脱氢表雄酮对卵巢储备功能低下患者性激素及妊娠率的影响

Effects of dehydroepiandrosterone on sex hormones and pregnancy rate in patients with diminished ovarian reserve dysfunction

目的探讨脱氢表雄酮(DHEA)对卵巢储备功能低下(DOR)患者性激素及妊娠率的影响。方法选取2017年5月至2019年1月于本院就诊的88例卵巢储备功能低下患者,采用随机数字表法分为两组,各44例。对照组口服维生素E,观察组在对照组的基础上口服DHEA,两组均治疗2个月经周期后,进行促排卵方案。比较两组性激素水平、促排卵指标、临床妊娠率及不良反应发生情况。结果治疗前,两组雌二醇(E_2)、卵泡生成激素(FSH)、睾酮(T)、FSH/黄体生成激素(LH)水平比较差异无统计学意义;治疗后,两组FSH、T、FSH/LH水平均降低,且观察组上述指标低于对照组,差异有统计学意义(P<0.05);治疗后,两组E_2水平比较差异无统计学意义;观察组hCG日时E_2、LH水平均高于对照组,差异有统计学意义(P<0.05);随访1年,观察组临床妊娠率为97.73%(43/44),高于对照组的81.82%(36/44),差异有统计学意义(P<0.05);两组早期自然流产率比较差异无统计学意义;观察组轻度卵巢刺激征发生率低于对照组,差异有统计学意义(P<0.05)。结论 DOR患者采用脱氢表雄酮和促排卵方案的效果较好,可有效调节患者性激素水平,提高妊娠率,减少不良反应发生。

Objective To investigate the effect of dehydroepiandrosterone(DHEA)on sex hormones and pregnancy rate in patients with diminished ovarian reserve dysfunction(DOR).Methods 88 patients with poor ovarian reserve were divided into two groups by random number table method from May 2017 to January 2019,with 44 cases in each group.Vitamin E was given orally in the control group,and DHEA was given orally in the observation group on the basis of the control group.The sex hormone level,ovulation induction index,clinical pregnancy rate and adverse reactions were compared between the two groups.Results Before treatment,there was no significant difference in the levels of estradiol(E2),follicle-forming hormone(FSH),testosterone(T),and FSH/luteinizing hormone(LH)between the two groups;after treatment,the two groups of FSH,T,FSH/LH level decreased,and the above indicators of the observation group were lower than those of the control group,the difference was statistically significant(P<0.05).After treatment,the difference in E2 levels between the two groups was not statistically significant;the hCG levels of the observation group were E2 and LH on the day both were higher than the control group,and the difference was statistically significant(P<0.05).The clinical pregnancy rate of the observation group was 97.73%(43/44)after a 1-year follow-up,which was higher than 81.82%(36/44)of the control group.There was statistically significant differences(P<0.05).There was no statistically significant difference in the early spontaneous abortion rate between the two groups;the incidence of mild ovarian irritation in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Dehydroepiandrosterone and ovulation induction regimen are effective in the treatment of DOR,which can effectively regulate the sex hormone level,increase the pregnancy rate and reduce the occurrence of adverse reactions.