Dehydroepiandrosterone supplementation improves reproductive outcomes in women of the POSEIDON IV group
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20241052Keywords:
DHEA supplementation, Dehydroepiandrosterone, Poor ovarian response, ICSI, PrasteroneAbstract
Background: The decrease in ovarian reserve has become one of the main causes of infertility. Recent studies have sought to improve the reproductive outcomes of these women through adjuvant treatments. In patients undergoing assisted reproduction treatments, exogenous Dehydroepiandrosterone (DHEA) or prasterone acts as a precursor to testosterone in the follicular fluid, which increases steroidogenesis and the number of primary and antral follicles.
Methods: A quantitative, quasi-experimental case series study was carried out in the clinical area of assisted reproduction from August 2021 to March 2022. All women included were over 34 years and categorized as POSEIDON IV. They were supplemented with 100 mg of DHEA one month prior to the follicular capture. Data was collected from the records of the patients who met the inclusion criteria, including the antral follicle count on the first three days of the menstrual period before the supplementation and one month after. Finally, the number of metaphase II oocytes and blastocysts obtained were analyzed.
Results: There were 22 women underwent controlled ovarian stimulation; there was a difference in antral follicle count from 5±2.1 SD to 8.23±4.29 SD (p=0.004) and MII oocytes 3.25±2.31 to 4.53±3.27 (p=0.04) before DHEA and after DHEA, respectively.
Conclusions: DHEA or prasterone supplementation can be used as an adjuvant treatment in women of the POSEIDON IV group one month before the ovarian stimulation to improve their reproductive outcome.
Metrics
References
Ulug U, Ben-Shlomo I, Turan E, Erden HF, Ali Akman M, Bahceci M. Conception rates following assisted reproduction in poor responder patients: A retrospective study in 300 consecutive cycles. Reprod Biomed Online. 2003;6(4):439-43.
Drakopoulos P, Bardhi E, Boudry L, et al. Update on the management of poor ovarian response in IVF: the shift from Bologna criteria to the Poseidon concept. Ther Adv Reprod Heal. 2020;14:263349412094148.
Casson PR, Lindsay MS, Pisarska, Carson SA, Buster JE. Dehydroepiandrosterone supplementation augments ovarian stimulation in poor responders: a case series technology depends on ovarian stimulation and concurrent multiple oocyte development, induced by administration of. Hum Reprod. 2000;15(10):2129-32.
Traish AM, Kang HP, Saad F, Guay AT. Dehydroepiandrosterone (DHEA)-A precursor steroid or an active hormone in human physiology (CME). J Sex Med. 2011;8(11):2960-82.
Palacios S. Hypoactive sexual desire disorder and current pharmacotherapeutic options in women. Women’s Heal. 2011;7(1):95-107.
Noventa M, Vitagliano A, Andrisani A, Blaganje M, Viganò P, Papaelo E, et al. Testosterone therapy for women with poor ovarian response undergoing IVF: a meta-analysis of randomized controlled trials. J Assist Reprod Genet. 2019;36(4):673-83.
Triantafyllidou O, Sigalos G, Vlahos N. Dehydroepiandrosterone (DHEA) supplementation and IVF outcome in poor responders. Hum Fertil. 2017;20(2):80-7.
Alviggi C, Andersen CY, Buehler K, Conforti A, De Placido G, Esteves SC, Fischer R, et al. A new more detailed stratification of low responders to ovarian stimulation: from a poor ovarian response to a low prognosis concept. Fertil Steril. 2016;105(6):1452-3.
Casson PR, Santoro N, Elkind-Hirsch K, et al. Postmenopausal dehydroepiandrosterone administration increases free insulin-like growth factor-I and decreases high-density lipoprotein: A six- month trial. Fertil Steril. 1998;70(1):107-10.
Sönmezer M, Oezmen BA, Cil AP, Özkavukçu S, Taşçı T, Olmuş H, et al. Dehydroepiandrosterone supplementation improves ovarian response and cycle outcome in poor responders. Reprod Biomed Online. 2009;19(4):508-13.
Li CJ, Lin L Te, Tsui KH. Dehydroepiandrosterone shifts energy metabolism to increase mitochondrial biogenesis in female fertility with advancing age. Nutrients. 2021;13(7).
Barad DH, Gleicher N. Increased oocyte production after treatment with dehydroepiandrosterone. Fertil Steril. 2005;84(3):756.e1-756.e3.
Gleicher N, Weghofer A, Barad DH. Improvement in diminished ovarian reserve after dehydroepiandrosterone supplementation. Reprod Biomed Online. 2010;21(3):360-5.
Gleicher N, Weghofer A, Barad D. Increased euploid embryos after supplementation with dehydroepiandrosterone (DHEA) in women with premature ovarian aging. Fertil Steril. 2007;88(September):S232.
Nielsen ME, Rasmussen IA, Kristensen SG, Christensen ST, Møllgård K, Wreford Andersen E, et al. In human granulosa cells from small antral follicles, androgen receptor mRNA and androgen levels in follicular fluid correlate with FSH receptor mRNA. Mol Hum Reprod. 2011;17(1):63-70.
De Leo V. Hormonal effects of flutamide in young women with polycystic ovary syndrome. J Clin Endocrinol Metab. 1998;83(1):99-102.
Rangel M. Metabolic, reproductive outcomes and side effects after the administration of 100 mg dehydroepiandrosterone (DHEA) in women with an adequate ovarian reserve. Fertil Steril. 2021;116(3):e316.
Sunkara SK, Pundir J, Khalaf Y. Effect of androgen supplementation or modulation on ovarian stimulation outcome in poor responders: A meta-analysis. Reprod Biomed Online. 2011;22(6):545-55.