The effect of 12-month dehydroepiandrosterone supplementation on the menstrual pattern, ovarian reserve markers, and safety profile in women with premature ovarian insufficiency

Wong, Queenie Ho Yan; Yeung, Tracy Wing Yee; Yung, S. P.; Ko, Jennifer K.Y.; Li, Raymond; Ng, Ernest Hung Yu

doi:10.1007/s10815-018-1152-2

Cited by 20 publications

(13 citation statements)

References 22 publications

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“…Six eligible studies were selected in this review, including one randomized controlled trial and five prospective observational cohort studies. Four strategies for ovarian function recovery were used, including PRP treatment ( 16 , 27 ), DHEA supplement ( 28 , 29 ), HRT treatment ( 30 ), and intraovarian transplantation of autologous adipose-derived mesenchymal stromal cells treatments ( 31 ). The sample size of the individual studies ranged from 9 to 311, with a total of 421 patients.…”

Section: Resultsmentioning

confidence: 99%

“…A prospective observational study of 31 Chinese women with POI conducted by Wong et al ( 28 ) had evaluated the long-term effect of DHEA in patients with POI. All patients had a normal karyotype and 19 (61.3%) patients had used HRT previously and HRT was withheld for at least two months before DHEA treatment, 24 (77.4%) patients were amenorrhoeic, and 7 (22.6%) patients were oligomenorrhoeic.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The Evaluation of Ovarian Function Recovery Following Treatment of Primary Ovarian Insufficiency: A Systematic Review

Kuang

Tang

et al. 2022

Front. Endocrinol.

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BackgroundPrimary ovarian insufficiency (POI) is gaining awareness as its prevalence increases and its effect on patients is extremely negative. To date, several therapies have been designed to treat POI, but the conclusions are conflicting, in part, due to inconsistent evaluation methods. Thus, we explore a multi-index of ovarian function assessment methods to evaluate the recovery of ovarian function after various therapies in order to evaluate effectiveness in a more comprehensive manner.AimThe purpose of this review is to assess the effectiveness of various therapies to recover ovarian function in patients with POI. The primary outcome measures were anti-Müllerian hormone (AMH) levels, follicle stimulating hormone (FSH) levels, and antral follicle count (AFC). The secondary outcomes included the change of mean ovarian volume, menstruation recovery, and pregnancy rate.MethodsOur systematic searching including PubMed, Web of Science, Cochrane, and Embase databases was conducted to find all human clinical trial articles published from January 2000 to April 2021 and related to POI treatment, including the keywords: POI, AFC, and hormones. All prospective and retrospective studies exploring ovarian function recovery that include AFC, AMH levels, and FSH levels evolution throughout treatment were included. All patients included in the studies met the POI criteria described by the European Society for Human Reproductive Embryology (ESHRE) guideline.ResultsSix studies were selected based on the criteria: one randomized controlled trial and five observational studies. Among them, two studies focused on the intraovarian platelet-rich plasma (PRP) infusion treatment, two studies focused on dehydroepiandrosterone (DHEA) supplements, one study focused on hormone replacement therapy (HRT), and one study focused on autologous adipose-derived stromal cells (ADSCs) treatment. There was insufficient scientific evidence that any approach could help ovarian function recovery in patients with POI because the ovarian function markers in each study had inconsistent changes with 26 patients (6.2%) reporting spontaneous pregnancy.ConclusionSerum AMH levels, FSH levels, and AFC are sensitive indicators and reflect the evolution of ovarian function. Large randomized controlled trials are necessary, and the data on ovarian function should be collected comprehensively to evaluate the effectiveness of a variety of treatments.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Evaluation of Ovarian Function Recovery Following Treatment of Primary Ovarian Insufficiency: A Systematic Review

Kuang

Tang

et al. 2022

Front. Endocrinol.

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“…With this in mind, 38 women with POI were recruited to an observational trial of 12 months of DHEA supplementation (25 mg three times a day), the aim being to allow sufficient time for any effect on follicle recruitment to become apparent. Thirty-one women completed the study and there was no effect on markers of ovarian reserve or menstrual pattern 138 .…”

Section: Dehydroepiandrosteronementioning

confidence: 99%

Premature ovarian insufficiency: an International Menopause Society White Paper

et al. 2020

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The aim of this International Menopause Society White Paper on premature ovarian insufficiency (POI) is to provide the latest information regarding this distressing condition. The impact of POI has far-reaching consequences due to its impact on general, psychological, and sexual quality of life, fertility prospects, and long-term bone, cardiovascular, and cognitive health. Progress in fully understanding the etiology, diagnosis, and optimal management options has been slow thus far due to the complexity of the condition and fragmented research. Recent advances in epidemiological and genetic research have improved our understanding of this condition and randomized prospective trials are being planned to determine the intervention strategies, which will optimize quality of life and long-term well-being. The International Menopause Society has commissioned a number of experts at the forefront of their specialty to define the state of the art in the understanding of this condition, to advise on practical management strategies, and to propose future research strategies. It is hoped that a global task force will subsequently be convened in order to formulate a consensus statement across key societies, to accelerate date collection and analysis of a global POI registry, and to facilitate progress in the key defined areas of research.

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“…The cause of the primordial follicular loss is not yet known, but this definite result has been tried to slow down with some adjuvant treatments such as dyhydroepiandrostenodione (DHEA) or testosterone. These molecules are synthesized by the ovary and the adrenal gland and enhance the effect of gonadotropin on follicle development through insulin-like growth factor 1 (IGF-1) (16,17). Some authors have concluded that the use of DHEA before IVF can increase ovarian reserve markers and ovarian response to ovarian stimulation (18)(19)(20)(21).…”

Section: Dhea and Testosteronementioning

confidence: 99%

“…Some authors have concluded that the use of DHEA before IVF can increase ovarian reserve markers and ovarian response to ovarian stimulation (18)(19)(20)(21). However, in many studies, the use of DHEA supplements in ovarian reserve or pregnancy rates before IVF treatment has not been observed (16,17). Qin et al (17), in a meta-analysis of pretreatment with DHEA, have shown that the pregnancy rates could increase (OR: 1.47, 95% CI: 1.09-1.99), but decrease (OR: 1.08, 95% CI: 0.67-1.73) if only randomized controlled trials (RCTs) were included, which reveals that pretreatment with DHEA has no effect on pregnancy rates, number of eggs, fertilization, and miscarriage rates.…”

Section: Dhea and Testosteronementioning

confidence: 99%

Erken Yumurtalık Yetersizliğinde Kadın İnfertilitesinin Optimizasyonu

AYTAÇ¹

2022

Düzce Tıp Fakültesi Dergisi

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Erken yumurtalık yetmezliği, az bilinen etiyolojisi ile neden olduğu yumurtalık hormonlarının azalmasıyla saptanan, kadınlarda birçok sistemi etkileyen patolojilere yol açar. Etiyolojisini belirlemeye yönelik çalışmalarda pek çok hastanın açıklanamayan grupta olduğu görülmektedir. Diğer yandan genetik yatkınlık ve otoimmün nedenli erken yumurtalık yetersizliği (premature ovarian insufficiency, POI) bilinen en sık etiyolojik nedenlerdir. Temelde östrojen eksikliği ile ilgili semptomların önlenmesi amacı ile erken tanı ve tedavi önemlidir. Hormon replasman tedavisinin bir an önce başlanması, kadınlarda menopozal semptomların önlenmesini ve uzun dönemli komplikasyonların azalmasını sağlayacaktır. Bu hastalarda diğer önemli sorun ise over yetmezliği ile ortaya çıkan infertilitedir. Aslında adet düzensizliği ortaya çıkmadan önce azalmaya başlayan fertilite, ilerleyen dönemde folikül sayısının daha hızlı azalması ile ciddi bir infertilite sorunu haline gelmektedir. Burada özellikle risk altındaki hastaların tespiti ile uygun zamanda fertilite koruyucu tedaviler (oosit, embryo veya over dokusunun dondurulması gibi) ve yardımla üreme teknikleri önerilebilir. Bununla birlikte, infertilite yakınması olan POI tanısı alan hastalarda; kök hücre tedavisi, trombositten zengin plazma (platelet-rich plasma, PRP) ve over dokusuna in vitro aktivasyon gibi uygulamalar yeni ve deneysel aşamada olsa da gelecekte umut verici olabilir. Sunulan bu derlemede erken yumurtalık yetmezliğinin güncel patofizyolojisi ve tedavi seçenekleri tartışılmıştır.

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The effect of 12-month dehydroepiandrosterone supplementation on the menstrual pattern, ovarian reserve markers, and safety profile in women with premature ovarian insufficiency

Abstract: Our results do not support any significant improvement in ovarian function by 12-month DHEA supplementation in women with POI.

Cited by 20 publications

References 22 publications

The Evaluation of Ovarian Function Recovery Following Treatment of Primary Ovarian Insufficiency: A Systematic Review

The Evaluation of Ovarian Function Recovery Following Treatment of Primary Ovarian Insufficiency: A Systematic Review

Premature ovarian insufficiency: an International Menopause Society White Paper

Erken Yumurtalık Yetersizliğinde Kadın İnfertilitesinin Optimizasyonu

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