Does dehydroepiandrosterone improve pregnancy rate in women undergoing IVF/ICSI with expected poor ovarian response according to the Bologna criteria? A randomized controlled trial

Kotb, Magd A.; Hassan, AbdelGany; Awadallah, Ahmed M.

doi:10.1016/j.ejogrb.2016.02.009

Cited by 37 publications

(39 citation statements)

References 24 publications

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“…Figure 1 shows the reasons for exclusion of studies. Studies included in this systematic review were published between 2007 and 2016 and their various study designs included: two retrospective studies ( Barad et al, 2007 ; Xu et al, 2014 ), two randomized clinical trials ( Wiser et al ., 2010 ; Kotb et al ., 2016 ), and one prospective cohort study ( Vlahos et al. , 2015 ).…”

Section: Resultsmentioning

confidence: 99%

DHEA use to improve likelihood of IVF/ICSI success in patients with diminished ovarian reserve: A systematic review and meta-analysis

Schwarze¹,

Canales²,

Crosby³

et al. 2018

JBRA Assisted Reproduction

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The aim of this review is to determine if the use of DHEA increases the likelihood of success in patients with POR. We searched MEDLINE and EMBASE using the terms "DHEA and diminished ovarian reserve", "DHEA and poor response", "DHEA and premature ovarian aging". A fixed effects model was used and Peto's method to get the odds ratio (OR) with 95% confidence intervals (CI 95%). For quantitative variables, Cohen's method was used to present the standardized mean differences (SMD) with their corresponding confidence intervals. Only five studied fulfilled the selection criteria. DHEA was administered in 25 mg doses, three times a day. In all studies, the authors corrected for the presence of confounding variables such as partner's age, infertility diagnosis and number of transferred embryos. The meta-analysis of the five selected studies assessed a total of 910 patients, who underwent IVF/ICSI, of which 413 had received DHEA. DHEA use was associated with a significant increase in pregnancy likelihood (OR 1.8, CI 95% 1.29 to 2.51, p=0.001). When analyzing the association between DHEA use and the likelihood of abortion, we found low heterogeneity between studies (I2=0.0%) and the use of DHEA to be associated to a significant reduction in the likelihood of abortion (OR 0.25, CI 0.07 to 0.95; p=0.045). Analysis of the association of DHEA with average oocyte retrieval showed high variability between studies (I2=98.6%), as well as no association between DHEA use and the number of oocytes retrieved (SMD -0.01, CI 95% -0.16 to 0.13; p<0.05).

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Section: Resultsmentioning

confidence: 99%

DHEA use to improve likelihood of IVF/ICSI success in patients with diminished ovarian reserve: A systematic review and meta-analysis

Schwarze¹,

Canales²,

Crosby³

et al. 2018

JBRA Assisted Reproduction

View full text Add to dashboard Cite

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“…Furthermore, the multivariate analysis displayed that PORs with DHEA supplementation exhibited a 4.93-fold increase in the clinical pregnancy rate (95% CI 1.68–14.53, p = 0.004) compared to those without DHEA supplementation (Table 3 ). Numerous studies [ 15 , 17 , 26 – 28 ] and some meta-analyses [ 18 , 19 , 29 ] also support the beneficial effects of DHEA on PORs undergoing IVF/ICSI cycles. The systematic review and meta-analysis conducted by Zhang et al showed that DHEA supplementation increased the clinical pregnancy rate, live birth rate and ovarian reserve in patients with poor ovarian response [ 18 ].…”

Section: Discussionmentioning

confidence: 98%

“…Nevertheless, the Cochrane Review also included the studies of pretreatment with testosterone and the patients who were not identified as PORs. An updated randomized controlled trial performed by Kotb and colleagues, enrolled PORs according to the Bologna criteria and revealed that DHEA supplementation significantly increased the number of oocytes, fertilization rate, fertilized oocytes, clinical pregnancy rate and ongoing pregnancy rate [ 26 ]. Similarly, the small sample size was also a limitation of the study.…”

Section: Discussionmentioning

confidence: 99%

Dehydroepiandrosterone (DHEA) supplementation improves in vitro fertilization outcomes of poor ovarian responders, especially in women with low serum concentration of DHEA-S: a retrospective cohort study

Chern

Tsui

Vitale

et al. 2018

Reprod Biol Endocrinol

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BackgroundDehydroepiandrosterone (DHEA) is now widely used as an adjuvant for in vitro fertilization (IVF) cycles in poor ovarian responders (PORs). Several studies showed that DHEA supplementation could improve IVF outcomes of PORs. However, most of the PORs do not respond to DHEA clinically. Therefore, the aim of this study is to confirm the beneficial effects of DHEA on IVF outcomes of PORs and to investigate which subgroups of PORs can best benefit from DHEA supplementation.MethodsThis retrospective cohort study was performed between January 2015 and December 2017. A total of 151 PORs who fulfilled the Bologna criteria and underwent IVF cycles with the gonadotropin-releasing hormone antagonist protocol were identified. The study group (n = 67) received 90 mg of DHEA daily for an average of 3 months before the IVF cycles. The control group (n = 84) underwent the IVF cycles without DHEA pretreatment. The basic and cycle characteristics and IVF outcomes between the two groups were compared using independent t-tests, Chi-Square tests and binary logistic regression.ResultsThe study and control groups did not show significant differences in terms of basic characteristics. The study group demonstrated a significantly greater number of retrieved oocytes, metaphase II oocytes, fertilized oocytes, day 3 embryos and top-quality embryos at day 3 and a higher clinical pregnancy rate, ongoing pregnancy rate and live birth rate than those measures in the control group. The multivariate analysis revealed that DHEA supplementation was positively associated with clinical pregnancy rate (OR = 4.93, 95% CI 1.68–14.43, p = 0.004). Additionally, in the study group, the multivariate analysis showed that serum dehydroepiandrosterone-sulfate (DHEA-S) levels < 180 μg/dl were significantly associated with a rate of retrieved oocytes > 3 (OR = 5.92, 95% CI 1.48–23.26, p = 0.012).ConclusionsDHEA supplementation improves IVF outcomes of PORs. In PORs with DHEA pretreatment, women with lower DHEA-S level may have greater possibility of attaining more than 3 oocytes.

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“…Dehydroepiandrosterone (DHEA) is a multifunctional prohormone secreted from adrenal gland and acts as a precursor for both estradiol and testosterone synthesis [2] also has been reported to increase pregnancy and live birth rates especially in poor responders [3]. Besides dehydroepiandrosterone (DHEA) has been sought to improve fertilization rates and increase quality embryos [4] [5] [6] [7].…”

Section: Introductionmentioning

confidence: 99%

Role of Dehydroepiandrosterone Supplementation in Improving Intracytoplasmic Sperm Injection Outcome for Women with Expected Poor Ovarian Response

Ali¹,

Khodry²

2019

OJOG

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Background: As regard to adjuvant supplementations, nowadays dehydroepiandrosterone (DHEA) is widely used all over the world and is considered to be a potential agent to ameliorate the assisted reproduction technologies outcomes of infertile women with poor ovarian reserve. Objective: To find out the role of DHEA supplementation in improving intracytoplasmic sperm injection (ICSI) outcome for infertile women with expected poor ovarian response in controlled ovarian stimulation. Setting: Assisted reproduction unit

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Does dehydroepiandrosterone improve pregnancy rate in women undergoing IVF/ICSI with expected poor ovarian response according to the Bologna criteria? A randomized controlled trial

Cited by 37 publications

References 24 publications

DHEA use to improve likelihood of IVF/ICSI success in patients with diminished ovarian reserve: A systematic review and meta-analysis

DHEA use to improve likelihood of IVF/ICSI success in patients with diminished ovarian reserve: A systematic review and meta-analysis

Dehydroepiandrosterone (DHEA) supplementation improves in vitro fertilization outcomes of poor ovarian responders, especially in women with low serum concentration of DHEA-S: a retrospective cohort study

Role of Dehydroepiandrosterone Supplementation in Improving Intracytoplasmic Sperm Injection Outcome for Women with Expected Poor Ovarian Response

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