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卵巢储备功能低下妇女在辅助生殖技术超促排卵治疗时的卵巢低反应一直是临床医生研究的热点和难点。近年对于辅助生殖技术治疗中卵巢储备差和卵巢功能减退的妇女通过各种类型雄激素包括睾酮和脱氢表雄酮补充的预治疗可增加获卵数,改善胚胎质量,提高妊娠率和活产率。补充雄激素可能通过类固醇合成底物、雄激素配体、增加颗粒细胞中卵泡刺激素(FSH)受体的表达等机制改善其临床结局,为治疗卵巢功能差的患者提供了新思路。但是由于缺乏有力的证据,雄激素的应用仍无法大规模开展。故仍有待于临床上进行多中心联合、大样本的随机对照试验来评价其安全性及有效性。
Low ovarian reserve in women with assisted reproductive technology ovarian hyperstimulation low ovarian response has been a hot and difficult clinicians. In recent years, pretreatment of women with poor ovarian reserve and ovarian dysfunction in assisted reproductive technology treatment with supplementation of various types of androgens including testosterone and dehydroepiandrosterone can increase the number of oocytes retrieved, improve embryo quality, increase pregnancy rate and live births rate. Androgen supplementation may improve its clinical outcome through the synthesis of steroid substrates and androgen ligands and increase the expression of follicle stimulating hormone (FSH) receptors in granulosa cells, which provides a new idea for the treatment of patients with poor ovarian function. However, due to the lack of strong evidence, the application of androgens still can not be carried out on a large scale. It is still pending in the clinical multi-center joint, large sample of randomized controlled trials to evaluate its safety and effectiveness.