title: A meta-analysis of dehydroepiandrosterone supplementation among women with diminished ovarian reserve undergoing in vitro fertilization or intracytoplasmic sperm injection.
abstract: BACKGROUND
  Evidence for the efficacy of dehydroepiandrosterone (DHEA) in improving ovarian responsiveness among poor responders, especially women with diminished ovarian reserve (DOR), remains inconsistent.
  
  
  OBJECTIVE
  To evaluate the effectiveness of DHEA in women with DOR undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  PubMed and Embase were searched for reports published in any language before October 31, 2014, using keywords such as "DHEA," "poor ovarian response," "diminished ovarian reserve," and "premature ovarian aging."
  
  
  METHODS
  Studies that explored the effects of DHEA in women with DOR undergoing IVF/ICSI were included if they evaluated the number of oocytes retrieved and/or the rates of clinical pregnancy, implantation, and spontaneous abortion.
  
  
  METHODS
  Risk ratios (RRs) and standardized mean differences with 95% confidence intervals (CIs) were calculated, combined with subgroup and sensitivity analyses.
  
  
  RESULTS
  Eight studies were included. The use of DHEA increased the clinical pregnancy rate (RR 2.13; 95% CI 1.12-4.08). Similar results were obtained in subgroup analyses including randomized controlled trials and case-control studies (RR 2.57; 95% CI 1.43-4.63) and self-controlled studies (RR 3.95; 95% CI 1.28-12.19). However, the effects of DHEA on oocyte retrieval, implantation, and abortion were not significant.
  
  
  CONCLUSIONS
  Supplementation with DHEA has a positive effect in women undergoing IVF/ICSI treatment for DOR.
authors.affiliation: Research Center for Guangxi Reproductive Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Research Center for Guangxi Reproductive Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Yuan
authors.affiliation: Department of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Research Center for Guangxi Reproductive Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Hongbo
authors.initials: H
authors.lastname: Wu
authors.affiliation: Research Center for Guangxi Reproductive Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Huimei
authors.initials: H
authors.lastname: Wu
authors.affiliation: Research Center for Guangxi Reproductive Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China. Electronic address: liliuming1231@163.com.
authors.forename: Liuming
authors.initials: L
authors.lastname: Li
mesh_terms: D003687:Dehydroepiandrosterone / Q000008:administration & dosage*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D065851:Ovarian Reserve / Q000502:physiology; D011247:Pregnancy; D018873:Pregnancy Rate; D016032:Randomized Controlled Trials as Topic; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*
chemical_list: D003687:Dehydroepiandrosterone
keywords: Dehydroepiandrosterone; Diminished ovarian reserve; Meta-analysis; Poor ovarian response