Dehydroepiandrosterone (DHEA) administration prior to IVF in poor

Dehydroepiandrosterone (DHEA) administration prior to IVF
in poor responders. A prospective cohort study.
Vlahos Nikos, Papalouka Maria, Triantafillidou Olga, Vlachos Athanasios,
Vakas Panagiotis, Grimbizis Gregory, Creatsas George, Zikopoulos
Konstantinos
Introduction
The use of DHEA improves ovarian
stimulation outcomes in a woman of
advanced reproductive age and could
reduce embryo aneuploidy.
Objective
To evaluate whether administration of
DHEA in women with history of poor
ovarian response provides any additional
benefit.
Material and methods
Women (n=48) diagnosed with poor
ovarian
response
where
offered
supplementation with DHEA for at least
12 weeks and were compared to a control
group (n=113) of poor responders. During
the
study
period,
patients
had
measurements of day 2 FSH and
estradiol on a monthly basis before and
after treatment. Evaluation of the AMH
was performed before the initiation of
treatment and just before the subsequent
stimulation.
Changes
stimulation
characteristics, stimulation outcome and
clinical outcome (clinical pregnancy and
take home baby rates) were reported.
Results
Supplementation with DHEA for at least
12 weeks resulted in a modest increase in
AMH levels and a decrease in baseline
FSH which were statistically significant.
Conclusions
DHEA administration had no impact in
any of the stimulation parameters nor
were there any differences in clinical
pregnancy rates and live birth rates
between the two groups.
Table 1: Primary outcomes in terms of pregnancy between the two
groups: Overall there were no differences between the two groups in
any of the clinical parameters that were examined. A similar proportion
of patients did not proceed to transfer either because of lack of oocytes
during retrieval or lack of available embryos.
DHEA use
Yes, N=48
No, N=113
(%)
(%)
P value∗
No oocytes
retrieved
8(16.6%)
21 (18.5%)
0.826
No embryos
available for
transfer
10(20.8%)
25(22.1%)
1.000
3(6.3%)
10 (8.8%)
0.580
1(2.1%)
8 (7.1%)
0.207
0(0.0%)
1(0.9%)
0.513
0(0.0%)
5(4.4%)
0.323
0(0.0%)
6(5.3%)
0.181
Biochemical
pregnancies
Clinical
pregnancies
Preterm
deliveries
Term
deliveries
Take home
baby rates
Table 2: Changes in ovarian reserve markers before and after
treatment for the group treated with DHEA
DHEA administration (N=48)
Befor
e
treat
ment
Mean
(SE)
After
treat
ment
Mean
(SE)
Mean
differe
nce
(SE)
95% CI
P
val
ue
∗
FSH
(mIU/ml)
13.4
(2.45
)
12.6
(2.45
)
0.79
(0.28)
0.2221.36
.00
7
AMH
(ng/ml)
1.47
(0.68
)
1.63
(0.76
)
0.163
(0.04)
-0.246—
0.0793
.00
0