A meta‐analysis of dehydroepiandrosterone supplementation among women with diminished ovarian reserve undergoing in vitro fertilization or intracytoplasmic sperm injection

Li, Jie; Yuan, Hua; Chen, Yang; Wu, Hongbo; Wu, Hui-Mei; Li, Liuming

doi:10.1016/j.ijgo.2015.06.028

Cited by 46 publications

(34 citation statements)

References 29 publications

(67 reference statements)

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“…DHEA is produced in a variety of vertebrates, including birds , mammals and humans . It is also utilised as an over‐the‐counter supplement and multiple health and therapeutic benefits have been reported . DHEA is classified as a performance enhancing drug and is listed as a banned substance by the World Anti‐Doping Agency, partly as a result of concerns about the potential role of exogenous androgens in facilitating aggression .…”

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confidence: 99%

Dehydroepiandrosterone Heightens Aggression and Increases Androgen Receptor and Aromatase mRNA Expression in the Brain of a Male Songbird

Wacker

Khalaj

Jones

et al. 2016

J Neuroendocrinology

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This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Dehydroepiandrosterone (DHEA) is a testosterone/oestrogen precursor and known modulator of vertebrate aggression. Male song sparrows (Melospiza melodia morphna) show high aggression during breeding and nonbreeding life-history stages when circulating DHEA levels are high, and low aggression during molt when DHEA levels are low. We previously showed that androgen receptor and aromatase mRNA expression are higher during breeding and/or nonbreeding in brain regions associated with reproductive and aggressive behaviour, although the potential role of DHEA in mediating these seasonal changes remained unclear. In the present study, nonbreeding male song sparrows were captured and held in the laboratory under short days (8 : 16 h light/dark cycle) and implanted with s.c. DHEA-filled or empty (control) implants for 14 days. DHEA implants increased aggression in a laboratory-based simulated territorial intrusion. Brains of DHEA-implanted birds showed higher aromatase mRNA expression in the preoptic area (POA) and higher androgen receptor mRNA expression in the periventricular nucleus of the medial striatum (pvMSt) and ventromedial nucleus of the hypothalamus. The DHEA-induced increases in aromatase expression in the POA and androgen receptor expression in the pvMSt are consistent with previously reported seasonal increases in these markers associated with naturally elevated DHEA levels. This suggests that DHEA facilitates seasonal increases in aggression in nonbreeding male song sparrows by up-regulating steroid signalling/synthesis machinery in a brain region-specific fashion.

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confidence: 99%

Dehydroepiandrosterone Heightens Aggression and Increases Androgen Receptor and Aromatase mRNA Expression in the Brain of a Male Songbird

Wacker

Khalaj

Jones

et al. 2016

J Neuroendocrinology

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“…Furthermore, a recent metaanalysis of DHEA supplementation in women with DOR undergoing IVF or ICSI assessed evidence from eight studies and concluded that DHEA supplementation improved pregnancy outcomes. DHEA treatment was associated with a significant increase in clinical pregnancy rates (Risk Ratio 2.13); however, there was insufficient power to detect an impact on oocyte retrieval, implantation or miscarriage rates (Li et al 2015). Thus, although it has been suggested that peripheral androgen supplementation may improve reproductive outcomes in women undergoing IVF, further evidence is required to elucidate the mechanisms by which this may impact on the establishment of pregnancy and specifically on endometrial function.…”

Section: Discussionmentioning

confidence: 99%

Regulation of androgen action during establishment of pregnancy

Gibson¹,

Simitsidellis²,

Saunders³

2016

Journal of Molecular Endocrinology

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During the establishment of pregnancy, the ovarian-derived hormones progesterone and oestradiol regulate remodelling of the endometrium to promote an environment that is able to support and maintain a successful pregnancy. Decidualisation is characterised by differentiation of endometrial stromal cells that secrete growth factors and cytokines that regulate vascular remodelling and immune cell influx. This differentiation process is critical for reproduction, and inadequate decidualisation is implicated in the aetiology of pregnancy disorders such as foetal growth restriction and preeclampsia. In contrast to progesterone and oestradiol, the role of androgens in regulating endometrial function is poorly understood. Androgen receptors are expressed in the endometrium, and androgens are reported to regulate both the transcriptome and the secretome of endometrial stromal cells. In androgen-target tissues, circulating precursors are activated to mediate local effects, and recent studies report that steroid concentrations detected in endometrial tissue are distinct to those detected in the peripheral circulation. New evidence suggests that decidualisation results in dynamic changes in the expression of androgen biosynthetic enzymes, highlighting a role for pre-receptor regulation of androgen action during the establishment of pregnancy. These results suggest that such enzymes could be future therapeutic targets for the treatment of infertility associated with endometrial dysfunction. In conclusion, these data support the hypothesis that androgens play a beneficial role in regulating the establishment and maintenance of pregnancy. Future studies should be focussed on investigating the safety and efficacy of androgen supplementation with the potential for utilisation of novel therapeutics, such as selective androgen receptor modulators, to improve reproductive outcomes in women.

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“…There are several studies evaluating the impact of DHEA supplementation in women with POR undergoing ART. In all cases, DHEA was given as a supplement before ovarian stimulation during in-vitro fertilization (IVF) cycle and mostly, the main outcomes were the number of oocytes retrieved, clinical pregnancy and/or live birth rates (2,4,5).…”

Section: Dehydroepiandrosterone (Dhea) Supplementationmentioning

confidence: 99%

Effects Of Hormonal Supplements In Women with Poor Ovarian Response Undergoing Assisted Reproductive Technology

Bozan

Bozdağ

2021

Gynecol Obstet Reprod Med

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<p>Poor ovarian response remains one of the major challenges of assisted reproductive technology. Over the years, various interventions have been proposed to improve reproductive outcomes in poor responders, yet few have been shown to be beneficial. Recent studies indicate that hormonal pretreatments might increase clinical pregnancy rate, live birth rate and the number of oocytes retrieved in women with poor ovarian response undergoing assisted reproductive technology. Areas covered: Following extensive research of the up to date literature, this review aims to cover current considerations and controversies regarding the use of hormonal supplements such as dehydroepiandrosterone, transdermal testosterone and growth hormone. Expert opinion: There is limited data for the validity of using growth hormone and androgens or androgen modulating agents during assisted reproductive technology cycles in women suffering from poor ovarian response. However, there is a need to support the available data with further randomized controlled trials seeking for live birth rate as the primary outcome.</p>

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A meta‐analysis of dehydroepiandrosterone supplementation among women with diminished ovarian reserve undergoing in vitro fertilization or intracytoplasmic sperm injection

Abstract: Supplementation with DHEA has a positive effect in women undergoing IVF/ICSI treatment for DOR.

Cited by 46 publications

References 29 publications

Dehydroepiandrosterone Heightens Aggression and Increases Androgen Receptor and Aromatase mRNA Expression in the Brain of a Male Songbird

Dehydroepiandrosterone Heightens Aggression and Increases Androgen Receptor and Aromatase mRNA Expression in the Brain of a Male Songbird

Regulation of androgen action during establishment of pregnancy

Effects Of Hormonal Supplements In Women with Poor Ovarian Response Undergoing Assisted Reproductive Technology

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