M So¨ nmezer1,2,5, B O¨ zmen1,2, AP C¸ il3, S O¨ zkavukcu1,2, T Tascı2, H Olmus4, CS Atabekog˘ lu1,2
1Ankara University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey; 2Ankara University
Centre for Research on Human Reproduction, Ankara, Turkey; 3Kirikkale University School of Medicine, Department
of Obstetrics and Gynecology, Kirikkale, Ankara, Turkey; 4Gazi University, Faculty of Science and Art, Department of
Statistics, Ankara, Turkey
5Correspondence: e-mail:
msonmezer@gmail.com
Abstract
The effect of dehydroepiandrosterone (DHEA) supplementation on cycle outcome was assessed in patients with poor
ovarian response. In total, 19 poor responder patients who were scheduled to undergo a second intracytoplasmic
sperm injection (ICSI)/embryo transfer cycle were enrolled and first ICSI/embryo transfer cycles were taken as
the control group. All subjects were given DHEA supplementation (25 mg t.i.d.) for at least 3 months prior to their
second ICSI/embryo transfer cycle. In both cycles a fixed dose of rFSH (300 IU/day) and human menopausal gonadotrophin
(HMG) (75 or 150 IU/day) along with a flexible gonadotrophin-releasing hormone (GnRH) antagonist
protocol were administered. A favourable decrease was noted in mean day 3 serum oestradiol concentrations after
DHEA supplementation (75.14 ± 28.93 versus 43.07 ± 11.77; P < 0.01). Increased number of >17 mm follicles
(3 ± 0.7 versus 1.9 ± 1.3; P < 0.05), MII oocytes (4 ± 1.8 versus 2.1 ± 1.8; P < 0.05), top quality day 2 (2.2 ± 0.8 versus
1.3 ± 1.1; P < 0.05) and day 3 embryos (1.9 ± 0.8 versus 0.7 ± 0.6; P < 0.05) were achieved in DHEA-supplemented
cycles. Cycle cancellation rates were reduced (5.3% versus 42.1%; P < 0.01), and the pregnancy rate per
patient and clinical pregnancy rate per embryo transfer (47.4% versus 10.5%; P < 0.01 and 44.4% versus 0%;
P < 0.01) were improved after DHEA supplementation. DHEA supplementation might enhance ovarian response,
reduce cycle cancellation rates and increase embryo quality in poor responders.