脱氢表雄酮对卵巢低反应患者卵巢反应性和体外受精-胚胎移植结局的影响  

Efficacy of Dehydroepiandrosterone in Improving Ovarian Response and Outcome of IVF-ET in Poor Responders

作　　者：胡蓉 瞿全新[1] HU Rong;QU Quan-xin(Department of Gynecology and Obstetrics,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院妇产科,300192

出　　处：《国际生殖健康／计划生育杂志》2018年第6期458-462,共5页Journal of International Reproductive Health/Family Planning

摘　　要：目的:评估脱氢表雄酮(DHEA)对卵巢低反应(POR)患者卵巢反应性及体外受精-胚胎移植(IVF-ET)治疗结局的影响。方法:选取78例2015年1月—2017年6月于天津市第一中心医院就诊接受IVF/胞浆内单精子注射(ICSI)-ET治疗的POR患者进行前瞻性对照研究,其中治疗组(n=41)患者在超促排卵前接受DHEA辅助治疗,对照组(n=37)未行DHEA辅助治疗。比较2组患者一般情况、卵巢储备功能和妊娠结局等相关指标。结果:2组患者年龄、不孕年限、体质量指数(BMI)和基础卵泡刺激素(FSH)、基础黄体生成激素(LH)等卵巢储备功能指标差异无统计学意义(均P>0.05)。治疗组卵泡数、获卵数和临床妊娠率高于对照组,促性腺激素(Gn)总剂量低于对照组,差异有统计学意义(均P<0.05);获卵率、卵裂率、优质胚胎率、胚胎种植率高于对照组,周期取消率低于对照组,但差异无统计学意义(P>0.05)。治疗组年龄<37岁的患者获卵数、获卵率和胚胎种植率高于年龄≥37岁的患者(均P<0.05)。结论:DHEA辅助治疗可以提高POR患者的卵巢反应性,减少Gn用量,改善IVF治疗结局,年轻患者使用后效果更佳。Objective：To evaluate the effect of dehydroepiandrosterone （DHEA） supplementation on the ovarian response and clinical outcomes of in vitro tertilization and embryo transter （IVF-ET） in poor responders. Methods：A prospective case-control study was conducted in 78 POR patients treated by IVF/ICSI-ET from January 2015 to June 2017 in Tianjin First Central Hospital, including 41 cases in the DHEA pre-freatment group （DHEA group） and 37 cases in the control group. Patients in the DHEA group received DHEA pretreatment beobre controlled ovarian hyperstimulation. General data, ovarian reserve and IVF outcome were compared between the two groups. Results：There were no significant differences in age, duration of infertility, body mass index （BMI） and parameters of ovarian reserve including basic follicle stimulating hormone （FSH） and luteinizing hormone （LH） between the two groups （all P〉0.05）. The number of follicles, the number of retrieved ooeytes and clinical pregnancy rate were significantly higher in the DHEA group than those in the control group, while the total dosage of gonadotropin （Gn） was significantly lower in the DHEA group （all P〈0.05）. There were the trends in improving the ooeyte retrieval rate, cleavage rate, high-qualily embryo rate and implantation rate in the DHEA group, and a trend in decreasing the cycle cancellation rate （all P〉0.05）. The number of follicles, ooeyte retrieval rate and implantation rate were significantly higher in patients aged 〈37 years than those aged ≥37 years in the DHEA group （P 〈0.05）. Conclusions：DHEA supplementation in some women with POR can enhance the ovarian response, reduce the dosage of gonadotropin and improve the clinical outcome of IVF. DHEA supplementation is more effective for young patients.

关 键 词：去氢表雄酮 卵巢低反应 卵巢 受精 体外 胚胎移植 抗苗勒管激素 

分 类 号：R714.8[医药卫生—妇产科学]