***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The aim of this study was to investigate the effect of treatment with dehydroepi and rosterone ( DHEA ) on fertility outcomes among women with diminished ovarian reserve . MATERIAL S AND METHODS This is a case-control study in an academically affiliated private infertility centre . Twenty-five women with significantly diminished ovarian reserve had one IVF cycle before and after DHEA treatment  , with otherwise identical hormonal stimulation . Women received 75 mg of DHEA daily ( 25 mg three times daily ) for an average of 17.6 + /- 2.13 weeks . We performed a comparison of IVF outcome parameters , before and after DHEA treatment , including peak estradiol ( E(2 ) ) levels , oocyte and embryo numbers , oocyte and embryo quality and embryo transfer statistics . RESULTS Paired analysis of IVF cycle outcomes in 25 patients , who underwent cycles both before and after DHEA supplementation , demonstrated significant increases in fertilized oocytes ( P < 0.001 ) , normal day 3 embryos ( P = 0.001 ) , embryos transferred ( P = 0.005 ) and average embryo scores per oocyte ( P < 0.001 ) after DHEA treatment . CONCLUSION This study confirms the previously reported beneficial effects of DHEA supplementation on ovarian function in women with diminished ovarian reserve OBJECTIVES It is difficult to choose the correct fertility treatment in women with poor ovarian reserve . Although various methods have been used , the management of controlled ovarian hyperstimulation is not easy in poor responders . The aim of this study was to evaluate the efficacy of dehydroepi and rosterone ( DHEA ) on in vitro fertilization-intracytoplasmic sperm injection ( IVF-ICSI ) outcome of poor responders . STUDY DESIGN This was a r and omized , prospect i ve controlled trial . Women with serum antimullerian hormone<1 ng/ml or serum follicle-stimulating hormone>15 IU/l and antral follicle count < 4 on day 2 of the menstrual cycle were considered to have poor ovarian reserve . All women were treated with a microdose induction protocol . Women in the study group received IVF-ICSI and DHEA 75 mg daily for 12 weeks . Women in the control group received IVF-ICSI without DHEA supplementation . RESULTS In total , 208 women with diminished ovarian reserve was enrolled in the study , 104 in the study group and 104 in the control group . The number of oocytes retrieved and the fertilization rate were slightly higher in the study group , but the pregnancy rate was higher in the control group . The differences were not significant . CONCLUSIONS The results failed to show that DHEA supplementation enhances IVF-ICSI outcome in women with poor ovarian reserve Background With infertility population s rapidly aging , treatments improving pregnancy chances assume increasing clinical importance . Dehydroepi and rosterone ( DHEA ) has been reported to improve pregnancy rates and lower miscarriage rates in women with diminished ovarian function . This study was planned to evaluate whether pretreatment with DHEA may improve in vitro fertilization ( IVF ) parameters and pregnancy outcomes in infertile women with advanced reproductive age and normal ovarian reserve . Methods In this double-blind , r and omized , placebo-controlled study , 109 infertile patients aging 36–40 years old were selected to undergo the long protocol IVF . Eight weeks before starting the IVF cycle and during treatment , patients in Group 1 received 75 mg of DHEA once a day ; patients in control group ( Group 2 ) received placebo . The primary endpoint of the study was number of clinical pregnancy , live birth and miscarriage rates ; secondary endpoint was modification of st and ard IVF parameters , including stimulation duration ( days of rhFSH administration ) , E2 on HCG-day , endometrial thickness , number of retrieved oocytes , metaphase II oocytes , number of transferred embryos and score of leading embryos transferred . Results Patients in the DHEA group had a significantly higher live birth rate compared with controls ( P < 0.05 ) . Conversely , miscarriage rate was higher for patients in the control group ( P < 0.05 ) . Conclusions DHEA supplementation may significantly improve IVF outcomes in infertile women with advanced reproductive age and normal ovarian reserve BACKGROUND The aim of this study was to evaluate the effect of dehydroepi and rosterone ( DHEA ) supplementation on in vitro fertilization ( IVF ) data and outcomes among poor-responder patients . METHODS A r and omized , prospect i ve , controlled study was conducted . All patients received the long- protocol IVF .  Those in the study group received 75 mg of DHEA once a day before starting the next IVF cycle and during treatment . RESULTS Thirty-three women with significantly diminished ovarian reserves were enrolled , 17 in the DHEA group and 16 in the control group . The 33 patients underwent 51 IVF cycles . The DHEA group demonstrated a non-significant improvement in estradiol levels on day of hCG ( P = 0.09 ) and improved embryo quality during treatment ( P = 0.04 ) between first and second cycles . Patients in the DHEA group also had a significantly higher live birth rate compared with controls ( 23.1 % versus 4.0 % ; P = 0.05 ) , respectively . Six of seven deliveries were among patients with secondary infertility ( P = 0.006 ) . CONCLUSION Dehydroepi and rosterone supplementation can have a beneficial effect on ovarian reserves for poor-responder patients on IVF treatment . Clinical trials.gov : NCT01145144 Abstract Objective : To investigate whether laboratory strategies can improve in vitro fertilization ( IVF ) outcome in poor responder patients . We compared the effectiveness of conventional IVF and intra cytoplasmic sperm injection ( ICSI ) in assisted reproductive technologies cycles in which only one or two oocytes were retrieved at ovarian pick up , in the absence of male infertility . Design : Retrospective analysis of 425 cycles in 386 poor responder patients . Intervention(s ) : St and ard stimulation protocol with gonadotropins and gonadotropin releasing hormone ( GnRH ) antagonist . Main outcome measure(s ) : Fertilization rate , cleavage rate , good- quality embryo rate , implantation rate , clinical pregnancy rate ( PR ) and miscarriage rate . Results : IVF was found to be more advantageous for implantation and PR , especially in patients under 35 years and in women aged between 35 and 38 years . No differences were noted in the other parameter evaluated . Patients aged over 38 years showed no difference using the two techniques . Conclusion : The employment of ICSI in the absence of a male factor can reduce reproductive outcome in poor responder . Probably because of aging-related defects overcoming the advantage of sperm selection , the choice of IVF technique is not relevant to reproductive success when oocyte quality is compromised by reproductive aging . Although further r and omized trials are needed to confirm our results , we propose that , in absence of male infertility , conventional IVF might be the technique of choice in young patients , especially in those aged below 35 years OBJECTIVE To determine the effect of administering 6 months of oral postmenopausal DHEA therapy on serum DHEA , DHEAS , and T levels and on physiologic endpoints including lipoproteins and insulin-like growth factor-I ( IGF-I ) . DESIGN R and omized , double-blind , parallel trial . SETTING Academic referral practice . PATIENT(S ) Thirteen normal-weight or overweight , healthy , nonsmoking , postmenopausal women . INTERVENTION(S ) Administration of oral micronized DHEA ( 25 mg/d ) . MAIN OUTCOME MEASURE(S ) Monthly fasting 23 hours postdose levels of serum DHEA , DHEAS , T , lipoproteins , IGF-I , IGF binding protein-3 ( IGFBP-3 ) , and liver function tests . Morphometric indices by dual-energy x-ray absorptiometry scan ( percent body fat ; lean body mass ) , immune indices , and insulin sensitivity . RESULT ( S ) Levels of DHEA , DHEAS , and T all rose into premenopausal ranges , but after 6 months , levels of DHEA and T did not differ from baseline or placebo . At 3 months , the ratio of IGF-I to IGFBP-3 rose by 36.1 % + /- 12.7 % , but it fell to placebo values by 6 months . High-density lipoprotein and apolipoprotein A1 levels declined . CONCLUSION ( S ) Patients appeared to tolerate 6 months of DHEA therapy well . Given the small study size , no statistically significant differences in morphometric indices , immune indices , or insulin-sensitizing properties were observed , but significant attenuation of bioavailability occurred . Supplementation with DHEA increased IGF-I/IGFBP-3 levels at 3 months and decreased high-density lipoprotein and apolipoprotein A1 levels at 6 months Abstract The aim of this article is to describe unexpected spontaneous pregnancies in poor responder patients with long-term infertility , when treated with dehydroepi and rosterone ( DHEA ) supplementation prior to in vitro fertilization ( IVF ) . Our evaluation was carried out in two groups of women . The first group included 39 young women with < 40 years , all treated with DHEA because of a previous poor response . The second group included 38 women over 40 years who received DHEA supplementation . Controls for latter group were 24 comparable women who had not been treated with DHEA before the first IVF cycle to evaluate the spontaneous pregnancy rate during preparation to IVF . Three tablets daily of 25 mg micronized DHEA were administered for at least 12 weeks before starting a long stimulation protocol for IVF . Surprisingly , spontaneous pregnancy rate significantly increased after DHEA treatment , allowing to achieve 10 spontaneous pregnancies and 9 spontaneous ongoing pregnancies among young poor responders . Pregnancy rate and ongoing pregnancy rate obtained before starting the IVF cycle were also significantly higher in older women treated with DHEA than in the control group : 21.05 % and 13.15 % and 4.1 % and 0 , respectively . Our results show that DHEA supplementation improves the ovarian function in poor responders and in women over 40 years , suggesting that this molecule alone can raise fecundity and fertility treatment success in women with poor prognosis for pregnancy OBJECTIVE To identify baseline characteristics of couples that are likely to predict conception , clinical pregnancy , and live birth after up to four cycles of ovarian stimulation with IUI in couples with unexplained infertility . DESIGN Secondary analyses of data from a prospect i ve , r and omized , multicenter clinical trial investigating pregnancy , live birth , and multiple pregnancy rates after ovarian stimulation-IUI with clomiphene citrate , letrozole , or gonadotropins . SETTING Outpatient clinical units . PATIENT(S ) Nine-hundred couples with unexplained infertility who participated in the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation clinical trial . INTERVENTION(S ) As part of the clinical trial , treatment was r and omized equally to one of three arms and continued for up to four cycles or until pregnancy was achieved . MAIN OUTCOME MEASURE(S ) Conception , clinical pregnancy , and live-birth rates . RESULT ( S ) In a multivariable logistic regression analysis , after adjustment for other covariates , age , waist circumference , income level , duration of infertility , and a history of prior pregnancy loss were significantly associated with at least one pregnancy outcome . Other baseline demographic and lifestyle characteristics including smoking , alcohol use , and serum levels of antimüllerian hormone were not significantly associated with pregnancy outcomes . CONCLUSION ( S ) While age and duration of infertility were significant predictors of all pregnancy outcomes , many other baseline characteristics were not . The identification of level of income as a significant predictor of outcomes independent of race and education may reflect differences in the underlying etiologies of unexplained infertility or could reveal disparities in access to fertility and /or obstetrical care . CLINICAL TRIAL REGISTRATION NCT01044862 AIM The aim of this paper was to evaluate the hypothesis that pretreatment with dehydroepi and rosterone ( DEHA ) may improve the result on in vitro fertilization ( IVF ) and the pregnancy outcome among infertile women with normal ovarian reserve . METHODS Double-blind , r and omized , placebo-controlled study ; 52 infertile patients received the long protocol IVF . Patients in Group 1 , received 75 mg of DHEA once a day , 8 weeks before starting the IVF cycle and during treatment ; control group ( Group 2 ) received placebo . The primary endpoint was pregnancy , live birth and miscarriage rates , secondary endpoint was st and ard IVF parameters such us stimulation duration ( hCG day ) , E2 on HCG-day , endometrial thickness , number of retrieved oocytes , metaphase II oocytes , embryos transferred and score of leading embryos transferred . RESULTS Patients in the DHEA group had a significantly higher live birth rate compared with controls ( P<0.05 ) . Miscarriage rate was higher in control group ( P<0.05 ) . CONCLUSION DHEA supplementation could have a beneficial effect on IVF outcome in infertile 
    Output:
    
DHEA supplementation could significantly improve clinical pregnancy , live birth rate , endometrial thickness and retrieved oocytes but failed to alter E2 on hCG day , embryos transferred and miscarriage rate