David H Barad1, Norbert Gleicher. 1. Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, New York, New York, USA. dbarade@theCHR.com
Abstract
OBJECTIVE: To describe a case of dramatically improved ovarian reserve in a 42.7-year-old woman who was using the dietary supplement dehydroepiandrosterone (DHEA) as well as acupuncture. DESIGN: Case report. SETTING: Private IVF center. PATIENT(S): A 42.7-year-old patient with initial severely decreased ovarian reserve. INTERVENTION(S): Serial ovulation induction with concomitant use of DHEA dietary supplementation as well as acupuncture. MAIN OUTCOME MEASURE(S): Peak E2 concentration, oocytes retrieved, and cyropreservable embryos. RESULT(S): In her first treatment cycle peak E2 was 1,211 pmol/mL. After seven months of DHEA supplementation her peak E2 in cycle 8 was > 18,000 pmol/mL. Because of fear of hyperstimulation we reduced her gonadotropin stimulation by 25%. In the ninth cycle peak E2 was 9,178 pmol/mL, resulting in retrieval of 17 oocytes (16 embryos). In the last 11 months the patient has undergone nine treatment cycles while continuously and dramatically improving her ovarian response and banking of 66 embryos overall. CONCLUSION(S): This case illustrates the possibility that ovarian function may be salvaged, even in women of advanced reproductive age.
OBJECTIVE: To describe a case of dramatically improved ovarian reserve in a 42.7-year-old woman who was using the dietary supplement dehydroepiandrosterone (DHEA) as well as acupuncture. DESIGN: Case report. SETTING: Private IVF center. PATIENT(S): A 42.7-year-old patient with initial severely decreased ovarian reserve. INTERVENTION(S): Serial ovulation induction with concomitant use of DHEA dietary supplementation as well as acupuncture. MAIN OUTCOME MEASURE(S): Peak E2 concentration, oocytes retrieved, and cyropreservable embryos. RESULT(S): In her first treatment cycle peak E2 was 1,211 pmol/mL. After seven months of DHEA supplementation her peak E2 in cycle 8 was > 18,000 pmol/mL. Because of fear of hyperstimulation we reduced her gonadotropin stimulation by 25%. In the ninth cycle peak E2 was 9,178 pmol/mL, resulting in retrieval of 17 oocytes (16 embryos). In the last 11 months the patient has undergone nine treatment cycles while continuously and dramatically improving her ovarian response and banking of 66 embryos overall. CONCLUSION(S): This case illustrates the possibility that ovarian function may be salvaged, even in women of advanced reproductive age.
Authors: Queenie Ho Yan Wong; Tracy Wing Yee Yeung; Sofie Shuk Fei Yung; Jennifer Ka Yee Ko; Hang Wun Raymond Li; Ernest Hung Yu Ng Journal: J Assist Reprod Genet Date: 2018-03-09 Impact factor: 3.412