Publication:
Efficacy of Dehydroepiandrosterone (DHEA) to overcome the effect of ovarian ageing (DITTO): A proof of principle double blinded randomized placebo controlled trial

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Issued Date

2017

Resource Type

Article

File Type

application/pdf

ISSN

3012115

DOI

10.1016/j.ejogrb.2017.09.006

Other identifier(s)

2-s2.0-85029532377

Rights Holder(s)

Scopus

Bibliographic Citation

European Journal of Obstetrics and Gynecology and Reproductive Biology. Vol 218, (2017), p.39-48

Suggested Citation

Narkwichean A., Maalouf W., Baumgarten M., Polanski L., Raine-Fenning N., Campbell B., Jayaprakasan K. Efficacy of Dehydroepiandrosterone (DHEA) to overcome the effect of ovarian ageing (DITTO): A proof of principle double blinded randomized placebo controlled trial. European Journal of Obstetrics and Gynecology and Reproductive Biology. Vol 218, (2017), p.39-48. doi:10.1016/j.ejogrb.2017.09.006 Retrieved from: https://hdl.handle.net/20.500.14740/4040

Title

Efficacy of Dehydroepiandrosterone (DHEA) to overcome the effect of ovarian ageing (DITTO): A proof of principle double blinded randomized placebo controlled trial

Author(s)

Narkwichean A.
 Maalouf W.
 Baumgarten M.
 Polanski L.
 Raine-Fenning N.
 Campbell B.
 Jayaprakasan K.

Abstract

Objective To evaluate the effect of DHEA supplementation on In-Vitro Fertilisation (IVF) outcome as assessed by ovarian response, oocyte developmental competence and live birth rates in women predicted to have poor ovarian reserve (OR). The feasibility of conducting a large trial is also assessed by evaluating the recruitment rates and compliance of the recruited participants with DHEA/placebo intake and follow-up rates. Study design A single centre, double blinded, placebo controlled, randomized trial was performed over two years with 60 women undergoing in-vitro fertilisation (IVF). Subjects were randomized, based on a computer-generated pseudo-random code to receive either DHEA or placebo with both capsules having similar colour, size and appearance. 60 women with poor OR based on antral follicle count or anti-Mullerian hormone thresholds undergoing IVF were recruited. They were randomised to receive DHEA 75 mg/day or placebo for at-least 12 weeks before starting ovarian stimulation. They had long protocol using hMG 300 IU/day. Data analysed by “intention to treat”. Ovarian response, live birth rates and molecular markers of oocyte quality were compared between the study and control groups. Results The recruitment rate was 39% (60/154). A total of 52 participants (27 versus 25 in the study and placebo groups) were included in the final analysis after excluding eight. While the mean (standard deviation) DHEA levels were similar at recruitment (9.4 (5) versus 7.5 (2.4) ng/ml; P = 0.1), the DHEA levels at pre-stimulation were higher in the study group than in the controls (16.3 (5.8) versus 11.1 (4.5) ng/ml; P < 0.01). The number (median, range) of oocytes retrieved (4, 0–18 versus 4, 0–15 respectively; P = 0.54) and live birth rates (7/27, 26% versus 8/25, 32% respectively; RR (95% CI): 0.74 (0.22-2.48) and mRNA expression of developmental biomarkers in granulosa and cumulus cells were similar between the groups. Conclusion Pre-treatment DHEA supplementation, albeit statistical power in this study is low, did not improve the response to controlled ovarian hyperstimulation or oocyte quality or live birth rates during IVF treatment with long protocol in women predicted to have poor OR. © 2017

Subject(s)

Ampiregulin
 Betaregulin
 Biological marker
 Buserelin
 Chorionic gonadotropin
 Cyclooxygenase 2
 Epiregulin
 Follitropin receptor
 GREM1 protein
 Human menopausal gonadotropin
 Hyaluronan synthase 2
 Luteinizing hormone receptor
 Messenger RNA
 Molecular marker
 Muellerian inhibiting factor
 Nafarelin
 Nafarelin acetate
 Pentraxin 3
 Placebo
 Prasterone
 Progesterone
 PTGS2 protein
 Somatomedin C
 Unclassified drug
 Androgen
 Prasterone
 Acne
 Adult
 Antral follicle count
 Article
 Birth rate
 Clinical outcome
 Controlled study
 Cumulus cell
 Double blind procedure
 Drug efficacy
 Drug withdrawal
 Embryo
 Embryo transfer
 Female
 Follow up
 Gastrointestinal symptom
 Gene expression profiling
 Granulosa cell
 Human
 In vitro fertilization
 Intention to treat analysis
 Intracytoplasmic sperm injection
 Live birth
 Major clinical study
 Nausea
 Oily skin
 Oocyte development
 Oocyte retrieval
 Ovarian reserve
 Ovary hyperstimulation
 Pregnancy outcome
 Priority journal
 Randomized controlled trial
 Single embryo transfer
 Aging
 Drug effect
 Metabolism
 Oocyte
 Ovary
 Ovulation induction
 Pregnancy
 Procedures
 Adult
 Aging
 Androgens
 Dehydroepiandrosterone
 Double-Blind Method
 Female
 Fertilization in Vitro
 Humans
 Intention to Treat Analysis
 Live Birth
 Oocyte Retrieval
 Oocytes
 Ovarian Reserve
 Ovary
 Ovulation Induction
 Pregnancy

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URI

https://hdl.handle.net/20.500.14740/4040

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Scopus: Year 1983-2021

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