This is a prospective, self-controlled study of poor responders to IVF treatment, comparing day 3 biochemical (anti-Mullerian hormone (AMH), inhibin B and FSH) and ultrasound (antral follicle count (AFC)) ovarian reserve markers and IVF treatment outcome before and after DHEA supplementation of at least 3 months duration.
Thirty-two women were included. Following DHEA, there was a significant increase in AFC (P = 0.0003) without significant changes in the baseline biochemical parameters AMH, inhibin B, or FSH. The enhanced response comprised increased peak estradiol levels (P = 0.0005), number of follicles > 15 mm, oocytes, MII oocytes and embryos (P = 0.004, P = 0.00001, P = 0.0004 and P = 0.0006, respectively) and oocytes number/total FSH dose (P = 0.0009). The proportion of cancelled cycles due to very poor response decreased significantly (P = 0.02).
DHEA does not appear to exert influence via recruitment of pre-antral or very small antral follicles (no change in AMH and inhibin B) but rather by rescue from atresia of small antral follicles (increased AFC).