Role of dhea in diminished ovarian reserve, systematic review
Journal name: World Journal of Pharmaceutical Research
Original article title: Role of dhea in diminished ovarian reserve, systematic review
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Vinita Singh, Pushpawati Thakur, Sarita Agrawal, Anjum, Byasdev.
World Journal of Pharmaceutical Research:
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Full text available for: Role of dhea in diminished ovarian reserve, systematic review
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
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Summary of article contents:
1) Introduction
Dehydroepiandrosterone (DHEA) is a key steroid hormone in the human body and has gained attention for its potential role in enhancing fertility, especially in women with diminished ovarian reserve (DOR). This systematic review aims to compile and analyze the existing literature on DHEA's use as an adjunct in ovarian stimulation protocols for women who are poor responders to fertility treatments, especially in in vitro fertilization (IVF) settings. The findings indicate that DHEA supplementation may improve oocyte yield and quality, embryo quality, and pregnancy rates, though high-quality evidence is still needed to make definitive recommendations.
2) The Role of DHEA in Ovarian Function Improvement
One significant aspect of DHEA is its potential to improve ovarian function by reducing oxidative stress and follicular atresia. Evidence suggests that DHEA supplementation can positively influence follicular steroidogenesis and increase insulin-like growth factor 1 (IGF-1) levels. Increased levels of hormones like Anti-Müllerian hormone (AMH) and antral follicle count have been observed in women undergoing DHEA treatment. The improvements in these parameters may help mitigate the impacts of aging on ovarian environments, leading to better egg quality and increasing the chances of successful pregnancies—a promising therapeutic approach for women struggling with infertility.
3) Evidence and Methodological Insights
Various studies support the benefits of DHEA for women with DOR, presenting data through case reports, retrospective analyses, and case-control studies. The aggregated data has shown consistent improvements in oocyte yield and overall IVF outcomes with DHEA use, though the evidence tends to be mixed concerning specific findings such as clinical pregnancy rates and miscarriage rates. Importantly, only a handful of randomized controlled trials (RCTs) are available, with many studies criticized for methodological flaws, such as small sample sizes and varied treatment protocols. These factors contribute to the ongoing debate regarding the validity and reliability of DHEA as a standard treatment.
4) Cautions and Considerations in DHEA Use
Despite the encouraging results associated with DHEA supplementation, researchers emphasize the need for large-scale, well-designed RCTs to substantiate its efficacy before endorsing routine clinical use. Issues such as publication bias and the generally small and localized nature of studies further complicate the therapeutic landscape. While some practitioners have noted spontaneous pregnancies and improved ovarian responses attributed to DHEA use, caution is warranted until more robust evidence can clarify the ideal patient populations, treatment dosages, and protocols.
5) Conclusion
In conclusion, while DHEA appears to offer a promising avenue for improving outcomes in women with diminished ovarian reserve—potentially enhancing fertility through various physiological mechanisms—the current body of evidence is not yet strong enough for blanket recommendations. Ongoing research is essential to confirm DHEA's safety and efficacy in broader populations, alongside better-defined treatment regimens. Meanwhile, DHEA may be considered an option for well-informed patients willing to engage in a treatment that promises benefits without significant side effects, pending further validation from the scientific community.
FAQ section (important questions/answers):
What is the role of DHEA in diminished ovarian reserve?
DHEA may improve pregnancy chances in women with diminished ovarian reserve by enhancing oocyte yield and quality, reducing oxidative stress, and increasing markers like AMH and antral follicle count.
What are the common methods to assess ovarian reserve?
Common methods include measuring FSH levels, anti-Mullerian hormone (AMH), and antral follicle count (AFC) via ultrasound to evaluate the number of available follicles.
What evidence supports the use of DHEA in IVF?
Published studies indicate that DHEA supplementation is associated with improved oocyte yields, embryo quality, and higher pregnancy rates in women who are poor responders in IVF treatments.
Are there significant side effects associated with DHEA supplementation?
The absence of significant side effects suggests that DHEA supplementation is safe for use in women with diminished ovarian reserve, making it an attractive option for treatment.
Why is further research on DHEA supplementation necessary?
Further large-scale, well-designed studies are needed to confirm DHEA's efficacy and determine optimal treatment protocols before it can be widely recommended in clinical practice.
How has DHEA been received by the medical community?
While some studies show promising results for DHEA's role in improving fertility, there is a call for more rigorous randomized controlled trials to validate these findings.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Role of dhea in diminished ovarian reserve, systematic review”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Study (Studying):
In the context of the text, 'Study' refers to the systematic investigation into the effects of DHEA on women with diminished ovarian reserve (DOR). Numerous studies involving various methodologies have been reviewed to assess how DHEA supplementation influences IVF outcomes and overall fertility in women facing challenges with ovarian response and egg quality.
2) Pur:
'Poor' describes the condition of ovarian response as referenced throughout the text. It acknowledges the challenges faced by women who do not produce an adequate number of viable oocytes following hormonal stimulation, which can severely impact their chances of conception during IVF, posing risks of unsuccessful cycles or low embryo quality.
3) Quality:
The term 'Quality' is significant in discussing oocytes and embryos produced during fertility treatments. Higher quality oocytes and embryos lead to better IVF outcomes, including increased implantation rates and successful pregnancies. The text emphasizes how DHEA supplementation may enhance the quality of these reproductive cells, especially for women with diminished reserve.
4) Barad:
Barad refers to one of the researchers involved in the studies concerning DHEA supplementation's role in improving fertility outcomes. The mentioned work by Barad and colleagues highlights previous findings, suggesting that DHEA can augment ovarian response and improve embryo quality, making a case for further exploration of this treatment.
5) Birth:
'Birth' pertains to the ultimate goal of fertility interventions described in the text. The focus is on how DHEA supplementation may contribute to achieving successful pregnancies and live births among women with diminished ovarian reserve through improved oocyte and embryo quantity and quality, leading to better chances of successful implantation.
6) Table:
'Table' signifies the structured presentation of various studies and their findings as part of the systematic review. The table summarizes key characteristics and metrics of each study regarding DHEA supplementation, including design, outcomes, and notable remarks. This organized form aids in comparing data and comprehending the effects across different research efforts.
7) Science (Scientific):
'Science' is the underlying basis for the systematic review, emphasizing the need for evidence-based practice in reproductive medicine. The studies reviewed represent the scientific inquiry into hormonal treatments and their physiological effects, illustrating the importance of rigorous research in understanding how DHEA influences ovarian reserve and fertility outcomes.
8) Animal:
The term 'Animal' is relevant as it denotes preclinical studies involving animal models that have explored the effects of androgens like DHEA on ovarian function. These studies contribute foundational knowledge regarding mechanisms that might be expected to influence human fertility, specifically the growth and quality of follicles in response to supplementation.
9) India:
'India' is mentioned in the context of the All India Institute of Medical Sciences, where the research was conducted. The location signifies the geographical and institutional backdrop for the collaboration of the authors in researching DHEA’s effects, indicating the country's involvement in advancing reproductive health studies.
10) Post:
'Post' relates to the outcomes or measurements taken after DHEA supplementation, specifically noting the significant changes or improvements seen in ovarian response. This term is critical in establishing the timeframe for evaluating the efficacy of treatment and the progression towards achieving desired reproductive goals.
11) Measurement:
'Measurement' refers to the evaluation process regarding various parameters associated with infertility treatments, such as hormone levels, oocyte quality, and embryo outcomes. Accurate measurements are vital to analyzing the effectiveness of DHEA in improving IVF success and understanding the physiological changes induced by the supplement.
12) Observation:
'Observation' is integral to clinical research, as it denotes the systematic collection of data through studying the effects of DHEA on women undergoing IVF. Continued observations across different studies help in identifying patterns, making correlations between DHEA usage and pregnancy-related metrics, and informing future recommendations.
13) Discussion:
'Discussion' pertains to the analysis and interpretation of the data presented in the systematic review. This section is crucial for exploring the implications of findings related to DHEA supplementation, addressing potential biases, limitations, and the necessity for larger, well-designed studies to substantiate the claims and gain consensus in the field.
14) Developing:
'Developing' encompasses the concept of follicular growth and the maturation of oocytes. In the context of the review, it points to how DHEA supplementation influences the development of ovarian follicles and their ability to yield quality oocytes, thereby impacting the success of fertility treatments.
15) Pregnant:
'Pregnant' is a central aim of the fertility treatments discussed, referring to the state of carrying a developing fetus. The text focuses on how enhanced ovarian response and improved embryo quality from DHEA supplementation may increase the likelihood of achieving and sustaining pregnancies in women experiencing infertility.
16) Reason:
'Reason' in this context addresses the justifications behind using DHEA supplementation among women with diminished ovarian reserve. It underscores the need for a solid basis of evidence to support its use and outlines the rational inquiries into how such hormonal treatments could mitigate issues related to poor ovarian response.
17) Doubt:
'Doubt' signifies the uncertainties surrounding the efficacy of DHEA in improving fertility and reproductive outcomes. The text addresses the need for more robust clinical trials and caution against the reliance on limited evidence, indicating a critical stance toward the routine application of DHEA supplementation without substantiated proof of its benefits.
18) Visit:
'Visit' refers to the medical consultations where patients discuss fertility challenges and potential treatments with healthcare professionals. These visits are vital for establishing individual cases regarding DHEA supplementation and understanding patient history to formulate a suitable plan that aligns with evidence-based practices.
19) Blood:
'Blood' is crucial in evaluating hormonal levels in the context of ovarian reserve and overall reproductive health. Hormonal measurements from blood tests, such as AMH and FSH, provide insights into ovarian function and guide clinical decisions regarding the use of supplements like DHEA to potentially enhance fertility outcomes.
20) Ovid:
Ovid refers to a database used for medical literature research, where relevant studies were accessed for this review. The mention indicates the importance of comprehensive literature searches in compiling evidence about DHEA’s roles and effects on fertility, showcasing academic rigor in the review process.
21) Food:
'Food' relates to the classification of DHEA as a dietary supplement, which influences its accessibility and potential for use in clinical settings. As DHEA is available without prescription, this context raises considerations about its usage in infertility treatment and signals a need for informed patient decisions regarding supplementation.
22) Hand:
'Hand' represents the collaborative effort and expertise of multiple authors and researchers in conducting the systematic review and analyzing data. This partnership is essential for synthesizing findings from various studies and rendering a comprehensive understanding of DHEA's implications in enhancing ovarian reserve and fertility outcomes.
23) Cai (Caí):
Chai is included as a reference to one of the authors involved in some studies related to DHEA and its effects on women with diminished ovarian reserve. The inclusion highlights the contributions of different researchers in the body of literature examining alternative approaches to address infertility and ovarian dysfunction.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Role of dhea in diminished ovarian reserve, systematic review’. Further sources in the context of Science might help you critically compare this page with similair documents:
Embryo transfer, Age-group, Randomized controlled trial, Clinical Practice, Oxidative stress, Randomized controlled study, Patient population, In Vitro Fertilization (IVF), Clinical pregnancy, Fertility treatment, Follicle Stimulating Hormone (FSH), Advanced maternal age, Case-control study, Publication bias, Anti-Mullerian hormone, Ovarian reserve, Food supplement, Assisted reproduction, IVF cycle, Anti Mullerian hormone (AMH), Antral follicle count (AFC), Diminished ovarian reserve (DOR), Clinical outcome, IVF Treatment, Randomized prospective study, Controlled ovarian hyperstimulation, Clinical pregnancy rate, Live birth rate, Oocyte quality, Embryo quality, Evidence-based recommendations, Poor responders.