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脱氢表雄酮(DHEA)可降低胚胎非整倍体率:来自胚胎植入前遗传学筛查(PGS)的直接证据。

Dehydroepiandrosterone (DHEA) reduces embryo aneuploidy: direct evidence from preimplantation genetic screening (PGS).

机构信息

Center for Human Reproduction (CHR)-New York, NY, USA.

出版信息

Reprod Biol Endocrinol. 2010 Nov 10;8:140. doi: 10.1186/1477-7827-8-140.

Abstract

BACKGROUND

Dehydroepiandrosterone (DHEA) has been reported to improve pregnancy chances in women with diminished ovarian reserve (DOR), and to reduce miscarriage rates by 50-80%. Such an effect is mathematically inconceivable without beneficial effects on embryo ploidy. This study, therefore, assesses effects of DHEA on embryo aneuploidy.

METHODS

In a 1:2, matched case control study 22 consecutive women with DOR, supplemented with DHEA, underwent preimplantation genetic screening (PGS) of embryos during in vitro fertilization (IVF) cycles. Each was matched by patient age and time period of IVF with two control IVF cycles without DHEA supplementation (n = 44). PGS was performed for chromosomes X, Y, 13, 16, 18, 21 and 22, and involved determination of numbers and percentages of aneuploid embryos.

RESULTS

DHEA supplementation to a significant degree reduced number (P = 0.029) and percentages (P < 0.001) of aneuploid embryos, adjusted for relevant covariates. Short term supplementation (4-12 weeks) resulted in greatest reduction in aneuploidy (21.6%, 95% CI -2.871-46.031).

DISCUSSION

Beneficial DHEA effects on DOR patients, at least partially, are the likely consequence of lower embryo aneuploidy. DHEA supplementation also deserves investigation in older fertile women, attempting to conceive, where a similar effect, potentially, could positively affect public health.

摘要

背景

脱氢表雄酮(DHEA)已被报道可提高卵巢储备功能降低(DOR)的女性的妊娠机会,并将流产率降低 50-80%。如果对胚胎倍性没有有益影响,这种效果在数学上是不可思议的。因此,本研究评估了 DHEA 对胚胎非整倍体的影响。

方法

在一项 1:2 的匹配病例对照研究中,22 名连续的 DOR 女性接受了体外受精(IVF)周期中的胚胎植入前遗传学筛查(PGS)。每位患者均按年龄和 IVF 时间段与未接受 DHEA 补充的两个对照 IVF 周期相匹配(n=44)。PGS 针对 X、Y、13、16、18、21 和 22 号染色体进行,涉及确定非整倍体胚胎的数量和百分比。

结果

DHEA 补充在很大程度上降低了非整倍体胚胎的数量(P=0.029)和百分比(P<0.001),调整了相关协变量。短期补充(4-12 周)导致非整倍体减少最多(21.6%,95%CI-2.871-46.031)。

讨论

DHEA 对 DOR 患者的有益影响至少部分是由于胚胎非整倍体减少所致。DHEA 补充也值得在试图怀孕的年龄较大的有生育能力的女性中进行研究,因为类似的效果可能会对公共健康产生积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfcd/2992540/d76e3feef609/1477-7827-8-140-1.jpg

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