The experimental focus of this project is on the interaction of DHEA treatment on pregnancy in women with open tubes, fertile male partners and evidence of premature ovarian failure.
Recruitment: * New patients presenting for Donor egg cycles * Possible print, magazine or Radio advertisement Experimental plan: 1. Informed consent 2. Baseline studies * Antral follicle counts * Serum FSH, LH, E2, Prog, DHEA, DHEAS, testosterone, AMH, Fragile X 3. Randomization * Group A: DHEA (25 mg three times per day) * Group B: Placebo 4. Monitoring during treatment * All participants will have: * USG for follicle measurement * Repeat serum, FSH, E2, DHEA, DHEAS, testosterone, AMH monthly during treatment. * Physical examination * Completion of study questionnaire regarding possible androgen effects of treatment 5. Analysis plan: * Primary Outcome * Pregnancy * Pregnancy rates will be compared using logistic regression with age and pre-treatment AMH as covariates. * Secondary Outcomes * Endocrine Factors * Androgen side effects * Primary analysis. We will perform a factorial ANOVA for the two pretreatment factors DHEA and Placebo. Baseline AMH and age as main covariates * Secondary analysis. * Examine rate of change of estradiol and other endocrine response over the four cycles of treatment * Compare antral follicle counts across cycles between groups * Compare possible androgen related effects * Power considerations: * Power assumptions: alpha 0.05; 80% power Spontaneous Pregnancy rate for POF is less than 1% per 3 months Intervention will improve pregnancy rate to 10% per 3 months. Patients will be treated for 3 cycles. Require 100 patients to complete treatment in each group. Allow for 20% dropout will need 120 patients randomized to each group * Randomization: Randomization will be by permuted blocks in order to maintain an even distribution among the groups (because of the small numbers of participants) * Human subjects issues * Potential risks associated with DHEA use * Potential risk of delay of treatment for 3 months and possible natural continued loss of fertility * Informed consent issues
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
5
25 mg PO TID
Blinded placebo
Center for Human Reproduction
New York, New York, United States
Live Birth
Time frame: 24 months
Live Birth
Live Birth outcome compared between DHEA active treatment and Placebo
Time frame: 9 months
Endocrine Effects
Time frame: 12 months
Androgen Side Effects
Time frame: 12 months
Clinical Pregnancy
Time frame: 12 months
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