Dehydroepinadrosterone (DHEA) supplementation improves pregnancy chances in women with diminished ovarian reserve, by possibly reducing aneuploidy. Since a large majority of spontaneous miscarriages are associated with aneuploidy, one can speculate that DHEA supplementation may also reduce miscarriage rates. METHODS: We compared miscarriage rates in DHEA supplemented pregnancies at two independent North American infertility centers to miscarriages reported in a national U.S. in vitro fertilization (IVF) data base. RESULTS: After DHEA supplementation the miscarriage rate at both centers was 15.1% (15.0% and 15.2%, respectively). For DHEA supplementation odds ratio was significantly lower, relative to odds of miscarriage in the general IVF control population [0.49]. Miscarriage rates after DHEA were significantly lower at all ages but most pronounced above age 35 years. DISCUSSION: Since diminished ovarian reserve patients in the literature are reported to experience significantly higher miscarriage rates than average IVF patients, the here observed reduction in miscarriages after DHEA supplementation exceeds, however, all expectations. Miscarriage rates after DHEA not only were lower than in an average national IVF population but were comparable to rates reported in normally fertile populations. Low miscarriage rates, comparable to those of normal fertile women, are statistically impossible to achieve in diminished ovarian reserve patients without assumption of a DHEA effect on embryo ploidy. Beyond further investigations in infertile populations, these data, therefore, also suggest the investigations of pre-conception DHEA supplementation in normal fertile populations above age 35 years.
http://www.ncbi.nlm.nih.gov/pubmed/19811650
Women with diminished ovarian reserve, premature ovarian failure and premature ovarian aging in the course of ovarian stimulation protocols followed either by intrauterine insemination or IVF. RECENT FINDINGS: Overall, 50-75 mg of dehydroepiandrosterone supplementation for at least 4 months may either result in natural conception or considerably improves intrauterine insemination and IVF outcome and pregnancy rates to women with confirmed diminished ovarian reserve, premature ovarian failure or premature ovarian aging. Positive effect has been reported to oocyte and embryo quality, even to women aged 40-47 years. The number of euploid embryos is increased, and miscarriage rate is decreased. SUMMARY: Although more data on the dehydroepiandrosterone effect on assisted reproduction are needed, results obtained over the last few years confirm the improvement of oocyte production and pregnancy rates. No significant side effects are reported, and those include mainly hirstusism and acne.
http://www.ncbi.nlm.nih.gov/pubmed/19610174
Women with diminished ovarian reserve, supplemented with DHEA, underwent preimplantation genetic screening of embryos during in vitro fertilization (IVF) cycles. RESULTS: DHEA supplementation to a significant degree reduced number and percentages of aneuploid embryos, adjusted for relevant covariates. Short term supplementation (4-12 weeks) resulted in greatest reduction in aneuploidy (21.6%). DISCUSSION: Beneficial DHEA effects on diminished ovarian reserve patients, at least partially, are the likely consequence of lower embryo aneuploidy. DHEA supplementation also deserves investigation in older fertile women, attempting to conceive, where a similar effect, potentially, could positively affect public health.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992540/
In 2007, a small pilot study demonstrated in 100 percent of DHEA treated but only 53 percent of control IVF cycles at least one euploid embryo.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3112409/
FSH, estradiol, LH, prolactin and DHEAS concentrations were significantly higher in the unexplained recurrent miscarriage group than in the explained recurrent miscarriage loss group, although serum concentrations of all hormones were within the normal range.
http://www.ncbi.nlm.nih.gov/pubmed/14503976
Treatment with DHEA (60mg/kg, s.c. 24 and 48h post-implantation) induces embryo resorption of early pregnant mice while simultaneous treatment with metformin (240mg/kg, oral 24 and 48h post-implantation) prevents it. During pregnancy progesterone-induced blocking factor (PIBF) modulates prostaglandins (PGs) and cytokine production. These findings prompted us to investigate the effect of DHEA and metformin on both PIBF and cyclooxygenase 2 (COX2) expressions at the implantation sites, as well as cytokine production. DHEA treatment both abolished PIBF expression and increased COX2 expression. Embryo resorption correlates with the lack of PIBF expression, diminished IL-6 levels and increased IL-2 concentration while metformin was able to reverse the effect of DHEA on both PIBF and COX2 expression and IL-6 levels. We concluded that hyperandrogenization induces embryo resorption in early pregnancy diminishing PIBF in implantation sites, having a pro-inflammatory effect. Metformin is able to prevent such effects.
http://www.ncbi.nlm.nih.gov/pubmed/18606228
The aim of the present report was to study the role of high levels of dehydroepiandrosterone (DHEA) on the ovarian function and embryonic resorption during early pregnancy in mice. Pregnant animals were injected with DHEA. Morphological studies of implantation sites showed embryonic resorption. Serum samples showed higher estradiol levels and a lower progesterone concentration than those of control groups. Ovarian prostaglandin E levels after treatment increased when compared to control groups. The antioxidant metabolite glutathione diminished during both DHEA treatments. In summary, the data presented here suggest that DHEA treatment during early pregnancy modulates the ovarian function and is responsible for embryonic resorption with different degrees depending on when it is administered.
http://www.ncbi.nlm.nih.gov/pubmed/16166807
A functional defect of a subpopulation of NK immune cells, involving both NKCC and the secretory activity, was demonstrated in newly-diagnosed Graves disease and Hashimoto's patients. This defect can be reversed by a dose-dependent treatment with DHEAS. The impairment of NK cell activity in autoimmune thyroid diseases could potentially determine a critical expansion of T/B-cell immune compartments leading to the generation of autoantibodies and to the pathogenesis of thyroid autoimmunity.