Liu Yaofang, Hu Lina, Fan Lingye, Wang Fang
a Department of Gynecology and Obstetrics , The Affiliated Hospital of Southwest Medical University , Luzhou , Sichuan , China.
b Department of Gynecology , The Second Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Gynecol Endocrinol. 2018 Mar;34(3):178-183. doi: 10.1080/09513590.2017.1391202. Epub 2017 Oct 26.
Dehydroepiandrosterone (DHEA) supplementation might hold some promise in vitro fertilization and embryo transfer cycles. However, the results remain controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy of DHEA in patients for in vitro fertilization. PubMed, EMbase, Web of science, EBSCO and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of DHEA versus placebo on in vitro fertilization were included. Two investigators independently searched articles, extracted data and assessed the quality of included studies. The primary outcomes were clinical pregnancy and live birth rate. Meta-analysis was performed using random-effect model. Six RCTs involving 745 patients were included in the meta-analysis. Overall, compared with placebo, DHEA supplementation was associated with the significant increase in clinical pregnancy (OR = 1.45; 95% CI = 1.04-2.03; p = .03), live birth rate (OR = 2.70; 95% CI = 1.24-5.85; p = .01) and endometrial thickness (Std. mean difference = 0.67; 95% CI = 0.02-1.32; p = .04) but showed no influence on E on hCG day (Std. mean difference = 0.69; 95% CI = -0.46 to 1.85; p = .24), embryos transferred (Std. mean difference = 0.42; 95% CI = -0.04 to 0.88; p = .07) and miscarriage rate (OR = 0.43; 95% CI = 0.03-6.66; p = .55). DHEA supplementation could significantly improve clinical pregnancy, live birth rate, endometrial thickness and retrieved oocytes but failed to alter E on hCG day, embryos transferred and miscarriage rate.
补充脱氢表雄酮（DHEA）在体外受精和胚胎移植周期中可能具有一定前景。然而，结果仍存在争议。我们进行了一项系统评价和荟萃分析，以评估DHEA对体外受精患者的疗效。系统检索了PubMed、EMbase、Web of science、EBSCO和Cochrane图书馆数据库。纳入评估DHEA与安慰剂对体外受精影响的随机对照试验（RCT）。两名研究者独立检索文章、提取数据并评估纳入研究的质量。主要结局为临床妊娠率和活产率。采用随机效应模型进行荟萃分析。荟萃分析纳入了6项涉及745例患者的RCT。总体而言，与安慰剂相比，补充DHEA与临床妊娠率显著增加（OR = 1.45；95%CI = 1.04 - 2.03；p = 0.03）、活产率（OR = 2.70；95%CI = 1.24 - 5.85；p = 0.01）和子宫内膜厚度（标准化平均差 = 0.67；95%CI = 0.02 - 1.32；p = 0.04）相关，但对hCG日的E值（标准化平均差 = 0.69；95%CI = -0.46至1.85；p = 0.24）、移植胚胎数（标准化平均差 = 0.42；95%CI = -0.04至0.88；p = 0.07）和流产率（OR = 0.43；95%CI = 0.03 - 6.66；p = 0.55）无影响。补充DHEA可显著提高临床妊娠率、活产率、子宫内膜厚度和获卵数，但未能改变hCG日的E值、移植胚胎数和流产率。
