A randomized controlled pilot trial on the effect of dehydroepiandrosterone on ovarian response markers ovarian response and in vitro fertilization outcomes in poor responders

No significant improvement in ovarian response markers, ovarian response to standard dose gonadotropin stimulation, or IVF outcomes was detected in poor responders receiving pretreatment DHEA compared with placebo.

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Authors

Tracy Wing Yee Yeung, M.B., B.S., Joyce Chai, M.B., Ch.B., Raymond Hang Wun Li, M.B., B.S., Vivian Chi Yan Lee, M.B., B.S., Pak Chung Ho, M.D., Ernest Hung Yu Ng, M.D.

Volume 102, Issue 1, Pages 108–115.e1

Abstract

Objective:

To evaluate whether pretreatment dehydroepiandrosterone (DHEA) supplementation improves ovarian response markers, ovarian response to standard low-dose gonadotropin stimulation, and in vitro fertilization (IVF) outcomes in poor responders.

Design:

Randomized, double-blind, placebo-controlled pilot study.

Setting:

Tertiary reproductive medicine unit.

Patient(s):

Thirty-two women with anticipated poor ovarian response.

Intervention(s):

Randomization into DHEA group (n = 16) receiving GNC (25 mg three times a day) or placebo (n = 16) starting from at least 12 weeks before the scheduled IVF treatment according to a computer-generated randomization list.

Main Outcome Measure(s):

Measurement of monthly ovarian response markers, including antral follicle count (AFC), serum antimüllerian hormone (AMH), and follicle-stimulating hormone (FSH) levels; comparison of ovarian response to a standard dose of gonadotropin stimulation at week 8 and IVF outcomes; and AFC after 12 weeks (primary outcome).

Result(s):

The DHEA supplementation resulted in statistically significantly higher serum DHEA-S, free androgen index, and follicular DHEA-S levels. No statistically significant differences in the ovarian response markers (AFC, AMH, or FSH), the ovarian response to standard-dose gonadotropin stimulation, or IVF outcomes were found between the two groups.

Conclusion(s):

No statistically significant improvement in ovarian response markers, ovarian response to standard dose gonadotropin stimulation, or IVF outcomes was found in poor responders receiving pretreatment DHEA.

Clinical Trial Registration Number:

HKCTR-1149 (www.hkclinicaltrials.com) and NCT01915186 (www.ClinicalTrials.org).

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)00299-4/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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