Abstract Objective: To describe a case of dramatically improved ovarian reserve in a 42.7-year-old woman who was using the dietary supplement dehydroepiandrosterone (DHEA) as well as acupuncture.
Setting: Private IVF center.
Patient(s): A 42.7-year-old patient with initial severely decreased ovarian reserve. Intervention(s): Serial ovulation induction with concomitant use of DHEA dietary supplementation as well as acupuncture.
Main Outcome Measure(s): Peak E2 concentration, oocytes retrieved, and cyropreservable embryos. Result(s): In her first treatment cycle peak E 2 was 1,211 pmol/mL. After seven months of DHEA supplementation her peak E2 in cycle 8 was >18,000 pmol/mL. Because of fear of hyperstimulation we reduced her gonadotropin stimulation by 25%. In the ninth cycle peak E2 was 9,178 pmol/mL, resulting in retrieval of 17 oocytes (16 embryos). In the last 11 months the patient has undergone nine treatment cycles while continuously and dramatically improving her ovarian response and banking of 66 embryos overall.
Conclusion(s): This case illustrates the possibility that ovarian function may be salvaged, even in women of advanced reproductive age.
©2005 by American Society for Reproductive Medicine.
Barad D., Gleicher N. Effect of dehydroepiandrosterone on oocyte and embryo yields, embryo grade and cell number in IVF (2006) Human Reproduction, 21 (11), pp. 2845-2849.
Abstract Background: The aim of this study was to investigate the effect of treatment with dehydroepiandrosterone (DHEA) on fertility outcomes among women with diminished ovarian reserve.
Materials and Methods: This is a case-control study in an academically affiliated private infertility centre. Twenty-five women with significantly diminished ovarian reserve had one IVF cycle before and after DHEA treatment, with otherwise identical hormonal stimulation. Women received 75 mg of DHEA daily (25 mg three times daily) for an average of 17.6 ± 2.13 weeks. We performed a comparison of IVF outcome parameters, before and after DHEA treatment, including peak estradiol (E2) levels, oocyte and embryo numbers, oocyte and embryo quality and embryo transfer statistics.
Results: Paired analysis of IVF cycle outcomes in 25 patients, who underwent cycles both before and after DHEA supplementation, demonstrated significant increases in fertilized oocytes (P < p =" 0.001)," p =" 0.005)">
Conclusion: This study confirms the previously reported beneficial effects of DHEA supplementation on ovarian function in women with diminished ovarian reserve.
© 2006 Oxford University Press.
Barad D., Brill H., Gleicher N. Update on the use of dehydroepiandrosterone supplementation among women with diminished ovarian function (2007) Journal of Assisted Reproduction and Genetics, 24 (12), pp. 629-634.
Abstract Objective: We assessed the role of DHEA supplementation on pregnancy rates in women with diminished ovarian function.
Design: This is a case control study of 190 women with diminished ovarian function. The study group includes 89 patients who used supplementation with 75 mg daily of oral, micronized DHEA for up to 4 months prior to entry into in vitro fertilization (IVF). The control group is composed of 101 couples who received infertility treatment, but did not use DHEA. The primary outcome was clinical pregnancy after the patient's initial visit. We developed a Cox proportional hazards model to compare the proportional hazards of pregnancy among women using DHEA with the controls group.
Results: Cumulative clinical pregnancy rates were significantly higher in the study group (25 pregnancies; 28.4% vs. 11 pregnancies; 11.9%; relative hazard of pregnancy in study group (HR 3.8; 95% CI 1.2-11.8; p<0.05).>Conclusions: DHEA treatment resulted in significantly higher cumulative pregnancy rates. These data support a beneficial effect of DHEA supplementation among women with diminished ovarian function.
© 2007 Springer Science+Business Media, LLC.
Fernandez-Shaw S., Ruesta C., Cercas R., Pons I. Use of dehydroepiandrosterone (DHEA) in low responders [Uso de dehydroepiandrosterone (DHEA) en bajas respondedoras] (2008) Revista Iberoamericana de Fertilidad y Reproduccion Humana, 25 (4), pp. 233-238.
Abstract Objective: To compare results in IVF cycles from patients with ovarian failure before and after treatment with Dehydroepiandrosterone (DHEA). Method: We included 16 patients with ovarian failure and a previous IVF cycle with a very low response. Ovarian stimulation was carried out following short protocols with recombinant FSH. We compared paired IVF results from women before and after treatment with DHEA (75 mg for 4 months).
Results: Basal FSH and estradiol were the same before and treatment with DHEA. Treatment with DHEA lowered the number of cancelled cycles and increased, although not significantly, the number of growing follicles, retrieved oocytes, mature oocytes, embryos and pregnancies obtained. Out of the 16 patients enrolled, one got pregnant spontaneously after two months of treatment with DHEA, 4 abandoned the study and 11 performed a cycle of IVF after treatment with DHEA.
Conclusion: Exogenous DHEA might be a concomitant treatment to offer to low responders to improve their ovarian stimulation, increasing the number of patients that achieve embryo transfer, and improving therefore their chances of pregnancy. However, success of this treatment is moderate, since patients, even after treatment with DHEA, continue to be low responders.
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Stories of Pregnancy over 44 years old - sharing stories I find online, for inspiration!
Pregnancy Stories by Age - Daily blog of hope & inspiration!
Stories of Pregnancy over 44 years old - sharing stories I find online, for inspiration!
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