7 research outputs found
Dehydroepiandrosterone (DHEA) supplementation improves in vitro fertilization outcomes of poor ovarian responders, especially in women with low serum concentration of DHEA-S: a retrospective cohort study
Background: Dehydroepiandrosterone (DHEA) is now widely used as an adjuvant for in vitro fertilization (IVF)
cycles in poor ovarian responders (PORs). Several studies showed that DHEA supplementation could improve IVF
outcomes of PORs. However, most of the PORs do not respond to DHEA clinically. Therefore, the aim of this study
is to confirm the beneficial effects of DHEA on IVF outcomes of PORs and to investigate which subgroups of PORs
can best benefit from DHEA supplementation.
Methods: This retrospective cohort study was performed between January 2015 and December 2017. A total of
151 PORs who fulfilled the Bologna criteria and underwent IVF cycles with the gonadotropin-releasing hormone
antagonist protocol were identified. The study group (n = 67) received 90 mg of DHEA daily for an average of
3 months before the IVF cycles. The control group (n = 84) underwent the IVF cycles without DHEA pretreatment.
The basic and cycle characteristics and IVF outcomes between the two groups were compared using independent
t-tests, Chi-Square tests and binary logistic regression.
Results: The study and control groups did not show significant differences in terms of basic characteristics. The study
group demonstrated a significantly greater number of retrieved oocytes, metaphase II oocytes, fertilized oocytes, day 3
embryos and top-quality embryos at day 3 and a higher clinical pregnancy rate, ongoing pregnancy rate and live birth
rate than those measures in the control group. The multivariate analysis revealed that DHEA supplementation was
positively associated with clinical pregnancy rate (OR = 4.93, 95% CI 1.68–14.43, p = 0.004). Additionally, in the study
group, the multivariate analysis showed that serum dehydroepiandrosterone-sulfate (DHEA-S) levels < 180 ÎĽg/dl were
significantly associated with a rate of retrieved oocytes > 3 (OR = 5.92, 95% CI 1.48–23.26, p = 0.012).
Conclusions: DHEA supplementation improves IVF outcomes of PORs. In PORs with DHEA pretreatment, women with
lower DHEA-S level may have greater possibility of attaining more than 3 oocytes
Luteal Phase Ovarian Stimulation May Improve Oocyte Retrieval and Oocyte Quality in Poor Ovarian Responders Undergoing In Vitro Fertilization: Preliminary Results from a Single-Center Prospective Pilot Study
Introduction: Luteal phase ovarian stimulation
(LPOS) has been proven a feasible protocol for
infertile patients. High progesterone level in the
luteal phase could physiologically inhibit premature
luteinizing hormone surge, from which
poor ovarian responders (PORs) could obtain
benefits. Therefore, we aimed to compare clinical
outcomes between LPOS and follicular phase
ovarian stimulation (FPOS) protocol in PORs
undergoing in vitro fertilization (IVF).
Methods: This prospective pilot study was performed
at one tertiary center from January 2016
to October 2017. A total of 60 PORs who met
Bologna criteria and undergoing IVF were
enrolled. Thirty PORs were allocated to the
LPOS group and 30 PORs were allocated to the
FPOS group. Basic characteristics, cycle characteristics,
and pregnancy outcomes were compared
between the two groups.
Results: The length of stimulation was significantly
longer in the LPOS group than in the
FPOS group. The numbers of retrieved oocytes,
metaphase II oocytes, fertilized oocytes, and
day-3 embryos were significantly higher in the
LPOS group than in the FPOS group. Conversely,
we could not find any significant difference for clinical pregnancy rate, ongoing
pregnancy rate, abortion rate, and cancellation
rate. The multivariate analysis showed that only
LPOS (p = 0.007) was significantly associated
the possibility to retrieve three or more oocytes,
whereas basal follicle-stimulating hormone
(FSH)\8 IU/l (p = 0.103) and antral follicle
count (AFC) C 3 (p = 0.143) did not significantly
affect this event.
Conclusion: LPOS allows improved oocyte
retrieval and oocyte quality in PORs with
respect to FPOS, despite comparable pregnancy
outcomes. LPOS may be considered a feasible
option for oocytes accumulation in PORs.
Trial Registration: ClinicalTrials.gov identifier,
NCT0323883