In the context of early pregnancy, low levels of serum estradiol have been linked to an escalated risk of miscarriage. This retrospective cohort study aimed to decipher whether supplementing with estradiol or dehydroepiandrosterone (DHEA) could mitigate this risk within a comprehensive treatment approach targeting various symptoms.

Women experiencing low serum estradiol levels during early pregnancy, defined as ≤50% of the reference levels based on gestational age were enrolled. Oral administration of either estradiol or DHEA was employed, with the primary focus on determining serum estradiol levels in relation to gestational age. Secondary endpoints encompassed  gestational age at delivery, birth weight, and miscarriage rates.

Estradiol use did not considerably impact serum estradiol levels relative to gestational age, whereas DHEA use notably increased these levels. Among pregnancies characterized by low estradiol, the miscarriage rates in the non-supplemented, estradiol supplemented, and the DHEA supplemented groups are depicted in Table 1:

No noticeable differences were witnessed in preterm delivery rates, gestational age, size, or birth weight. Furthermore, no sexual abnormalities were documented in the offspring (n = 29) of patients who received DHEA supplementation during a follow-up period of 5-7 years.

DHEA supplementation effectively restored serum estradiol levels and contributed to a statistically significant curtailment in miscarriage rates when integrated into the treatment regimen.