Chapter 17 - Dehydroepiandrosterone

Summary

The utilization of dehydroepiandrosterone (DHEA) not only improves treatment results in women with diminished ovarian reserve (DOR) but also leads to a modified understanding of the ovarian aging process. The investigation of DHEA as a supplement to decrease aneuploidy among normal older patients, akin to folic acid for prevention of neural tube defects would seem useful. Accurate and timely diagnosis allows for timely treatments. Patients initiate treatment at least six weeks before in vitro fertilization (IVF), and continue supplementation until a second, normally rising pregnancy test (or treatment termination). All patients receive intravaginal and intra-muscular progesterone support in the luteal phase, based on the understanding that the functionally older ovary requires more progesterone support. DHEA-supplemented patients with DOR repeatedly outperformed controls in practically all IVF outcome parameters. Improving anti-mullerian hormone (AMH) values represent a positive prognostic sign during DHEA supplementation.