Does dehydroepiandrosterone (DHEA) improve IVF outcomes in poor responders?

INTERVENTION: Controlled ovarian hyperstimulation and in‐vitro fertilisation. Two groups of poor responders going through IVF (200 in each group). Intervention: 75 mg DHEA daily Control: placebo to take for 10 weeks before their IVF CONDITION: Infertility ; Pregnancy and Childbirth ; Infertility PRIMARY OUTCOME: Clinical pregnancy rates (ultrasound confirmation of a foetus with a heartbeat at 6‐8 weeks gestation) SECONDARY OUTCOME: 1. Ovarian reserve defined AMH levels before and after ten weeks of DHEA supplementation; 2. Number of eggs retrieved; 3. Number and quality (grade) of embryos available for transfer/freezing; 4. Ongoing pregnancies after 14 weeks gestation (miscarriage rates) INCLUSION CRITERIA: Current inclusion criteria as of 24/10/2017: Inclusion criteria are based on the ESHRE definition of poor responders and would include any patient with any two of the following: 1. Age = 40 years 2. Markers for poor ovarian reserve (AMH <7 pmol/L(<1.1 ng/ml) and/or AFC< 7) 3. Previous poor response to ovarian stimulation ( =3 oocytes with a conventional stimulation protocol) Previous INCLUSION CRITERIA: European Society of Human Reproduction and Embryology (ESHRE) criteria for poor responders: 1. Age > 40 years 2. Markers for poor ovarian reserve [Anti‐Mullerian Hormone (AMH) < 0.5 ng/ml (5 pmol/L), Follicle‐Stimulating Hormone (FSH) > 15 IU, Antral Follicle Counts (AFC) < 6] 3. Previous poor response to ovarian stimulation (less than three mature follicles on day of hCG trigger/cycle cancellation due to poor response/less than three oocytes retrieved)