雄激素在卵巢储备功能低下妇女中的研究进展

Androgens Supplementation in Women with Diminished Ovarian Reserve

卵巢储备功能低下妇女在辅助生殖技术超促排卵治疗时的卵巢低反应一直是临床医生研究的热点和难点。近年对于辅助生殖技术治疗中卵巢储备差和卵巢功能减退的妇女通过各种类型雄激素包括睾酮和脱氢表雄酮补充的预治疗可增加获卵数,改善胚胎质量,提高妊娠率和活产率。补充雄激素可能通过类固醇合成底物、雄激素配体、增加颗粒细胞中卵泡刺激素(FSH)受体的表达等机制改善其临床结局,为治疗卵巢功能差的患者提供了新思路。但是由于缺乏有力的证据,雄激素的应用仍无法大规模开展。故仍有待于临床上进行多中心联合、大样本的随机对照试验来评价其安全性及有效性。

Poor ovarian response is a problem of the control ovarian stimulation in those women with the diminished ovarian reserve in assisted reproductive technology （ART）. In recent years, the various types of androgen supplementation including testosterone and dehydroepiandrosterone （DHEA） can increase the number of retrieved oocytes,improve embryos quality, and increase the clinical pregnancy rate and the live birth rate,for those women with diminished ovarian reserve in ART. The possible mechanisms of androgen supplementation include its roles as substrate of steroid hormones and ligand of androgen,the increased expression of follicle stimulating hormone （FSH） receptor in granulosa cells. The androgen supplementation provides us a new idea for the treatment of women with diminished ovarian reserve. However,application of androgen is still unable to carry out in large-scale due to the lack of strong evidences. It is necessary to can＇y out some clinical multicenter,large-scale randomized controlled trials to evaluate its safety and efficacy.