Dehydroepiandrosterone (DHEA) Intervention To Treat Ovarian Aging

Efficacy of Dehydroepiandrosterone to Overcome the Effect of Ovarian Aging - A Pilot Double Blinded Randomised Controlled Trial

• To test the hypothesis that supplementation of DHEA for at least twelve weeks prior to and during ovarian stimulation increases oocyte quantity (number of oocytes retrieved) and oocyte quality (clinical pregnancy rates and molecular markers) following IVF and IVF/ICSI treatment.
• To evaluate the feasibility of conducting a large multicentre trial

The purpose of this study is to evaluate the role of DHEA in counteracting the effects of ovarian ageing in an in-vitro fertilization (IVF) model. The study will examine whether the use of DHEA could improve clinical pregnancy rates following IVF treatment in women predicted to have aged ovaries by increasing oocyte quantity (ovarian response to gonadotrophins) and/ or by improving oocyte quality. The oocyte quality will be assessed by morphological and molecular markers.

This study will provide a mechanistic framework for translational research on mechanisms of ovarian ageing and drug interventions to slow down the ovarian ageing process and subsequent adverse physical and psychological consequences. Further, the data that will be produced from this research will have the potential to influence clinical practice in fertility clinics worldwide.

Inclusion Criteria:

• Women aged above 23 years with diminished ovarian reserve (predicted to be poor-responder), defined as antral follicle count <10 and/or Anti-Mullerian hormone <5pmol/L
• Women undergoing IVF and IVF/ICSI treatment
• Women must have a regular spontaneous menstrual cycle of 21 - 35 days

Exclusion Criteria:

• Women with BMI >35 Kg/M2
• Women with a single ovary
• Women with untreated hydrosalpinx/ submucous fibroid/ endometrial polyp at the start of treatment
• Women with any history of seizure disorders
• Women with previous participation in this trial in an earlier treatment cycle
• Women with any known endocrine disorders such as congenital adrenal hyperplasia, thyroid diseases, hyperprolactinemia
• Known allergy to DHEA
• Diabetic women on insulin as insulin lowers DHEA levels and might reduce the effectiveness of DHEA supplements.