加味桂枝茯苓丸联合拮抗剂方案干预对痰瘀互结型多囊卵巢综合征患者体外受精-胚胎移植结局的影响OA

Objective To investigate the effects of intervention with Modified Guizhi Fuling Pills combined with an antagonist protocol on in vitro fertilization-embryo transfer(IVF-ET)outcomes in polycystic ovary syndrome(PCOS)patients with phlegm-stasis intermingled syndrome.Methods Two hundred and forty PCOS patients with phlegm interweaved with stasis syndrome scheduled for IVF-ET treatment,admitted to the Reproductive Medicine Department of the First Affiliated Hospital of Henan University of Chinese Medicine from August 2023 to June 2024,were selected.Patients were randomly divided into a control group and a trial group using a random number table method,with 120 cases in each group.The control group received IVF-ET treatment using an antagonist protocol.The trial group received Modified Guizhi Fuling Pills combined with IVF-ET treatment using the antagonist protocol.The IVF-ET outcomes were compared between the two groups.Changes in traditional Chinese medicine(TCM)syndrome scores,sex hormone levels,ovarian volume,and glycolipid metabolism indicators before and after treatment were observed in both groups.Results(1)Regarding IVF-ET outcomes,the number of oocytes retrieved and the cleavage rate were comparable between the two groups,with no statistically significant differences(P＞0.05).The high-quality embryo rate,clinical pregnancy rate,and live birth rate in the trial group were higher than those in the control group,but the differences still lacked statistical significance(P＞0.05).(2)Regarding TCM syndrome scores,after treatment,the TCM syndrome scores in both groups decreased compared to before treatment(P＜0.01),and the extent of decrease in the trial group was significantly greater than that in the control group(P＜0.01).(3)Regarding sex hormone levels,after treatment,serum estradiol(E2)levels increased in both groups compared to before treatment(P＜0.05),while serum testosterone(T)levels and the luteinizing hormone(LH)/follicle-stimulating hormone(FSH)ratio decreased(P＜0.05).The extent of increase in serum E2 levels and the extent of decrease in serum T levels and the LH/FSH ratio in the trial group were significantly greater than those in the control group(P＜0.01).(4)Regarding ovarian volume,after treatment,bilateral ovarian volumes in both groups decreased compared to before treatment(P＜0.05),and the extent of decrease in the trial group was significantly greater than that in the control group(P＜0.01).(5)Regarding glycolipid metabolism indicators,after treatment,levels of fasting blood glucose(FBG),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),total cholesterol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C)decreased in both groups compared to before treatment(P＜0.05),while high-density lipoprotein cholesterol(HDL-C)levels increased(P＜0.05).The extent of decrease in FBG,FINS,HOMA-IR,TC,TG,and LDL-C levels and the extent of increase in HDL-C levels in the trial group were significantly greater than those in the control group(P＜0.01).Conclusion Treatment with Modified Guizhi Fuling Pills combined with an antagonist protocol in PCOS patients with phlegm interweaved with stasis syndrome can achieve favorable IVF-ET outcomes.Simultaneously,it can significantly improve patients'TCM syndrome manifestations,sex hormone levels,and glycolipid metabolism,as well as reduce ovarian volume,demonstrating good clinical application value.