title: Is there a role for DHEA supplementation in women with diminished ovarian reserve?
abstract: OBJECTIVE
  Poor ovarian reserve and poor ovarian response presents a challenge to IVF centers. Dehydroepiandrosterone (DHEA) supplementation is increasingly being used by many IVF centers around the world in poor responders despite the lack of convincing data. We therefore examined the rationale for the use of DHEA in poor responders, address the relevant studies, present new data, and address its potential mechanisms of action.
  
  
  METHODS
  All published articles on the role of DHEA in infertile women from 1990 to April 2013 were reviewed.
  
  
  RESULTS
  Several studies have suggested an improvement in pregnancy rates with the use of DHEA. Potential mechanisms include improved follicular steroidogenesis, increased IGF-1, acting as a pre-hormone for follicular testosterone, reducing aneuploidy, and increasing AMH and antral follicle count. While the role of DHEA is intriguing, evidence-based recommendations are lacking.
  
  
  CONCLUSIONS
  While nearly 25 % of IVF programs use DHEA currently, large randomized prospective trials are sorely needed. Until (and if) such trials are conducted, DHEA may be of benefit in suitable, well informed, and consented women with diminished ovarian reserve.
authors.affiliation: Department of Obstetrics and Gynecology, Charles Cole Memorial Hospital, Coudersport, PA, USA.
authors.forename: Mazen R
authors.initials: MR
authors.lastname: Fouany
authors.forename: Fady I
authors.initials: FI
authors.lastname: Sharara
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000096:biosynthesis; D003687:Dehydroepiandrosterone / Q000008:administration & dosage*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000473:pathology; D007334:Insulin-Like Growth Factor I / Q000096:biosynthesis*; D006080:Ovarian Follicle / Q000187:drug effects / Q000378:metabolism; D011247:Pregnancy; D013739:Testosterone / Q000096:biosynthesis*
chemical_list: D013739:Testosterone; D003687:Dehydroepiandrosterone; D007334:Insulin-Like Growth Factor I; D054304:Anti-Mullerian Hormone