Application of DHEA to advanced aged patients with diminished ovarian reserve in in vitro fertilization or intracytoplasmic sperm injection and embryo transfer

Abstract

Objective To investigate the effects of dehydroepiandrosterone (DHEA) supplementation on in vitro fertilization or intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) outcomes and changes in ovarian reserve among patients with diminished ovarian reserve (DOR). Methods The study enrolled 152 treatment cycles in 152 couples who accepted IVF/ICSI. All patients had repeated IVF/ICSI-ET cycles. The last cycle without DHEA supplementation were taken as before treatment group and this time received DHEA supplementation were taken as after treatment group, as self-control study. The ovarian reserve in after treatment group were compared between before and after oral DHEA subgroup. Also the IVF treatment parameters and outcomes were compared. Results 1) In after treatment group, serum anti-Mullerian hormone (AMH), testosterone (T), dehydroepiandrosterone sulfate (DHEA-s), and the number of antral follicle count (AFC) were increased and basic follicle-stimulating hormone (FSH) value was reduced after DHEA treatment which had a statistical significant (P<0.05). 2) Serum estradiol (E2) and progesterone (P) levels on the day of human chorionic gonadotropin (hCG) injection, the number of retrieved oocytes and available embryos, fertilization rate, embryo implantation rate, clinical pregnancy rate were significantly higher in after treatment group than in before treatment group. The dosage and duration of gonadotropin (Gn) used, cycle cancellation rate were significantly lower in after treatment group than in before treatment group. Conclusion DHEA supplementation can improve ovarian reserve and outcome of IVF/ICSI in aged patients with DOR. Key words: Dehydroepiandrosterone (DHEA); Diminished ovarian reserve (DOR); Anti-Mullerian hormone(AMH); Clinical pregnancy rate