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DHEA for Fertility

DHEA for fertility is used in treatments by approximately 1/3 of all IVF centers around the world. One of the interesting observations that CHR has made in their DHEA treated patients (with very, very severely diminished ovarian reserve) is not only that they are getting a surprising number of pregnancies but once these women get pregnant their miscarriage rates are surprisingly low as well.

We, like most of our colleagues, used to believe that as a woman gets older, the eggs she is born with, age. And that it is that aging process that leads to all the troubles afterwards in older women: poor quality eggs, more chromosomal abnormalities, more miscarriages, etc. Our center was instrumental in bringing DHEA into the infertility treatment and today, based on a recent survey, approximately 1/3 of all IVF centers around the world have started using DHEA and I wouldn’t be surprised if by now the number is even bigger. One of the interesting observations that we have made in our DHEA treated patients, with very, very severely diminished ovarian reserve, is not only that we are getting a surprising number of pregnancies but once these women get pregnant our miscarriage rates are surprisingly low. Such low miscarriage rates could not be achieved if indeed the eggs these women were born with aged and declined in quality because once an egg is of poor quality no DHEA or no drug that I can think about can reverse that kind of a process, it would seem irreversible. And as we recognized that we started thinking about what could really explain our observation of low miscarriage rates in these DHEA treated patients, and then it came to us that what likely is happening is that the very immature egg, the egg in storage if I may call it that, the egg that has not yet been recruited into maturation, that’s the egg a woman is born with. We think that egg at this very immature stage actually does not age, it’s suspended in time, even if women age. What is aging is the ovarian environment in which this egg,once it is recruited into maturation, goes through the maturation process. And when you think about this, that explains perfectly how DHEA can and probably does work because if this environment in an older woman is lacking DHEA, and if DHEA has an important function in this environment, then supplementing DHEA can improve the environment and therefore an initially perfect immature egg allow again a much healthier and better maturation process.