脱氢表雄酮联合微刺激方案在卵巢低反应体外受精-胚胎移植中的治疗效果

Effect of dehydroepiandrosterone combined with mild-stimulus in treating poor ovarian response in vitro fertilization embryo transfer

目的探讨脱氢表雄酮(dehydroepiandrosterone,DHEA)联合微刺激促排卵方案在卵巢低反应患者行体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)助孕治疗中的应用价值。方法选择2012年1月至2013年12月在内蒙古医科大学附属医院生殖中心行IVF-ET助孕治疗并诊断为卵巢反应低下的患者,比较行IVF-ET助孕治疗单用微刺激方案(对照组30周期)和DHEA联合微刺激方案(研究组109周期)促排卵的治疗效果及临床结局。结果研究组109个周期中,平均获卵数(2.40±0.72)个,可移植胚胎数(1.29±1.40)个,优质胚胎数(1.22±0.61)个,取消周期20%;对照组30个微刺激方案促排卵周期中,平均获卵数(1.30±0.62)个,可移植胚胎数(0.76±1.30)个,优质胚胎数(0.22±0.47)个,取消周期5.94%。两组比较差异有统计学意义(P<0.05)。研究组DHEA治疗后基础卵泡刺激素明显降低(P<0.05)。结论 DHEA辅助治疗可以提高卵巢低反应患者的卵巢反应性,应用DHEA联合微刺激方案行IVF-ET助孕治疗可以取得一定的临床效果。

Objective To investigate the application value of dehydroepiandrosterone（ DHEA） combined with mild- stimulation of ovulation induction in treating patients with poor ovarian response in vitro fertilization embryo transfer（ IVF- ET）. Methods The patients with poor ovarian response,who were treated with IVF- ET in Inner Mongolia Medical University Affiliated Hospital Reproductive Center from January 2012 to December 2013 were chosen. Compared the clinical outcomes and curative effeet of mild-stimulation Scheme（ 30 cycles of control group） and DHEA combined with mild- stimulus（ 109 cycles of study group） in ovulation induction. Results In study group,the average number of retrieved oocytes was（ 2. 40 ± 0. 72）,the number of transferable embryos was 1. 29 ± 1. 40,the highest quality embryonic number was（ 1. 22 ± 0. 61）,cancel cycles accouting for 20 %; In control group,the average number of retrieved oocytes was（ 1. 30 ± 0. 62）,the number of transferable embryos was（ 0. 76 ± 1. 30）,the highest quality embryonic number was（ 0. 22 ± 0. 47）,cancel cycles accouting for 5. 94 %. There were significant differences between two groups（ P〈0. 05）. BFSH decreased obviously after the treatment of DHEA in study group（ P〈0. 05）. Conclusion DHEA therapy can improve the ovarian reserve function in patients with poor ovarian response,application of DHEA combined with mild- stimulation scheme in IVF- ET assisting reproductive treatment could achieve good clinical effects.