A randomized controlled pilot trial on the effect of dehydroepiandrosterone on ovarian response markers ovarian response and in vitro fertilization outcomes in poor responders

Capsule:
No significant improvement in ovarian response markers, ovarian response to standard dose gonadotropin stimulation, or IVF outcomes was detected in poor responders receiving pretreatment DHEA compared with placebo.

Authors:
Tracy Wing Yee Yeung, M.B., B.S., Joyce Chai, M.B., Ch.B., Raymond Hang Wun Li, M.B., B.S., Vivian Chi Yan Lee, M.B., B.S., Pak Chung Ho, M.D., Ernest Hung Yu Ng, M.D.

Volume 102, Issue 1, Pages 108–115.e1

Abstract:

Objective:
To evaluate whether pretreatment dehydroepiandrosterone (DHEA) supplementation improves ovarian response markers, ovarian response to standard low-dose gonadotropin stimulation, and in vitro fertilization (IVF) outcomes in poor responders.

Design:
Randomized, double-blind, placebo-controlled pilot study.

Setting:
Tertiary reproductive medicine unit.

Patient(s):
Thirty-two women with anticipated poor ovarian response.

Intervention(s):
Randomization into DHEA group (n = 16) receiving GNC (25 mg three times a day) or placebo (n = 16) starting from at least 12 weeks before the scheduled IVF treatment according to a computer-generated randomization list.

Main Outcome Measure(s):
Measurement of monthly ovarian response markers, including antral follicle count (AFC), serum antimüllerian hormone (AMH), and follicle-stimulating hormone (FSH) levels; comparison of ovarian response to a standard dose of gonadotropin stimulation at week 8 and IVF outcomes; and AFC after 12 weeks (primary outcome).

Result(s):
The DHEA supplementation resulted in statistically significantly higher serum DHEA-S, free androgen index, and follicular DHEA-S levels. No statistically significant differences in the ovarian response markers (AFC, AMH, or FSH), the ovarian response to standard-dose gonadotropin stimulation, or IVF outcomes were found between the two groups.

Conclusion(s):
No statistically significant improvement in ovarian response markers, ovarian response to standard dose gonadotropin stimulation, or IVF outcomes was found in poor responders receiving pretreatment DHEA.

Clinical Trial Registration Number:
HKCTR-1149 (www.hkclinicaltrials.com) and NCT01915186 (www.ClinicalTrials.org).

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