脱氢表雄酮预处理对卵巢低反应患者体外受精-胚胎移植结果的影响  

Influence of pretreatment with dehydroepiandrosterone in patients with poor ovarian response

作　　者：宋晖[1] 武雁[1] 田国华[1] 李砚[1] 滑玮[1] 黄艳红[1] 

机构地区：[1]第四军医大学西京医院妇产科生殖中心,西安710032

出　　处：《生殖医学杂志》2015年第8期622-625,共4页Journal of Reproductive Medicine

摘　　要：目的探讨使用脱氢表雄酮(DHEA)预处理对卵巢低反应患者卵巢功能及体外受精-胚胎移植结果的影响。方法将112例符合卵巢低反应诊断标准并使用短方案进行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)的患者随机分为经DHEA预处理的研究组和未用DHEA处理的对照组,每组各56例。分析比较研究组患者服用DHEA前后卵巢储备功能变化;同时比较研究组与对照组IVF/ICSI-ET治疗周期相关参数变化。结果研究组DHEA预处理后FSH值较前下降(7.43±3.04vs.10.15±3.07U/L,P<0.05),窦卵泡数较前增加(4.68±2.12vs.2.32±1.37,P<0.05);研究组与对照组比较,Gn总量呈降低趋势但无统计学差异(P>0.05),获卵数显著增加(4.23±1.74vs.2.17±1.03,P<0.05),卵裂率、受精率呈升高趋势但无统计学差异(P>0.05),优质胚胎率(32.14%vs.13.18%)、胚胎种植率(26.89%vs.8.97%)、临床妊娠率(25.00%vs.13.89%)均显著升高(P<0.05),周期取消率显著降低(9.43%vs.14.29%,P<0.05),而流产率无统计学差异(16.16%vs.20.00%,P>0.05)。结论对卵巢低反应患者使用DHEA预处理能有效改善其卵巢储备功能,增强促排卵效果,提高优质胚胎率和胚胎种植率,进而提高IVF-ET的临床妊娠率。Objective： To observe the influence of pretreatment with dehydroepiandrosterone（DHEA）in patients with poor ovarian response（POR）for IVF. Methods： A total of 112 POR patients with short protocol for IVF-ET/ICSI were randomly divided into the DHEA pretreatment group and control group, 56 patients for each group. The ovarian reserve function was analyzed and compared before and after DHEA treatment in the DHEA pretreatment group. Meanwhile the parameters of IVF-ET/ICSI were compared between the DHEA pretreatment group and control group. Results： The FSH levels were significantly declined [（7.43 ± 3.04） vs. （10.15± 3.07） U/L] （P〉 0.05） ,and the number of antral follicle was significantly increased [（4.68±2.12）vs. （2.32±1.37）]（P〈 0.05）after DHEA treatment. Comparing DHEA pretreatment group with control group,the total doses of gonadotropin used showed a trend of decrease（P〉0.05）. The number of oocytes retrieved was significantly increased [（4.23±1.74）vs.（2.17±1.03）]（P〈0.05）. The cleavage rate and fertilization rate showed a trend of increase（P〉0.05）. The rate of high quality embryo rate（32.14% vs. 13.18%） ,implantation rate （26. 89% vs. 8.97%） and clinical pregnancy rate（25.00% vs. 13.89%）were significantly increased（all P〈0.05）. The cycle cancellation rate was decreased significantly（9.43% vs. 14.29%,P〈0.05）and the abortion rate was not significantly different（16.16% vs. 20.00% ,P〉0.05）. Conclusions： Pretreatment with DHEA in patients with POR can effectively improve the ovarian reserve function, enhance the effect of ovulation induction, increase the high-quality embryo rate and implantation rate,and improve clinical pregnancy rate of IVF-ET.

关 键 词：脱氢表雄酮 卵巢低反应 短方案 体外受精-胚胎移植 

分 类 号：R[医药卫生]