Shulman's group managed to rack up an important research milestone that CHR had failed to accomplish in spite of its six years of important work on the subject: a prospectively randomized study. Shulman and his associates did make sure to mention that fertility experts worldwide, including those from Tel Aviv University had been using DHEA as a boon for female fertility for a number of years based on the work of CHR. The work done by Shulman and his colleagues adds to the body of knowledge about the benefits of DHEA for female factor infertility.
Login to comment Log in or sign up Username: Password:. Login to add a comment. You must be logged in to comment. Connect With Us. Barad are wonderful doctors. Nice employees! Helped us have our first little miracle. Gleitcher is knowledgeable and has vast experience as well. IVF more info. Egg Freezing more info. Donor Eggs more info.
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Second Opinions more info. International Patients more info. This is why physicians at CHR look out for confirmed androgen level improvements in blood with concomitant declines in sex hormone binding globulin SHBG , which usually goes into opposite direction to testosterone levels. It appears that women of African descent are more affected by poor DHEA-to-testosterone conversions than either Caucasian or Asian women.
In the image, these early stages correspond to the pre-antral follicle stage to early antral follicle stage, which can take months. Supplementation can be initiated at any time. The reason is that well-functioning ovaries constantly recruit fresh follicles out of the so-called resting follicle pool , to start a months-long journey of maturation.
The time periods when good testosterone levels are of crucial importance are the so-called small growing follicle stages , ranging from primary follicles to small antral follicles. If, at those stages, the microenvironment of ovaries does not offer follicles adequate testosterone levels, follicle maturation slows down, and even the follicles that are still maturing produce eggs of poor quality.
Small growing follicles require at least weeks of further maturation before reaching the so-called gonadotropin-dependent stage, where they finally become responsive to fertility drugs and, therefore, available for retrieval in IVF cycles. If it is given for a shorter period or only during ovarian stimulation with fertility drugs, the follicles receiving the treatment benefits are still weeks or even months away from the gonadotropin-dependent stage of follicle maturation, and the follicles available in the current treatment cycle will not have received significant benefits from the supplementation.
Without intervention, women with diminished ovarian reserve tend to have a very small number of poor-quality eggs. Poor-quality eggs frequently fail to fertilize, and when they do fertilize, they often develop into poor-quality embryos that stop growing before embryo transfer, fail to implant, or stop developing in the uterus and end in miscarriages. Adding a DHEA supplement for at least weeks before the start of an IVF cycle improves egg quality and results in overall better outcomes.
These beneficial effects on the eggs appear to be exerted through androgen receptors that are on the cells—called granulosa cells—that surround and support the developing eggs. Norbert Gleicher.
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