Investigation Of Effects Of DHEA On Ovary Function And Hormone Secretion Of DOR Patients In IVF-ET Cycle And Mice

PART ? Clinical study of DHEA treatment outcomes in women with diminished ovarian reserve(DOR)during in vitro fertilizationAims:Dehydroepiandrosterone(DHEA)has been used to improve the pregnancy rate in women with diminished ovarian reserve(DOR)during in vitro fertilization.Materials and Methods:We studied 169 DOR patients in our center between January 2015 and September 2015.Results:There were no significant differences between the two groups in terms of age,age of infertility,BMI and infertility.DHEA treatment group before and after treatment,BMI,LH,based on the basis of E2,T,DHEA of treatment group before and after treatment,BMI,LH,based on the basis of E2,T compared with the control group,the difference was not statistically significant;DHEA treatment group before and after treatment,AFC,AMH,DHEA in treatment group after FSH,AMH compared with the control group,the differences were statistically significant(P<0.05).DHEA treatment group before and after treatment and the control group,Gn total dose between Gn days,hCG days of E2,there were no significant differences;DHEA after treatment was increased the number of oocytes than before treatment,the difference was statistically significant;DHEA treatment group compared the number of high-quality embryos before and after treatment,and compared with the control group comparison,the differences were statistically significant(P<0.05).DHEA treatment group and control group before and after treatment,the fertilization rate,good embryo rate,cycle cancellation rate comparison,there were no significant differences between the treatment group after treatment;DHEA cleavage rate,clinical treatment increased the pregnancy rate,the difference was statistically significant;DHEA after treatment,the abortion rate and multiple pregnancy rate and live birth rate compared with the control group,there were no significant differences(P<0.05).Conclusions:Our study supported evidences that DHEA might modulate the hormone receptors in the ovary and hormone secretions to the peripheral circulation to regulate the ovary reserve functions.PART ? The establishment and evaluation of DOR model miceAim:To further investigate the DHEA effect on ovarian reserve,the main purpose of this part research is to establish the murine DOR model.Method:mice of DOR model group were intraperitoneal injected with 5 IU PMSG.54 hours later after injection,mice of DOR model group were injected with 5 IU HCG,which was followed by injection with 25 IU F2a 19 hours later.Repective injection with PMSG,HCG and F2? was considered as a complete superovulation cycle.12 hours later after the first injection cycle,the next cycle were proceeded.In total,ten injection cycles were required to complete COH.In the meanwhile,mice of DOR model group were placed in the ozone box of which the onzone concemtration shoud maintain at 2.8 mg/m3 level.In the control group,the mice were injected with the same volue of saline and same injection cycle.All the mice were feeded with the same feedstuff.was recored for each group of mice.Results:compared with the control group,the proportion of primordial follicles in the experimental group was reduced to 18.99%,while that of the control group was 27.75%,and the difference was statistically significant(P<0.05).The serum levels of FSH and LH in the control group were significantly higher than those in the model group(1.27 +0.37vs41.46 + 1.53 IU/L,289.13 + 23.64vs728.36 + 25.90 ng/L),the difference was statistically significant.The serum levels of E2,AMH and INHB in the control group were significantly lower than those in the model group(16.45 + 0.57vs13.45 + 0.39 ng/L,12.02 + 2.53vs2.8 + 1.13 ng/L,23.45 + 1.12vs10.18 + 0.57 ng/L),the difference was statistically significant(P<0.05).Conclusion:the estrous cycle disorder in the mice after modeling is confirmed,and the DOR model is established successfully.PART ? The effect of DHEA treatment on hormones and the ovary in the DOR mouseAim:To investigate the effect of DHEA on the ovary related parameters in the DOR mouse.Methods:constitutively intraperitoneal injection PMSG,HCG,PGF2a into DOR or control mice to induce superovulation.Further more,ozone exposure was adopted to establish DOR mouse model Experimental mice were divided into control group,DOR model group and DOR+DHEA group.In the DOR+DHEA group,all mice were intragastricly admistrated with 0.41 mg/0.3ml DHEA for 21 days.Mice of control and DOR groups were administrated with the same volume of normal saline for 21 days.E2,P,LH,INHB and AMH were determined by ELISA.The mRNA level of FSHR was quantified by qPCR.In addition,follicles of different stages were measured by HE staining and microscopic observation.Results:DHEA treatment was able to increase E2,P and AMH level and primordial follicles in the ovary(P<0.05).In the meanwhile,DHEA administration could upregulate the ovarial expression of FSH receptor.Conclusion:DHEA treatment could improve murine ovarial function through influencing ovary-related hormone and its receptor and increasing antral follicles amount.