Dehydroepiandrosterone supplementation improves ovarian response and cycle outcome in poor responders

Reprod Biomed Online. 2009 Oct;19(4):508-13. doi: 10.1016/j.rbmo.2009.06.006.

Abstract

The effect of dehydroepiandrosterone (DHEA) supplementation on cycle outcome was assessed in patients with poor ovarian response. In total, 19 poor responder patients who were scheduled to undergo a second intracytoplasmic sperm injection (ICSI)/embryo transfer cycle were enrolled and first ICSI/embryo transfer cycles were taken as the control group. All subjects were given DHEA supplementation (25 mg t.i.d.) for at least 3 months prior to their second ICSI/embryo transfer cycle. In both cycles a fixed dose of rFSH (300 IU/day) and human menopausal gonadotrophin (HMG) (75 or 150 IU/day) along with a flexible gonadotrophin-releasing hormone (GnRH) antagonist protocol were administered. A favourable decrease was noted in mean day 3 serum oestradiol concentrations after DHEA supplementation (75.14 +/- 28.93 versus 43.07 +/- 11.77; P < 0.01). Increased number of >17 mm follicles (3 +/- 0.7 versus 1.9 +/- 1.3; P < 0.05), MII oocytes (4 +/- 1.8 versus 2.1 +/- 1.8; P < 0.05), top quality day 2 (2.2 +/- 0.8 versus 1.3 +/- 1.1; P < 0.05) and day 3 embryos (1.9 +/- 0.8 versus 0.7 +/- 0.6; P < 0.05) were achieved in DHEA-supplemented cycles. Cycle cancellation rates were reduced (5.3% versus 42.1%; P < 0.01), and the pregnancy rate per patient and clinical pregnancy rate per embryo transfer (47.4% versus 10.5%; P < 0.01 and 44.4% versus 0%; P < 0.01) were improved after DHEA supplementation. DHEA supplementation might enhance ovarian response, reduce cycle cancellation rates and increase embryo quality in poor responders.

MeSH terms

  • Dehydroepiandrosterone / therapeutic use*
  • Embryo Transfer
  • Estradiol / blood
  • Female
  • Fertility Agents, Female / therapeutic use*
  • Humans
  • Ovarian Follicle / drug effects
  • Ovarian Follicle / physiology
  • Ovary / drug effects
  • Ovulation Induction / methods*
  • Pregnancy
  • Pregnancy Rate
  • Sperm Injections, Intracytoplasmic

Substances

  • Fertility Agents, Female
  • Dehydroepiandrosterone
  • Estradiol