title: Clinical observations of sequential therapy with Chinese medicine and hysteroscopic mechanical stimulation of the endometrium in infertile patients with repeated implantation failure undergoing frozen-thawed embryo transfer.
abstract: OBJECTIVE
  To investigate the clinical effect of sequential therapeutic intervention Yupei Qisun [compensating for weakness by invigorating Kidney (Shen) and Spleen (Pi) in advance] in Chinese medicine (CM) and hysteroscopic endometrial mechanical stimulation on the treatment of infertile patients with repeated implantation failure (RIF); and to study the differences in patients' endometrial thickness and type on the day of embryo transfer, serum hormone levels on embryo transfer day and clinical pregnancy outcomes.
  
  
  METHODS
  In the clinical study, 168 frozen-thawed embryo transfer (FET) cycles for couples with RIF conforming to the research protocol were randomly divided into three groups: a CM group with 56 cycles (CM combined with FET), a hysteroscopy group with 55 cycles (hysteroscopic endometrial mechanical stimulation), and a control group with 57 cycles (conventional FET). Differences in endometrial thickness on the embryo transfer day, levels of serum estradiol (E2) and progesterone (P) on the embryo transfer day, the E2/P ratio on the embryo transfer day, biochemical and clinical pregnancy rates, implantation rate, abnormal pregnancy rate and other indices were compared among the three groups.
  
  
  RESULTS
  Endometrial thickness, E2 and P levels, and the E2/P ratio on embryo transfer day and other factors had no significant differences among groups. The biochemical pregnancy, clinical pregnancy, and implantation rates of the CM and hysteroscopy groups were significantly higher than the control group (P<0.05), and there were no significant differences between these two groups. The abnormal pregnancy rate had no significant difference among the three groups.
  
  
  CONCLUSIONS
  Sequential therapy of Yupei Qisun could significantly improve the clinical outcomes of rif-fet cycles, being equivalent to hysteroscopic endometrial mechanical stimulation, and provided a reliable method to treat such infertile couples.
authors.affiliation: Department of Gynecology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
authors.forename: Xiao-le
authors.initials: XL
authors.lastname: Zhang
authors.forename: Yong-lun
authors.initials: YL
authors.lastname: Fu
authors.forename: Yan
authors.initials: Y
authors.lastname: Kang
authors.forename: Cong
authors.initials: C
authors.lastname: Qi
authors.forename: Qin-hua
authors.initials: QH
authors.lastname: Zhang
authors.forename: Yan-ping
authors.initials: YP
authors.lastname: Kuang
mesh_terms: D000026:Abortion, Habitual / Q000628:therapy; D000328:Adult; D010064:Embryo Implantation; D020964:Embryo Loss / Q000628:therapy; D004624:Embryo Transfer; D004717:Endometrium / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007247:Infertility, Female / Q000473:pathology / Q000628:therapy*; D008516:Medicine, Chinese Traditional / Q000379:methods; D010812:Physical Stimulation / Q000379:methods; D011247:Pregnancy; D019233:Retreatment / Q000706:statistics & numerical data