Li Jing, Teng Tao, Liang Qi, Cui Wei
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016 Sep;36(9):1046-1050.
Objective To observe the effect of Chinese herbs combined dehydroepiandrosterone (DHEA) pretreatment on pregnancy outcomes of elderly patients with normal ovarian function undergoing in vitro fertilization-embryo transfer ( IVF-ET). Methods Totally 233 IVF patients with normal ovarian function scheduled for IVF-ET, 36 -42 years old, were assigned to the combined group, the DHEA group, the control group according to random number table. Patients in the combined group (76 cases) were pretreated with Chinese herbs plus DHEA before IVF cycle for 8 weeks. Patients in the DHEA group (82 cases) were pretreated with DHEA before IVF cycle for 8 weeks. Those in the control group (75 cases) received no pretreatment. The number of retrieved oocytes , the fertilization rate, the rate of good quality embryos, the number of frozen embryos, clinical pregnancy rate, early spontaneous abortion rate, live birth rate, levels of anti-Mullerian hormone (AMH) , the cycle cancellation rate, endometrial thickness and estradiol (E₂) level on human chorionic gonadotropin (hCG) injection day, the dosage and duration of Gn were observed in the 3 groups. Results The good quality embryo rate was significantly higher in the combined group and the DHEA group than in the control group (P <0. 05). Compared with the control group, the fertilization rate, the number of frozen embryos, the clinical pregnancy rate, and the live birth rate were higher; the early spontaneous abortion rate was lower in the two pretreatment groups (P > 0. 05). AMH increased more significantly in the two pretreatment groups after treatment (P <0. 05). There was no obvious change in the control group. The post-treatment number of retrieved oocytes, the cycle cancellation rate, E₂ level and endometrial thickness on hCG injection day, the dosage and duration of Gn had no significant difference among the 3 groups (P >0. 05). Conclusion Pretreatment of Chinese herbs combined DHEA could improve the good quality embryo rate of elderly patients with normal ovarian re- serve, which might be associated with AMH.
目的 观察中药联合脱氢表雄酮（DHEA）预处理对卵巢功能正常的高龄患者体外受精-胚胎移植（IVF-ET）妊娠结局的影响。方法 将233例年龄36～42岁、计划行IVF-ET且卵巢功能正常的患者，按随机数字表法分为联合组、DHEA组、对照组。联合组（76例）在IVF周期前用中药加DHEA预处理8周；DHEA组（82例）在IVF周期前用DHEA预处理8周；对照组（75例）不进行预处理。观察3组患者的取卵数、受精率、优质胚胎率、冻胚数、临床妊娠率、早期自然流产率、活产率、抗苗勒管激素（AMH）水平、周期取消率、人绒毛膜促性腺激素（hCG）注射日的子宫内膜厚度和雌二醇（E₂）水平、Gn用量及用药时间。结果 联合组和DHEA组的优质胚胎率显著高于对照组（P<0.05）。与对照组比较，两个预处理组的受精率、冻胚数、临床妊娠率和活产率较高；早期自然流产率较低（P>0.05）。两个预处理组治疗后AMH升高更明显（P<0.05），对照组无明显变化。3组治疗后取卵数、周期取消率、hCG注射日E₂水平和子宫内膜厚度、Gn用量及用药时间比较，差异无统计学意义（P>0.05）。结论 中药联合DHEA预处理可提高卵巢储备功能正常的高龄患者的优质胚胎率，其机制可能与AMH有关。
