Does Dehydroepiandrosterone supplementation improve reproductive outcomes in patients with normal ovarian reserve undergoing in vitro fertilization? A systematic review and meta-analysis

Abstract

Objective

The aim of this systematic review and meta-analysis is to study the efficacy of Dehydroepiandrosterone in patients with normal ovarian reserve undergoing in vitro fertilization treatment.

Design

Systematic review and meta-analysis.

Setting

Centers for reproductive care.

Patients

Patients with normal ovarian reserve (NOR) undergoing in vitro fertilization treatment and previously supplemented or not with DHEA.

Intervention

A comprehensive electronic literature search was conducted in Pubmed, the Cochrane Library and Web of Science up to March 2021. Randomized controlled trials studying the effect of DHEA supplementation on reproductive outcomes in patients with normal ovarian reserve were included.

Main outcome measures

The outcomes of interest were miscarriage rate, clinical pregnancy rate and live birth rate per embryo transfer.

Results

DHEA supplementation, compared with placebo or no treatment, was associated with a significant decrease in miscarriage rate (OR = 0.30, 95% CI: 0.10–0.93; p = 0.04) in DHEA group. In contrast, there were no statistically significant differences in live birth rate (OR = 1.52, 95% CI: 0.8–2.89; p = 0.2) or clinical pregnancy rate (OR = 1.19, 95% CI: 0.73–1.95; p = 0.47) per embryo transfer. There were also no statistically significant differences in the number of oocytes (MD = 0.66 95% CI: - 0.04–1.36; p = 0.07) or metaphase II oocytes retrieved (MD = 0.32 95% CI: − 0.12–0.76; p = 0.16) in one IVF cycle between the two groups.

Conclusions

Our study suggested that DHEA supplementation could improve the miscarriage rate in NOR patients who underwent IVF treatment. However, no increase in clinical pregnancy rate, live birth rate or number of oocytes retrieved per IVF cycle could be demonstrated.