脱氢表雄酮对卵巢储备功能下降患者卵巢反应性和IVF-ET结局的影响  

Efficacy of dehydroepiandrosterone to improve ovarian response and the outcome of IVF-ET in women with diminished ovarian reserve

作　　者：龚瑜[1] 周黎明[1] 蔡婕[1] 孙亦婷[1] 赵雅云[1] 夏爱丽[1] 

机构地区：[1]宁波市妇女儿童医院生殖中心,宁波315012

出　　处：《生殖医学杂志》2017年第7期675-678,共4页Journal of Reproductive Medicine

基　　金：宁波市自然基金项目(2015A610199)

摘　　要：目的探讨脱氢表雄酮(DHEA)对卵巢储备功能下降(DOR)患者卵巢反应性和IVF-ET结局的影响。方法收集2014年10月至2016年8月接受IVF和ICSI治疗DOR患者58例,第一周期采用拮抗剂方案,未服用DHEA(对照组);予服用DHEA至少2个月后,第二周期再次采用拮抗剂(治疗组),周期间隔不超过一年。以外源性促性腺激素用量、天数,周期取消率、FSH、窦卵泡计数(AFC)和卵泡数、获卵母细胞数、获卵率、MII数、正常受精率、优胚数、优质胚胎率、妊娠率为变量,利用配对t检验和卡方检验分析。结果对照组和治疗组的Gn总量分别为(36.6±1.9)和(31.4±1.4)支,两组差异有统计学意义(P<0.05)。治疗组比对照组有更高的获卵率(83.7%vs.74.1%,P<0.01)。对照组和治疗组的妊娠例数分别是3例(5.7%)和20例(37.7%),两组具有统计学差异(P<0.01)。结论 DHEA可改善DOR患者卵巢功能,提高获卵率,改善胚胎质量从而提高IVF妊娠率。另外,DHEA可减少IVF中Gn的用量,为患者降低经济成本。Objective：To investigate the efficacy of dehydroepiandrosterone（DHEA）to improve ovarian response and the outcome of IVF-ET in women with diminished ovarian reserve（DOR）.Methods：The data were obtained from 58 DOR patients with 29 to 41years old.The patients were and received GnRH-antagonist（GnRH-ant）protocol in the first cycle without DHEA treatment（control cycle）;and the patients was given dehydroepiandrosterone at least for 2months,and then received GnRHantagonist（GnRH-ant）protocol in the second cycle（treatment cycle）.The interval of two cycles was no more than one year.The dose and duration of gonadotropin（Gn）used,cycle cancellation rate,FSH levels,number of AFC and oocyte retrieved,oocyte retrieval rate,number of MII oocytes,normal fertilization rate,number of good embryos,good embryo rate and pregnant rate were compared between the two cycles by paired-samples t-test and Chi-square.Results：Gn dosage used was significantly lower in treatment cycles than that in the control cycles（31.4±1.4vs.36.6±1.9ampoules）（P〈0.05）.The oocyte retrieval rate（83.7% vs.74.1%）and pregnancy rate（37.7% vs.5.7%）in the treatment cycles were significantly higher than those in the control cycles（P〈0.01）.Conclusions：Dehydroepiandrosterone can improve ovarian function in DOR patients and increase oocyte retrieval rate and good-quality embryo rate,as well as IVF pregnancy rate.In addition,DHEA can decrease the Gn dosage used,therefore reduce the cost for patients.

关 键 词：DHEA 卵巢储备功能下降 拮抗剂 体外受精-胚胎移植 

分 类 号：R[医药卫生]