在IVF-ET中卵巢功能低下患者经脱氢表雄酮治疗的临床分析  

Clinical analysis of DHEA treatment in patients with low ovarian function in IVF-ET

作　　者：吴惠梅[1] 袁华[1] 李柳铭 江莉[1] 李慕军[1] 

机构地区：[1]广西医科大学第一附属医院生殖医学研究中心,南宁530021

出　　处：《生殖医学杂志》2016年第7期633-638,共6页Journal of Reproductive Medicine

基　　金：2015年度广西高校科学技术研究项目(KY2015TYB06)

摘　　要：目的本研究评估在体外受精-胚胎移植(IVF-ET)治疗中的卵巢功能低下(DOR)患者经脱氢表雄酮(DHEA)治疗的效果。方法采用随机对照研究,对符合卵巢功能低下患者86例,通过计算机产生随机数字表法,分为实验组(43例)和对照组(43例)。实验组患者口服DHEA胶囊(25mg/粒,GNC,美国),对照组患者不服用DHEA但给予无药效的安慰剂(25mg/粒),每天三次,每次一粒,连续服用三个月。使用彩色超声监测治疗前后的基础窦卵泡数(AFC)及卵巢血流动力学参数搏动指数(PI)、阻力指数(RI)、收缩期最大血流速度(PSV)、动脉血流收缩期峰值的流速/舒张期低值的流速(S/D),记录患者行IVF-ET促性腺激素(Gn)用量、Gn天数、HCG日E2、获卵数、受精数、2PN数、可移植胚胎数,并将各参数的差异进行比较研究。结果最终完成实验67例,实验组32例,对照组35例。治疗前,实验组与对照组患者年龄、不孕年限、基础内分泌激素(FSH、LH、E2)、AFC、超声参数(PI、RI、PSV及S/D)差异均无统计学意义(P>0.05)。治疗后,实验组的AFC数量高于治疗前(5.27±1.88vs.4.33±2.09)及治疗后的对照组(5.27±1.88vs.4.21±1.64)(P<0.05);治疗后实验组的基础FSH低于治疗前[(10.32±3.23)vs.(15.46±2.97)U/L]及治疗后的对照组[(10.32±3.23)vs.(15.34±3.18)U/L],差异有统计学意义(P<0.05);实验组治疗前后基础LH和E2差异无统计学意义(P>0.05);对照组治疗前后FSH、LH、E2均无统计学差异(P>0.05)。实验组的PI、RI和S/D均低于治疗前(PI:0.80±0.03vs.0.91±0.03;RI:0.50±0.05vs.0.61±0.04;S/D:1.80±0.029vs.1.91±0.028)及治疗后的对照组(PI:0.80±0.03vs.0.90±0.03;RI:0.50±0.05vs.0.60±0.02;S/D:1.80±0.029vs.1.90±0.027),实验组治疗后PSV高于治疗前(11.87±0.54vs.11.28±0.53),及治疗后的对照组(11.87±0.54vs.11.26±0.39),差异均具有统计学意义(P<0.001)。实验组的Gn用量低于对照组,获卵数、受精数、2PN数高于对照组,差异有统计学意义,而Gn�Objective： To assess the effects of dehydroepiandrosterone （ diminished ovarian reserve （DOR） undergoing IVF-ET. Methods： Eighty six women with diminished ovarian reserve our hospital from January 2014 to August 2015. The patients were control group. The DHEA group patients took oral DHEA cap DHEA） treatment on the patients with were enrolled in this prospective trial in randomly divided into DHEA group and sule （25mg/capsule, GNC, USA）, one capsule for each time, three times per day for three months; and the patients in the control group took placebo instead of DHEA. Basis antral follicle count （AFC）, the parameters of ovarian hemodynamics including pulsatility index （PI）, resistance index （RI）, peak systolic velocity （PSV）, the ratio of peak systolic arterial blood flow velocity/low diastolic velocity（S/D） before and after treatment were monitored by color ultrasound. The gonadotropin （Gn） dosage, Gn used days, E2 level onH CG day, number of oocytes, number of fertilized oocytes, 2PN embryo number, and number of embryos transferred were recorded and compared. Results： Sixty seven patients were enrolled in this study,including 32 patients in the DHEA group and 35 patients in the control group. There were no significant differences in age, infertile years, levels of FSH,LH and E2,AFC,PI,RI,PSV and S/D before treatment between DHEA group and control group （P〉0.05）. The AFC after treatment （5.27±1.88） was significantly higher than before treatment （4.33±2.09）in DHEA group and after treatment in control group（4.21±1.64） （P〈0.05）. The basal FSH levels after treatment [（10.32± 3.23） U/L] were significantly lower than that of before treatment [（15.46±2.97） U/L] in DHEA group and after treatment in the control group[（15.34±3.18） U/L] （P〈0.05）. There were no significant differences in the basal levels of LH and E2 before and after treatment in DHEA group（P〉0.05）. The PI （0.80±0.03 vs. 0.91±0.03）,RI （0.50-±0.05vs. 0.

关 键 词：彩色超声 卵巢功能低下 脱氢表雄酮 体外受精-胚胎移植 

分 类 号：R[医药卫生]