March 2016 · Volume 5 · Issue 3 Page 826 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Dayal M et al. Int J Reprod Contracept Obstet Gynecol. 2016 Mar;5(3):826-830 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Research Article Role of oral dehydroepiandrosterone in diminished ovarian function Meena Dayal, Preeti Yadav*, Amrita Chaurasia, Urvashi Singh, Veena Gupta, Shweta Patel INTRODUCTION Ovarian factors are responsible for 20-40 per cent cases of infertility. Ageing is associated with a decline in the number of ovarian follicles, menstrual irregularities, ovarian hormonal deficiency, anovulation, decreased fertility and finally, menopause, usually occurring at a mean age of 51 years. Ovarian reserve describes a woman’s reproductive potential with respect to ovarian follicle number and oocyte quality. Total ovarian reserve decreases with time due to continuous follicle recruitment. 1 Diminished ovarian reserves (DOR) is defined as the follicle pool, at any given age, smaller than expected. Older ovaries have few antral follicles and high rates of atresia. Androgens play a major role in follicular maturation. There is high concentration of androgen receptors in preantral and antral stages. They stimulate granulosa cells and are important for ovarian steroidogenesis. 2,3 DHEA can improve steroidogenesis since it is a precursor of estrogen and testosterone. It may also influence ovarian follicular growth by increase in IGF-1, that in turn stimulating mitosis, proliferation of the granulosa cells and production of AMH as well. This optimizes the hormonal feedback to the pituitary gland leading to adequate response of the pituitary FSH and thus inducing normal oocyte maturation and good oocyte quality. The latest evidences suggest a new concept, ovarian environment and the synergism between androgens and FSH in early stages of follicular maturation. DHEA progressively improves ovarian reserve by improving ovarian environment as nicely as lowers miscarriage chances in DOR individuals. 4,5 This study was conducted with aim to determine the effect of oral DHEA supplementation on ovarian reserve and conception rate in women with DOR. Department of obstetrics and gynecology, Moti Lal Nehru Medical College, Allahabad, UP, India Received: 19 January 2016 Revised: 27 January 2016 Accepted: 16 February 2016 *Correspondence: Dr. Preeti Yadav, E-mail: preeti_yadav3@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Ovarian reserve decreases with age and this study determine the effect of oral DHEA supplementation on S.AMH concentration and conception rate in women with diminished ovarian function. Methods: The study was conducted on 72 infertile women of 20-45 years age who had S.AMH <2.2 ng/ml, which was taken as cut off for diminished ovarian reserve in the study. The cases of study group received oral DHEA 25mg TDS and cases of control group received placebo (folic acid 5 mg OD) for 12 weeks. Day 2 S.AMH, S.FSH, S.LH, S.E2, S. Inhibin B, ovarian volume and AFC were measured at first visit and after 12 weeks of oral DHEA or placebo. Results: After 12 weeks of oral DHEA supplementation, S. AMH concentration was found to be significantly improved (p=0.01). S.FSH was decreased (p=0.04) and S. E 2 was increased (p=0.03). S. LH showed insignificant decrease. S. Inhibin B, ovarian volume and AFC were increased but insignificantly. Improvement in ovarian reserve resulted in significantly higher pregnancy rate (p=0.04) and live births (p=0.04) in women treated with DHEA than in the control group. Miscarriage rate was found to be decreased but insignificantly. Conclusions: DHEA improves the ovarian reserve. Keywords: Serum antimullerian hormone, Serum follicular stimulating hormone, Serum luteinizing hormone, Serum estradiol, Antral follicular count, Dehydroepiandrosterone DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160592