|Effects of Dehydroepiandrosterone on the Response of Ovarian Stimulation During In Vitro Fertilization Cycle in Infertile Women With Diminished Ovarian Reserve: Before and After Clinical Trials|
|Marzieh Zamaniyan1,2, Bahar Farshidfar3, Sepideh Peyvandi1,2, Hamed Jafarpour4, Robabeh Taheripanah5, Siavash Moradi6, Mojtaba Ghorbani7|
|1Infertility Center, Department of Obstetrics and Gynecology, Mazandaran University of Medical Sciences, Sari, Iran
2Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
3Student Research Committee, College of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
4Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
5Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6Community Medicine Specialist, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
7Department of Surgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
CJMB 2019; 6: 361-368
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Keywords : Dehydroepiandrosterone, Ovarian reserve, Anti-Mullerian Hormone, Infertility
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Objectives: The use of dehydroepiandrosterone (DHEA) before initiating in vitro fertilization (IVF) cycles to increase the ovarian reserve is considered as one of the best therapies in women with diminished ovarian reserve (DOR). Therefore, the present study aimed to compare the effect of DHEA on women (below and above 35 years old) with DOR and to find if this therapy is useful at an earlier age.
Materials and Methods: This clinical trial study was conducted on 35 infertile women with DOR who referred to Imam Khomeini hospital in Sari, Iran, during 2017. The intervention lasted for 6 weeks and DHEA tablets were used before the start of the intra-cytoplasmic sperm injection-embryo transfer (ICSI-ET) cycle. Antral follicular counts (AFCs) and the serum levels of anti-Mullerian hormone (AMH) were estimated before and after the intervention, followed by performing the ICSI. Finally, the changes in AMH levels and AFC, the number and quality of ovum and embryos and pregnancy, along with the rates of implantation and abortion were measured as well.
Results: The mean AMH levels (P = 0.02) and AFC (P < 0.001) after DHEA consumption varied significantly from those before administering the DHEA, and the increase in the AFC was more significant in the age group under 35 years (P = 0.03). In addition, these changes were more significant in body mass of less than 25 kg/m2 (P = 0.04).
Conclusions: In general, the supplementation of DHEA in women with insufficient ovarian capacity probably improves IVF prognosis and other parameters including AFC and AMH, especially in women under 35 years old. Further, based on different evidence, the probability of pregnancy occurrence in women is lower with increased body mass index (BMI).
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