补充DHEA对卵巢储备功能降低患者TVF＋ET的影响

目的探讨补充脱氢表雄酮对卵巢储备功能降低患者卵巢功能及IVF—ET妊娠结局的影响。方法选择89例进行IVF／ICSI—ET的DOR患者进行随机对照研究，对照组为未服用DHEA的患者（n=47）。研究组（n=42）患者口服DHEA75mg／d，3个月后接受IVF—ET周期。分析比较研究组患者服用DHEA前后卵巢储备功能指标（基础卵泡数、基础内分泌水平等）；同时比较两组患者IVF周期治疗参数（获卵数、受精率、卵裂率、胚胎种植率、周期取消率、临床妊娠率、流产率等）的变化。结果研究组用药后FSH值较前下降（P〈0．05），窦卵泡数较前增加（P〈0．05）；DHEA预治疗组较对照组基础卵泡计数、获卵数较对照组均显著增加（P〈0．05），促排周期中Gn总量明显低于对照组（P〈0．05），胚胎种植率、临床妊娠率呈提高趋势（P〉0．05），周期取消率呈降低趋势（P〉0．05），而卵裂率、受精率、流产率无差异（P〉0．05）。结论对卵巢储备功能降低患者补充DHEA能有效改善其卵巢储备功能，提高卵巢反应性，增加促排卵效果，进而提高IVF—ET的临床妊娠率。

Effect of Dehydroepiandrosterone （DHEA） Supplementation on IVF -ET of Patients with Diminished Ovarian Reserve （DOR）

Objective To evaluate the effect of dehydroepiandrosterone （DHEA） supplementation on IVF- ET of Patients with Diminished Ovarian Reserve （DOR） and outcomes among poor - responder patients. Methods This study was a randomly controlled study conducted on 89 DOR patients treated with IVF/ICSI - ET. Patients in the control group didn＇ t take DHEA at all （ n = 47 ）. Patients in the study group （n = 42） took DHEA 75 mg/d orally, and would receive IVF - ET cycle 3 months later. Ovarian reserve function index （ number of follicles, basis hormone levels, etc. ） in the study group was analyzed and compared before and after pa- tients taking DHEA. The parameters of ovarian reserve and IVF outcomes between the cycles with and without DHEA treatment were compared, including the number of follicles, the number of oocytes retrieved, fertilization rate, cleavage rate, implantation rate, cycle cancellation rate, clinical pregnancy rate and the abortion rate. Results The levels of FSH after the treatment in the study group were decreased, the number of antral follicles increased, and the dosage of Gn was significantly lower than that in the control group （ P 〈 0. 05）. The number of follicles and retrieved oocytes increased after DHEA supplementation （ P 〈 0. 05 ）. There was no significant difference in cleavage rate, fertilization rate, abortion rate or cycle cancellation rate （ P 〉 0. 05 ）, but there was a trend that the cycle cancellation rate after DHEA treatment would reduce, and the implantation rate and clinical pregnancy rate would increase. （ P 〉 0. 05）. Conclusion DHEA supplementation for the patients with diminished ovarian reserve function can effectively improve the o- varian reserve function, improve the ovarian reactivity, increase the effect of promoting ovulation, and improve the clinical pregnancy rate of IVF - ET.