From the Guidelines
DHEA does not have sufficient evidence to support its use in improving infertility, and its effectiveness is uncertain. The most recent and highest quality study, a randomized controlled trial of 464 survivors of breast or gynecologic cancer, found that vaginal DHEA led to significant improvements in sexual desire, arousal, pain, and overall sexual function, but its impact on fertility is not clear 1. Typical supplementation involves 25-75 mg of DHEA daily, taken for at least 6-12 weeks before fertility treatments, but the evidence for its effectiveness in improving fertility outcomes is limited and mixed.
Some studies suggest that DHEA may improve follicular environment, egg quality, and ovarian response to stimulation, but these findings are not consistent across all studies. The use of DHEA for fertility treatment is not FDA-approved, and its quality can vary between brands. Before starting DHEA, women should have their baseline hormone levels checked and consult with a reproductive endocrinologist, as it's not recommended for those with PCOS or androgen-sensitive conditions.
Key points to consider:
- DHEA may improve sexual function in postmenopausal women, but its impact on fertility is uncertain
- The evidence for DHEA's effectiveness in improving fertility outcomes is limited and mixed
- DHEA is not FDA-approved for fertility treatment, and its quality can vary between brands
- Women should consult with a reproductive endocrinologist before starting DHEA, especially if they have PCOS or androgen-sensitive conditions. The study by 1 provides the most recent and highest quality evidence, and its findings should be considered when making decisions about the use of DHEA for fertility treatment.
From the Research
Dehydroepiandrosterone (DHEA) and Infertility
- DHEA supplementation has been studied as a potential treatment for infertility in women with diminished ovarian reserve or poor ovarian response 2, 3, 4, 5, 6.
- Some studies suggest that DHEA may improve pregnancy rates, increase antral follicle count, and reduce follicle-stimulating hormone (FSH) levels 2, 3, 6.
- A 2014 study found that DHEA treatment significantly improved follicular fluid bone morphogenetic protein-15 and accumulated embryo score in infertility patients with diminished ovarian reserve undergoing in vitro fertilization (IVF) 3.
- A 2015 Cochrane review found that pre-treatment with DHEA was associated with higher rates of live birth or ongoing pregnancy in women with poor ovarian response, but the evidence was moderate quality and limited by lack of blinding and inadequate reporting of study methods 4.
- A 2023 meta-analysis found that DHEA treatment significantly increased antral follicle count and reduced FSH levels, but did not significantly improve live birth rates in women with poor ovarian response or diminished ovarian reserve undergoing IVF/ICSI 6.
Potential Mechanisms of DHEA
- DHEA may improve follicular steroidogenesis, increase insulin-like growth factor-1 (IGF-1), and act as a pre-hormone for follicular testosterone 2.
- DHEA may also reduce aneuploidy and increase anti-Müllerian hormone (AMH) and antral follicle count 2, 3.
- The exact mechanisms of DHEA's effects on infertility are not fully understood and require further study 2, 4, 5, 6.
Safety and Efficacy
- The safety and efficacy of DHEA supplementation for infertility are not fully established, and more research is needed to determine its potential benefits and risks 4, 5, 6.
- The 2015 Cochrane review found that the quality of the evidence was moderate, and there was insufficient evidence to draw conclusions about the safety of DHEA supplementation 4.
- A 2019 review noted that only intravaginal DHEA supplementation is approved and recommended for treatment, and further investigation is needed to determine its safety and effectiveness 5.