雄激素预处理对卵巢储备功能低下患者促排卵的疗效观察

Observation on the Curative Effect of Androgen Pretreatment Stimulating Ovulation in Patients with Deficient Ovarian Reserve

目的探讨脱氢表雄酮(DHEA)对卵巢储备功能低下(DOR)患者的促排卵效果及安全性。方法选择2011年6月至2013年4月广西梧州市人民医院不孕门诊收治的DOR患者66例,依据施加因素不同分为两组:观察组(36例)在促排卵前应用DHEA预处理两个周期,对照组(30例)未应用DHEA预处理,两组患者均给予常规促排卵方案。比较两组患者的性激素水平变化及大卵泡排卵率、妊娠率。结果观察组月经第2日或第3日及HCG日血清卵泡刺激素、黄体生成激素、睾酮、雌二醇水平均较对照组显著改善(P<0.01);观察组优势卵泡排卵率显著高于对照组大卵泡排卵率(88.9%vs 40%)(P<0.01);观察组妊娠率显著高于对照组(61.1%vs 6.7%)(P<0.01);观察组卵巢刺激征发生率显著低于对照组(5.6%vs 26.7%)(P<0.01)。结论 DHEA预处理可以改善DOR患者卵巢储备功能,提高卵巢反应性,促进优势卵泡排卵,改善妊娠结局。

Objective To explore the ovulation induction effect and safety of dehydroepiandrosterone （DHEA） on the deficient ovarian reserve （DOR）. Methods A total of 66 DOR patients admitted to Guangxi Wuzhou People＇s Hospital from Jun. 2011 to Apr. 2013 were included in the study, according to the random-number table method they were divided into two groups：observation group （36 cases）, given DHEA pretreatment for 2 two cycle before ovulation, and the control group（ 30 cases） was not given DHEA pretreatment, and both groups were given conventional ovulation stimulation scheme. The sex hormone levels change, big follicle ovulation rate and pregnancy rate of the two groups were compared. Results The serum folliclestimulating hormone, luteinizing hormone, testosterone, estradiol level on the 2^nd or 3^rd day menstruation and HCG day of the observation group were significantly improved than the control group（ P 〈 0.01 ） ; the advantage folhcle rate of the observation group was significantly higher than the big follicle ovulation rate of the control group（88.9% vs 40% ,P 〈 0.01 ） ;the observation group had a significantly higher pregnancy rate than the control group（61.1% vs 6.7% ,P 〈 0.01 ）;the incidence of ovarian stimulation syndrome of the observation group was significantly lower than the control group （5.6% vs 26.7 %, P 〈 0.01 ）. Conclusion DHEA pretreatment can improve the ovarian reserve function in DOR patients, improve ovarian reactivity, promote the advantageous follicle ovulation, and improve the pregnancy outcome.