Clinical Research Of Dehydroepiandrosterone(DHEA)Supplementation On Patients With Diminished Ovarian Function

Background and ObjectiveThe Dehydro-epiandrosterone(DHEA) makes contributions in the treatment of patients with diminished ovarian function for over10years, It has obvious effects in improving ovary function, regulating immune system, evaluating metabolism and protecting cardiovascular system. As a result, DHEA is becoming a hotspot in gynecological endocrinology researches. When deeply analyzing the mechanism and safety of DHEA, large sample size, randomized controlled basical and clinical trials are still needed. There is little research on DHEA in domestic, and it’s also lack of information about the efficacy and tolerability of DHEA supplementation on Chinese.In this study, we compared indicators of ovarian function and liver function in patients with diminished ovarian function before and after taking DHEA, evaluated whether DHEA can improve the ovarian function, and impact on the liver function, to provide evidence for the efficacy and safety of DHEA applications in patients with diminished ovarian function.MethodsFifty-four patients with diagnosis of diminished ovarian function for the study, we divided them into two groups according to their visit number by random number table, one is experimental group and the other is control group. The experimental group (n=32) received DHEA25mg po tid, take oral drugs daily08:00, 14:00,20:00, the control group (n=22) received vitamin E100mg po qd, take oral drugs daily08:00, continuous treatment for3months. Recorded indicators of patients before and after continuous treatment for3months, as follicle-stimulating hormone(FSH), luteotrophic hormone (LH), estradiol (E2), testosterone(T), dehydroepiandrosterone sulphate(DHEAS), insulin-like growth factor-1(IGF-1), alanine aminotransferas(AST), alanine aminotransferase(ALT), antral follicle count(AFC), height and weight, calculated FSH/LH, body mass index(BMI). We used Chinese version SPSS20.0statistical software package for the analysis of the data.ResultsBy comparing general information, endocrine levels, AFC and liver function of patients before treatment, both of the experimental group and the control group was not statistically significant (P>0.05). After DHEA treatment for3months, serum FSHof the patients in experimental group was statistically lower (P<0.05) than before treatment, and the same as lower FSH/LH (P<0.05); serum LH, E2no significant change; the count of AFC increased compared to before treatment, but do not have statistically significant difference (P>0.05). Increased serum IGF-1in experimental grou does not have significant difference after treatment (P>0.05); significantly increased serum T levels after treatment (P<0.05), significantly higher DHEAS levels after treatment (P<0.05); AST, changes in ALT and BMI had no statistically significant difference (P>0.05); Adverse reactions in experimental group:one of them withdrawal because of polycystic ovarian changes; two of them facial acne, four cases of facial greasy feeling. Compared with the control group after treatment, the experimental group, serum FSH levels were significantly lower (P<0.05), FSH/LH was significantly lower (P<0.05), serum DHEAS levels were significantly increased (P<0.05), T levels were significantly increased (P<0.05); observed between the two groups other indicators (AFC, serum LH, E2, IGF-1levels, AST, ALT, and BMI) did not change significantly (P>0.05); there is no adverse reaction found in the control group. Conclusions1. DHEA supplementation may reduce the serum level of FSH, FSH/LH ratio, indicating that it could improve ovarian function;2. DHEA supplementation can increase serum DHEAS, T levels, while androgens may increase adverse reactions associated;3. This study does not support DHEA to improve the antral follicle count, serum IGF-1levels;4. DHEA applications of this study did not result in changes in liver function and body mass index.