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

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.