TY - JOUR
T1 - Dehydroepiandrosterone (DHEA) supplementation in diminished ovarian reserve (DOR)
AU - Gleicher, Norbert
AU - Barad, David H.
N1 - Funding Information:
This study was supported by the Foundation for Reproductive Medicine and intramural research grants from the Center for Human reproduction (CHR) - New York. The authors wish to acknowledge and to thank E. Ryan, MD (Toronto West Fertility Center, Toronto, Canada) and L. Mamas, MD (Athens, Greece) for the personal communications, noted in the body of the manuscript.
PY - 2011/5/17
Y1 - 2011/5/17
N2 - Background: With infertility populations in the developed world rapidly aging, treatment of diminished ovarian reserve (DOR) assumes increasing clinical importance. Dehydroepiandrosterone (DHEA) has been reported to improve pregnancy chances with DOR, and is now utilized by approximately one third of all IVF centers world-wide. Increasing DHEA utilization and publication of a first prospectively randomized trial now warrants a systematic review.Methods: PubMed, Cochrane and Ovid Medline were searched between 1995 and 2010 under the following strategy: [ and ]. Bibliographies of relevant publications were further explored for additional relevant citations. Since only one randomized study has been published, publications, independent of evidence levels and quality assessment, were reviewed.Results: Current best available evidence suggests that DHEA improves ovarian function, increases pregnancy chances and, by reducing aneuploidy, lowers miscarriage rates. DHEA over time also appears to objectively improve ovarian reserve. Recent animal data support androgens in promoting preantral follicle growth and reduction in follicle atresia.Discussion: Improvement of oocyte/embryo quality with DHEA supplementation potentially suggests a new concept of ovarian aging, where ovarian environments, but not oocytes themselves, age. DHEA may, thus, represent a first agent beneficially affecting aging ovarian environments. Others can be expected to follow.
AB - Background: With infertility populations in the developed world rapidly aging, treatment of diminished ovarian reserve (DOR) assumes increasing clinical importance. Dehydroepiandrosterone (DHEA) has been reported to improve pregnancy chances with DOR, and is now utilized by approximately one third of all IVF centers world-wide. Increasing DHEA utilization and publication of a first prospectively randomized trial now warrants a systematic review.Methods: PubMed, Cochrane and Ovid Medline were searched between 1995 and 2010 under the following strategy: [ and ]. Bibliographies of relevant publications were further explored for additional relevant citations. Since only one randomized study has been published, publications, independent of evidence levels and quality assessment, were reviewed.Results: Current best available evidence suggests that DHEA improves ovarian function, increases pregnancy chances and, by reducing aneuploidy, lowers miscarriage rates. DHEA over time also appears to objectively improve ovarian reserve. Recent animal data support androgens in promoting preantral follicle growth and reduction in follicle atresia.Discussion: Improvement of oocyte/embryo quality with DHEA supplementation potentially suggests a new concept of ovarian aging, where ovarian environments, but not oocytes themselves, age. DHEA may, thus, represent a first agent beneficially affecting aging ovarian environments. Others can be expected to follow.
UR - http://www.scopus.com/inward/record.url?scp=79955954716&partnerID=8YFLogxK
U2 - 10.1186/1477-7827-9-67
DO - 10.1186/1477-7827-9-67
M3 - Review article
C2 - 21586137
AN - SCOPUS:79955954716
SN - 1477-7827
VL - 9
JO - Reproductive Biology and Endocrinology
JF - Reproductive Biology and Endocrinology
M1 - 67
ER -