人工周期疗法联合脱氢表雄酮在卵巢储备功能低下治疗中的效果以及对激素水平的影响

The effect of artificial cycle therapy combined with dehydroepiandrosterone in the treatment of poorovarian reserve and its influence on hormone levels

目的探析脱氢表雄酮联合人工周期疗法在卵巢储备功能低下治疗中的效果。方法180例卵巢储备功能低下患者作为研究对象,根据治疗方案不同分为芬吗通组、人工周期组、人工周期联合脱氢表雄酮组,每组60例。芬吗通组患者接受芬吗通治疗,人工周期组患者接受戊酸雌二醇与黄体酮胶囊人工周期治疗,人工周期联合脱氢表雄酮组患者在人工周期组基础上接受脱氢表雄酮治疗。比较三组患者激素[黄体生成素(LH)、雌二醇(E2)、促卵泡激素(FSH)]水平,卵巢储备功能指标[卵巢体积、子宫内膜厚度、窦卵泡计数(AFC)],不良反应发生情况以及妊娠情况。结果三组治疗后LH水平比较差异无统计学意义(P>0.05);治疗后,人工周期联合脱氢表雄酮组的E2(130.76±19.26)pmol/L、FSH(23.28±4.17)IU/L均优于芬吗通组的(161.58±28.95)pmol/L、(26.19±5.46)IU/L和人工周期组的(150.12±22.53)pmol/L、(25.24±5.31)IU/L,差异具有统计学意义(P<0.05)。治疗后,人工周期联合脱氢表雄酮组患者的子宫内膜厚度、AFC均优于芬吗通组和人工周期组,差异具有统计学意义(P<0.05)。三组患者的妊娠率和胃肠道不适、下腹痛、乳房胀痛发生率比较,差异均无统计学意义(P>0.05)。结论卵巢储备功能低下患者接受人工周期联合脱氢表雄酮治疗有利于促进卵巢储备功能的改善,具有理想的助孕效果,且具有较高的安全性。

Objective To discuss the effect of artificial cycle therapy combined with dehydroepiandrosterone in the treatment of poor ovarian reserve.Methods A total of 180 patients with poor ovarian reserve as study subjects were divided into fematon group,artificial cycle therapy group and artificial cycle therapy combined with dehydroepiandrosterone group,with 60 cases in each group.Fematon group received fematon treatment,artificial cycle group received artificial cycle treatment with estradiol valerate and progesterone capsules,and artificial cycle combined with dehydroepiandrosterone group received dehydroepiandrosterone treatment on the basis of the artificial cycle group.The hormone[luteinizing hormone(LH),estradiol(E2),follicle stimulating hormone(FSH)]level,ovarian reserve function indicators[ovarian volume,endometrial thickness,antral follicle count(AFC)],occurrence of adverse reactions and pregnancy status of the three groups were compared.Results After treatment,there was no statistically significant difference in LH among the three groups(P>0.05).After treatment,the E2(130.76±19.26)pmol/L and FSH(23.28±4.17)IU/L of artificial cycle combined with dehydroepiandrosterone group were better than fematon group[(161.58±28.95)pmol/L and(26.19±5.46)IU/L]and artificial cycle group[(150.12±22.53)pmol/L and(25.24±5.31)IU/L],and the difference was statistically significant(P<0.05).After treatment,the endometrial thickness and AFC of artificial cycle combined with dehydroepiandrosterone group were better than those of fematon group and artificial cycle group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in pregnancy rate,and incidence of gastrointestinal discomfort,lower abdominal pain,breast tenderness among the three groups(P>0.05).Conclusion Combination of artificial cycle and dehydroepiandrosterone for patients with poor ovarian reserve is beneficial to improve the ovarian reserve function,and has ideal fertility assistance and high safety.