Meixiang Zhang1, Wenbin Niu1, Yu Wang2, Jiawei Xu1, Xiao Bao1, Linlin Wang1, Linqing Du1, Yingpu Sun3. 1. Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. 2. Center for Reproductive Medicine, The First Affiliated Hospital of Inner Mongolia University, Hohhot, People's Republic of China. 3. Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. syp2008@vip.sina.com.
Abstract
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. Continuous variables were expressed as the weighted mean difference (WMD). All data were analyzed using Revman Software v. 5 and are shown with 95 % confidence intervals (CI). RESULTS: Twenty-one studies met the inclusion criteria. DHEA pretreatment increased the clinical pregnancy rate (RR 1.53, 95 % CI 1.25-1.86), live birth rate (RR 1.87, 95 % CI 1.22-2.88), implantation rate (RR 1.56, 95 % CI 1.20-2.01), and antral follicle count (WMD 0.4, 95 % CI 0.14 to 0.66) while reducing miscarriages (RR 0.50, 95 % CI 0.27-0.90). After subgroup analysis, oocyte numbers and anti-Müllerian hormone levels were also enhanced after DHEA treatment. However, the endometrial thickness and estradiol levels on the day of injecting hCG to induce ovulation were similar between the DHEA supplementation groups and controls. CONCLUSIONS: Based on the limited available evidence, DHEA supplementation seems to improve ovarian reserves and IVF/ICSI outcome in patients with POR. Further research is required to clarify the effect of DHEA exposure in assisted reproduction technology.
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. Continuous variables were expressed as the weighted mean difference (WMD). All data were analyzed using Revman Software v. 5 and are shown with 95 % confidence intervals (CI). RESULTS: Twenty-one studies met the inclusion criteria. DHEA pretreatment increased the clinical pregnancy rate (RR 1.53, 95 % CI 1.25-1.86), live birth rate (RR 1.87, 95 % CI 1.22-2.88), implantation rate (RR 1.56, 95 % CI 1.20-2.01), and antral follicle count (WMD 0.4, 95 % CI 0.14 to 0.66) while reducing miscarriages (RR 0.50, 95 % CI 0.27-0.90). After subgroup analysis, oocyte numbers and anti-Müllerian hormone levels were also enhanced after DHEA treatment. However, the endometrial thickness and estradiol levels on the day of injecting hCG to induce ovulation were similar between the DHEA supplementation groups and controls. CONCLUSIONS: Based on the limited available evidence, DHEA supplementation seems to improve ovarian reserves and IVF/ICSI outcome in patients with POR. Further research is required to clarify the effect of DHEA exposure in assisted reproduction technology.
Authors: A R Genazzani; S Inglese; I Lombardi; M Pieri; F Bernardi; A D Genazzani; L Rovati; M Luisi Journal: Aging Male Date: 2004-06 Impact factor: 5.892
Authors: N Yilmaz; D Uygur; H Inal; U Gorkem; N Cicek; L Mollamahmutoglu Journal: Eur J Obstet Gynecol Reprod Biol Date: 2013-05-09 Impact factor: 2.435
Authors: Marie Lebbe; Angela E Taylor; Jenny A Visser; Jackson C Kirkman-Brown; Teresa K Woodruff; Wiebke Arlt Journal: Endocrinology Date: 2017-05-01 Impact factor: 4.736
Authors: Thor Haahr; Carlos Dosouto; Carlo Alviggi; Sandro C Esteves; Peter Humaidan Journal: Front Endocrinol (Lausanne) Date: 2019-09-11 Impact factor: 5.555
Authors: Kevin N Keane; Peter M Hinchliffe; Philip K Rowlands; Gayatri Borude; Shanti Srinivasan; Satvinder S Dhaliwal; John L Yovich Journal: Front Endocrinol (Lausanne) Date: 2018-01-31 Impact factor: 5.555