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DHEA supplementation may improve pregnancy rates in advanced reproductive age women
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In women of advanced reproductive age, supplementation with dehydroepiandrosterone may improve chances for achieving pregnancy, according to findings from an in vitro study published in Fertility and Sterility.
"A fertilized egg will implant only if the conditions are just right, and we were excited to see that [dehydroepiandrosterone, or DHEA] and androgens might help improve this environment in cells,” Douglas A. Gibson, PhD, of the MRC Centre for Inflammation Research at the University of Edinburgh, said in a press release. “The findings will help us develop studies for potential therapies, but more research is needed before we can tell if this approach could be used to help women who are struggling to conceive."
Gibson and colleagues analyzed proliferative phase primary human endometrial stromal fibroblasts, isolated from 16 healthy women of advanced reproductive age (mean age, 45 years) undergoing unrelated surgery. Included women were naïve to hormone therapy. Cells were decidualized in vitro by incubation in either the presence or absence of 10 nM DHEA. Main outcomes measures were the secretion of androgens by decidualized cells and the expression of decidualization and endometrial receptivity markers.
Researchers found that, at days 4 and 8, decidualized cells exposed to DHEAS secreted 3 times more testosterone into the culture media vs. decidualized cells not exposed to DHEA (P < .0001). Concentrations of dihydrotestosterone also increased in decidualized cells exposed to DHEA, with levels twice as high as decidualized cells not exposed to DHEA by day 4 (P < .01).
The study also suggests that levels of DHEA could play a role in infertility in later life.
“In the current study, we provide the first evidence that DHEA can act as a prohormone to increase intracrine androgen production in [human endometrial stromal fibroblasts] derived from normal endometrium during decidualization,” the researchers wrote. “Furthermore, we demonstrate that the capacity for a robust decidualization response is retained in women of advanced reproductive age and can be enhanced by increasing availability of the androgen precursor DHEA.”
The researchers noted that the results suggest that poor endometrial responses in some older women may reflect deficits in the bioavailability of systemic factors, such as DHEA, rather than functional decline of the cells or tissues.
“These findings support and expand evidence that androgens have the capacity to fine-tune the trajectory of endometrial tissue remodeling, and thus targeting androgen action may be beneficial in improving suboptimal endometrial responses,” the researchers wrote. – by Regina Schaffer
Disclosure: The Medical Research Council funded this study.
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