title: Effect of inter-cycle interval on oocyte production in humans in the presence of the weak androgen DHEA and follicle stimulating hormone: a case-control study.
abstract: BACKGROUND
  In various animal models androgens have been demonstrated to enhance follicle stimulating hormone (FSH) activity on granulosa cells during small growing follicle stages. To assess whether similar synergism may also exist in humans we investigated women on androgen (dehydroepiandrosterone, DHEA) supplementation with varying concomitant FSH exposure.
  
  
  METHODS
  In a case controlled cohort study we determine if time interval between IVF cycles of IVF treatment with FSH had an effect on ovarian response to ovulation induction in women supplemented with DHEA. Among 85 women with known low functional ovarian reserve (LFOR), supplemented with DHEA, and undergoing at least 3 consecutive IVF cycles, 68 demonstrated short (<120 days) intervals between repeated cycles (Group 1) and were, therefore, considered to have consistent FSH exposure. In contrast 17 women (Group 2) demonstrated long (>=120 days) intervals between repeated cycles and, therefore, were considered to demonstrate inconsistent FSH exposure. Trends in oocyte yields were compared between these groups, utilizing mixed model repeated measures ANOVA, adjusted for initial age and FSH dose.
  
  
  RESULTS
  Only women in Group I demonstrated a linear increase in oocyte yields across their three cycles of treatments (F=7.92; df 1, 68.6; p=0.017). Moreover, the analysis revealed a significant interaction between the two patient groups and cycle number for retrieved oocytes (F=6.32, df=2, 85.9, p=0.003).
  
  
  CONCLUSIONS
  This study offers preliminary confirmatory evidence that repeated short interval exposure to androgens in combination with FSH improves human FOR. A higher level of evidence will require prospectively randomized studies.
authors.affiliation: The Center for Human Reproduction, 21 East 69th St, New York, New York, USA. dbarad@thechr.com.
authors.forename: David H
authors.initials: DH
authors.lastname: Barad
authors.forename: Vitaly A
authors.initials: VA
authors.lastname: Kushnir
authors.forename: Ho-Joon
authors.initials: HJ
authors.lastname: Lee
authors.forename: Emanuela
authors.initials: E
authors.lastname: Lazzaroni
authors.forename: Norbert
authors.initials: N
authors.lastname: Gleicher
mesh_terms: D000328:Adult; D000728:Androgens / Q000494:pharmacology*; D016022:Case-Control Studies; D015331:Cohort Studies; D003687:Dehydroepiandrosterone / Q000494:pharmacology*; D004357:Drug Synergism; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology*; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000494:pharmacology*; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D007248:Infertility, Male; D008297:Male; D054315:Oocyte Retrieval; D009866:Oogenesis / Q000187:drug effects*; D006080:Ovarian Follicle / Q000166:cytology / Q000187:drug effects / Q000473:pathology; D065851:Ovarian Reserve; D010062:Ovulation Induction; D016649:Primary Ovarian Insufficiency / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000728:Androgens; D005300:Fertility Agents, Female; D003687:Dehydroepiandrosterone; D005640:Follicle Stimulating Hormone