Document Detail


Starting and resulting testosterone levels after androgen supplementation determine at all ages in vitro fertilization (IVF) pregnancy rates in women with diminished ovarian reserve (DOR).
MedLine Citation:
PMID:  23212832     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate whether androgen conversion rates after supplementation with dehydroepiandrosterone (DHEA) differ, and whether differences between patients with diminished ovarian reserve (DOR) are predictive of pregnancy chances in association with in vitro fertilization (IVF).
METHODS: In a prospective cohort study we investigated 213 women with DOR, stratified for age (≤ 38 or >38 years) and ovarian FMR1 genotypes/sub-genotypes. All women were for at least 6 weeks supplemented with 75 mg of DHEA daily prior to IVF, between initial presentation and start of 1st IVF cycles. Levels of DHEA, DHEA-sulfate (DHEAS), total T (TT) and free T (FT) at baseline ((BL)) and IVF cycle start ((CS)) were then compared between conception and non-conception cycles.
RESULTS: Mean age for the study population was 41.5 ± 4.4 years. Forty-seven IVF cycles (22.1 %) resulted in clinical pregnancy. Benefits of DHEA on pregnancy rates were statistically associated with efficiency of androgen conversion from DHEA to T and amplitude of T gain. Younger women converted significantly more efficiently than older females, and selected FMR1 genotypes/sub-genotypes converted better than others. FSH/androgen and AMH/androgen ratios represent promising new predictors of IVF pregnancy chances in women with DOR.
CONCLUSIONS: DOR at all ages appears to represent an androgen-deficient state, benefitting from androgen supplementation. Efficacy of androgen supplementation with DHEA, however, varies depending on female age and FMR1 genotype/sub-genotype. Further clarification of FMR1 effects should lead to better individualization of androgen supplementation, whether via DHEA or other androgenic compounds.
Authors:
Norbert Gleicher; Ann Kim; Andrea Weghofer; Aya Shohat-Tal; Emanuela Lazzaroni; Ho-Joon Lee; David H Barad
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-12-05
Journal Detail:
Title:  Journal of assisted reproduction and genetics     Volume:  30     ISSN:  1573-7330     ISO Abbreviation:  J. Assist. Reprod. Genet.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-24     Completed Date:  2013-07-22     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  9206495     Medline TA:  J Assist Reprod Genet     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  49-62     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Androgens / administration & dosage*,  deficiency
Anti-Mullerian Hormone / blood
Dehydroepiandrosterone / administration & dosage,  blood
Female
Fertilization in Vitro / methods
Follicle Stimulating Hormone / blood
Fragile X Mental Retardation Protein / genetics
Genotype
Humans
Infertility, Female / diagnosis,  therapy*
Logistic Models
Menstrual Cycle
Middle Aged
Ovary / drug effects,  metabolism*
Ovulation Induction / methods
Predictive Value of Tests
Pregnancy
Pregnancy Rate*
Prospective Studies
Testosterone / blood*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Androgens; 0/FMR1 protein, human; 139135-51-6/Fragile X Mental Retardation Protein; 3XMK78S47O/Testosterone; 459AG36T1B/Dehydroepiandrosterone; 80497-65-0/Anti-Mullerian Hormone; 9002-68-0/Follicle Stimulating Hormone
Comments/Corrections

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