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Reprod Biol Endocrinol. 2018 Sep 17;16(1):90. doi: 10.1186/s12958-018-0409-z.

Dehydroepiandrosterone (DHEA) supplementation improves in vitro fertilization outcomes of poor ovarian responders, especially in women with low serum concentration of DHEA-S: a retrospective cohort study.

Author information

1
Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist, Kaohsiung City, 81362, Taiwan.
2
Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, No. 155, Sec. 2, Li-Nong Street, Pei-Tou, Taipei, 112, Taiwan.
3
Department of Pharmacy and Master Program, College of Pharmacy and Health Care, Tajen University, No.20, Weixin Rd, Yanpu, Township, Pingtung County, 90741, Taiwan.
4
Department of General Surgery and Medical Surgical Specialties, University of Catania, 95123, Catania, Italy.
5
Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan.
6
Department of Medical Research, China Medical University Hospital, No. 2, Yude Road, North District, Taichung City, 40447, Taiwan.
7
Department of Marine Biotechnology and Resources, National Sun Yat-sen University, 70 Lienhai Rd, Kaohsiung City, 80424, Taiwan.
8
Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist, Kaohsiung City, 81362, Taiwan. litelin1982@gmail.com.
9
Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, No. 155, Sec. 2, Li-Nong Street, Pei-Tou, Taipei, 112, Taiwan. litelin1982@gmail.com.
10
Department of Biological Science, National Sun Yat-Sen University, 70 Lienhai Rd, Kaohsiung City, 80424, Taiwan. litelin1982@gmail.com.

Abstract

BACKGROUND:

Dehydroepiandrosterone (DHEA) is now widely used as an adjuvant for in vitro fertilization (IVF) cycles in poor ovarian responders (PORs). Several studies showed that DHEA supplementation could improve IVF outcomes of PORs. However, most of the PORs do not respond to DHEA clinically. Therefore, the aim of this study is to confirm the beneficial effects of DHEA on IVF outcomes of PORs and to investigate which subgroups of PORs can best benefit from DHEA supplementation.

METHODS:

This retrospective cohort study was performed between January 2015 and December 2017. A total of 151 PORs who fulfilled the Bologna criteria and underwent IVF cycles with the gonadotropin-releasing hormone antagonist protocol were identified. The study group (n = 67) received 90 mg of DHEA daily for an average of 3 months before the IVF cycles. The control group (n = 84) underwent the IVF cycles without DHEA pretreatment. The basic and cycle characteristics and IVF outcomes between the two groups were compared using independent t-tests, Chi-Square tests and binary logistic regression.

RESULTS:

The study and control groups did not show significant differences in terms of basic characteristics. The study group demonstrated a significantly greater number of retrieved oocytes, metaphase II oocytes, fertilized oocytes, day 3 embryos and top-quality embryos at day 3 and a higher clinical pregnancy rate, ongoing pregnancy rate and live birth rate than those measures in the control group. The multivariate analysis revealed that DHEA supplementation was positively associated with clinical pregnancy rate (OR = 4.93, 95% CI 1.68-14.43, p = 0.004). Additionally, in the study group, the multivariate analysis showed that serum dehydroepiandrosterone-sulfate (DHEA-S) levels < 180 μg/dl were significantly associated with a rate of retrieved oocytes > 3 (OR = 5.92, 95% CI 1.48-23.26, p = 0.012).

CONCLUSIONS:

DHEA supplementation improves IVF outcomes of PORs. In PORs with DHEA pretreatment, women with lower DHEA-S level may have greater possibility of attaining more than 3 oocytes.

KEYWORDS:

DHEA; Dehydroepiandrosterone; Diminished ovarian reserve; In vitro fertilization; Poor ovarian responders

PMID:
30223902
PMCID:
PMC6142344
DOI:
10.1186/s12958-018-0409-z
[Indexed for MEDLINE]
Free PMC Article

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