The effect of dehydroepiandrosterone supplementation on ovarian response is associated with androgen receptor in diminished ovarian reserve women.
The effect of dehydroepiandrosterone supplementation on ovarian response is associated with androgen receptor in diminished ovarian reserve women.
复制标题
补充脱氢表雄酮对卵巢反应的影响与卵巢储备减少女性的雄激素受体有关
DOI：
10.1186/s13048-017-0326-3
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发表时间：
2017-05-04
影响因子：
4
通讯作者：
Yang X
中科院分区：
文献类型：
--
作者：
Hu Q;Hong L;Nie M;Wang Q;Fang Y;Dai Y;Zhai Y;Wang S;Yin C;Yang X
背景卵巢储备功能下降（DOR）与女性不孕症和卵巢刺激反应不良有关.本研究的目的是评估脱氢表雄酮（DHEA）对DOR妇女的影响，并探讨补充DHEA后卵巢反应性的改善是否依赖于雄激素受体（AR）的表达水平。103名完成研究的DOR妇女被分为DHEA组（n= 53），在IVF周期前接受DHEA补充（25 mg，每日3次）8周，对照组（n= 50）未接受DHEA。检测两组患者血清FSH、LH、E2、T、DHEAs、AMH、INHB水平、窦卵泡计数（AFC）、颗粒细胞AR和FSH受体（FSHR）表达，比较两组患者的卵巢反应参数和IVF结局。另外36例DOR妇女的GC与不同浓度的DHEA进行体外培养。然后，我们比较了AR和FSHR在GC中的表达，根据不同数量的卵母细胞检索在DHEA和control group.ResultsIn本研究中，DHEA补充导致显着较高水平的血清T（P= 0.047），DHEAs（P= 0.019）和AR mRNA的表达在GC中（P= 0.049）。在体外实验中，DHEA可显著增加排卵前GC中AR和FSHR的蛋白和mRNA表达（P<0.05）。两组之间的卵巢储备、卵巢反应或IVF结局无显著差异。亚组分析显示，DHEA组取卵数≥5个时，GC中AR和FSHR mRNA水平显著升高（P<0.05）。补充DHEA对DOR妇女卵巢反应的选择性有益作用可能取决于GC中AR和FSHR表达的增加。 ChiCTR-IPR-15006126 ).追溯注册2015年3月19日。
BackgroundDiminished ovarian reserve(DOR) is associated with female infertility and poor response to ovarian stimulation. Our objective was to assess the effect of dehydroepiandrosterone(DHEA) on DOR women and to explore whether the improvement of ovarian response after DHEA supplementation was dependent on the expression levels of androgen receptor(AR).MethodsA prospective cohort study was performed in the Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital during August 2014 to August 2016. 103 DOR women who completed the study were divided into the DHEA group (n= 53), which received DHEA supplementation (25 mg three times a day) for 8 weeks, and the control group (n= 50), which did not receive DHEA, before the IVF cycles. Serum hormone levels(FSH, LH, E2, T, DHEAs, AMH, INHB), antral follicle count(AFC) and the expression of AR and FSH receptor(FSHR) in granulosa cells(GCs) were measured, meanwhile ovarian response parameters and IVF outcomes were compared. The GCs from another 36 DOR women were cultured with different concentrations of DHEA in vitro. Then, we compared the expression of AR and FSHR in GCs according to the different numbers of oocytes retrieved both in DHEA and control group.ResultsIn the present study, DHEA supplementation resulted in significantly higher levels of serum T(P= 0.047), DHEAs(P= 0.019) and AR mRNA expression in GCs(P= 0.049). In vitro experiment, the protein and mRNA expression of AR and FSHR in the preovulatory GCs were significantly increased in response to DHEA supplementation(P<0.05). No significant differences were found in ovarian reserve, ovarian response, or IVF outcomes between the two groups. Subgroup analyses showed the levels of AR and FSHR mRNA in GCs were significantly increased in DHEA group with ≥5 oocytes retrieved(P<0.05).ConclusionDHEA supplementation can increase the expression of AR in preovulatory GCs both in vivo and in vitro. The selective beneficial effects of DHEA supplementation on ovarian response in DOR women may depend on the increasing expression of AR and FSHR in GCs.Trial registrationThe Chinese Clinical Trial Registry ( ChiCTR-IPR-15006126 ). Retrospectively Registered 19 March 2015.