DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160592

Role of oral dehydroepiandrosterone in diminished ovarian function

Meena Dayal, Amrita Chaurasia, Urvashi Singh, Veena Gupta, Shweta Patel

Abstract


Background: Ovarian reserve decreases with age and this study determine the effect of oral DHEA supplementation on S.AMH concentration and conception rate in women with diminished ovarian function.

Methods: The study was conducted on 72 infertile women of 20-45 years age who had S.AMH <2.2 ng/ml, which was taken as cut off for diminished ovarian reserve in the study. The cases of study group received oral DHEA 25mg TDS and cases of control group received placebo (folic acid 5 mg OD) for 12 weeks. Day 2 S.AMH, S.FSH, S.LH, S.E2, S. Inhibin B, ovarian volume and AFC were measured at first visit and after 12 weeks of oral DHEA or placebo.

Results: After 12 weeks of oral DHEA supplementation, S. AMH concentration was found to be significantly improved (p=0.01). S.FSH was decreased (p=0.04) and S. E2 was increased (p=0.03). S. LH showed insignificant decrease. S. Inhibin B, ovarian volume and AFC were increased but insignificantly. Improvement in ovarian reserve resulted in significantly higher pregnancy rate (p=0.04) and live births (p=0.04) in women treated with DHEA than in the control group. Miscarriage rate was found to be decreased but insignificantly.

Conclusions: DHEA improves the ovarian reserve.

Keywords


Serum antimullerian hormone, Serum follicular stimulating hormone, Serum luteinizing hormone, Serum estradiol, Antral follicular count, Dehydroepiandrosterone

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References


Te Velde ER, Scheffer GJ, Dorland M, Broekmans FJ, Fauser BC. Developmental and endocrine aspects of normal ovarian ageing. Molecular and cellular endocrinology. 1998a;145:67-73.

Hillier SG, Tetsuka M, Fraser HM. Androgen receptor function in folliculogenesis and its clinical implication in premature ovarian failure. Hum Reprod. 1997;12:107-11.

Weil SJ, Vendola K, Zhou J, Adesanya OO, Wang J, Bondy CA. Androgen receptor gene expression in the primate ovary: cellular localization, regulation and functional correlations. J Clin Endocrinol Metab. 1998;83:2479-85.

Gleicher et al. Improvement in diminished ovarian reserve after dehydroepiandrosterone supplementation. Reprod Biomed Online. 2010;21:360-5.

Gleicher N, Weghofer A, Barad DH. Dehydroepiandrosterone (DHEA) reduces embryo aneuploidy: direct evidence from pre implantation genetic screening (PGS). Reprod Biol Endocrinol. 2010;8:140.

Sonmezer M, Ozmen B, Cil AP, Ozkavukcu S, Tasci T, OlmuĊŸ H, Atabekoglu CS. Dehydroepiandrosterone supplementation improves ovarian response and cycle outcome in poor responders. Reprod Biomed Online. 2009;19(4):508-13.

Mamas L, Mamas E. Premature ovarian failure and dehydroepiandrosterone. Fertil Steril. 2009;91(2):644-6.

Gleicher N, Barad DH. Dehydroepiandrosterone (DHEA) supplementation in diminished ovarian reserve (DOR). Reprod Biol Endocrinol. 2011;17(9):67.

Barad DH, Brill H, Gleicher N. Update on the use of dehydroepiandrosterone supplementation among women with diminished ovarian function. J Assist Reprod Genet. 2007;24:629-34.

Fusi FM, Ferrario M, Bosisio C, Arnoldi M, Zanga. DHEA supplementation positively affects spontaneous pregnancies in women with diminished ovarian function. Gynecol Endocrinol. 2013;29(10):940-3.

Gleicher N, Ryan E, Weghofer A, Blanco S, Barad DH. Miscarriage rates after dehydroepiandrosterone (DHEA) supplementation in women with diminished ovarian reserve: a case control study. Reprod Biol Endocrinol. 2009;7:108.

Wiser A, Gonen O, Ghetler Y, Shavit T, Berkovitz A, Shulman A. Addition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate : a randomized prospective study. Human Reproduction. 2010;25(10):2496-2500.