Evaluating the Therapeutic Effect of Dehydroepiandrosterone on Stromal Fibrosis and Endocrine Function in Patients With Resistant Ovary Syndrome: A Case-Control Study

TL;DR

This study found that DHEA improves ovarian structure and hormone levels in patients with resistant ovary syndrome.

Contribution

The study evaluates DHEA's therapeutic effects on stromal fibrosis and endocrine function in resistant ovary syndrome patients.

Findings

DHEA supplementation reduced stromal fibrosis grade in 60% of participants.

Ovarian volume increased in 70% of DHEA-treated patients.

Hormone levels like AMH and estradiol improved significantly in the DHEA group.

Abstract

Background: Resistant ovary syndrome (ROS) is a rare form of ovarian dysfunction defined by the presence of normal ovarian follicles that fail to respond to gonadotropin stimulation. The adrenal androgen, dehydroepiandrosterone (DHEA), has been studied for its potential in improving ovarian response and reserve. This study investigated the therapeutic effects of DHEA on ovarian stromal fibrosis and hormonal parameters in ROS patients.

Methods: A case-control study was conducted on 60 women diagnosed with ROS. Participants were designated as cases treated with DHEA (75 mg/day, 12 weeks) or controls (no supplementation), with 30 participants in each group. Transvaginal ultrasound (TVUS) assessments of ovarian volume, stromal fibrosis grade, and echotexture were performed before and after the treatment. Serum levels of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol (E2) were also analyzed. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 26 (Released 2018; IBM Corp., Armonk, New York, United States). p < 0.05 was considered significant.

Results: No significant differences were found between the two groups at baseline. By the end of 12th week, the DHEA group showed a significant improvement: 18 (60%) participants experienced a reduction in stromal fibrosis grade most commonly from Grade 2 to Grade 1, 21 (70%) showed an increase in their ovarian volume, and 14 (47%) had normalized stromal echo-texture. Changes in hormone levels were also observed, including a rise in AMH in 13 individuals (45%), a decrease in FSH in eight (28%), and an increase in estradiol in 10 (34%), which were greater than in the control group (p < 0.05).

Conclusion: Supplementation with DHEA greatly improved the ovarian stromal structure and hormonal function in ROS patients. Due to its anti-fibrotic and functional benefits, DHEA may prove to be a promising adjunctive therapy in the management of the challenging ROS condition.