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

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. 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. 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). 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).