INCREASED EUPLOID EMBRYOS AFTER SUPPLEMENTATION WITH DEHYDROEPIANDROSTERONE (DHEA) IN WOMEN WITH PREMATURE OVARIAN AGING. N. Gleicher, A. Weghofer, D. Barad. Center for Human Reproduction, New York, NY; The University of Vienna Medical School, Vienna, Austria.
OBJECTIVE: To determine whether dehydroepiandrosterone (DHEA) supplementation in women with premature ovarian aging (POA) increases the number of euploid embryos available for embryo transfer.
DESIGN: Retrospective case-control study.
MATERIALS AND METHODS: Embryo ploidy was investigated by preimplantation genetic diagnosis (PGD) in 27 consecutive IVF cycles in women with POA. Women with baseline FSH levels that exceeded the 95% CI expected among women in their age categories were considered to have evidence of POA. Amongst those, 8 had received at least 1 month of supplementation with DHEA (micronized, pharmaceutical grade; 25 mg, TID) prior to oocyte retrieval and 19 had not received such substitution. Patients in both groups received a microdose GnRH agonist protocol (leuprolide acetate 40 micrograms per 0.1 mL) with gonadotropin stimulation of 600–750 IU daily, all FSH and 150 IU HMG. PGD was performed by fluorescence in situ hybridization (FISH) on day 3 after fertilization and involved analysis of chromosomes X, Y, 13, 16, 18, 21 and 22. Data are presented as mean 1 standard deviation. Differences between the two groups were tested by chi-square and (two-sided) Fisher’s Exact Test, utilizing SPSS for Windows, standard version 15, with significance defined as P<0.05.
RESULTS: The DHEA group tended to be older age (38.95.1 vs. 41.2 4.7 years) and have higher baseline FSH levels (9.02.7 vs. 12.49.1mIU/ml). TheTable summarizes comparisons: Peak estradiol levels, oocyte and embryo numbers, and aneuploidy rates, all demonstrated trends towards improvement after DHEA supplementation, but none reached statistical significance. The percentage of IVF cycles, reaching embryo transfer of at least one euploid embryo was, however, significantly higher after DHEA treatment.
CONCLUSIONS: These data suggest that DHEA supplementation increases the number of euploid embryos, available for embryo transfer. Whether this increase is due to reduction in aneuploidy after DHEA treatment, a larger number of oocytes/embryos, as previously reported, or both in combined fashion, remains to be determined through larger studies.
