脱氢表雄酮对卵巢低反应患者妊娠结局及卵泡液的影响  

Effect of Dehydroepiandrosterone Preconditioning on Pregnancy Outcome and Follicular Fluid Markers in Patients With Low Ovarian Response

作　　者：李新宁 林秀峰 郑湘琼 杜静 李洁亮 程立子 LI Xinning;LIN Xiufeng;ZHENG Xiangqiong;DU Jing;LI Jieliang;CHENG Lizi(Reproductive Center,Zhongshan Boai Hospital,Zhongshan Guangdong 528403,China;The Second Clinical College,Southern Medical University,Guangzhou Guangdong 510515,China)

机构地区：[1]中山市博爱医院生殖中心,广东中山528403 [2]南方医科大学第二临床医学院,广东广州510515

出　　处：《中国卫生标准管理》2022年第7期113-116,共4页China Health Standard Management

基　　金：广东省中山市社会公益科技研究项目(2018B1044)。

摘　　要：目的探讨脱氢表雄酮(dehydroepiandrosterone,DHEA)对于卵巢低反应(poor ovarian response,POR)患者妊娠结局及卵泡液标志物的影响。方法采用前瞻性随机对照研究将85例POR患者随机分为用药组与对照组。用药组(n=41)给予DHEA 25 mg/次,每天3次,连用12周。对照组(n=44)直接进入周期。比较两组的卵巢反应性指标(促性腺激素总量、平均获卵数、卵裂数、平均可利用胚胎数、平均优质胚胎数、新鲜周期临床妊娠率和累计活产率)并检测两组卵泡液中的抗苗勒管激素(anti-Müllerian,AMH)、胰岛素样生长因子-1(insulinlike growth factor-1,IGF-1)及生长分化因子-9(growth differentiation factor-9,GDF-9)在卵泡液中的含量。结果两组患者卵巢反应性指标差异无统计学意义(P>0.05)。HCG日血清FSH、E2、子宫内膜厚度等差异无统计学意义(P>0.05)。卵泡液中AMH、IGF-1、DHEA-s和GDF-9的相对表达量在两组中差异无统计学意义(P>0.05)。结论POR患者在促排卵周期前进行DHEA预处理并不能改善其妊娠结局且对卵泡液中标志物的表达无明显改善。Objective To investigate the effect of dehydroepiandrosterone(DHEA)supplementation on pregnancy outcome and follicular fluid markers in patients with poor ovarian response(POR).Methods A prospective randomized controlled study was used to randomly divide 85 patients with POR into medication group and control group.The medication group(n=41)was given DHEA 25 mg/time,three times a day,for 12 weeks.The control group(n=44)was entered the cycle directly.The ovarian responsiveness indicators(total gonadotropin,average number of oocytes retrieved,number of cleavage,average number of available embryos,average number of high-quality embryos,fresh cycle clinical pregnancy rate and cumulative live birth rate)were compared between the two groups.Anti-Müllerian hormone(AMH),insulin-like growth factor-1(IGF-1)and growth differentiation factor-9(GDF-9)were detected in the follicular fluid of the two groups.Results There were no statistically significant differences in ovarian responsiveness indicators between the two groups(P>0.05).There was no significant difference in serum FSH,E2 and endometrial thickness on HCG day(P>0.05).The relative expression levels of AMH,IGF-1,and GDF-9 in follicular fluid were not statistically different between the two groups(P>0.05).Conclusion Pretreatment of POR patients with DHEA before the IVF cycle cannot improve their pregnancy outcome and has no obvious benefit to the expression of markers in the follicular fluid.

关 键 词：脱氢表雄酮(DHEA) 卵巢低反应(POR) 卵泡液 生长分化因子-9(GDF-9) AMH 子宫内膜厚度 

分 类 号：R714[医药卫生—妇产科学]