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脱氢表雄酮(DHEA)能否改善卵巢低反应患者的体外受精(IVF)结局?

Does Dehydroepiandrosterone (DHEA) improve in vitro fertilisation (IVF) outcomes in poor responders?

机构信息

Hospital Sultanah Nur Zahirah, Department of Obstetric & Gynaecology, Kuala Terengganu, Terengganu, Malaysia.

Hospital Sultanah Bahiyah, Department of Obstetric & Gynaecology, Alor Setar, Kedah, Malaysia.

出版信息

Med J Malaysia. 2020 Jan;75(1):24-28.

Abstract

BACKGROUND

In reproductive medicine poor ovarian response (POR) among women undergoing in vitro fertilisation (IVF) is of great concern. Meta-analysis showed that Dehydroepiandrosterone (DHEA) administration resulted in a significant increase in the number of oocytes retrieved in women with POR. The aim of this study was to assess the effectiveness of DHEA supplementation on IVF outcomes among poor responders undergoing IVF.

METHODS

Sixteen patients who were diagnosed with POR scheduled to undergo their second cycle of Intracytoplasmic sperm injection (ICSI)/embryo transfer cycle were enrolled. All enrolled patients had earlier undergone their first ICSI/embryo transfer cycle at least four months prior to this study. All subjects were given DHEA supplementation of 25mg three times daily for at least three months prior to their second ICSI/embryo transfer cycle. Statistical analysis of various ovarian response and ICSI outcomes parameter were compared pre and post DHEA.

RESULTS

Sixteen women with the mean age of 35 years were enrolled in the study. The comparative analysis of results showed a significant increase in the number of good quality of embryos obtained (p<0.05). After the treatment with DHEA, there was an improvement in the number of oocytes retrieved, Metaphase II (MII) oocyte (mature) oocytes obtained, fertilised and transferrable embryos and the pregnancy rate. There was no significant effect of DHEA treatment on the number of days of stimulation and cumulative dose of gonadotrophins used.

CONCLUSION

Our results is able to show that DHEA supplementation may help to enhance IVF-ICSI outcomes in women with POR especially in those age 35 years and below.

摘要

背景

在体外受精(IVF)中,女性卵巢反应不良(POR)是一个严重的问题。荟萃分析表明,脱氢表雄酮(DHEA)的使用可显著增加 POR 患者的获卵数。本研究旨在评估 DHEA 补充剂对 POR 患者行 IVF 的效果。

方法

16 名被诊断为 POR 并计划进行第二次卵胞浆内单精子注射(ICSI)/胚胎移植周期的患者入组。所有入组患者在本研究前至少四个月已进行过第一次 ICSI/胚胎移植周期。所有患者在第二次 ICSI/胚胎移植周期前至少三个月开始每天服用 DHEA 25mg,分三次服用。在 DHEA 治疗前后,对各种卵巢反应和 ICSI 结果参数进行了统计分析。

结果

本研究共纳入 16 名年龄均为 35 岁的女性。结果比较分析显示,获得的优质胚胎数量显著增加(p<0.05)。在接受 DHEA 治疗后,获卵数、中期 II(MII)卵(成熟)卵数、受精和可移植胚胎数以及妊娠率均有所改善。DHEA 治疗对刺激天数和促性腺激素累积剂量无显著影响。

结论

我们的研究结果表明,DHEA 补充剂可能有助于提高 POR 女性,尤其是年龄在 35 岁及以下的女性的 IVF-ICSI 结局。

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