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Dehydroepiandrosterone (DHEA) reduces embryo aneuploidy: direct evidence from preimplantation genetic screening (PGS).

Gleicher N, Weghofer A, Barad DH - Reprod. Biol. Endocrinol. (2010)

Bottom Line: DHEA supplementation to a significant degree reduced number (P = 0.029) and percentages (P < 0.001) of aneuploid embryos, adjusted for relevant covariates.Short term supplementation (4-12 weeks) resulted in greatest reduction in aneuploidy (21.6%, 95% CI -2.871-46.031).DHEA supplementation also deserves investigation in older fertile women, attempting to conceive, where a similar effect, potentially, could positively affect public health.

View Article: PubMed Central - HTML - PubMed

Affiliation: Center for Human Reproduction (CHR)-New York, NY, USA. ngleicher@thechr.com

ABSTRACT

Background: Dehydroepiandrosterone (DHEA) has been reported to improve pregnancy chances in women with diminished ovarian reserve (DOR), and to reduce miscarriage rates by 50-80%. Such an effect is mathematically inconceivable without beneficial effects on embryo ploidy. This study, therefore, assesses effects of DHEA on embryo aneuploidy.

Methods: In a 1:2, matched case control study 22 consecutive women with DOR, supplemented with DHEA, underwent preimplantation genetic screening (PGS) of embryos during in vitro fertilization (IVF) cycles. Each was matched by patient age and time period of IVF with two control IVF cycles without DHEA supplementation (n = 44). PGS was performed for chromosomes X, Y, 13, 16, 18, 21 and 22, and involved determination of numbers and percentages of aneuploid embryos.

Results: DHEA supplementation to a significant degree reduced number (P = 0.029) and percentages (P < 0.001) of aneuploid embryos, adjusted for relevant covariates. Short term supplementation (4-12 weeks) resulted in greatest reduction in aneuploidy (21.6%, 95% CI -2.871-46.031).

Discussion: Beneficial DHEA effects on DOR patients, at least partially, are the likely consequence of lower embryo aneuploidy. DHEA supplementation also deserves investigation in older fertile women, attempting to conceive, where a similar effect, potentially, could positively affect public health.

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Comparison of absolute and percentages of aneuploidy in DHEA and control patients.
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Figure 1: Comparison of absolute and percentages of aneuploidy in DHEA and control patients.

Mentions: As Figure 1, however, demonstrates, aneuploid embryos were significantly more prevalent amongst controls (4.5 ± 3.1 vs. 2.8 ± 2.5; P = 0.03), as were percentages of aneuploidy (61.0 ± 22.4 vs. 38.2 ± 24.4; P < 0.001). In the general linear model, after adjustment for age, FSH dose and indication for PGS, the association of DHEA supplementation effects on ploidy remained significant (F = 13.2, df 1, p = 0.001). As expected, women who underwent PGS for aneuploidy screening had a greater percentage of aneuploidy embryos than women who underwent PGS for elective gender selection purposes (P < 0.007).


Dehydroepiandrosterone (DHEA) reduces embryo aneuploidy: direct evidence from preimplantation genetic screening (PGS).

Gleicher N, Weghofer A, Barad DH - Reprod. Biol. Endocrinol. (2010)

Comparison of absolute and percentages of aneuploidy in DHEA and control patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2992540&req=5

Figure 1: Comparison of absolute and percentages of aneuploidy in DHEA and control patients.
Mentions: As Figure 1, however, demonstrates, aneuploid embryos were significantly more prevalent amongst controls (4.5 ± 3.1 vs. 2.8 ± 2.5; P = 0.03), as were percentages of aneuploidy (61.0 ± 22.4 vs. 38.2 ± 24.4; P < 0.001). In the general linear model, after adjustment for age, FSH dose and indication for PGS, the association of DHEA supplementation effects on ploidy remained significant (F = 13.2, df 1, p = 0.001). As expected, women who underwent PGS for aneuploidy screening had a greater percentage of aneuploidy embryos than women who underwent PGS for elective gender selection purposes (P < 0.007).

Bottom Line: DHEA supplementation to a significant degree reduced number (P = 0.029) and percentages (P < 0.001) of aneuploid embryos, adjusted for relevant covariates.Short term supplementation (4-12 weeks) resulted in greatest reduction in aneuploidy (21.6%, 95% CI -2.871-46.031).DHEA supplementation also deserves investigation in older fertile women, attempting to conceive, where a similar effect, potentially, could positively affect public health.

View Article: PubMed Central - HTML - PubMed

Affiliation: Center for Human Reproduction (CHR)-New York, NY, USA. ngleicher@thechr.com

ABSTRACT

Background: Dehydroepiandrosterone (DHEA) has been reported to improve pregnancy chances in women with diminished ovarian reserve (DOR), and to reduce miscarriage rates by 50-80%. Such an effect is mathematically inconceivable without beneficial effects on embryo ploidy. This study, therefore, assesses effects of DHEA on embryo aneuploidy.

Methods: In a 1:2, matched case control study 22 consecutive women with DOR, supplemented with DHEA, underwent preimplantation genetic screening (PGS) of embryos during in vitro fertilization (IVF) cycles. Each was matched by patient age and time period of IVF with two control IVF cycles without DHEA supplementation (n = 44). PGS was performed for chromosomes X, Y, 13, 16, 18, 21 and 22, and involved determination of numbers and percentages of aneuploid embryos.

Results: DHEA supplementation to a significant degree reduced number (P = 0.029) and percentages (P < 0.001) of aneuploid embryos, adjusted for relevant covariates. Short term supplementation (4-12 weeks) resulted in greatest reduction in aneuploidy (21.6%, 95% CI -2.871-46.031).

Discussion: Beneficial DHEA effects on DOR patients, at least partially, are the likely consequence of lower embryo aneuploidy. DHEA supplementation also deserves investigation in older fertile women, attempting to conceive, where a similar effect, potentially, could positively affect public health.

Show MeSH
Related in: MedlinePlus