Evening primrose is a flowering plant native to North America; the oil extracted from this plant contains omega-6 and omega-3 fatty acids. There are several purported ways that evening primrose oil supports fertility:
Vitamin D is an interesting case, because, while the mechanism by which it affects fertility is still unclear, the correlations between blood vitamin D levels and conception rates are well established. In one review of 2,700 subjects, researchers found that women with sufficient levels of vitamin D had higher pregnancy and live birth rates than insufficient and deficient women. Another analysis of 1,191 women also concluded that women with sufficient concentrations of vitamin D in their blood were more likely to achieve clinical pregnancy than women with insufficient concentrations.
Only three studies recorded abortion rates and in all of them the rates were lower inthose groups that had been given DHEA (Wiseret al., 2010; Vlahoset al., 2015; Barad& Gleicher, 2006). In all studies, the authors corrected for thepresence of confounding variables such as partner's age, infertility diagnosis andnumber of transferred embryos (Xu etal., 2014; Wiser etal., 2010; Kotb etal., 2016; Vlahos etal., 2015; Barad &Gleiche, 2006).
The mechanism of action whereby DHEA use might improve oocyte quality and orendometrium receptivity is yet to be elucidated, which is clinically translated intoan improved pregnancy rate and a decrease in the abortion rate. In addition, it isyet to be determined whether there are differences between the different PORprofiles (previous poor ovarian response age, or altered ovarian reserve tests) andDHEA use prior to ovarian stimulation.
It was left to a 43 year old infertility patient to rediscover their paper, searching the literature for remedies to overcome DOR. She, in a first in vitro fertilization (IVF) cycle, had produced only a single egg and embryo, and was advised to consider oocyte donation . This lay-person, reviewing the medical literature, amongst various suggested treatment options for improving low egg counts, chose DHEA because it was the only medication in the United States (US) available without prescription (DHEA in the U.S. is considered a food supplement).
Depending on statistical method utilized, pregnancy loss after DHEA supplementation was reduced by 50 to 80 percent in comparison to national U.S. IVF pregnancy rates, a conclusion further strengthened by the following: (i) Miscarriage rates in Toronto and New York were practically identical (15.2 and 15.0%, respectively); (ii) The U.S. national IVF registry, used as control population, in contrast to DHEA patients, included only relatively few DOR patients. Women with DOR are known to demonstrate significantly increased miscarriage rates in comparison to other infertility etiologies .
The, likely, most important study in support of essential androgen effects on follicle development and normal female fertility was recently, however, reported by Sen and Hammes . These two authors were encouraged towards their study by previously reported observations in global androgen receptor knockout (ARKO) female mice, characterized by reduced androgen signaling, and subfertility. The mice also demonstrate defective folliculogenesis, decreased antral follicle counts and corpora lutea, exhibit higher granulose cell apoptosis, are resistant to ovarian stimulation with gonadotropins and often develop POF.
While androgen excess in animal and human experience has widely been associated with excessive and unregulated follicle formation, Sen and Hammes suspected that androgen signaling via androgen receptors may actually be important for normal follicle development and function. Since androgen receptors are widely expressed in different cell types, they decided to determine which androgen receptor - expressing cells contribute to ovarian function and fertility in female ARKO mice.
Once recruited, they, however, enter age-dependent ovarian environments where follicle maturation takes place. These ovarian environments can be of different quality and will, uniformly, deteriorate as women age. As proposed by Hodges et al, these environments affect segregation processes during meiosis, giving rise to increased aneuploidy at older ages. Hodges and associates, however, also pointed out that these envrironments, and with it aneuploidy and miscarriage rates, may be open to pharmacologic manipulation .
Patients often ask the team at our Austin infertility center whether a fertility supplement can help them conceive. However, most supplements have no research supporting their effectiveness. Others can even negatively affect fertility treatments. Many women have questions about DHEA for fertility. Specifically, they want to know if it could help women who have a diminished egg supply (ovarian reserve).
Until recently, IVF and donor eggs were the only fertility treatments available for women with poor egg quality. However, new research into DHEA for fertility is making more patients ask our Austin infertility center team whether they should be taking this supplement.
However, researchers stress that we need more studies before suggesting DHEA is an effective treatment for female infertility. Contact our Austin infertility center if you would like to learn more about female fertility supplements.
Our patients visit Texas Fertility Center to achieve their dreams of having a baby. Utilizing advanced tools and technologies, our doctors take on the toughest cases, providing renewed hope for would-be parents. Since TFC opened its doors more than 40 years ago, we have helped our patients deliver 23,000 miracles through IVF, IUI, egg donation, intracytoplasmic sperm injection, and reconstructive fertility surgery. Texas Fertility Center has brought world-class care to San Antonio, Austin, Round Rock, Central Texas, and the entire Southwestern United States.
In addition, it is important to test your DHEA-S and testosterone levels to determine whether supplementing with DHEA may help in your individual case, and to continue testing regularly to monitor whether you are taking the correct dose. (You can also order these tests yourself through Life Extension (US) or Medichecks (UK). See below for a discussion of the optimal level of DHEA for fertility).
The level of DHEA in the bloodstream fluctuates widely, so it is more accurate to measure the sulfated version, DHEA-S. Another way to check whether DHEA levels are adequate is to measure testosterone in the blood. (Because the body uses DHEA to produce testosterone when and where it is needed).
We retroactively compared, utilizing two independent statistical models, miscarriage rates in 73 DHEA supplemented pregnancies at two independent North American infertility centers, age-stratified, to miscarriages reported in a national U.S. in vitro fertilization (IVF) data base.
Since women with diminished ovarian reserve produce only small oocyte and embryo numbers with IVF [6, 9], preimplantation genetic diagnosis (PGD) in association with IVF is only rarely indicated, and, indeed, may be detrimental . To accumulate direct embryo ploidy data in such patients is, therefore, difficult. Seeking alternatives, we were attracted by the fact that spontaneous miscarriage rates to such a large degree reflect aneuploidy rates. This study, therefore, presents pregnancy outcomes after DHEA supplementation from two independent North American fertility centers and compares those with age-specific national USA outcome data after IVF.
This study reports on miscarriage rates, at both fertility centers, independently established under DHEA supplementation, and compares these rates, age-stratified, to miscarriage rates reported in a national USA IVF outcome data base, which involves unselected infertility patients . While study populations at the New York and Toronto centers, thus, involve women with significantly DOR, the national control data reflect only a rather small percentage of women with this primary diagnosis.
Pregnancy and miscarriage rates at both fertility centers were pooled after confirmation of homogeneity of variance. Common odds ratios of the pooled miscarriage rates among age stratified pregnant patients were compared between the pooled centers and 2004 national rates, utilizing the Mantel-Hänszel common odds ratio (tests for homogeneity of the odds ratio across layers were not significant, meeting assumption for use of this test) and using dichotomous exposure (DHEA versus controls) and dichotomous outcomes (live births versus spontaneous miscarriages), stratified by five age categories.
Though infertile women with normal ovarian reserve experience significantly lower miscarriage rates than DOR patients , they still experience higher miscarriage rates than average populations . Here reported miscarriage rates in DHEA treated DOR patients are, therefore, remarkably low and practically identical to those reported for general populations [26, 27]. Caution should, nevertheless, be exercised in concluding that observed DHEA effect can automatically be extrapolated to normal, fertile populations, though such a possibility deserves further investigation. If confirmed, one could perceive DHEA as a routine preconception supplement, akin to prenatal vitamins, even in women with no fertility problems.
Should efficacy of DHEA supplementation be proven not only in infertile patients but also in general populations, the potential significance on public health could be considerable and by far exceed the more imminent utilization of DHEA in fertility practice.
The aim of this article is to describe unexpected spontaneous pregnancies in poor responder patients with long-term infertility, when treated with dehydroepiandrosterone (DHEA) supplementation prior to in vitro fertilization (IVF). Our evaluation was carried out in two groups of women. The first group included 39 young women with
At my acupuncture clinic I see many clients who are undergoing assisted fertility treatments. Some of these clients have undergone numerous rounds of unsuccessful cycles or been given a poor prognosis of becoming pregnant or keeping a pregnancy. In our internet age many women will often start to research ways that they can improve their chances and come in asking questions about information they have found on the internet. 59ce067264