Premature Ovarian Aging (POA): Can It Be Treated?

Women who have premature ovarian aging, which causes diminished or low ovarian reserve, can possibly be helped with a hormone called DHEA (dehydroepiandrosterone). The Center for Human Reproduction (CHR), a New York fertility clinic that specializes in patients with premature ovarian aging, has been treating patients with DHEA since 2004 with significant success.

DHEA is a natural steroid hormone produced primarily by the adrenal gland located on top of the kidneys. When DHEA is released into your bloodstream, your body uses it to make testosterone and estrogens. "DHEA is a mild male hormone that both women and men produce," says Norbert Gleicher, M.D., medical director for CHR. "Our DHEA levels decline as we get older."

The researchers at CHR have published studies showing that DHEA:

• Improves spontaneous pregnancy rates
• Decreases the amount of time that it takes a woman to become pregnant
• Increases the amount of eggs retrieved in in vitro fertilization (IVF) treatments

"Over 90 percent of women who come to our center have significantly diminished ovarian reserve — either because of age or because of premature ovarian aging — and have previously failed treatment in other centers," says Dr. Gleicher. "And in over 60 percent of cases, they have been told to go to egg donation. So we are talking about a very adversely selected patient group. Now in those very adversely selected patients, after DHEA supplementation, we are still getting a very good number of pregnancies reported, even with undetectable AMH levels or very low very low AMH levels and relatively high FSH levels."

In addition, the researchers investigated aneuploidy rates in embryos with a case-controlled study where they matched IVF patients on DHEA with patients who were not on DHEA and performed preimplantation genetic screening on the embryos. They found that DHEA:

• Improves the quality of embryos
• Reduces aneuploidy (chromosomal abnormalities) in embryos
• Reduces the incidence of miscarriages

"We published papers showing that the miscarriage rate in women who got pregnant on DHEA is much lower than one would expect —it's about 50 to 80 percent decreased in comparison to the national IVF miscarriage rates reported," Dr. Gleicher explains. "And when we saw that, our statisticians told us that you cannot get such a decrease in miscarriage rates without affecting aneuploidy and chromosomal abnormalities. And we started investigating that, and we found that the number of chromosomal abnormalities after DHEA supplementation is greatly reduced."

CHR researchers are currently investigating the effect of DHEA on women in premature ovarian failure.