Monday, April 18, 2011

DHEA and fertility. Does it help in decreasing infertility in women with diminished ovarian reserve and low AMH (Anti Mullerian Hormone)? Study.

A recent review study published on RBMonline  put together all the published cycles of  DHEA use ad IVF outcome in poor responders. The result was disappointing as there was no diference in the two groups (DHEA users vs non-users). 
As usual when it comes to retrospective meta analyses we have to be extra careful in making final conclusions as  this type of study puts together  a very eterogeneous group of patient treated in different clinics.
At this point , as the data is not conclusive i still think it is a good ideat to try DHEA  , it is a supplement that  does not require a prescription , in the dosage of 50 mg/day .

Reproductive BioMedicine Online
Article in Press

Effect of androgen supplementation or modulation on ovarian stimulation outcome in poor responders: a meta-analysis


Many trials have evaluated the use of androgen supplements and androgen-modulating agents to improve outcome of poor responders undergoing IVF treatment. This study conducted a systematic review and meta-analysis of controlled trials of androgen adjuvants (testosterone, dehydroepiandrostereone) and the androgen-modulating agent (letrozole) in poor responders undergoing IVF treatment. Searches were conducted on MEDLINE, EMBASE, Cochrane Library, ISRCTN Register and ISI proceedings. All randomized and non-randomized controlled trials were included. Study selection, quality appraisal and data extraction were performed independently and in duplicate. The main outcome measure was clinical pregnancy rate. The secondary outcome measures were dose and duration of gonadotrophin use, cycles cancelled before oocyte retrieval, oocytes retrieved and ongoing pregnancy rates. A total of 2481 cycles in women considered as poor responders undergoing IVF/intracytoplasmic sperm injection (ICSI) treatment were included in nine controlled trials. Meta-analyses of these studies did not show any significant difference in the number of oocytes retrieved and ongoing pregnancy/live-birth rates with androgen supplementation or modulation compared with the control groups. There is currently insufficient evidence from the few randomized controlled trials to support the use of androgen supplementation or modulation to improve live birth outcome in poor responders undergoing IVF/ICSI treatment.


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