Effect of treatment of Wenyang Huazhuo recipe for chronic endometritis on pregnancy outcomes in patients with repeated implant failure:a randomized controlled study
Objective To study the effect of the addition of Wenyang Huazhuo recipe(WYHZ)to antibiotics for the treatment of chronic endometritis(CE)on the pregnancy outcome of patients with recurrent implantation failure(RIF).Methods Totally 60 patients with spleen-kidney yang deficiency RIF combined with CE were selected who attended the Reproductive Center of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from February 2020 to January 2021.They were randomly divided into control group and Traditional Chinese Medicine(TCM)group in a 1∶1 ratio using a random number table method.Thirty patients in control group were treated with oral doxycycline and metronidazole for 14 d,and 30 patients in TCM group were treated with the addition of WYHZ for three menstrual cycles.The patients underwent frozen-thawed embryo transfer during the next menstrual cycle at the end of treatment.We compared pregnancy outcomes,ultrasound endometrial thickness,morphology,endometrial flow branches,flow-related index,and endometrial tissue CD138,vascular endothelial growth factor(VEGF)and homeobox A10(HOXA10)mRNA between the two groups.The influencing factors of persistent pregnancy rate was analyzed by univariate logistic regression.Results The continuous pregnancy rate[46.67%(14/30)]and the embryo implantation rate[54.05%(20/37)]in the TCM group were higher than those in control group[20.00%(6/30),P=0.028;31.71%(13/41),P=0.046],and the differences of clinical pregnancy rate,biochemical pregnancy rate,and early miscarriage rate were not statistically significant(all P>0.05).After treatment,the proportion of type A endometrium in the TCM group[66.67%(18/27)]was higher than that in control group[33.33%(10/30),P=0.017],and the hemodynamic index(2.29±0.76)and systolic/diastolic(5.52±1.24)values were lower than those in control group(2.86±0.92,P=0.015;6.44±1.43,P=0.012).There was no statistically significant difference in the CE negative rate between the two groups after treatment(P>0.05),and the expression level of VEGF[(33.37±11.46)ng/L vs.(64.52±10.14)ng/L,P<0.001]and HOXA10(2.06±0.89 vs.3.67±1.27,P<0.001)in the mid-luteal endometrium was increased in the TCM group after treatment compared with control group.In univariate logistic regression analysis,the results showed that endometrial blood flow was an independent factor affecting persistent pregnancy of RIF with CE(OR= 2.956,95%CI:1.072-8.148,P=0.036).Conclusion WYHZ is able to improve the endometrial blood supply of patients with RIF combined with CE,increase their endometrial receptivity,and improve their pregnancy outcome.
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