生殖医学杂志

目的观察脱氢表雄酮(DHEA)应用在不同年龄阶段的卵巢储备功能下降(DOR)患者的疗效。方法回顾性分析在我院进行IVF助孕治疗前行DHEA预处理的220例DOR患者资料,按年龄分为3组:<35岁为A组(40例),35～40岁为B组(80例),>40岁为C组(100例)。比较不同年龄组患者助孕过程参数及临床结局。结果 DHEA预处理前,3组患者间基础性激素水平和窦卵泡计数(AFC)均无统计学差异(P>0.05)。DHEA预处理后,3组患者的基础FSH、E2水平均显著下降(P<0.05),而LH、AMH水平、AFC并无显著改善(P>0.05)。A组在获卵数、获卵率、受精率、优质胚胎率、FET胚胎种植率、FET临床妊娠率均显著优于B、C两组(P<0.05),3组患者间Gn总剂量及使用天数、HCG日E2水平、卵裂率均无统计学差异(P>0.05)。结论 DHEA辅助治疗可使DOR患者中的年轻人群反应性显著提升,进而使其卵巢储备功能得到改善,最终改善IVF治疗的结局;而>35岁的DOR患者使用DHEA后没有明显疗效。

Objective:To observe the efficacy of dehydroepiandrosterone(DHEA)in patients with decreased ovarian reserve(DOR)in different age.Methods:The data 220 patients with DOR undergone IVF in our hospital were retrospectively analyzed.The patients were divided into 3 groups according to age:<35 years old in group A(n=40),35-40 years old in group B(n=80),and>40 years old in group C(n=100).The parameters of the assisted pregnancy process and clinical outcomes were compared among different age groups.Results:There was no significant difference in basal sex hormone levels and antral follicle count(AFC)before DHEA treatment among the three groups(P>0.05).The basal FSH and E2 levels were decreased after DHEA treatment in the three groups(P<0.05),but there was no significant improvement in LH,AMH level and AFC(P>0.05).The number of oocytes retrieved,oocyte retrieval rate,fertilization rate,high quality embryo rate,FET embryo implantation rate and FET clinical pregnancy rate in group A were significantly better than those in group B and C(P<0.05).The doses of Gn used,days of Gn used,E2 level on HCG day and cleavage rate were not significantly different among the three groups(P>0.05).Conclusions:Administration of DHEA as adjuvant therapy can significantly improve younger DOR patients' ovarian response,and thus improve their ovarian reserve function,ultimately improve the outcome of IVF treatment.There was no significant effect of DHEA pre-treatment on those>35-year-old DOR patients.