Objective

To report the effect of dehydroepiandrosterone co-treatment on the outcome of controlled ovarian stimulation (COS) and timed intercourse (TIC) in women 35 years of age and older.

Design

A cohort study.

Materials and Methods

In 2 private practice centers, 136 infertile women ≥35 years of age were scheduled to undergo COS-TIC.  Forty-four subjects have received 75 mg oral DHEA per day prior and during COS by cc or Letrozole ± FSH followed by HCG administration ant TIC.  An age and basal FSH matched control group of 92 subjects treated by the same COS protocol without DHEA co-treatment was included.  Both groups were compared regarding COS indices and pregnancy outcome.

Results

DHEA treatment resulted in significantly more number of basal antral follicles at day 3 of the cycle compared with controls (mean ± SD 2.18 ± 1.18 versus 1.28 ± 0.96; respectively; P=0.0006).  The number of the mature follicles (≥ 16 mm) at the day of HCG administration is significantly higher in the group treated by DHEA compared with the controls (P=0.007).  On the other side, the mean serum level of the peakestradiol at the day of HCG administration is comparable between the two study groups of women co-treated with DHEA compared with controls (8/44 (18.2%) versus 4/92 (2.9%) respectively [P<0.001; RR 4.9 (CI 1.3-17.2)].

Conclusions

DHEA co-treatment has significantly modified the COS cycle characteristics without reducing PRs and could be of potential benefit in TIC cycles in older infertile women.

Authored by Dr's

Mohamed A. Bedaiwy
Edward A.J. Ryan
Omar Shaaban
E.A. Claessens
Sonia Blanco-Mejia
R.F. Casper