Dehydroepiandrosterone can restore the function of the ovaries – a series of 5 cases and a review of the literature

Introduction
We studied the impact of dehydroepiandrosterone (DHEA) supplementation in women with diminished ovarian reserve and very low DHEA-S in the blood.

Aim
In vivo study. The paper also presents a review of the literature regarding diminished ovarian reserve and the use of dehydroepiandrosterone.

Material and methods
The paper presents a description of 5 patients with diminished ovarian reserve (DOR). Patients reported because of problems with getting pregnant. Infertility lasted for several years. The patients disagreed on in vitro fertilization (IVF) for ethical and religious reasons. All of the presented patients were diagnosed with diminished ovarian reserve (very low anti-Müllerian hormone or high follicle stimulating hormone, elevated estradiol concentration on day 3 of the cycle). We also found a very low dehydroepiandrosterone sulphate (DHEA-S) concentration. The patients were given dehydroepiandrosterone. After several months of treatment (3–6 months), the patients became pregnant. None of them had procedures for in vitro fertilization.

Results
Five patients gave birth to healthy children. Our experience with DHEA is much greater, but these 5 cases are very well documented. The obtained results indicate that DHEA supplementation in conditions of its deficiency improves the function of the ovaries and increases the chance of pregnancy.

Conclusions
In some cases the aging of the ovaries can be delayed by administering DHEA. This effect occurs specially when the endogenous concentration of DHEA-S is reduced. In the case of reduced ovarian reserve, DHEA-S concentration should be determined.