Effect Of Dehydroepiandrosterone Supplementation On Endometrial Receptivity In Infertile Patients With Diminished Ovarian Reserve

Dehydroepiandrosterone(DHEA)is a natural steroid that is secreted mainly by the adrenal cortex,gonads.DHEA is a weak androgen that is converted to estradiol and testosterone.DHEAS is the sulphate ester of DHEA,and it is synthesized in the adrenal gland.Serum levels of those two sex steroid hormones decline with age.In 1996,DHEA's anti-aging effects were described.This motivated several scientists to study the role of DHEA in reproduction and specifically in diminished ovarian reserve.The first case series report was in 2000,which concluded that DHEA patients demonstrated improved embryo quality over time and higher live birth rates with increasing length of DHEA supplementation.Then more and more reproductive center use DHEA for poor responders in an attempt to improve response to stimulation during IVF treatment.In the process of human embryo implantation,the quality of embryos and endometrial receptivity are two of the most important factors affecting implantation.However,very little coverage of DHEA's ability that affect endometrial receptivity while improving ovarian function.We speculated that at the same time of DHEA in improving DOR patients with ovarian response,androgen levels rise,androgen as a substrate by granules in the role of aromatase into estrogen,by autocrine or paracrine regulation of endometrial.In this study,patients with DOR as the object of study.Objective: To explore the effect of DHEA on endometrial receptivity of patients with DOR.Methods: Fifty patients with DOR were given DHEA on the second day at the menses cycle,one capsules each time,three times daily,twenty one days for a treatment course,and a total of treatment for three courses.The endometrium thickness,endometrium type,resistance index(RI)and pulsative index(PI)of uterine spiral artery were observed before and after treatment by vaginal ultrasound.In the treatment before and after planting window with a disposable S straw to absorb a small amount of endometrial tissue,fixed preservation.The endometrial glands were detected by HE staining.Results:There were statistic difference of endometrium thickness,PI,RI and type A endometrium between before and after treatment(P<0.05).After treatment,endometrial glands increased,glandular cavity also enlarge.Conclusion: DHEA can improve the endometrial receptivity and promote embryo implantation.We verify the effect of DHEA on endometrial receptivity,and provide a theoretical basis for the clinical use of DHEA,to further improve the embryo implantation rate and clinical pregnancy rate in IVF.