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Dehydroepiandrosterone plus climen supplementation shows better effects than dehydroepiandrosterone alone on infertility patients with diminished ovarian reserve of low-FSH level undergoing in-vitro fertilization cycles: a randomized controlled trial.
Reprod Biol Endocrinol. 2016 Feb 16; 14:9.RB

Abstract

BACKGROUND

This study aimed to assess the effect of dehydroepiandrosterone (DHEA) plus climen (estradiol valerate and cyproterone acetate drug combination) on infertility patients with diminished ovarian reserve (DOR) and to determine if the combination of DHEA plus climen is superior to DHEA alone in improving ovarian response.

METHODS

A total of 124 women were randomized into the DHEA group (n = 64) and the DHEA plus climen group (n = 60) for 12 weeks before being subjected to in-vitro fertilization (IVF) cycles. To investigate if there is a FSH-related difference on the effect of the addition of climen, the DHEA group and the DHEA plus climen group were further divided into four subgroups according to a basal FSH level cut-off of 10 mIU/ml. We performed a comparison of Day 3 blood samples before and after treatment and IVF outcome parameters, including AMH, FSH, E2, AFC, oocytes retrieved, MII oocyte numbers, embryo numbers and accumulated embryo scores.

RESULTS

After 12 weeks of pretreatment, the DHEA plus climen group demonstrated a significantly higher level of AMH (P = 0.001) and a significantly lower level of FSH (P = 0.001) compared with the DHEA group. When the two groups were divided into four subgroups based on the FSH cut-off of 10 mIU/mL, a significant increase of AMH (P = 0.034) was found in the high-FSH DHEA plus climen group, whereas there was no significant difference in the high-FSH DHEA group (P = 0.322). A significantly higher accumulated score of embryos was observed in the low-FSH DHEA plus climen group compared with the low-FSH DHEA group (P = 0.034).

CONCLUSIONS

These observations suggest that patients with DOR of a low-FSH level might benefit more from DHEA plus climen supplementation than from DHEA supplementation alone.

Links

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Authors+Show Affiliations

Zhang H
Department of Reproductive Endocrinology, The Reproductive Medicine Center, The Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China. 413959928@qq.com. Hangzhou Women's Health Hospital, Zhejiang, China. 413959928@qq.com.
Chu Y
Department of Reproductive Endocrinology, The Reproductive Medicine Center, The Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China. 747634147@qq.com.
Zhou P
Department of Reproductive Endocrinology, The Reproductive Medicine Center, The Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China. zhoup_325@aliyun.com.
He X
Department of Reproductive Endocrinology, The Reproductive Medicine Center, The Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China. hxj0117@126.com.
Xu Q
Department of Reproductive Endocrinology, The Reproductive Medicine Center, The Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China. 13721020782@139.com.
Zhang Z
Department of Reproductive Endocrinology, The Reproductive Medicine Center, The Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China. zzg_100@163.com.
Cao Y
Department of Reproductive Endocrinology, The Reproductive Medicine Center, The Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China. caoyunxia6@126.com.
Wei Z
Department of Reproductive Endocrinology, The Reproductive Medicine Center, The Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China. weizhaolian_1@126.com.

MeSH

AdultAnti-Mullerian HormoneCyproterone AcetateDehydroepiandrosteroneDrug CombinationsDrug Therapy, CombinationEstradiolFemaleFertilization in VitroFollicle Stimulating HormoneHumansInfertility, FemaleOvarian ReserveOvulation InductionPregnancyPregnancy RateProspective StudiesTreatment Outcome

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26879683

Citation

Zhang, Huanhuan, et al. "Dehydroepiandrosterone Plus Climen Supplementation Shows Better Effects Than Dehydroepiandrosterone Alone On Infertility Patients With Diminished Ovarian Reserve of low-FSH Level Undergoing In-vitro Fertilization Cycles: a Randomized Controlled Trial." Reproductive Biology and Endocrinology : RB&E, vol. 14, 2016, p. 9.
Zhang H, Chu Y, Zhou P, et al. Dehydroepiandrosterone plus climen supplementation shows better effects than dehydroepiandrosterone alone on infertility patients with diminished ovarian reserve of low-FSH level undergoing in-vitro fertilization cycles: a randomized controlled trial. Reprod Biol Endocrinol. 2016;14:9.
Zhang, H., Chu, Y., Zhou, P., He, X., Xu, Q., Zhang, Z., Cao, Y., & Wei, Z. (2016). Dehydroepiandrosterone plus climen supplementation shows better effects than dehydroepiandrosterone alone on infertility patients with diminished ovarian reserve of low-FSH level undergoing in-vitro fertilization cycles: a randomized controlled trial. Reproductive Biology and Endocrinology : RB&E, 14, 9. https://doi.org/10.1186/s12958-016-0139-z
Zhang H, et al. Dehydroepiandrosterone Plus Climen Supplementation Shows Better Effects Than Dehydroepiandrosterone Alone On Infertility Patients With Diminished Ovarian Reserve of low-FSH Level Undergoing In-vitro Fertilization Cycles: a Randomized Controlled Trial. Reprod Biol Endocrinol. 2016 Feb 16;14:9. PubMed PMID: 26879683.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dehydroepiandrosterone plus climen supplementation shows better effects than dehydroepiandrosterone alone on infertility patients with diminished ovarian reserve of low-FSH level undergoing in-vitro fertilization cycles: a randomized controlled trial. AU - Zhang,Huanhuan, AU - Chu,Yaping, AU - Zhou,Ping, AU - He,Xiaojin, AU - Xu,Qianhua, AU - Zhang,Zhiguo, AU - Cao,Yunxia, AU - Wei,Zhaolian, Y1 - 2016/02/16/ PY - 2015/08/20/received PY - 2016/01/13/accepted PY - 2016/2/17/entrez PY - 2016/2/18/pubmed PY - 2016/10/21/medline SP - 9 EP - 9 JF - Reproductive biology and endocrinology : RB&E JO - Reprod Biol Endocrinol VL - 14 N2 - BACKGROUND: This study aimed to assess the effect of dehydroepiandrosterone (DHEA) plus climen (estradiol valerate and cyproterone acetate drug combination) on infertility patients with diminished ovarian reserve (DOR) and to determine if the combination of DHEA plus climen is superior to DHEA alone in improving ovarian response. METHODS: A total of 124 women were randomized into the DHEA group (n = 64) and the DHEA plus climen group (n = 60) for 12 weeks before being subjected to in-vitro fertilization (IVF) cycles. To investigate if there is a FSH-related difference on the effect of the addition of climen, the DHEA group and the DHEA plus climen group were further divided into four subgroups according to a basal FSH level cut-off of 10 mIU/ml. We performed a comparison of Day 3 blood samples before and after treatment and IVF outcome parameters, including AMH, FSH, E2, AFC, oocytes retrieved, MII oocyte numbers, embryo numbers and accumulated embryo scores. RESULTS: After 12 weeks of pretreatment, the DHEA plus climen group demonstrated a significantly higher level of AMH (P = 0.001) and a significantly lower level of FSH (P = 0.001) compared with the DHEA group. When the two groups were divided into four subgroups based on the FSH cut-off of 10 mIU/mL, a significant increase of AMH (P = 0.034) was found in the high-FSH DHEA plus climen group, whereas there was no significant difference in the high-FSH DHEA group (P = 0.322). A significantly higher accumulated score of embryos was observed in the low-FSH DHEA plus climen group compared with the low-FSH DHEA group (P = 0.034). CONCLUSIONS: These observations suggest that patients with DOR of a low-FSH level might benefit more from DHEA plus climen supplementation than from DHEA supplementation alone. SN - 1477-7827 UR - https://www.unboundmedicine.com/medline/citation/26879683/Dehydroepiandrosterone_plus_climen_supplementation_shows_better_effects_than_dehydroepiandrosterone_alone_on_infertility_patients_with_diminished_ovarian_reserve_of_low_FSH_level_undergoing_in_vitro_fertilization_cycles:_a_randomized_controlled_trial_ DB - PRIME DP - Unbound Medicine ER -
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