Serum Hormone Levels, T Lymphocyte Subsets, and Achievement of Pregnancies in Patients with Premature Ovarian Insufficiency following Administration of Ethinylestradiol/Drospirenone

Abstract

Primary ovarian insufficiency (POI) is closely associated with ovarian hormone deficiency, amenorrhea, menopause, and infertility in women. Hormone replacement therapy remains the mainstay of treatment and management of POI. A combined oral contraceptive (Yasmin) containing 0.02 mg ethinylestradiol and 3 mg drospirenone has been shown to be a well-tolerated and effective combination that provides high contraceptive reliability and good cycle control. Herein, we aim to examine clinical efficacy of ethinylestradiol/drospirenone in treating patients with POI and its effects on serum hormone levels, body mass, lipid metabolism, and T lymphocyte subsets. Retrospective analysis of clinical records and follow-up data from 80 patients with POI was performed. The control group contained 40 patients with POI receiving oral administration of 0.035 mg ethinylestradiol and 2 mg cyproterone acetate once a day for consecutive 21 days with drug withdrawal of 7 days in 3 months. The observation group contained 40 patients with POI receiving oral administration of 0.02 mg ethinylestradiol and 3 mg drospirenone once a day for consecutive 28 days in 3 months. There was no significant difference on serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T), concentrations of high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), and triglycerides (TG), body mass, the numbers of CD+3, CD+4, CD+8 T cells, and ratio of CD+4/CD+8 between the control and observation group ( $P>0.05$ ) before treatment. After treatment, serum levels of FSH, LH, and T, concentrations of LDL-C, and TG, body mass, and CD+8 T cells were reduced but the concentration of HDL-C, CD+3, and CD+4 T cells and ratio of CD+4/CD+8 were increased in both two groups ( $P<0.05$ ); these changes were more significant in the observation group compared with the control group ( $P<0.05$ ). Besides, the total response rate of the observation group was 90.00%, which is higher than that of the control group, 77.50% ( $P<0.05$ ). The pregnancy rate of the observation group was 45.00%, which is higher than that of the control group, 30.00% ( $P<0.05$ ). Taken together, these results suggest that the combined oral contraceptive (Yasmin) containing 0.02 mg ethinylestradiol and 3 mg drospirenone restores hormone levels, improves body mass and lipid metabolism, and sustains autoimmune function for patients with POI, suggesting ethinylestradiol/drospirenone treatment is effective in treating POI.