Improvement in diminished ovarian reserve after dehydroepiandrosterone supplementation

Abstract

Dehydroepiandrosterone (DHEA) has been reported to improve oocyte/embryo yields and oocyte/embryo quality in women with diminished ovarian reserve. Whether DHEA objectively improves ovarian reserve is, however, unknown. This study investigated 120 consecutive patients with diminished ovarian reserve, supplemented for 30-120 days (mean 73+/-27) with DHEA (25mg three times daily). Anti-Müllerian hormone (AMH) concentrations were determined in relationship to DHEA supplementation using linear regression and, longitudinally, by examining interaction between days of DHEA treatment and pregnancy success in respect to changes in AMH. AMH concentrations significantly improved after DHEA supplementation over time (P=0.002). Women under age 38 years demonstrated higher AMH concentrations and improved AMH concentrations more than older females. AMH improved longitudinally by approximately 60% (P<0.0002). Women reaching IVF experienced a 23.64% clinical pregnancy rate and conceiving women showed significantly improved AMH concentrations compared with those who did not (P=0.001). DHEA supplementation, thus, significantly improved ovarian reserve in parallel with longer DHEA use and was more pronounced in younger women.

Starting and resulting testosterone levels after androgen supplementation determine at all ages in vitro fertilization (IVF) pregnancy rates in women with diminished ovarian reserve (DOR)

“…By IVF cycle start, however, only AMH was left significantly associated with pregnancy chances (Fig. 2a), which correlates well with the earlier reported observations that AMH, but not FSH improves with DHEA supplementation, and that increases in AMH levels are associated with improved pregnancy chances with IVF [21].…”

Dehydroepiandrosterone treatment in women with poor ovarian response undergoing IVF or ICSI: a systematic review and meta-analysis

“…6a) [15,17,23]. Six trials including 163 patients that studied women older than 36 also indicated increased oocyte numbers after DHEA treatment (WMD 1.31, [13] Ca se-control None None N/A Intention to treat analysis *** * ** Barad [12] Prospective cohort study None None N/A Intention to treat analysis *** * ** Sonmezer [23] Prospective cohort study None None N/A Intention to treat analysis *** * ** Gleicher [32] Case-control None None N/A Intention to treat analysis *** * ** Wiser [14] RC T Artini [33] RC T Moawad [24] RCT Fusi [25] Prospective cohort study None None N/A Intention to treat analysis *** * ** Hyman [26] Prospective cohort study None None N/A Intention to treat analysis ** * ** Singh [27] Prospective cohort study None None N/A Intention to treat analysis ** * ** Yeung [32] RCT Yilmaz [36] Prospective cohort study None None N/A Intention to treat analysis *** * ** Jirge [15] Prospective cohort study None None N/A Intention to treat analysis *** * ** Kara [28] R C T Vlahos [2] Prospective cohort study None None N/A Intention to treat analysis **** * ** Xu [16] C a s e -control None None N/A Intention to treat analysis ** * ** Yeung [6] R C T Zangmo [17] Prospective cohort study None None N/A Intention to treat analysis ** * ** Zhang [29] RCT Tartagni [30] RCT Tsui [31] Prospective cohort study None None N/A Intention to treat analysis *** * ** Fig. 6b) [12,14,17,25,26,31].…”

“…We also compared the results from case-control trials. Of nine such trials, we selected five (total 280 patients) and discarded four when controlling for age, DHEA treatment time, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) doses for COH [2, 14,16,33,34]. This analysis also indicated a larger retrieved oocyte number after DHEA treatment (WMD 0.27, 95 % CI 0.12-0.42, p = 0.0004, I 2 = 49 %, Fig.…”

Dehydroepiandrosterone improves the ovarian reserve of women with diminished ovarian reserve and is a potential regulator of the immune response in the ovaries

“…DHEA supplementation is usually oral and administered at 25 mg, three times a day, or 75-90 mg for the entire day, for 6 to 24 weeks. A previous casecontrol study showed that DHEA improved ovarian reserve and that it significantly increased antral follicle counts (AFCs), anti-Müllerian hormone (AMH) levels (32)(33)(34), numbers of fertilized oocytes, normal day 3 embryos, embryos transferred, and the average embryo score per oocyte (35) while significantly decreasing day 3 follicle-stimulating hormone (FSH) (33), fertilized aneuploid embryos (36), and miscarriage rates (37) (all p-values < 0.05). Estradiol (E2) levels tripled according to two studies (12,38) but decreased according to a third (34).…”