Reprod Biomed Online. 2012 Aug;25(2):98-102. doi: 10.1016/j.rbmo.2012.04.003. Epub 2012 Apr 21.
This communication suggests that investigations of treatments for women with diminished functional ovarian reserve (DOR) call for specific practical and ethical considerations, as women with DOR, because of limited remaining reproductive life spans, appropriately feel under time constraints. Another medical journal recently published an opinion piece on the use of dehydroepiandrosterone in women with DOR, raising important questions about what approaches should be taken to develop best available evidence in such patients. Their manuscript offers an excellent opportunity to consider ethical and clinical aspects of study design in clinical circumstances where patients have little to lose but face the promise of considerable gains in clinical pregnancy chances if effective treatments can be developed. This commentary concludes that, in such circumstances, common sense as well as ethical considerations support the introduction of new treatments into the clinical mainstream even in absence of prospectively randomized studies if lower levels of evidence are supportive of positive treatment effects.
这篇通讯表明，对功能卵巢储备减少（DOR）女性治疗方法的研究需要特别考虑实际情况和伦理问题，因为 DOR 女性由于剩余生育年限有限，因此合理地感到时间紧迫。另一本医学期刊最近发表了一篇关于脱氢表雄酮（DHEA）在 DOR 女性中应用的观点文章，提出了关于在这些患者中应采取何种方法来制定最佳现有证据的重要问题。他们的手稿为考虑在患者几乎没有损失但如果能够开发出有效的治疗方法则有望大大提高临床妊娠机会的临床情况下的研究设计的伦理和临床方面提供了一个极好的机会。本评论得出的结论是，在这种情况下，即使缺乏前瞻性随机研究，如果较低水平的证据支持积极的治疗效果，那么即使没有前瞻性随机研究，常识和伦理考虑也支持将新的治疗方法引入临床主流。
