单因素方差分析和χ²检验。结果　正常组和研究组子宫内膜厚度均高于对照组，PI、RI均低于对照组，3组子宫内膜厚度、PI、RI比较［（10.33±2.27）mm比（10.24±1.81）mm比（9.03±1.41）mm、（1.86±0.52）比（1.96±0.21）比（1.97±0.20）、（0.56±0.10）比（0.58±0.90）比（0.62±0.09）］，差异均有统计学意义（F=8.40、6.08、6.89，均P<0.05）。正常组和研究组胚胎着床率、临床妊娠率均高于对照组，3组比较差异均有统计学意义［43.9%（43/98）比38.8%（40/103）比25.2%（26/103）、57.9%（33/57）比55.0%（33/60）比35.0%（21/60）；χ²=8.18、7.37，均P<0.05］。结论　益气血补肝肾方可通过降低子宫内膜血流阻力指数和搏动指数，增加子宫内膜厚度，提高胚胎着床率和临床妊娠率，改善RIF患者FET周期妊娠结局。

关键词:

益气血补肝肾方, 反复种植失败, 冻融胚胎移植, 妊娠结局