Discussion
endometriosis, thin endometrium infertility, dyspermia, ovulation disorder, infertility, myoma, thyroid dysfunction, thin endometrium, endometrial tuberculosis, abnormal uterine anatomy
ENDOMETRIOSIS, MYOMA, THYROID DYSFUNCTION, ENDOCRINE DISEASES, PREMATURE OVARIAN FAILURE, INTRAUTERINE ADHESIONS, HYPERPROLACTINEMIA, BLOCKED FALLOPIAN TUBE, VENOUS THROMBOSIS
In our study, we found that the average EMT of patients in the experimental group was significantly higher than that in the control group, exceeding the minimum threshold for pregnancy when the same dose of estrogen was supplemented. In contrast, the average EMT of patients in the control group on average just reached the pregnancy threshold, which means that, for some patients, the endometrium proliferating effect was perhaps not sufficient enough for an implantation during a possible pregnancy. Undoubtedly, proper EMT is crucial for embryo implantation. Once the EMT increased in those patients with thin endometrium infertility, the clinical pregnancy rate also increased significantly (It was suggested that the mechanisms of DKP in treating infertility may be not only to increase EMT, but also to promote some changes that are beneficial for endometrial receptivity. Impaired endometrial receptivity may account for up to two-thirds of implantation failures in younger women (There are many factors that can cause infertility, and some are not very clear even. We focused on endometrial factors, but within our diagnostic and clinical procedures, we tried to exclude most of the other common potential causes, including ovulation disorder, premature ovarian failure, hyperprolactinemia, thyroid dysfunction and other reproductive endocrine diseases, abnormal uterine anatomy, blocked fallopian tube, endometrial tuberculosis, myoma, endometriosis, intrauterine adhesions, and dyspermia.It can be stated that a strength of this study is that all EMT measurements, the main endpoint of this study, were performed by one experienced doctor. The sample size corresponds to the statistical calculation. The study design is prospective and clearly suitable to test the efficacy of DKP under routinely clinical conditions. Only patients with thin endometrium have been included, as a precondition for randomization to the two groups.The weakness of this trial is that there was no placebo–control due to the limited clinical conditions. Only one dose of estrogen supplement (2 mg per day) was studied. It remains unclear if the use of Dingkun alone, without addition of hormone therapy, would have similar beneficial results. Despite this question being of interest (to reduce hormone-dependent risks such as venous thrombosis), hormonal treatment is the “gold standard” for increasing endometrial thickness in women who wish to conceive. Therefore, our aim was to investigate whether the endometrium proliferating effect of hormones could be further increased by adding this form of traditional Chinese medicine, but without increasing the dosage of the estrogen. Further studies should investigate if the dose of hormones could be decreased, or if hormones could even be completely omitted.