卵巢功能低下者添加DHEA获卵数随机对照研究

目的：评价接受体外受精-胚胎移植（IVF-ET）治疗卵巢储备功能低下患者，经脱氢表雄酮（DHEA）治疗后的效果。方法采用随机对照研究，对符合卵巢功能低下（DOR）拟行体外受精-胚胎移植（IVF-ET）助孕治疗的患者，随机分为两组（通过计算机产生随机数字表法）。试验组（n ＝53）为 IVF-ET前接受 DHEA治疗者，25 mg，每日3次；对照组（n ＝51）为不进行 DHEA治疗者。对两组基础内分泌激素、HCG日雌激素值、促排天数、Gn总量、获卵数、2PN数、可移植胚胎数、优胚数等进行比较。结果试验组与对照组患者年龄、不孕年限、基础内分泌激素 FSH水平差异无统计学意义（P ＞0．05），试验组患者Gn用量少及获卵数、2PN数增加，差异有统计学意义（P ＜0．05）；试验组促排天数少、可移植胚胎数及优胚数多，但差异无统计学意义（P ＞0．05）；两组间 HCG日雌激素水平无明显变化。结论 DOR的不孕妇女，经DHEA治疗后，Gn用量减少，获卵数增加，降低 IVF-ET周期取消率，增加妊娠率。添加DHEA对接受 IVF-ET的DOR患者是有益的。

Randomized controlled trail on the number of retrieved oocytes from women with diminished ovarian reserve treated with DHEA supplementation

Objective To evaluate the role of dehydroepiandrosterone （DHEA）supplementation in infertile patients with diminished ovarian reserve （DOR）received in-vitro fertilization （IVF）cycles and to see whether DHEA would increase the number of retrieved oocytes.Methods This was a randomized, placebo-controlled study.Eligible subjects were randomized into the DHEA group （n=53）or the control group （n=51）according to a computer-generated randomization list.One group received 25 mg 3 times daily of DHEA supplementation,while the other did not receive any treatment.Results There were no statistically significant differences between treated and non-treated group regarding mean age,duration of infertility and baseline serum levels of FSH.The total number of oocytes retrieved and fertilized oocytes was statistically significant higher in women treated with DHEA （14.76＆#177;51.13 vs.270.03＆#177;262.18 pg/mL;P =0.002）,than that of the study group.Gonadotropin requirements during COH were lower.On the other hand,In the DHEA-group the mean duration of stimulation was slightly lower,although it was not statistically significant （9.83＆#177;1.85 vs 12.09＆#177;2.81;P =0.023）.The number of good-quality embryos and transferred embryos tended to be higher in the study group,but the results were not statistically signifi-cant.Conclusion DHEA supplementation may improve the total number of oocytes retrieved.Gonadotro-pin requirements tended to be lower,which was statistically significant.The study has shown the effect of DHEA which is possibly beneficial to the fertility outcome.