Explorative Analyse zum Einfluss von Dehydroepiandrosteronsulfat in humaner Follikelflüssigkeit auf deren Hormonmetabolismus und den Erfolg der assistierten Reproduktionstherapie
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Philipps-Universität Marburg
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Abstract
Assisted reproductive technology is used to aid becoming pregnant in couples with difficulties achieving pregnancy. For an optimal success in assisted reproductive technology, the scientific fundamentals of the hormonal interaction und potential biomarkers must be understood. Whether a nutritional supplementation of Dehydroepiandrosterone (DHEA) could increase the success in achieving pregnancy or not is a topic of ongoing discussion in the literature. Until now, the existence of a correlation between the Dehydroepiandrosterone sulfate (DHEAS) concentration in follicular fluid with other hormones is yet to be unmistakenly proven. There is still a lack of understanding of the influence of such correlation on the outcomes of assisted reproductive technology. To adress this topic, this prospective, explorative study was designed. The aim was to investigate if there are correlations between the concentration of DHEAS in follicular fluid and other hormones and whether a connection between DHEAS concentration and the success in the assisted reproductive technology could be found.
This study included patients who underwent a controlled ovarian stimulation with Invitro fertilisation or intracytoplasmatic spermia injection therapy at the Reproduction Competence Center of the University Hospital in Marburg, Germany, between November 2018 and December 2019. In total 327 follicles from 54 patients were analysed seperatly. It was ensured that fluids from different follicles were not mixed. The oocytes were selected from the fluid and incubated seperately. The aim of this study was to analyse a
huge variety of different follicle diameters per patient. The results were not corrected for multiple testing.
This study confirmed that the concentration of DHEAS in the follicular fluid correlated strongly positive with the DHEAS concentration of the serum (r = 0,918, p < 0,001). The DHEAS concentration was shown to be higher in the follicular fluid than in serum. The mean of quotients of the concentration of DHEAS in follicular fluid to serum concentration was: 1,433 μg/ml. Upon comparison between the follicles of a given patient, there
was no significant difference in the DHEAS concentration. Logically it was additionally proven that DHEAS concentration in the follicular fluid was not influenced by either the size of the follicle or the presence of an oocyte. Upon comparison between different patients there was a significant variation shown in the mean concentration of DHEAS in the follicular fluid.
No correlation was found between DHEAS follicular fluid concentration and the concentrationin follicular fluid of Estradiol, Testosteron or Insuline-like-Growth-Factor-1. There was a weak positive correlation between DHEAS and the Anti-Müllerian hormone found. The DHEAS concentration correlated weakly positive with the total number of follicles and oocytes as well as with the fraction of successully fertilised oocytes. The correlation between the DHEAS concentration and the fraction of mature oocytes was weakly negative. The DHEAS concentration in the follicular fluid was 30% higher in the group of patients with pregnancy occurence compared to the group without occurence. In the group with live birth the DHEAS concentration was 34% higher compared to the group without live birth. The binary logistic regression could not present any predictability from the follicular fluid concentration of DHEAS on pregnancy onset. In this study it was shown that the follicular fluid concentration of DHEAS is dependent on the serum concentration and that the concentration in follicular fluid is higher than in serum. Local production of DHEAS in the follicle is not known yet. Therefore it could be assumed that DHEAS accumulates in the follicular fluid because of active transport
processes. The postualted positive effect of DHEAS on the success of assisted reproductive technology
cannot only result from the conversion of the prohormone to testosterone and estradiol and their effects. Moreover, it shows that there could be a direct enhancing effect of DHEAS on the success of the assisted reproductive technology. The increase in Insulin-like-growth-factor-1 und Anti-Müllerian hormone concentrations decsribed after DHEA supplementation in the literature should be seen as caused by the increase in the total follicle amount.
The results show that DHEAS cannot be used as a biomarker to distinguish between the quality of different follicles in one woman. The concentration of DHEAS was significantly higher in the group of pregnant patients and widely varying among the patients. Therefore, it is impossible to define certain value ranges in which a pregnancy would become more likely. Nevertheless, this data provides an indication of a possible influence
of DHEAS on the success of assisted reproductive technology.
From this explorative study no conclusions can be drawn on the causality. The data suggests a sligth positive influence from DHEAS on the success of the assisted reproductive technology. In conclusion, larger studies to investigate the correlation between the concentration of DHEAS in the follicular fluid and the succes of the assisted reproductive technology, especially referred to a possible advantage of DHEA as a food supplement,
are required.
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Created: 2024Issued: 2025-08-11Updated: 2025-08-11
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
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DoctoralThesis
Keywords
DHEASIVFdehydroepiandrosterone sulfateReproductive medicinefollicular fluid
DFG-subjects
DehydroepiandrosteronsulfatIVFFollikelflüssigkeitReproduktionsmedizinDHEAS
DDC-Numbers
610
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Huschka, Dorothea: Explorative Analyse zum Einfluss von Dehydroepiandrosteronsulfat in humaner Follikelflüssigkeit auf deren Hormonmetabolismus und den Erfolg der assistierten Reproduktionstherapie. : Philipps-Universität Marburg 2025-08-11. DOI: https://doi.org/10.17192/z2025.0023.
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This item has been published with the following license: In Copyright