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目的:探讨脱氢表雄酮(dehydroepiandrosterone,DHEA)对卵巢反应不良(poor ovarian response,POR)患者在辅助生殖技术(assisted reproductive technique,ART)周期中的卵巢反应性及妊娠结局的影响。方法:选取152例接受体外受精/卵胞质内单精子注射-胚胎移植(in vitro fertilizative/intracytoplasmic sperm injection and embryo transfer,IVF/ICSI-ET)的POR患者,给予DHEA 25 mg,po,bid×2~4个月,服药前、后周期采用同一控制性超促排卵(COH)方案对患者ART周期中卵巢反应性相关指标和妊娠结局进行自身对照研究。结果:152例患者服用DHEA后h CG注射日直径≥14 mm的卵泡数、获卵数、双原核(2PN)胚胎数和优质胚胎数(4.9±3.4枚,5.4±4.1枚,3.1±2.5枚,1.6±1.9枚)较服药前(4.3±2.6枚,4.8±3.2枚,2.5±2.2枚,1.1±1.7枚)均有显著改善,差异均有统计学意义(P<0.05)。治疗后临床妊娠率(32.7%)显著高于治疗前(7.2%)(P<0.01)。结论:DHEA预处理可以提高POR患者的卵巢反应性,增加获卵数,改善卵子及胚胎质量,提高临床妊娠率。
Objective: To investigate the effect of dehydroepiandrosterone (DHEA) on ovarian response and pregnancy outcome in patients with poor ovarian response (POR) during assisted reproductive technique (ART). Methods: 152 POR patients receiving in vitro fertilization / intracytoplasmic sperm injection and embryo transfer (IVF / ICSI-ET) were given DHEA 25 mg, po, bid × 2 ~ 4 months, taking the same controlled ovarian hyperstimulation (COH) regimen before and after taking the medication for self-control study of ovarian response-related index and pregnancy outcome in ART cycle. Results: The number of oocytes, the number of oocytes, the number of 2PN embryos and the number of high quality embryos (4.9 ± 3.4, 5.4 ± 4.1, 3.1 ± 2.5) , 1.6 ± 1.9) were significantly improved compared with those before treatment (4.3 ± 2.6, 4.8 ± 3.2, 2.5 ± 2.2, 1.1 ± 1.7), with statistical significance (P <0.05). The clinical pregnancy rate (32.7%) after treatment was significantly higher than that before treatment (7.2%) (P <0.01). Conclusion: DHEA pretreatment can improve the ovarian response in POR patients, increase the number of oocytes retrieved, improve the quality of eggs and embryos, and improve the clinical pregnancy rate.