Pregnancy Chances in Women over the Age of Forty


  • Hanan AbdulJabbar Al-Taee Medical college /Babylon university/Iraq


Ovarian Reserve, Dehydroepiandrosterone (DHEA) supplementation, ovarian stimulation


Objective:To determine whether Dehydroepiandrosterone (DHEA)  improve ovarian response and pregnancy potential in women  whose age is ≥ 40 years, and whether such potential is age dependent.

Methods: Between January 2013 and October 2013, 39 infertile women ≥ 40 years were prospectively evaluated for ovarian response and pregnancy chances without and with DHEA treatment (A= 22 normal ovarian reserve & B= 17 poor ovarian reserve).

Results:  Group B women have  a significant lower baseline Anti Mullerian Hormone and Estradiol indicating a poor ovarian reserve. There were insignificant difference between the two  groups in term of follicle numbers after controlled ovarian stimulation, and the pregnancy rate is significantly better in group A.

Conclusion: our study failed to demonstrate any beneficial effect of DHEA to improve OR in women above or = 40 with baseline poor OR in term of  follicular recruitment and pregnancy rate after controlled ovarian stimulation. Efficacy of androgen supplementation with DHEA seems to vary depending on female age and baseline OR.


Author Biography

Hanan AbdulJabbar Al-Taee, Medical college /Babylon university/Iraq

department of physiology


Barad DH, Weghofer A and Gleicher N, “Age-specific level of basal follicle stimulating hormone assessment of ovarian functionâ€.Obstet. Gynecol.109, 1404–1410, 2007a.

Vav Roij IA, Broekmans FJ, Scheffer GJ Looman CW, Habbema JD et al. â€Serum antimullerian hormone levels best reflect the reproductive decline with age in normal women with proven fertility: a longitudinal studyâ€. Fertil. Steril. 83,979–987,2005.

Casson PR, Lindsay MS, Pisarska MD, Carson SA and Buster JE â€Dehydroepiandrosterone supplementation augments ovarian stimulation in poor responders: a case seriesâ€. Hum.Reprod.15:2129–2132,2000.

Barad D and Gleicher N “ Increased oocyte production after treatment with dehydroepiandrosteroneâ€. Fertil. Steril. 84, 756,2005.

Barad D and Gleicher N “ Effect of dehydroepiandrosterone on oocytes and embryo yields, embryo grade and cell number in IVF “.Hum.Reprod. 21, 2845–2849,2006.

Barad D, Brill H, Gleicher N †Update on the use of dehydroepiandrosterone supplementation among women with diminished ovarian function “. J. Assist. Reprod. Genet. 24, 629–634,2007b

Gleicher N, Ryan E, Weghofer A , Blanco-Mejia S. and Barad DH, “ Dehydroepiandrosterone (DHEA) reduces miscarriage rates in women with diminished ovarian reserve: a multicenter study “.Reprod. Biol.Endocrinol. 7,108 ,2009.

Hugues N. Reply “ Effects of transdermal testosterone application on the ovarian response to FSH in poor responders undergoing assisted reproduction technique–a prospective randomized doubleâ€blind study. Hum Reprod ,21:3027 â€3028, 2006.

Tremellen KP, Kolo M, Gilmore A and Lekamge DN †Anti-mullerian hormone as marker of ovarian reserveâ€. Aust. J.Obstet.Gynaecol. 45, 20–24, 2005.

Gleicher N, Weghofer A, and Barad DH †Improvement in diminished ovarian reserve after dehydroepiandrosterone supplementation “. Reprod.Bio Medicine Online 21, 360–365, 2010.

Weghofer A, Dietrich W, Barad D H and Gleicher N†Live birth chances in women with extremely low-serum anti-Mullerian hormone levelsâ€. Hum . Reprod,26, 1905–1909,2011.

Ryan KJ, Petro Z, Kaiser J.†Steroid formation by isolated and recombined ovarian granulosa and tehcal cells “. J Clin Endocrinol. Metab; 28:355–358,1968.

Vendola KA, Zhou J, Adesanya OO, Weil SJ and Bondy CA “ Androgens stimulate early stages of follicular growth in the primate ovary “. J Clin Invest.101 (12):2622â€9, 1998.

Weil S, Vendola K, Zhou J and Bondy CA.†Androgen and follicle-stimulating hormone interactions in primate ovarian follicle development.†J Clin Endocrinol Metab, 84:2951–2956,1999.

Walters KA, Simanainen U and Handelsman DJ †Molecular insights into androgen actions in male and female reproductive function from androgen receptor knockout models “. Hum Reprod Update,11,543–558 , 2010.

Nielsen ME, Rasmussen IA, Kristensen SG, Christensen ST, Møllgard K, et al.(2011): In human granulosa cells from small antral follicles, androgen receptor mRNA and androgen levels in follicular fluid correlate with FSH receptor mRNA. Mol Hum.Reprod.17:63–70.

Arlt W, Justl HG, Callies F, Reincke M, Hubler D, Oettel M, Ernst M,Schulte HM, Allolio B, “Oral dehydroepiandrosterone for adrenal androgen replacement: pharmacokinetics and peripheral conversion to androgens and estrogens in young healthy female after dexamethasone suppression “. J Clin. Endocrinol Metab; 83,1928–1934, 1998.

Haning RV Jr, Hackett RJ, Flood CA, Loughlin JS, Zhao QY, Longcope C.,†Plasma dehydroepiandrosterone sulfate serves as a prehormone for 48% of follicular fluid testosterone during treatment with menotropins “. J Clin Endocrinol Metab, 76,1301– 1307,1993.

Gleicher N, Weghofer A and Barad DH, “Defining ovarian reserve to better understand ovarian agingâ€. Reprod Biol Endocrinol, 9,23,2011.

Walters KA, Allan CM and Handelsman DJ , †Androgen actions and the ovaryâ€, Biol Reprod,11,380–389,2008.

Menezo Y, Dale B and Cohen M †DNA damage and repair in human oocytes and embryos: a review†Zygote,11,357–365,2010.

Pitteloud N, Mootha VK, Dwyer AA, Hardin M, Lee H, et al .†Relationship between testosterone levels, insulin sensitivity, and mitochondrial function in men†Diabetes Care,11,1636–1642, 2005.

Zeleznik AJ, Littleâ€Ihrig L and Ramasawamy S “ Administration of dihydrotestosterone to rhesus monkeys inhibits gonadotropin stimulated ovarian steroidogenesisâ€.J Clin Endocrinol Metab,89 ,2,860â€6,2004.

Kilani Z, Shaban M, Haj Hassan L, Sherbiny W†Ovarian Stimulation Is Detrimental To IVF Outcome†KAJOG, 1,3,101-106,2010.

Narkwichean A, Maalouf W, [...], and Jayaprakasan K†Reproductive Biology and Endocrinology: Efficacy of dehydroepiandrosterone to improve ovarian response in women with diminished ovarian reserve: a meta-analysisâ€, 11,44,2013.




How to Cite

Al-Taee, H. A. (2013). Pregnancy Chances in Women over the Age of Forty. Asian Journal of Pharmacy, Nursing and Medical Sciences, 1(4). Retrieved from