脱氢表雄酮在卵巢储备功能低下不孕症患者中的应用

The application of dehydroepiandrosterone in infertile patients with diminished ovarian reserve

目的:探讨脱氢表雄酮(DHEA)在卵巢储备功能低下(DOR)不孕症患者中的治疗效果。方法:30例DOR不孕症患者连续3个月DHEA治疗。比较其治疗前后各项储备指标的变化,观察治疗后诱发排卵率、临床妊娠率、流产率等。结果:患者服用DHEA 3个月后,月经周期第3天卵泡刺激素、卵泡刺激素/黄体生成素、雌二醇均较治疗前明显下降(P<0.01),窦卵泡计数明显增加(P<0.01);诱发排卵成功24例,排卵率达80.00%;11例成功妊娠,累积妊娠率达45.83%,其中2例患者孕2个月流产,流产率18.18%。结论:DHEA能改善DOR患者卵巢储备功能,增加患者对促排卵药物的敏感性,诱发排卵成功率高,卵子质量也相应提高,能获得较好的临床妊娠率,且不良反应小。

Objective： To investigate the effects of dehydroepiandrosterone（ DHEA） on patients with diminished ovarian reserve（ DOR）. Methods： Thirty patients with DOR were treated with DHEA for 3 months. The ovarian reserve indexes before and after DHEA treatment were compared,and the induced ovulation rate,clinical pregnancy rate and abortion rate after treatment were observed.Results： Compared with before treatment,the levels of follicle-stimulating hormone（ FSH）,FSH / lutenizing hormone and estradiol on the3 rd day of menstrual cycle obviously decreased（ P〈0. 01）,and antral follicle count significantly increased after 3 months of treatment with DHEA（ P〈0. 01）. The induced ovulation in 24 cases were successful,the ovulation rate was 80. 00%. The pregnancy in 11 cases were successful,the cumulative pregnancy rate was 45. 83%. Two pregnancy cases for 2 months aborted,the abortion rate was 18. 18%.Conclusions： DHEA can effectively improve the ovarian reserve function,sensitivity of fertility drugs,success rate of induced ovulation and egg quality,obtain the good clinical pregnancy rate,and decrease the adverse reaction.