助孕消抗方对雌性大鼠抗精子抗体抑制作用的实验研究

目的观察助孕消抗方对免疫性不孕症大鼠的作用机制。方法 50只SD大鼠随机分为两组,正常对照组10只,造模组40只。将AsAb阳性雌鼠40只随机分成4组:中药治疗组、造模组、强的松治疗组、中药+强的松治疗组,每组各10只。分别灌胃给药,2周后取血,酶联免疫法(ELISA)测定AsAb A值。将雌鼠以3:1比例与雄鼠配对合笼,停药后第6天处死雌鼠,取子宫、卵巢称重,常规病理切片检查,比较各组大鼠受孕率及孕鼠平均着床点数,用免疫组化法检测卵巢TNF-α、IL-2、IL-6的表达。结果 (1)与模型组比较,各药物治疗组均表现出AsAb A值降低作用(P0.05)。(2)模型组和强的松治疗组的胚胎数明显降低,与正常对照组比较有统计学意义(P0.05);而助孕消抗方组能增加胚胎数,且与模型组比较有显著性差异(P0.05)。(3)模型组和强的松治疗组TNF-α、IL-2、IL-6表达增强,而助孕消抗方能降低TNF-α、IL-2、IL-6的表达。结论助孕消抗方能通过降低TNF-α、IL-2、IL-6的表达,降低抗精子抗体阳性雌鼠AsAb A值,增加平均胚胎数。     

观察自拟助孕汤对免疫性不孕不育患者的临床疗效

目的：观察自拟助孕汤对免疫性不孕不育患者的临床疗效。方法：选取来我院进行治疗的免疫性不孕不育患者100例,将患者在知情且自愿的基础上进行随机分组,分为观察组和对照组两组,每组组内均50例患者。对照组患者给予口服地塞米松、维生素E和维生素C进行治疗,观察组患者给予自拟助孕汤进行治疗。结果：观察组患者的临床治疗总有效率为90．0％,对照组患者为68．0％,组间比较差异具有统计学意义（P〈0．05）。观察组患者治疗后46例患者抗体转阴,转阴率为92．0％,对照组患者29例患者抗体转阴,转阴率为58．0％,组间比较差异具有统计学意义（x？=4．904,P〈0．05）。对照组患者治疗后内分泌指标无显著变化,观察组患者治疗后内分泌指标得到显著改善,比较差异具有统计学意义（P〈0．05）。结论：自拟助孕汤治疗免疫性不孕不育能够显著提高患者临床疗效,可促使抗体转阴改善内分泌指标,从而提高患者受孕率。     

补肾助孕汤联合克罗米芬治疗排卵障碍性不孕症的疗效观察研究

目的:研究补肾助孕汤和克罗米芬联合用于排卵障碍性不孕症的价值.方法:2018年1月-2019年8月本科接诊排卵障碍性不孕症病患56例,随机均分两组.研究组联用补肾助孕汤和克罗米芬,对照组单用克罗米芬.对比LH等指标.结果:疗程结束时,对于LH和E2水平,研究组依次是(22.93±3.61)mlU/ml、(161.96±...     

朱氏调经促孕方联合针灸治疗排卵障碍性不孕症的效果

目的 探讨朱氏调经促孕方联合针灸治疗排卵障碍性不孕症的效果。方法 选取2018年10月至2021年6月我院收治的96例排卵障碍性不孕症患者,根据入组单双顺序分为观察组与对照组。对照组采用枸橼酸氯米芬治疗,观察组采用朱氏调经促孕方联合针灸治疗。比较两组的临床疗效、性激素水平、氧化应激指标。结果 观察组总有效率为97.92%,高于对照组的83.33%(P <0.05)。治疗后,两组的黄体生成素(LH)、雌二醇(E₂)水平高于治疗前,且观察组的E₂水平高于对照组(P <0.05)。治疗后,两组的丙二醛(MDA)水平低于治疗前,超氧化物歧化酶(SOD)水平高于治疗前,且观察组的MDA水平低于对照组,SOD水平高于对照组(P <0.05)。结论 朱氏调经促孕方联合针灸治疗排卵障碍性不孕症的效果理想,可调节机体性激素及氧化应激指标水平。     

几种助孕技术引起早产风险的评估

为比较不孕症患者经过简单助孕技术(IUI、DI)或复杂助孕技术(IVF、ICSI、GIFT)治疗获得单胎妊娠引起早产的风险，回顾1986～1998年间经简单助孕技术治疗分娩1015例单胎妊娠，复杂助孕技术分娩1019例，自然妊娠分娩1019例(对照组)，比较3种情况引起早产的风险。其中简单助孕组：IUI治疗后分娩730例、DI：285例，复杂助孕组IVF：710例，     

不孕症患者血清免疫性抗体检测的临床价值与治疗体会

目的研究不孕症患者血清免疫性抗体检测的临床价值。方法选取吉林省人口生命科学技术研究院2013~2014年收治的不孕症患者150例为观察组,正常生育妇女150例为对照组,观察组患者给予肾上腺皮质激素类和隔绝疗法进行治疗。比较两组治疗前抗精子抗体(Antisperm antibody,As Ab)、抗子宫内膜抗体(Endometrial antibody,EMAb)、抗卵巢抗体(antiovary antibody,Ao Ab)、抗透明带抗体(Anti zona pellucida antibodies,Azp Ab)阳性比例的差异和观察组治疗前后的变化情况,并评价疗效。结果观察组治疗前As Ab阳性、EMAb阳性、Ao Ab阳性、Azp Ab阳性的例数(34、17、11、10)均高于对照组(2、1、1、1)(P0.05);观察组治疗后As Ab阳性、EMAb阳性、Ao Ab阳性、Azp Ab阳性的例数(19、7、3、3)低于治疗前(34、17、11、10)(P0.05)。观察组治疗后自然受孕和人工受孕的例数高于治疗前的例数(8 vs 0,16 vs 0)(P0.05)。结论免疫抑制治疗不孕有良好的效果,通过检测和分析自身免疫抗体的变化诊断和治疗不孕症具有可行性,值得临床推广应用。     

补肾化痰助孕方联合达英-35治疗多囊卵巢综合征的临床效果观察

目的探究补肾化痰助孕方联合达英-35治疗多囊卵巢综合征(PCOS)的临床效果。方法选取2014年3月-2015年8月该院收治的PCOS患者120例为研究对象。按照随机数字表法将120例患者分为两组,随机数字为奇数者为观察组,偶数者为对照组,每组患者60例。观察组采用补肾化痰助孕方联合达英-35治疗;对照组单纯采用达英-35治疗,两组均共治疗3个周期,治疗后观察并比较患者的月经恢复情况、治疗前后的血激素睾酮(T)、排卵率及黄体生成素/卵泡刺激素(LH/FSH)水平变化。结果 3个周期治疗后,观察组月经恢复人数(完全恢复+基本恢复)约占88.3%,对照组月经恢复人数约为75.0%,观察组月经完全恢复人数明显高于对照组,差异有统计学意义(χ~2=5.829,P=0.016);对照组排卵率明显低于观察组,差异有统计学意义(χ~2=12.150,P0.001)。两组患者T值及LH/FSH值均明显降低,且观察组治疗效果明显优于对照组,差异有统计学意义(t=4.952,P0.001;t=2.311,P=0.023)。结论补肾化痰助孕方联合达英-35对于PCOS患者的治疗效果高于单纯的西药治疗,促进卵泡的发育与成熟的同时还可诱发排卵,对于提升妊娠率非常有帮助,值得临床推广。     

中药孕宝2号治疗免疫性不孕不育128例临床分析

目的探讨免疫性不孕不育较优的药物治疗方法.方法女性测定血清AsAb、EmAb、AoAb、HCGAb,其中一项或多项阳性者,男性仅测AsAb,阳性者为治疗病例.治疗组128例,对照组66例.治疗组服用孕宝2号(18味中药制成的胶囊),对照组采用六味地黄丸,疗程均为2～3个月.结果治疗组转阴117例,转阴率平均为91.41%,其中,妊娠73例,妊娠率为62.39%.对照组转阴39例,转阴率为59.09%,其中妊娠19例,妊娠率为48.72%.经X2检验,治疗组疗效显著优于对照组(P<0.05).结论中药孕宝2号为治疗免疫性不孕不育的较佳治疗方法.     

中药助孕方加克罗米酚治疗耐克罗米酚的多囊卵巢综合征不孕

目的:探讨中药助孕方加克罗米酚(CC)治疗常规CC疗法不敏感的多囊卵巢综合征(PCOS)不孕患者的疗效。方法:选择耐CC的PCOS患者68例,随机分成A组和B组。A组:34例患者中药助孕方加CC治疗。B组:34例患者TMX加CC治疗。结果:A组的妊娠明显高于B组(P<0 .05),两组的排卵率、自然流产率比较无显著性差异(P>0 .05)。A组的黄体功能不足及未破裂卵泡发生率明显低于B组。结论:采用中药助孕方联合CC的促排卵方案治疗耐CC的PCOS不孕患者是安全、有效的,具有临床应用和进一步研究的价值。     

输卵管梗阻性不孕的综合治疗

目的观察中西医综合治疗输卵管梗阻性不孕的临床疗效。方法经超声检查排除生殖器官肿瘤和畸形,经生殖内分泌激素检测等排除无排卵性不孕,经精液检查排除男性不孕,对输卵管阻塞性不孕给予抗生素消炎,并通过四诊合参辨证论治,口服中药,每日1剂,中药保留灌肠,每日1次,深部热疗每日1次,输卵管通液每月3次。结果治疗1个月治愈1例;治疗3个月治愈3例;6个月至1年治愈3例,好转20例,无效13例;治疗1年治愈8例,好转17例,无效8例;治疗2年治愈5例,好转15例,无效5例。总治愈率50％,总有效率87．5％。结论中西医综合治疗输卵管梗阻性不孕,无痛苦,创伤小,临床疗效较好。     

中隔子宫不孕不育合并子宫内膜异位症的临床诊治

目的:探讨中隔子宫不孕不育患者合并子宫内膜异位症的临床特征、诊断及治疗方法。方法:对2001年2月～2005年8月北京大学深圳医院住院治疗的24例中隔子宫不孕不育合并子宫内膜异位症患者的临床资料进行回顾性分析。结果:24例中隔子宫不孕不育患者全部合并子宫内膜异位症,平均年龄28.5岁,临床表现均为不孕不育,其中不孕不育16例,月经紊乱4例,无症状体检发现4例,全部患者经手术治疗(宫腔镜、腹腔镜联合手术)。手术证实完全中隔7例,不全中隔17例。子宫内膜异位症按(ASF-r)分期,均为Ⅰ～Ⅱ期,多处盆腔异位病灶8例,直肠窝异位病灶6例,子宫骶骨韧带异位病灶10例,所有患者术后均放置宫内节育器,雌激素治疗3～6个月,追踪随访妊娠10例,分娩5例。结论:中隔子宫不孕不育患者易合并子宫内膜异位症,应早期诊断、早期手术治疗,宫腔镜、腹腔镜联合手术治疗是治疗的最佳方法。术后雌激素治疗有利于子宫内膜的修复。但对盆腔子宫内膜异位病灶则不利,必要时需二次腹腔镜手术去除异位病灶,疗效满意。     

The role of Tadalafil in treatment of infertility

ObjectiveIt was the aim of this research to assess whether Tadalafil 5 mg once daily can improves the sperm count of unexplained infertile males with erectile deficiency induced by the emotional stress of attempting to father children.MethodsTwo groups, each made up of 30 unexplained infertile males with psychogenic erectile deficiency related to attempts to father children received Tadalafil 5 mg once daily (Group 1) or a placebo (Group 2) for one month. Unexplained infertile men are intended as normospermic men who could not father children over a one year period and whose female partner is free of factors causing infertility. The endpoints were: differences between the groups in restoring erectile response, modifying sperm count, side effects and modifications of sperm analyses with respect to resolution or not of the erectile deficiency irrespective of the substance (Tadalafil or placebo) used. The means were compared using analysis of variance and the percentages using the chi square test.ResultsThe patients who received Tadalafil had their sperm volume, concentration and motility increased, but not the percentage of typical forms. Patients who received a placebo had no significant improvement. Additional analyses indicated that sperm volume, concentration and motility (but not morphology) significantly increased only in the patients who restored erectile response to sexual stimulation, independently of Tadalafil or placebo administration. No significant side effects were present.ConclusionsIt is thought that therapies aimed at removing emotional stress linked to the performance anxiety of fathering children might improve sperm count in unexplained infertile couples.     

The increasing demand for infertility treatment.

At present NHS services for infertile couples are under-developed compared with those available in the private sector. Health care planners should be aware that the demand for infertility treatment is likely to increase. The average age at first child birth has increased and presumably also the average age at the first attempt to conceive. The rise in divorce rates and second marriages has resulted in increasing numbers of couples wishing to start a second family at a comparatively advanced age. If, as it appears, the time taken to conceive increases with age, the higher average age of women attempting to conceive could cause an increase in the prevalence of infertility, and the demand for treatment. Divorce and remarriage of sterilised people has resulted in a demand for reversal of sterilisation and for in vitro fertilisation (IVF). The age of onset of sexual activity has fallen. This, combined with later marriage, has led to an increase in the number of sexually active single people, with an increase in the incidence of sexually transmitted disease of which infertility is a possible sequel. The opportunity to adopt is now available for very few couples because of the decreasing proportion of illegitimate babies available for adoption. Recent publicity given to developments such as gamete intra fallopian transfer (GIFT) and IVF may have increased the demand for treatment.     

宫腔镜治疗宫腔因素所致不孕不育患者的生殖预后分析

目的探讨宫腔镜治疗宫腔因素所致不孕不育患者的生殖预后疗效。方法研究对象为2008年1月～2011年6月某院收治的被确诊为宫腔因素所致不孕不育的患者56例,实施宫腔镜检查明确导致不孕不育的宫腔因素,并实施宫腔镜手术及治疗后评价患者的生殖预后情况。结果经宫腔镜检查确诊导致不孕不育的宫腔因素包括子宫内膜息肉16例、息肉样增生16例、宫腔黏连14例、子宫纵膈5例、子宫贴膜下肌瘤3例、子宫内膜结核2例,且上述56例患者中共有16例获得妊娠。结论针对宫腔因素所致不孕不育患者实施宫腔镜术,有助于疾病的确诊及治疗,可以明显改善患者的生殖预后,值得临床上推广应用。     

经阴道实时三维子宫输卵管超声造影对不孕症患者的治疗作用

目的观察经阴道实时三维子宫输卵管超声造影对不孕症患者的治疗作用。方法选择2016年1月至2017年3月在南京中医药大学附属医院因不孕症就诊并行经阴道实时三维子宫输卵管超声造影检查的832例患者的临床资料,随访其造影检查后1年内的受孕情况。采用视觉模拟评分法(visual analogue scale,VAS)评估造影过程中患者的疼痛程度。结果在检查后1年内怀孕289例(34.74%);247例(29.69%)积极备孕但未受孕;296例(35.58%)失访。289例受孕患者中,做完造影检查后前3个月之内受孕的例数多于后3个月受孕的例数(P0.05)。1年内受孕的患者中双侧通畅的例数多于未受孕组。289例受孕患者的VAS评分中,"无疼痛"和"轻度疼痛"的患者占全部受孕患者的85.57%。结论经阴道实时三维子宫输卵管超声造影术是一种患者耐受程度较好的评估输卵管通畅性的方法,除了可提供诊断性结论,对输卵管可能也有一定的辅助疏通作用,对受孕可能存在一定帮助。     

子宫内膜异位症相关不孕治疗进展

子宫内膜异位症是引起育龄女性不孕的重要因素之一,目前手术仍是主要的治疗方式,手术时机、手术方式、内异症手术分期及不同类型程度子宫内膜异位症对术后妊娠结局均有影响,药物治疗不能够提高患者的生育能力,只能延缓复发,而辅助生殖技术作为辅助生育治疗措施,对于提高患者的生育能力是必要的。     

腹腔镜在48例输卵管性不孕患者诊治中的应用

目的:探讨腹腔镜诊治输卵管不孕的临床效果及技术特点。方法:收集2006年6月～2009年10月仙桃市第一人民医院行腹腔镜诊治输卵管不孕48例患者的资料,回顾性分析患者的腹腔镜诊断和手术治疗的情况。结果:48例患者均在腹腔镜下顺利完成手术,无1例中转开腹。手术时间20～70min,平均42.62min;术中出血5～55ml,平均28.98ml,所有患者无并发症发生,术后受孕率达87.50%,取得满意的临床效果。结论:腹腔镜诊治输卵管不孕具有创伤小、出血少、恢复快、住院时间短、并发症少等优点,术后受孕率高,是诊治输卵管性不孕的最佳术式。     

Ascorbic acid and infertility treatment

AIM OF THE STUDY: To assess the ascorbic acid (AA) in the follicular fluid in women treated by in vitro fertilization and embryonic transfer levels (IVF/ET) and to analyse the influence of vitamin C supplementation on the results of infertility treatment. TYPE OF THE STUDY: Prospective study in women treated by IVF/ET. METHODS: The influence of vitamin C supplementation on the outcome of infertility treatment in the assisted reproduction programme in 76 women (38 of them smokers, 38 non-smokers) was studied. Half the women (19 smokers and 19 non-smokers) were administered vitamin C in daily doses of 500 mg in so-called pellets allowing for gradual release over 8 to 12 hours. The control group consisted of the same number of smokers and non-smokers. In all the women, ascorbic acid levels were determined in two urine samples (prior to supplementation and at follicle retrieval) and in follicular fluid by means of a colorimetric method. Ovarian response to hormonal stimulation with gonadotropins (hMG, FSH) at a dosage of 150-225 IU per day combined with GnRH analogues in the short (buserelin) or long (triptorelin) protocols, and 5,000-10,000 IU of human chorionic gonadotropin was evaluated based on the number of follicles created and number of retrieved oocytes. Fertilisation was assessed, based on the number of successfully fertilised oocytes (fertilisation rate) and based on the number of cultivated embryos. The success of the infertility treatment was evaluated based on the number of pregnancies. RESULTS: Ascorbic acid levels in follicles were significantly higher (p < 0.001) in women with vitamin C supplementation than in the control group (8.98 +/- 5.09 vs. 5.04 +/- 2.85 mg/l). The administration of vitamin C during the period of hormonal stimulation showed a statistically insignificant impact in terms of the higher number of pregnancies (34.2% vs. 23.7%). Vitamin supplementation had a greater impact on the number of pregnancies in the non-smokers' group (57.9% vs. 31.6%). The pregnancy rate was significantly higher (p < 0.01) in non-smoking women than in smokers--44.7% vs. 13.2%, which appears to be a reason for asking women to cease smoking prior to infertility treatment.