Centers in Study

Toronto West Fertility Center, Toronto, ON
The Center for Human Reproduction, New York, NY
Foundation for Reproductive Medecine, New York, NY
Departments of Epidermiology and Social Medicine and Obstetrics, Gynecology & Women's Health,
Albert Einstein College of Medicine, Bronx, NY
Department of Obstetrics and Gynecology, University of Vienna School of Medicine, Vienna, Austria
Department of Obstetrics and Gynecology, New York Medical College, Valhalla, NY
Department of Obstetrics Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT

Introduction

We previously reported that women, supplemented with dehydroepiandrosterone (DHEA), produce lower embryo aneuploidy rates (Gleicher et al. Fertil Steril 2007; Suppl1:s232).  DHEA treated women with diminished ovarian reserve, producing few embryos, only rarely qualify for preimplantation genetic screening.  Data accumulation on embryo aneuploidy rates is, therefore, difficult.  Embryo aneuploidy rates are, however, reflected in miscarriage rates.  This study, therefore, investigated spontaneous miscarriage rates in pregnancies established under DHEA supplementation.

Materials & Methods

We investigated the complete DHEA treatment experience of 2 independent fertility centers in New York City, USA, and Toronto, Ont, Canada.  Combined, this involved 73 pregnancies.  Their miscarriage rates were stratefied for and and compared to 2006 national SART outcomes.

Results

As can be seen in the Table (below) miscarriages in NY/TO (15.0/15.2%) were identical and combined to 15.1%.  DHEA was at all ages associated with lower miscarriage rates, with  the effect being the smallest <35 years. 

Conclusions

By demonstrating a remarkable reduction in miscarriage rates, the here-presented data provide further circumstantial evidence that DHEA supplemetation  may reduce the rate of aneuploid embryos in infertile women.  Because both, practically identical data sets come from different countries and involve patients with diminished ovarian reserve, they attain considerable credibility.  Lower aneuploidy rates, at least partially, may explain improvements in pregnancy rates with DHEA supplementation.  Less effect under age 35 is expected, since at those ages women with diminished ovarian reserve do not demonstrate increased age specific aneuploidy rates (Werghofer et al. Fertil Steril 2007;88:90-4).

Authored by Drs

E. Ryan
DH Barad
A Weghofer
K Oktay
Mejia Blanco
N Gleicher