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DHEA poor ovarian reserve

Olga Triantafyllidou, George Sigalos, Nikos Vlahos
Ovarian stimulation of poor ovarian responders still remains a challenging issue. The incidence of poor responders among infertile women is reported in 9-24% IVF cycles and is associated with very low clinical pregnancy rates. Different treatments have been reported in the literature in an attempt to identify the best stimulation protocol for those patients. Administration of dehydroepiandrosterone acetate (DHEA) was suggested as a promising treatment. It is well known that androgens can influence ovarian follicular growth, augment steroidogenesis, promote follicular recruitment and increase the number of primary and pre-antral follicles...
December 7, 2016: Human Fertility: Journal of the British Fertility Society
Norbert Gleicher, Vitaly A Kushnir, Andrea Weghofer, David H Barad
BACKGROUND: Low testosterone (T), whether due to ovarian and/or adrenal insufficiency, usually results in poor follicle maturation at small growing follicle stages. The consequence is a phenotype of low functional ovarian reserve (LFOR), characterized by poor granulosa cell mass, low anti-Müllerian hormone and estradiol but rising follicle stimulating hormone. Such hypoandrogenism can be of ovarian and/or adrenal origin. Dehydroepiandrosterone sulfate (DHEAS) is exclusively produced by adrenals and, therefore, reflects adrenal androgen production in the zona reticularis...
April 26, 2016: Reproductive Biology and Endocrinology: RB&E
Meixiang Zhang, Wenbin Niu, Yu Wang, Jiawei Xu, Xiao Bao, Linlin Wang, Linqing Du, Yingpu Sun
PURPOSE: We reviewed the influence of dehydroepiandrosterone (DHEA) supplementation in patients with poor ovarian response (POR) undergoing in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI). METHODS: We searched Embase, MEDLINE, PubMed, and the Cochrane Library (1980-2015) for relevant papers and used the Newcastle-Ottawa Scale scoring system to evaluate study quality. Dichotomous data were expressed as pooled relative risk (RR) estimates with fixed or random effect models...
August 2016: Journal of Assisted Reproduction and Genetics
Jiali Zhang, Xuemin Qiu, Yuyan Gui, Yingping Xu, Dajin Li, Ling Wang
Diminished ovarian reserve (DOR) has a high morbidity rate worldwide and has become a primary cause of infertility. DOR is a daunting obstacle in in vitro fertilization (IVF) and leads to poor ovarian response, high cancellation rates, poor IVF outcomes, and low pregnancy rates. Abnormal autoimmune function may also contribute to DOR. Dehydroepiandrosterone (DHEA) is a C19 androgenic steroid. DHEA is secreted mainly by the adrenal gland, and its secretion declines with age. DHEA has a pro-inflammatory immune function that opposes cortisol...
December 2015: Bioscience Trends
Nisha Malik, Alka Kriplani, Nutan Agarwal, Neerja Bhatla, Garima Kachhawa, Raj Kumar Yadav
BACKGROUND: Dehydroepiandrosterone (DHEA) supplementation is a relatively recent development that augments ovarian responsiveness in patients with poor ovarian reserve and premature ovarian aging (POA). AIMS: To evaluate the efficacy of DHEA supplementation prior to gonadotropins for ovulation induction in women with POA. DESIGN: Prospective randomized controlled study. METHODS: Fifty infertile women with POA were randomized into two groups of 25 each...
July 2015: Journal of Human Reproductive Sciences
Jie Li, Hua Yuan, Yang Chen, Hongbo Wu, Huimei Wu, Liuming Li
BACKGROUND: Evidence for the efficacy of dehydroepiandrosterone (DHEA) in improving ovarian responsiveness among poor responders, especially women with diminished ovarian reserve (DOR), remains inconsistent. OBJECTIVES: To evaluate the effectiveness of DHEA in women with DOR undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). SEARCH STRATEGY: PubMed and Embase were searched for reports published in any language before October 31, 2014, using keywords such as "DHEA," "poor ovarian response," "diminished ovarian reserve," and "premature ovarian aging...
December 2015: International Journal of Gynaecology and Obstetrics
Nikita Naredi, K Sandeep, V D S Jamwal, N Nagraj, Seema Rai
Considerable improvements and advancements have been made in the treatment of infertility but poor ovarian reserve whether due to prematurely or a physiologically ageing ovary, continues to be one of the few unresolved problems of modern infertility care. Fertility researchers had been active for quite some time to find a way to help reverse the effects of ageing on the ovaries but none made an impact till the introduction of Dehydroepiandrosterone [DHEA]. DHEA a mild, and therapeutically well tolerated, male hormone has emerged as a real potential candidate to reverse the effects of ageing on ovaries...
July 2015: Medical Journal, Armed Forces India
Svetlana Spremović-Radjenović, Jovan Bila, Aleksandra Gudović, Snežana Vidaković, Milan Dokić, Nebojša Radunović
The term "poor respond (POR) patients" is used for the group of women who respond badly to usual doses of gonadotropins in in vitro fertilization (IVF) treatments; the consequence is low pregnancy rate. A consensus was reached on the minimal criteria needed to define POR. At least two of the following three features must be present: 1. advanced maternal age (40 years or more) 2. previous POR (3 or less oocytes with a conventional stimulation protocol) 3. abnormal ovarian reserve (AMH 0.5-1.1 ng/ml or AFC 5-7)...
May 2015: Srpski Arhiv za Celokupno Lekarstvo
Li-Te Lin, Kuan-Hao Tsui, Peng-Hui Wang
The effect of dehydroepiandrosterone (DHEA) therapy on improvement of reproduction outcome is uncertain. Many earlier studies have shown conflicting results. Therefore, a review of the literature is needed to explore the role of DHEA in reproduction. We conducted a literature search of MEDLINE (Ovid) and Pub-Med (2000-June 2014) for all relevant articles that included the terms "dehydroepiandrosterone," "DHEA," and "in vitro fertilization." Among the search-identified articles, seven prospective self-controlled studies and four retrospective case-control studies showed DHEA as an adjuvant therapy able to improve in vitro fertilization outcomes in poor responders (women with diminished ovarian reserve and/or poor ovarian response)...
August 2015: Journal of the Chinese Medical Association: JCMA
Kannamannadiar Jayaprakasan, Amarin Narkwichean, Walid E Maalouf, Bruce K Campbell
INTRODUCTION: Dehydroepiandrosterone (DHEA) has been proposed to improve pregnancy rates in women with diminished ovarian reserve undergoing in vitro fertilisation (IVF) treatment. However, evidence regarding its efficacy is supported by a limited number of randomised controlled trials (RCTs). This double-blinded RCT aims to measure the effect of DHEA supplementation prior to and during controlled ovarian hyperstimulation on ovarian response prior to IVF treatment in women predicted to have poor ovarian reserve...
October 8, 2014: BMJ Open
M Tartagni, G De Pergola, G R Damiani, A Pellegrino, D Baldini, M V Tartagni, H Alrasheed, M A De Salvia, G Loverro
AIM: The aim of this paper was to evaluate the hypothesis that pretreatment with dehydroepiandrosterone (DEHA) may improve the result on in vitro fertilization (IVF) and the pregnancy outcome among infertile women with normal ovarian reserve. METHODS: Double-blind, randomized, placebo-controlled study; 52 infertile patients received the long protocol IVF. Patients in Group 1, received 75 mg of DHEA once a day, 8 weeks before starting the IVF cycle and during treatment; control group (Group 2) received placebo...
February 2015: Minerva Ginecologica
E Poli, S Manfé, D Capuzzo, S Gava, F Viganò, M L Coronella, M Gangemi
PURPOSE: To evaluate the effect of the premedication with dehydroepiandrosterone (DHEA) on the results of the in vitro fertilization (IVF) treatments in a group of women with evidence of diminished ovarian reserve. MATERIALS AND METHODS: This experimental, prospective, pre-post study enrolled 29 patients with evidence of diminished ovarian reserve and poor-responders to a previous treatment. They received 75 mg/die of DHEA for a minimum of eight weeks; from the 18th day of the cycle before the stimulation with follicle stimulating hormone (FSH), they took trans-dermal estradiol (E2) (50 mcg every other day)...
2014: Clinical and Experimental Obstetrics & Gynecology
M Kara, T Aydin, T Aran, N Turktekin, B Ozdemir
OBJECTIVES: It is difficult to choose the correct fertility treatment in women with poor ovarian reserve. Although various methods have been used, the management of controlled ovarian hyperstimulation is not easy in poor responders. The aim of this study was to evaluate the efficacy of dehydroepiandrosterone (DHEA) on in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) outcome of poor responders. STUDY DESIGN: This was a randomized, prospective controlled trial...
February 2014: European Journal of Obstetrics, Gynecology, and Reproductive Biology
A Narkwichean, K Jayaprakasan, W E Maalouf, J H Hernandez-Medrano, C Pincott-Allen, B K Campbell
STUDY QUESTION: What are the effects of exposure of ovarian tissue to dehydroepiandrosterone (DHEA) supplementation in vivo? SUMMARY ANSWER: DHEA exposure stimulates initiation of primordial follicles and development of gonadotrophin-responsive preantral/early antral follicles possibly mediated through promoting granulosa cell proliferation and enhancing anti-Mullerian hormone (AMH) expression. WHAT IS KNOWN ALREADY?: Ovarian ageing is a cause of subfertility and is associated with poor outcomes of IVF treatment and premature menopause...
January 2014: Human Reproduction
Neeta Singh, Rinchen Zangmo, Sunesh Kumar, K K Roy, J B Sharma, Neena Malhotra, Perumal Vanamail
AIM: The aim of this study was to evaluate the role of dehydroepiandrosterone (DHEA) supplementation on the ovarian reserve markers in infertile patients who were poor responders in previous in vitro fertilization (IVF) cycles. STUDY DESIGN: A prospective clinical trial was conducted on 30 patients with history of poor response in previous IVF cycles. These patients were treated with DHEA, (Tab Eema-D, Corona Remedies Pvt Ltd., Ahmedabad, Gujurat, India) 25 mg thrice a day for four months...
November 2013: Gynecological Endocrinology
Panda Subrat, Singh A Santa, Jha Vandana
Apparent rise in the incidence of infertility in females and the trend shifting towards delayed child bearing brought up the concept of ovarian ageing. Women in their early thirties show poor ovarian reserve which is an entity named as early ovarian ageing. Early ovarian ageing is mostly genetically determined, but acquired modifiable factors like smoking, or ovarian surgery have some roles. Infertility and subfertility are the only clinical recognizable sequelae in the early ovarian ageing. The worrisome fact is that the outcome of assisted reproductive techniques is also not that much encouraging...
January 2013: Journal of Reproduction & Infertility
Mazen R Fouany, Fady I Sharara
PURPOSE: Poor ovarian reserve and poor ovarian response presents a challenge to IVF centers. Dehydroepiandrosterone (DHEA) supplementation is increasingly being used by many IVF centers around the world in poor responders despite the lack of convincing data. We therefore examined the rationale for the use of DHEA in poor responders, address the relevant studies, present new data, and address its potential mechanisms of action. METHODS: All published articles on the role of DHEA in infertile women from 1990 to April 2013 were reviewed...
September 2013: Journal of Assisted Reproduction and Genetics
Amarin Narkwichean, Walid Maalouf, Bruce K Campbell, Kannamannadiar Jayaprakasan
Women with diminished ovarian reserve often respond poorly to controlled ovarian stimulation resulting in retrieval of fewer oocytes and reduced pregnancy rates. It has been proposed that pre-IVF Dehydroepiandrosterone (DHEA) adjuvant therapy may improve ovarian response and pregnancy rates in women with diminished ovarian reserve. This meta-analysis aims to investigate efficacy of DHEA as an adjuvant to improve ovarian response and IVF outcome in women with diminished ovarian reserve. Electronic databases were searched under the following terms: (DHEA) and (diminished ovarian reserve) and/or (poor response)...
2013: Reproductive Biology and Endocrinology: RB&E
E Borman, J H Check, J Mitchell-Williams, R Cohen
PURPOSE: To determine if in a population of women with diminished oocyte reserve as evidenced by day 3 serum follicle stimulating hormone (FSH) levels > 12 mIU/ml women with lower dehydroepiandrosterone sulfate (DHEA-s) levels produce fewer oocytes or have lower pregnancy rates following in vitro fertilization-embryo transfer (IVF-ET) compared to women with higher levels. METHODS: The women were divided into poor responders (producing < or = 4 oocytes) following oocyte retrieval or good responders (> or = 5 oocytes)...
2012: Clinical and Experimental Obstetrics & Gynecology
Jordana H Hyman, Ehud J Margalioth, Ron Rabinowitz, Avi Tsafrir, Michael Gal, Sarah Alerhand, Nurit Algur, Talia Eldar-Geva
OBJECTIVE: Dehydroepiandrosterone (DHEA) supplementation for poor responders may improve ovarian response and IVF treatment outcome. This study aimed to determine the mechanism of action of DHEA, and specifically, the stage of folliculogenesis influenced by DHEA. STUDY DESIGN: This is a prospective, self-controlled study of poor responders to IVF treatment, comparing day 3 biochemical (anti-Mullerian hormone (AMH), inhibin B and FSH) and ultrasound (antral follicle count (AFC)) ovarian reserve markers and IVF treatment outcome before and after DHEA supplementation of at least 3 months duration...
May 2013: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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