Dehydroepiandrosterone (DHEA) is a supplement regularly suggested by doctors for IVF preparation, especially in those women who were previously poor-responders due to diminished ovarian reserve (DOR). A collection of statistical analyses and a few small studies have shown positive outcomes for many women hoping to have a child of their own despite diminished ovarian reserve.

What is DHEA?

DHEA is in a class of steroid hormones known as androgens. DHEA is a precursor to testosterone and estrogens. This means that those hormones are made from it. In women, DHEA is made in the adrenals and ovaries. DHEA is also sold in health foods stores as a bio-identical over-the-counter nutritional supplement.

Can DHEA Supplementation Help You Get Pregnant?

While DHEA supplementation has been found to help women with DOR, it should only be used if advised by your doctor. There is easy access to DHEA as a supplement, so it can be tempting to want to try it for any fertility issue, but this may do more harm than good, as it can cause hormone imbalances.

Women with PCOS are advised to avoid this supplement, as their bodies often already have elevated levels of androgens and the common side effects of supplementation are two bothersome symptoms of PCOS – acne and hirsutism. Hirsutism is characterized by male pattern hair loss, with excessive body hair growth, including excess facial hair. This is not something women want to have to live with!

While doctors have been suggesting its use for years, there is little research to show it is beneficial for general fertility purposes. We advise only supplementing with DHEA if directed to do so by your doctor.

Who Can Benefit From DHEA Supplementation?

Women with confirmed diminished ovarian reserve due to the following reasons:

• Premature ovarian failure
• Premature ovarian aging
• Age-related infertility
• Poor response to IVF

Research on DHEA for Diminished Ovarian Reserve

According to a study published in Human Reproduction (Wiser et al., 2010), “Dehydroepiandrosterone supplementation can have a beneficial effect on ovarian reserves for poor-responder patients on IVF treatment.”

Findings in this small study:

• 33 women took part in the study, all had significantly diminished ovarian reserve
• 16 were in the control group, 17 in the DHEA group
• Each woman was given 75 mg of DHEA once a day before starting the next IVF cycle and during treatment
• Improved embryo quality was noted during treatment between the first and second cycles
• Women in the DHEA group had higher live birth rates, compared with the controls (21% vs. 4%)
• It is important to note that six of the seven deliveries were among women with secondary infertility
• 12 women were older than 42
• There was no significant increase in estradiol (E2) levels among women in the DHEA group
• 1 woman in the DHEA group became naturally pregnant 45 days after DHEA use and was included in the live birth rate

Another study published in Obstetrics and Gynecology (Mamas and Mamas, 2009) found that DHEA supplementation at 50 – 75mg for at least 4 months prior to IVF, in women with confirmed diminished ovarian reserve, premature ovarian failure (POF) or premature ovarian aging, may result in:

• improved oocyte (ova, egg) production
• improved embryo quality
• both improved egg production and embryo quality in women aged 40-47 years
• natural conception
• considerable improvement in intrauterine insemination (IUI) and IVF outcome, as well as pregnancy outcome
• reduced miscarriage risk

Yet another study reviewed (Gleicher, N. et al. 2009) miscarriage rates at fertility clinics in the United States and found that women with DOR that were treated with DHEA had a nearly identical miscarriage rate as compared to average populations. It is well known that infertile women with DOR have a much higher miscarriage rate than both average populations, and infertile women with normal ovarian reserve.

Researchers point to improved egg and embryo quality by reducing aneuploidy*. Anu – what? Aneuploidy speaks to chromosomal alignment. It is thought that DHEA supplementation helps reduce chromosomal abnormalities, resulting in better egg and embryo quality, and a reduction in miscarriage, with a better term pregnancy outcome.

“Caution should, nevertheless, be exercised in concluding that observed DHEA effect can automatically be extrapolated to normal, fertile populations, though such a possibility deserves further investigation.”

Are There Side Effects?

Side effects reported for the use of DHEA in preparation for IVF were oily skin, hirsutism and acne. There have been other side effects reported at different dose levels and when utilized for other health issues.

Where Can You Get DHEA?

Should your doctor suggest you supplement with this, ask them for a reputable source. Research shows that DHEA supplements at local pharmacies and health food stores lack quality control and often do not contain the level of DHEA stated on the product label. You are going to want a high quality DHEA supplement to help ensure a positive outcome, as will your doctor, so they should be the best resource in helping you locate the DHEA supplement they find dependable.

To DHEA or Not – That is the Question!

Many fertility clinics have found increased results in helping women who were once told “you can only achieve pregnancy through egg donation” by simply having them supplement with DHEA prior to and through IVF. If you have diminished ovarian reserve, DHEA is a supplement you should definitely talk to your doctor about.

It is important to note that DHEA is not going to resolve reproductive health-related infertility. It appears to focus on egg health, so while it may be helpful in achieving pregnancy, it is not going to fix other health-related fertility issues a person may be dealing with.

Have you used DHEA? What were your experiences? We would love to hear from you!

*aneuploidy medical definition
/an·eu·ploi·dy/ (an″u-ploi´de) any deviation from an exact multiple of the haploid number of chromosomes, whether fewer or more.

References:
1. Wiser, A., et al. (2010) Addition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: A randomized prospective study. IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
2. Mamas, L., Mamas, E. (2009) Dehydroepiandrosterone supplementation in assisted reproduction: rationale and results. Current Opinion in Obstetrics & Gynecology: Issue 4 – p 306–308, August. doi: 10.1097/GCO.0b013e32832e0785
3. Gleicher, N. et al. (2009) Miscarriage rates after dehydroepiandrosterone (DHEA) supplementation in women with diminished ovarian reserve: a case control study. Reproductive Biology and Endocrinology, 7:108 doi:10.1186/1477-7827-7-108
4. Fett, Rebecca. (2014) It Starts With the Egg: How the Science of Egg Quality Can Help You Get Pregnant Naturally, Prevent Miscarriage, and Improve Your Odds in IVF (pp. 155-171). New York: Franklin Fox Publishing