Miscarriage rates after dehydroepiandrosterone (DHEA) supplementation in women with diminished ovarian reserve: a case control study

Gleicher, Norbert; Ryan, E.; Weghofer, Andrea; Mejía, Sonia Blanco; Barad, David H.

doi:10.1186/1477-7827-7-108

Cited by 109 publications

(78 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition to these encouraging studies, no significant differences in clinical pregnancy rates and miscarriage rates between DOR women pre-treated with DHEA, compared to those without DHEA pre-treatment were found in a recent meta-analysis [Narkwichean et al 2013]. Because the probable effect of DHEA on patients with DOR is still not clear, the proposed mechanisms obtained from clinical studies, such as improved follicular steroidogenesis, increased IGF-1 [Casson et al 2000] acting as a pre-hormone for follicular testosterone [Gelicher and , reducing aneuploidy Gleicher et al 2009], and increasing AMH with antral follicle count [Andersen and Lossi 2008] remain speculative. Narkwichean et al [2014] conducted studies using an experimental sheep model to search for the effects of exposure of ovarian tissue to DHEA supplementation in vivo, and this study was the first to evaluate the effect of DHEA treatment on early follicle development in vivo.…”

Section: Discussionmentioning

confidence: 99%

Effects of dehydroepiandrosterone (DHEA) on follicular dynamics in a diminished ovarian reservein vivomodel

Hassa¹,

Aydın²,

Özatik³

et al. 2015

Systems Biology in Reproductive Medicine

View full text Add to dashboard Cite

The objective of this study was to determine whether there are changes in primary, primordial, and growing follicles after dehydroepiandrosterone (DHEA) administration in rats that have diminished ovarian reserve (DOR) due to 4-vinylcyclohexene diepoxide (VCD) application, and to examine the mechanism of the probable effect of DHEA on folliculogenesis. Two groups of Wistar rats were used. In Group A unilateral oophorectomy (eight rats) was carried out on day-0. The remaining study ovary was removed by relaparotomy after VCD (160 mg/kg, intraperitoneally) was administered for 15 days. In Group B unilateral oophorectomy (eight rats) was carried out on day-0. The remaining study ovary was removed by relaparotomy after VCD (160 mg/kg, intraperitoneally) administration for 15 days followed by DHEA (60 mg/kg body weight) daily for 45 days. Primordial, primary, and growing (secondary + antral) follicles were counted in 1,664 sections from 32 ovaries. In all three types of follicles (primordial, primary, and growing), the number of follicles significantly decreased in the study ovaries compared to the control ovaries in both Group A and Group B. In Group B, atresia rates were significantly lower in the study ovary compared to the control ovary in all of the follicular groups: primordial (p ¼ 0.02), primary (p ¼ 0.01), and growing (p ¼ .027). To demonstrate the probable effects of DHEA on follicular dynamics, we also compared the study ovaries in both groups; the primordial (p ¼ 0.027), primary (p ¼ 0.031), and growing (p ¼ 0.04) number of follicles were significantly higher in Group B compared to Group A. In conclusion, our findings suggest that DHEA administration in DOR rats due to VCD results in a larger follicular pool. Decreased atresia may be one of the possible effects of DHEA in DOR cases. Whatever the mechanism, DHEA treatment potentially may be useful clinically as a means to increase the number of gonadotropin-responsive follicles for ovarian stimulation.

show abstract

Section: Discussionmentioning

confidence: 99%

Effects of dehydroepiandrosterone (DHEA) on follicular dynamics in a diminished ovarian reservein vivomodel

Hassa¹,

Aydın²,

Özatik³

et al. 2015

Systems Biology in Reproductive Medicine

View full text Add to dashboard Cite

show abstract

“…Previous studies indicated that DHEA improved the outcomes of IVF by reducing aneuploidy and improving ovarian reserve (25,61). The current study found that administration of DHEA tended to delay the loss of cohesin in oocytes and thus reduce the rate of oocyte aneuploidy.…”

Section: Discussionmentioning

confidence: 49%

The effect of DHEA on apoptosis and cohesin levels in oocytes in aged mice

Chu

Gui

Zhang

et al. 2017

BST

View full text Add to dashboard Cite

“…Also, DHEA resulted in a similar improvement in patients with age-dependent diminished ovarian reserve and patients with premature ovarian insufficiency. Similar outcomes were suggested by another group [22], who studied forty seven patients with prior clomiphene citrate failures and were supplemented with 75 mg of DHEA daily for at least 60 days prior to stimulation with either letrozole or clomiphene citrate in combination with FSH [22]. Another study evaluated the outcome of nineteen poor responder patients undergoing IVF supplemented with DHEA for at least 3 months.…”

Section: Published Studiesmentioning

confidence: 58%

“…The apparent improvement in miscarriage rate and IVF pregnancy rate may be explained by improving embryo ploidy [22,23]. The risk of age related aneuploidy is explained by major disturbances in chromosomes alignments on the meiotic spindle of oocytes which is primarily caused from the complex interplay of inter and intracellular signals regulating follicular development.…”

Section: Mechanism(s) Of Actionmentioning

confidence: 99%

Is there a role for DHEA supplementation in women with diminished ovarian reserve?

Fouany

Sharara

2013

J Assist Reprod Genet

View full text Add to dashboard Cite

Purpose Poor ovarian reserve and poor ovarian response presents a challenge to IVF centers. Dehydroepiandrosterone (DHEA) supplementation is increasingly being used by many IVF centers around the world in poor responders despite the lack of convincing data. We therefore examined the rationale for the use of DHEA in poor responders, address the relevant studies, present new data, and address its potential mechanisms of action. Methods All published articles on the role of DHEA in infertile women from 1990 to April 2013 were reviewed. Results Several studies have suggested an improvement in pregnancy rates with the use of DHEA. Potential mechanisms include improved follicular steroidogenesis, increased IGF-1, acting as a pre-hormone for follicular testosterone, reducing aneuploidy, and increasing AMH and antral follicle count. While the role of DHEA is intriguing, evidencebased recommendations are lacking. Conclusions While nearly 25 % of IVF programs use DHEA currently, large randomized prospective trials are sorely needed. Until (and if) such trials are conducted, DHEA may be of benefit in suitable, well informed, and consented women with diminished ovarian reserve.

show abstract

Miscarriage rates after dehydroepiandrosterone (DHEA) supplementation in women with diminished ovarian reserve: a case control study

Cited by 109 publications

References 27 publications

Effects of dehydroepiandrosterone (DHEA) on follicular dynamics in a diminished ovarian reservein vivomodel

Effects of dehydroepiandrosterone (DHEA) on follicular dynamics in a diminished ovarian reservein vivomodel

The effect of DHEA on apoptosis and cohesin levels in oocytes in aged mice

Is there a role for DHEA supplementation in women with diminished ovarian reserve?

Contact Info

Product

Resources

About