A randomized, controlled, pilot trial on the effect of dehydroepiandrosterone on ovarian response markers, ovarian response, and in vitro fertilization outcomes in poor responders
Objective To evaluate whether pretreatment dehydroepiandrosterone (DHEA) supplementation improves ovarian response markers, ovarian response to standard low-dose gonadotropin stimulation, and in vitro fertilization (IVF) outcomes in poor responders. Design Randomized, double-blind, placebo-controlle...
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| Veröffentlicht in: | Fertility and sterility 2014-07, Vol.102 (1), p.108-115.e1 |
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| creator | Yeung, Tracy Wing Yee, M.B., B.S Chai, Joyce, M.B., Ch.B Li, Raymond Hang Wun, M.B., B.S Lee, Vivian Chi Yan, M.B., B.S Ho, Pak Chung, M.D Ng, Ernest Hung Yu, M.D |
| description | Objective To evaluate whether pretreatment dehydroepiandrosterone (DHEA) supplementation improves ovarian response markers, ovarian response to standard low-dose gonadotropin stimulation, and in vitro fertilization (IVF) outcomes in poor responders. Design Randomized, double-blind, placebo-controlled pilot study. Setting Tertiary reproductive medicine unit. Patient(s) Thirty-two women with anticipated poor ovarian response. Intervention(s) Randomization into DHEA group (n = 16) receiving GNC (25 mg three times a day) or placebo (n = 16) starting from at least 12 weeks before the scheduled IVF treatment according to a computer-generated randomization list. Main Outcome Measure(s) Measurement of monthly ovarian response markers, including antral follicle count (AFC), serum antimüllerian hormone (AMH), and follicle-stimulating hormone (FSH) levels; comparison of ovarian response to a standard dose of gonadotropin stimulation at week 8 and IVF outcomes; and AFC after 12 weeks (primary outcome). Result(s) The DHEA supplementation resulted in statistically significantly higher serum DHEA-S, free androgen index, and follicular DHEA-S levels. No statistically significant differences in the ovarian response markers (AFC, AMH, or FSH), the ovarian response to standard-dose gonadotropin stimulation, or IVF outcomes were found between the two groups. Conclusion(s) No statistically significant improvement in ovarian response markers, ovarian response to standard dose gonadotropin stimulation, or IVF outcomes was found in poor responders receiving pretreatment DHEA. Clinical Trial Registration Number HKCTR-1149 ( www.hkclinicaltrials.com ) and NCT01915186 ( www.ClinicalTrials.org ). |
| doi_str_mv | 10.1016/j.fertnstert.2014.03.044 |
| format | Article |
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Design Randomized, double-blind, placebo-controlled pilot study. Setting Tertiary reproductive medicine unit. Patient(s) Thirty-two women with anticipated poor ovarian response. Intervention(s) Randomization into DHEA group (n = 16) receiving GNC (25 mg three times a day) or placebo (n = 16) starting from at least 12 weeks before the scheduled IVF treatment according to a computer-generated randomization list. Main Outcome Measure(s) Measurement of monthly ovarian response markers, including antral follicle count (AFC), serum antimüllerian hormone (AMH), and follicle-stimulating hormone (FSH) levels; comparison of ovarian response to a standard dose of gonadotropin stimulation at week 8 and IVF outcomes; and AFC after 12 weeks (primary outcome). Result(s) The DHEA supplementation resulted in statistically significantly higher serum DHEA-S, free androgen index, and follicular DHEA-S levels. No statistically significant differences in the ovarian response markers (AFC, AMH, or FSH), the ovarian response to standard-dose gonadotropin stimulation, or IVF outcomes were found between the two groups. Conclusion(s) No statistically significant improvement in ovarian response markers, ovarian response to standard dose gonadotropin stimulation, or IVF outcomes was found in poor responders receiving pretreatment DHEA. Clinical Trial Registration Number HKCTR-1149 ( www.hkclinicaltrials.com ) and NCT01915186 ( www.ClinicalTrials.org ).</description><identifier>ISSN: 0015-0282</identifier><identifier>EISSN: 1556-5653</identifier><identifier>DOI: 10.1016/j.fertnstert.2014.03.044</identifier><identifier>PMID: 24796766</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Anti-Mullerian Hormone - blood ; Biomarkers - blood ; Chorionic Gonadotropin - administration & dosage ; Dehydroepiandrosterone - administration & dosage ; Dehydroepiandrosterone - adverse effects ; DHEA ; Double-Blind Method ; Drug Administration Schedule ; Female ; Fertility - drug effects ; Fertility Agents, Female - administration & dosage ; Fertility Agents, Female - adverse effects ; Fertilization in Vitro ; Follicle Stimulating Hormone, Human - blood ; Hong Kong ; Humans ; Infertility - blood ; Infertility - physiopathology ; Infertility - therapy ; Internal Medicine ; in vitro fertilization ; Menotropins - administration & dosage ; Obstetrics and Gynecology ; ovarian response markers ; Ovary - drug effects ; Ovary - metabolism ; Ovary - physiopathology ; Ovulation Induction - adverse effects ; Ovulation Induction - methods ; Pilot Projects ; poor responders ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Tertiary Care Centers ; Time Factors ; Treatment Outcome</subject><ispartof>Fertility and sterility, 2014-07, Vol.102 (1), p.108-115.e1</ispartof><rights>American Society for Reproductive Medicine</rights><rights>2014 American Society for Reproductive Medicine</rights><rights>Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c615t-dee78a8ea53a4640a78b047a52e93720834f69d29f36f2c35eb7fcfae2d141dc3</citedby><cites>FETCH-LOGICAL-c615t-dee78a8ea53a4640a78b047a52e93720834f69d29f36f2c35eb7fcfae2d141dc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0015028214002994$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24796766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yeung, Tracy Wing Yee, M.B., B.S</creatorcontrib><creatorcontrib>Chai, Joyce, M.B., Ch.B</creatorcontrib><creatorcontrib>Li, Raymond Hang Wun, M.B., B.S</creatorcontrib><creatorcontrib>Lee, Vivian Chi Yan, M.B., B.S</creatorcontrib><creatorcontrib>Ho, Pak Chung, M.D</creatorcontrib><creatorcontrib>Ng, Ernest Hung Yu, M.D</creatorcontrib><title>A randomized, controlled, pilot trial on the effect of dehydroepiandrosterone on ovarian response markers, ovarian response, and in vitro fertilization outcomes in poor responders</title><title>Fertility and sterility</title><addtitle>Fertil Steril</addtitle><description>Objective To evaluate whether pretreatment dehydroepiandrosterone (DHEA) supplementation improves ovarian response markers, ovarian response to standard low-dose gonadotropin stimulation, and in vitro fertilization (IVF) outcomes in poor responders. Design Randomized, double-blind, placebo-controlled pilot study. Setting Tertiary reproductive medicine unit. Patient(s) Thirty-two women with anticipated poor ovarian response. Intervention(s) Randomization into DHEA group (n = 16) receiving GNC (25 mg three times a day) or placebo (n = 16) starting from at least 12 weeks before the scheduled IVF treatment according to a computer-generated randomization list. Main Outcome Measure(s) Measurement of monthly ovarian response markers, including antral follicle count (AFC), serum antimüllerian hormone (AMH), and follicle-stimulating hormone (FSH) levels; comparison of ovarian response to a standard dose of gonadotropin stimulation at week 8 and IVF outcomes; and AFC after 12 weeks (primary outcome). Result(s) The DHEA supplementation resulted in statistically significantly higher serum DHEA-S, free androgen index, and follicular DHEA-S levels. No statistically significant differences in the ovarian response markers (AFC, AMH, or FSH), the ovarian response to standard-dose gonadotropin stimulation, or IVF outcomes were found between the two groups. Conclusion(s) No statistically significant improvement in ovarian response markers, ovarian response to standard dose gonadotropin stimulation, or IVF outcomes was found in poor responders receiving pretreatment DHEA. Clinical Trial Registration Number HKCTR-1149 ( www.hkclinicaltrials.com ) and NCT01915186 ( www.ClinicalTrials.org ).</description><subject>Adult</subject><subject>Anti-Mullerian Hormone - blood</subject><subject>Biomarkers - blood</subject><subject>Chorionic Gonadotropin - administration & dosage</subject><subject>Dehydroepiandrosterone - administration & dosage</subject><subject>Dehydroepiandrosterone - adverse effects</subject><subject>DHEA</subject><subject>Double-Blind Method</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Fertility - drug effects</subject><subject>Fertility Agents, Female - administration & dosage</subject><subject>Fertility Agents, Female - adverse effects</subject><subject>Fertilization in Vitro</subject><subject>Follicle Stimulating Hormone, Human - blood</subject><subject>Hong Kong</subject><subject>Humans</subject><subject>Infertility - blood</subject><subject>Infertility - physiopathology</subject><subject>Infertility - therapy</subject><subject>Internal Medicine</subject><subject>in vitro fertilization</subject><subject>Menotropins - administration & dosage</subject><subject>Obstetrics and Gynecology</subject><subject>ovarian response markers</subject><subject>Ovary - drug effects</subject><subject>Ovary - metabolism</subject><subject>Ovary - physiopathology</subject><subject>Ovulation Induction - adverse effects</subject><subject>Ovulation Induction - methods</subject><subject>Pilot Projects</subject><subject>poor responders</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy Rate</subject><subject>Tertiary Care Centers</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0015-0282</issn><issn>1556-5653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUkuO1DAQjRCIaQaugLxk0Qn-xUk2SMOInzQSC2Btue2yxj2JHWynpZ7TcAhOwMlw1A1IsGFjW_L7VNWrqkIENwQT8XLfWIjZp1zOhmLCG8wazPmDakPaVtStaNnDaoMxaWtMe3pRPUlpjzEWpKOPqwvKu0F0Qmyq71coKm_C5O7BbJEOPscwjut7dmPIKEenRhQ8yreAwFrQGQWLDNweTQwwu8KOYa0keFhx4aAKxaMIaQ4-AZpUvIOYtv_8bFHhIud_fDu44orWntzo7lV2q86SdZggFQCaQ4hnmilST6tHVo0Jnp3vy-rL2zefr9_XNx_ffbi-uqm1IG2uDUDXqx5UyxQXHKuu32HeqZbCwDqKe8atGAwdLBOWatbCrrPaKqCGcGI0u6xenHTnGL4ukLKcXNIwjspDWJIkLSes50zwAu1PUF2GkSJYOUdXOj9KguWamdzLP5nJNTOJmSyZFerzs8uym8D8Jv4KqQBenwBQej04iDJpB16DcbHEIU1w_-Py6i8RPTrvtBrv4AhpH5boyywlkYlKLD-tu7OuDuEY02Hg7CfbJsko</recordid><startdate>20140701</startdate><enddate>20140701</enddate><creator>Yeung, Tracy Wing Yee, M.B., B.S</creator><creator>Chai, Joyce, M.B., Ch.B</creator><creator>Li, Raymond Hang Wun, M.B., B.S</creator><creator>Lee, Vivian Chi Yan, M.B., B.S</creator><creator>Ho, Pak Chung, M.D</creator><creator>Ng, Ernest Hung Yu, M.D</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140701</creationdate><title>A randomized, controlled, pilot trial on the effect of dehydroepiandrosterone on ovarian response markers, ovarian response, and in vitro fertilization outcomes in poor responders</title><author>Yeung, Tracy Wing Yee, M.B., B.S ; Chai, Joyce, M.B., Ch.B ; Li, Raymond Hang Wun, M.B., B.S ; Lee, Vivian Chi Yan, M.B., B.S ; Ho, Pak Chung, M.D ; Ng, Ernest Hung Yu, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c615t-dee78a8ea53a4640a78b047a52e93720834f69d29f36f2c35eb7fcfae2d141dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Anti-Mullerian Hormone - blood</topic><topic>Biomarkers - blood</topic><topic>Chorionic Gonadotropin - administration & dosage</topic><topic>Dehydroepiandrosterone - administration & dosage</topic><topic>Dehydroepiandrosterone - adverse effects</topic><topic>DHEA</topic><topic>Double-Blind Method</topic><topic>Drug Administration Schedule</topic><topic>Female</topic><topic>Fertility - drug effects</topic><topic>Fertility Agents, Female - administration & dosage</topic><topic>Fertility Agents, Female - adverse effects</topic><topic>Fertilization in Vitro</topic><topic>Follicle Stimulating Hormone, Human - blood</topic><topic>Hong Kong</topic><topic>Humans</topic><topic>Infertility - blood</topic><topic>Infertility - physiopathology</topic><topic>Infertility - therapy</topic><topic>Internal Medicine</topic><topic>in vitro fertilization</topic><topic>Menotropins - administration & dosage</topic><topic>Obstetrics and Gynecology</topic><topic>ovarian response markers</topic><topic>Ovary - drug effects</topic><topic>Ovary - metabolism</topic><topic>Ovary - physiopathology</topic><topic>Ovulation Induction - adverse effects</topic><topic>Ovulation Induction - methods</topic><topic>Pilot Projects</topic><topic>poor responders</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy Rate</topic><topic>Tertiary Care Centers</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yeung, Tracy Wing Yee, M.B., B.S</creatorcontrib><creatorcontrib>Chai, Joyce, M.B., Ch.B</creatorcontrib><creatorcontrib>Li, Raymond Hang Wun, M.B., B.S</creatorcontrib><creatorcontrib>Lee, Vivian Chi Yan, M.B., B.S</creatorcontrib><creatorcontrib>Ho, Pak Chung, M.D</creatorcontrib><creatorcontrib>Ng, Ernest Hung Yu, M.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Fertility and sterility</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yeung, Tracy Wing Yee, M.B., B.S</au><au>Chai, Joyce, M.B., Ch.B</au><au>Li, Raymond Hang Wun, M.B., B.S</au><au>Lee, Vivian Chi Yan, M.B., B.S</au><au>Ho, Pak Chung, M.D</au><au>Ng, Ernest Hung Yu, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A randomized, controlled, pilot trial on the effect of dehydroepiandrosterone on ovarian response markers, ovarian response, and in vitro fertilization outcomes in poor responders</atitle><jtitle>Fertility and sterility</jtitle><addtitle>Fertil Steril</addtitle><date>2014-07-01</date><risdate>2014</risdate><volume>102</volume><issue>1</issue><spage>108</spage><epage>115.e1</epage><pages>108-115.e1</pages><issn>0015-0282</issn><eissn>1556-5653</eissn><abstract>Objective To evaluate whether pretreatment dehydroepiandrosterone (DHEA) supplementation improves ovarian response markers, ovarian response to standard low-dose gonadotropin stimulation, and in vitro fertilization (IVF) outcomes in poor responders. Design Randomized, double-blind, placebo-controlled pilot study. Setting Tertiary reproductive medicine unit. Patient(s) Thirty-two women with anticipated poor ovarian response. Intervention(s) Randomization into DHEA group (n = 16) receiving GNC (25 mg three times a day) or placebo (n = 16) starting from at least 12 weeks before the scheduled IVF treatment according to a computer-generated randomization list. Main Outcome Measure(s) Measurement of monthly ovarian response markers, including antral follicle count (AFC), serum antimüllerian hormone (AMH), and follicle-stimulating hormone (FSH) levels; comparison of ovarian response to a standard dose of gonadotropin stimulation at week 8 and IVF outcomes; and AFC after 12 weeks (primary outcome). Result(s) The DHEA supplementation resulted in statistically significantly higher serum DHEA-S, free androgen index, and follicular DHEA-S levels. No statistically significant differences in the ovarian response markers (AFC, AMH, or FSH), the ovarian response to standard-dose gonadotropin stimulation, or IVF outcomes were found between the two groups. Conclusion(s) No statistically significant improvement in ovarian response markers, ovarian response to standard dose gonadotropin stimulation, or IVF outcomes was found in poor responders receiving pretreatment DHEA. Clinical Trial Registration Number HKCTR-1149 ( www.hkclinicaltrials.com ) and NCT01915186 ( www.ClinicalTrials.org ).</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24796766</pmid><doi>10.1016/j.fertnstert.2014.03.044</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | Fertility and sterility, 2014-07, Vol.102 (1), p.108-115.e1 |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Anti-Mullerian Hormone - blood Biomarkers - blood Chorionic Gonadotropin - administration & dosage Dehydroepiandrosterone - administration & dosage Dehydroepiandrosterone - adverse effects DHEA Double-Blind Method Drug Administration Schedule Female Fertility - drug effects Fertility Agents, Female - administration & dosage Fertility Agents, Female - adverse effects Fertilization in Vitro Follicle Stimulating Hormone, Human - blood Hong Kong Humans Infertility - blood Infertility - physiopathology Infertility - therapy Internal Medicine in vitro fertilization Menotropins - administration & dosage Obstetrics and Gynecology ovarian response markers Ovary - drug effects Ovary - metabolism Ovary - physiopathology Ovulation Induction - adverse effects Ovulation Induction - methods Pilot Projects poor responders Pregnancy Pregnancy Outcome Pregnancy Rate Tertiary Care Centers Time Factors Treatment Outcome |
| title | A randomized, controlled, pilot trial on the effect of dehydroepiandrosterone on ovarian response markers, ovarian response, and in vitro fertilization outcomes in poor responders |
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