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目的:研究添加脱氢表雄酮(dehydroepiandrosterone,DHEA)对于卵巢储备功能低下(DOR)患者的有效性。方法:数据库检索术语DHEA/dehydroepiandrosterone/diminished ovarian reserve/poor responders/premature ovarian failure(POF)/primary ovarian insufficiency(POI)/premature ovarian aging(POA)。研究至少包括下列结果中的一项:抗苗勒氏管激素(AMH)、促卵泡生成素(FSH)、获卵数、胚胎移植数、临床妊娠率。经筛选在116篇临床试验中只有3项随机对照试验(RCT)研究,1项队列研究和1项配对研究符合纳入标准。结果:使用DHEA治疗组的临床妊娠率高于未治疗使用DHEA的对照组,差异有统计学意义(OR=8.23,95%CI=1.47~46.12)。AMH、FSH、获卵数、胚胎移植数治疗组与对照组间无统计学差异(P>0.05)。结论:在大约206个IVF周期中,基于上述可用的有限数据研究分析,DHEA能提高IVF周期中DOR女性的临床妊娠率。但没有证据支持DHEA治疗后能改善患者FSH、AMH值,以及提高获卵数、可移植胚胎数。
Objective: To study the effectiveness of adding dehydroepiandrosterone (DHEA) to patients with ovarian reserve dysfunction (DOR). METHODS: The database search term DHEA / dehydroepiandrosterone / diminished ovarian reserve / poor responders / premature ovarian failure (POF) / primary ovarian insufficiency (POI) / premature ovarian aging (POA). The study included at least one of the following: anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), number of oocytes retrieved, number of embryos transplanted, and clinical pregnancy rate. Of the 116 clinical trials screened, only 3 randomized controlled trials (RCTs), 1 cohort and 1 matched study met the inclusion criteria. Results: The clinical pregnancy rate in DHEA-treated group was higher than that in untreated DHEA-treated group (OR = 8.23, 95% CI = 1.47-46.12). AMH, FSH, number of oocytes retrieved, number of embryo transfer between the treatment group and the control group had no statistical difference (P> 0.05). CONCLUSIONS: DHEA increased the clinical pregnancy rate of DOR women during the IVF cycle based on the limited data available for analysis during approximately 206 IVF cycles. However, there is no evidence to support DHEA treatment can improve patients with FSH, AMH value, as well as improve the number of oocytes, the number of transferable embryos.