With the progress of the times and the increase of social pressure, there are more and more late marriage and late childbearing advanced age expectant mothers. The most serious challenge they face is the reduction of ovarian reserve.
Many doctors recommend that women with suboptimal ovarian function take DHEA in hopes of improving the outcome of low ovarian response. So, what exactly is DHEA?
DHEA-Dehydroepiandrosterone, known as the "mother of hormones". Because it is the most abundant steroid substance in the human blood circulation, it is an important precursor hormone for the synthesis of steroid hormones in the follicle, and can contribute to the formation of other sex hormones.
However, with the increase of age, the endocrine of DHEA in the human body gradually decreases. Studies have found that the level of DHEA in people is very low when they are kids, and the secretion increases after the age of 6-7. It peaks around the age of 25, and gradually declines after the age of 30. By the age of 75, it will drop to 20% of its peak.
The Main Role of DHEA
1. Promote follicle growth and maturation
DHEA is an essential substance for the synthesis of steroid hormones, and androgens are precursors of estradiol. If DHEA is abnormally low, it can lead to low levels of these hormones. These hormones are critical for follicle growth and maturation.
2. Increase follicles recruited number
Androgens can induce the production of follicle-stimulating hormone receptor (FSHR) in granulosa cells, promote follicle recruitment, and increase the number of follicles that can be recruited. With the increase of androgen content in the follicle, the secretion of anti-Müllerian hormone (AMH), inhibin B and ICF-1 by granulosa cells increased.
3. Reduced embryo aneuploidy rate
DHEA can reduce the risk of age-related chromosomal aneuploidy by affecting chromosomal segregation during decelerated division, which may at least partially explain the improved embryo quality and increased pregnancy rates.
4. Improve ovarian function
DHEA improves the ovarian microenvironment in patients with low ovarian function and makes them function younger, which may be associated with improved egg, embryo quality, and increased pregnancy rate, and reduced miscarriage rate. In addition, DHEA may also improve vascular function and neurotrophic effects, and regulate immune responses.
Suitable groups:
Patients with advanced age and low ovarian response need to enter ovulation induction therapy or start supplementation 2 months before the IVF cycle, and can be discontinued after confirmation of pregnancy. A small number of patients need multiple consecutive stimulation or IVF cycles, and they can take it continuously.
Clinically, it is recommended for patients with poor ovarian function to take it, hoping to improve the outcome of patients with low ovarian response, but it is not recommended to take it continuously for more than 10 months.
Unsuitable groups:
Children, pregnant women, patients with polycystic ovary syndrome, patients with high androgen manifestations (hirsutism, acne, etc.), people with high serum DHEA-S, etc.
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