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脱氢表雄酮改善卵巢储备功能减退的不孕患者体外受精时的卵泡液骨形态发生蛋白-15及累积胚胎评分:一项随机对照试验

Dehydroepiandrosterone improves follicular fluid bone morphogenetic protein-15 and accumulated embryo score of infertility patients with diminished ovarian reserve undergoing in vitro fertilization: a randomized controlled trial.

作者信息

Zhang Huan H, Xu Ping Y, Wu Juan, Zou Wei W, Xu Xia M, Cao Xia Y, Wei Lian Z

机构信息

Department of Reproductive Endocrinology, the Reproductive Medicine Center, The Affiliated Hospital of Anhui Medical University, Anhui, People's Republic of China.

出版信息

J Ovarian Res. 2014 Oct 21;7:93. doi: 10.1186/s13048-014-0093-3.

Abstract

OBJECTIVE

To evaluate the effect of dehydroepiandrosterone (DHEA) on infertility patients with diminished ovarian reserve undergoing in vitro fertilization.

METHODS

This is a prospective study. Ninety-five patients with diminished ovarian reserve were included in this study. Of them, 42 patients were randomly allocated to the DHEA group, who received DHEA 75 mg daily for three consecutive menstrual cycles prior to IVF cycles, and 53 patients were allocated to the control group, who entered IVF cycles directly. All patients were treated with the same ovarian stimulation protocol. Follicular fluid samples from both groups were collected for bone morphogenetic protein-15 (BMP-15) and growth differentiation factor-9 (GDF-9). Fluid from the first aspirated follicle without any visible blood contamination was carefully collected. In addition, day 3 Blood samples were collected pre- and post-treatment of DHEA for serum anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH) and estradiol (E2) in the DHEA group.

RESULTS

The level of BMP-15 in follicular fluid samples from the DHEA group was significantly higher than that of the control samples (P=.000). Patients after DHEA treatment demonstrated a significantly higher level of AMH and a significantly lower level of FSH, E2 compared to themselves prior to DHEA therapy (P=.015; P=.036; P=.002; respectively). Moreover, the accumulated score of embryos was significantly higher in the DHEA group (P=.033).

CONCLUSIONS

These observations confirm the beneficial effect of DHEA for infertility patients with diminished ovarian reserve.

TRIAL REGISTRATION

ChiCTR-TRC-14005002.

摘要

目的

评估脱氢表雄酮(DHEA)对卵巢储备功能减退的不孕患者体外受精的影响。

方法

这是一项前瞻性研究。本研究纳入了95例卵巢储备功能减退的患者。其中,42例患者被随机分配至DHEA组,在体外受精周期前连续三个月经周期每日服用75 mg DHEA,53例患者被分配至对照组,直接进入体外受精周期。所有患者均采用相同的卵巢刺激方案。收集两组的卵泡液样本检测骨形态发生蛋白-15(BMP-15)和生长分化因子-9(GDF-9)。小心收集首个吸出的无明显血液污染的卵泡液。此外,在DHEA组治疗前后采集第3天的血样检测血清抗苗勒管激素(AMH)、卵泡刺激素(FSH)和雌二醇(E2)。

结果

DHEA组卵泡液样本中BMP-15水平显著高于对照组样本(P = .000)。与DHEA治疗前相比,DHEA治疗后的患者AMH水平显著升高,FSH、E2水平显著降低(分别为P = .015;P = .036;P = .002)。此外,DHEA组的胚胎累积评分显著更高(P = .033)。

结论

这些观察结果证实了DHEA对卵巢储备功能减退的不孕患者有益。

试验注册

ChiCTR-TRC-14005002。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c28/4210503/023e002ed40e/13048_2014_93_Fig1_HTML.jpg

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