The Clinical Application Of DHEA In Women With Diminished Ovarian Reserve

[Objective]:The aim of the study was to evaluated the action ofdehydroepiandrosterone in patients with diminished ovarian reserve (DOR) and theadverse drug reaction.[Methods]:fifty-six women with significantly diminished ovarian reserves wereenrolled.we divided them into three groups according the out-patient appointmentnumber mantissa.The experimental group A(n=27):Those patients received DHEA(50mg qd,orally)for three months;The control groupB(n=19):those patients weretreated sequentially with artificial cycle(estradiol valerate and Duphaston) for3months；The control groupC(n=10):those patients were supplemented with vitaminE(100mg Bid)for three months;A and B groups with the same dose of vitaminE.After3months of therapy.Patients of the adverse drug reaction and the antralfollicle count，mean ovarian diameter，Anti-mullerian hormone and changes of serumsex hormone(FSH,LH,FSH/LH,E2,T,DHESA) levels were observed before and aftertreatment.[Results]:1.before and after treatment,Patients in the A group demonstrated asignificant improvement in FSH(P<0.05) and AMH(P<0.05)levels, The antral folliclecount (P<0.05) is alsosignificant improvemented on third day of the menstrual cycle.2.After3months treatment,there are no significant differents in the antral folliclecount，mean ovarian diameter，Anti-mullerian hormone and serum sex hormone(FSH, LH,FSH/LH,E2,T,DHESA) levels between A and B groups.The FSH and FSH/LH ofC group increased significantly after treatment,showed significant difference(P <0.05)compared to A group.while,two groups of patients serum FSH,LH and E2levelsshowed no significant difference(P>0.05).3.After3months treatment,Body Mass Index showed no significantdifference(P>0.05) before treatment. the T and DHEAS levels of Patients in theDHEA group improved significantly as compared with that before treatment (P<0.05).The patients with oligomenorrhea had non-significant improvement in thepictorial blood loss assessment chart(PBAC)score during before treatment andfirst,second and third cycles (P>0.05).[conclusions]: Dehydroepiandrosterone supplementation(50mg/d）can reduce thelevel of FSH,increase AMHand the count of antral follicle,It has a beneficial effecton ovarian reserves for patients with diminished ovarian reserve after3monthstreatment.a low dose of DHEAhas no significant adverse drug reaction.But its clinicaleffects need to be further confirmed. [Objectives] By eliminating the physiological factors that influence the ovarianreserve,in order to observe the relationship between social psychological factors andDiminished Ovarian Reserve.[Methods] We choose the patients with diminished ovarian reserve and heath womenwith normal ovarian reserve,who visited gynaecological operation of the UnionHospital Affiliated to Fujian Medical University.We have to test there ovarianfunction, and to investigate the patients with questionnaire of Residents GeneralStatus Table, SF-36scale, self-ratinganxietyscale(SAS), self-ratingdepressionscale(SDS),analyzed statistically by spssl7.0statistical analysis software.[Results] there are61cases with diminished ovarian reserve,and64cases of healthywomen of the125patients surveyed.the statistical analysis show that：1.In the studygroup, passive smoking were significantly different from the control(P=0.000),Passive smoking increases the risk of ovarian reserve decline significantly(OR=11.543，95%CI：2.548～52.300).2the Ovarian reserve were related withfactors of state of health、depression and anxiety：total SF-36scores（P<0.05，OR=0.917，95%CI：0.855～0.983）、total SAS scores（P<0.05，0R=1.504，95%CI：1.183～1.568)、total SDS scores（P<0.05，0R=1.316，95%CI：1.152～1.568）.[Conclusions]：The social psychological factors are related to DOR, poor health、depression and anxiety from review scores on the high side of women who increasedrisk of DOR.