Effects of TCM Zishen Liangxue cycle therapy on the expression of ER,PR and VEGF in endometrium of patients with endometriosis-related infertility and the correlation with endometrial receptivity

Objective Many study focus on the low pregnancy rate in patients with endometriosis-related infertility. The key treatment for increasing the pregnancy rate is to improve the endometrial receptivity. The aim of this study is to observe the effect of TCM Zishen Liangxue cycle therapy on the the expression of ER, PR and VEGF in endometrium of patients with endometriosis-related infertility, and explore the clinical efficacy of TCM Zishen Liangxue cycle therapy in improving the pregnancy rate and the endometrial receptivity. Methods Total 130 patients with endometriosis-induced infertility in our hospital from July, 2015 to September, 2016 were enrolled into this study. Among them, 60 patients were defined as mild group, and other 70 cases were assigned into moderate-to-severe group. The patients in the mild group were randomly divided into TCM group (TCM Zishen Liangxue cycle therapy for continuous three months) and control group (without treatment), the clinical efficacy was observed for six menstrual cycles. The patients in the moderate-tosevere group were randomly divided into treatment group and western medicine group. All the patients in both groups received GnRH-a injection on the first day of menstruation after the operation, one injection every 4 weeks for three courses, then the treatment group continuous received treatment of TCM Zishen Liangxue cycle decoction for three menstrual cycles, while the western medicine group was only treated with GnRH-a. The expression of ER, PR and VEGF in endometrium before and after the treatment in all groups was tested by immunohistochemistry. Thee pregnancy rate were also observed. Results ① in the mild group:there were significantly lower expression of ER and VEGF in endometrium after treatment in TCM group as compared with the control group (P<0.05). There were no significantly change in the expression of PR (P<0.05). ② in moderate-to-severe group:significantly lower expression of ER, PR and VEGF in endometrium in the treatment group were observed after the treatment (P<0.05). ③ Significant increase of pregnancy rate were found in both TCM group and treatment group when compared with the contrast groups, the difference was statistical significant (P<0.05). Conclusion TCM Zishen Liangxue cycle therapy can improve the expression of ER, PR and VEGF in endometrium and increase the pregnancy rate of patients with endometriosis-related infertility. It has a close relationship with the improvement of the endometrial receptivity.