Participating Centers

C.H.R., New York, N.Y.
Toronto West Fertility Center, Toronto, ON.

Objective

Dehydroepiandrosterone (DHEA) supplementation appears to lower embryos aneuploidy rates (Gleicher et. Fertil Steril 2007; Suppl 1:S232).  Since DHEA treated women with diminished ovarian reserve produce only relatively few embryos and, therefore, only rarely qualify for preimplantation genetic screening, data accumulation on embry aneuploidy rates is difficult.  Aneuploidy rates are, however, reflected in miscarriage rates and this study, therefore, investigated spontaneous miscarriage rates in pregnancies established under DHEA supplementation.

Design

Historical controlled cohort study.

Materials and Methods

The complete DHEA treatment experience of 2 independent fertility centers in New York City, N.Y. and Toronto, Canada was investigated, involving a total of 73 clinical pregnancies.  Miscarriage rates were stratified for age and statistically compared to 2006 national SART outcomes.

Results

Total miscarriage rates in NY and Toronto were identical at 15.0 and 15.2% respectively (combined 15.1%).  The Mantel-Haenszel common odds ration (and 95% CI) for odds of miscarriage with DHEA supplementation was stratified for age, significantly lower relative to the odds of miscarriage in the general SART IVF population ([0.49(0.25-0.94; p = 0.04)].  Miscarriage rates after DHEA were lower at all ages but the difference was most pronounced above age 35. 

Conclusions

DHEA supplementation especially above the agoe of 35 appears associated with significantly decreased miscarriage rates in women with diminished ovarian reserve, reducing them to rates reported in general, low risk populations.  This observation further supports a beneficial effect on ploidy from DHEA supplementation, which in turn, at least partially, can explain improved pregnancy rates with DHEA Supplementation.

Supported by The Foundation for Reproduction Medicine.

Authored by Dr's:

N. Gleicher
E.A.J. Ryan
A. Weghofer
K. Oktay
S. Blanco-Mejia
D.H. Barad