Dehydroepiandrosterone supplementation improves ovarian response and cycle outcome in poor responders

• Published in: Reproductive biomedicine online Vol. 19; no. 4; pp. 508 - 513
• Main Authors: Sönmezer, M, Ozmen, B, Cil, A P, Ozkavukçu, S, Taşçi, T, Olmuş, H, Atabekoğlu, C S
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.10.2009
• Subjects: Dehydroepiandrosterone - therapeutic use; DHEA supplementation; Embryo Transfer; Estradiol - blood; Female; Fertility Agents, Female - therapeutic use; GnRH antagonist; Humans; ICSI; Obstetrics and Gynecology; Ovarian Follicle - drug effects; Ovarian Follicle - physiology; Ovary - drug effects; Ovulation Induction - methods; poor ovarian response; Pregnancy; Pregnancy Rate; Sperm Injections, Intracytoplasmic; DHEA supplementation; ICSI; GnRH antagonist; poor ovarian response
• ISSN: 1472-6483; 1472-6491
• 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.