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卵巢储备功能下降患者在宫腔内人工授精(IUI)和体外受精(IVF)周期中使用辅酶Q10和脱氢表雄酮(DHEA)。

The use of coenzyme Q10 and DHEA during IUI and IVF cycles in patients with decreased ovarian reserve.

作者信息

Gat Itai, Blanco Mejia Sonia, Balakier Hanna, Librach Clifford L, Claessens Anne, Ryan Edward A J

机构信息

a CReATe Fertility Centre , Toronto , Canada .

b Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center , Tel HaShomer , Ramat Gan , Israel .

出版信息

Gynecol Endocrinol. 2016 Jul;32(7):534-7. doi: 10.3109/09513590.2015.1137095. Epub 2016 Feb 1.

Abstract

OBJECTIVE

The objective of this study is to compare the combination of dehydroepiandrosterone (DHEA) and coenzyme Q10 (CoQ10) (D + C) with DHEA alone (D) in intrauterine insemination (IUI) and in vitro fertilization (IVF) cycles among patients with decreased ovarian reserve.

METHODS

We retrospectively extracted data from patients charts treated by DHEA with/without CoQ10 during IUI or IVF between February 2006 and June 2014. Prestimulation parameters included age, BMI, day 3 FSH and antral follicular count (AFC). Ovarian response parameters included total gonadotropins dosage, peak serum estradiol, number of follicles > 16 mm and fertilization rate. Clinical outcomes included clinical and ongoing pregnancy rates.

RESULTS

Three hundred and thirty IUI cycles involved D + C compared with 467 cycles of D; 78 IVF cycles involved D + C and 175 D. In both IUI and IVF, AFC was higher with D + C compared with D (7.4 ± 5.7 versus 5.9 ± 4.7, 8.2 ± 6.3 versus 5.2 ± 5, respectively, p < 0.05). D + C resulted in a more follicles > 16 mm during IUI cycles (3.3 ± 2.3 versus 2.9 ± 2.2, respectively, p = 0.01), while lower mean total gonadotropin dosage was administered after D + C supplementation compared with D (3414 ± 1141 IUs versus 3877 ± 1143 IUs respectively, p = 0.032) in IVF cycles. Pregnancy and delivery rates were similar for both IUI and IVF.

CONCLUSION

D + C significantly increases AFC and improves ovarian responsiveness during IUI and IVF without a difference in clinical outcome.

摘要

目的

本研究旨在比较脱氢表雄酮(DHEA)与辅酶Q10(CoQ10)联合使用(D+C)和单独使用DHEA(D)在卵巢储备功能下降患者的宫腔内人工授精(IUI)和体外受精(IVF)周期中的效果。

方法

我们回顾性提取了2006年2月至2014年6月期间接受DHEA联合或不联合CoQ10治疗的IUI或IVF患者病历中的数据。刺激前参数包括年龄、体重指数、第3天卵泡刺激素(FSH)和窦卵泡计数(AFC)。卵巢反应参数包括总促性腺激素剂量、血清雌二醇峰值、直径>16mm的卵泡数量和受精率。临床结局包括临床妊娠率和持续妊娠率。

结果

330个IUI周期使用了D+C,467个周期使用了D;78个IVF周期使用了D+C,175个周期使用了D。在IUI和IVF中,D+C组的AFC均高于D组(分别为7.4±5.7对5.9±4.7,8.2±6.3对5.2±5,p<0.05)。在IUI周期中,D+C组直径>16mm的卵泡更多(分别为3.3±2.3对2.9±2.2,p=0.01),而在IVF周期中,补充D+C后平均总促性腺激素剂量低于D组(分别为3414±1141IU对3877±1143IU,p=0.032)。IUI和IVF的妊娠率和分娩率相似。

结论

D+C在IUI和IVF过程中可显著增加AFC并改善卵巢反应性,且临床结局无差异。

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