[Exploring the effects of Chinese medicine in improving uterine endometrial blood flow for increasing the successful rate of in vitro fertilization and embryo transfer].

Endometrial blood flow is directly related to endometrial receptivity thereby affecting in vitro fertilization and embryo transfer (IVF-ET) outcomes. In recent years a growing number of studies have shown that traditional Chinese medicine (TCM) can play a role to improve endometrial blood flow and embryo transfer. Studies have confirmed that formulas based on reinforcing kidney and activating blood can promote the formation of uterine endometrial blood vessels by adjusting expressions of a variety of vessel growth factors, and regulating nitric oxide level for inhibition of vascular smooth muscle contraction of the uterus. Treatments based on differentiation of syndromes are key to the theory of TCM. Differentiation of syndromes should be combined with biomedical disease diagnosis. It is also necessary to further clarify other endometrial blood flow disorders using TCM diagnostic methods. In these cases, drugs for reinforcing kidney and activating blood are relevant, but other medicines for smoothing liver qi and nourishing blood, as well as tonifying the spleen and generating blood may also be effective. Future clinical studies should focus on the observation of different types of TCM syndromes and the research on compatibility ratio and dose-dependent relationship of Chinese medicines. Acupuncture has been used during IVF-ET for more than 10 years. Electro-acupuncture can control the expansion of the uterine arteries by inhibiting the sympathetic nerves. However, acupuncture has not been proved to regulate endometrial arteries. To sum up, TCM can be applied to improve endometrial blood flow so as to increase birth rates in IVF-ET. The combination of Chinese and Western medicines and acupuncture application will increase their combined effect, thereby obtaining greater clinical benefits.