When to Stop DHEA Before Egg Retrieval
Stop DHEA supplementation on the day of the hCG or GnRH-agonist trigger injection, which occurs approximately 35-37 hours before your scheduled oocyte retrieval. 1
Timing Algorithm
Standard Protocol
- Continue DHEA throughout ovarian stimulation until the trigger day 1
- Discontinue on trigger day when leading follicles reach ≥17-18 mm diameter 1
- The trigger injection is typically given 35-37 hours before retrieval 1
- This timing aligns with the end of DHEA's role as an FSH second messenger and the start of final oocyte maturation 1
Rationale for This Timing
DHEA works by rescuing small antral follicles from atresia during the stimulation phase, increasing the antral follicle count without affecting earlier recruitment stages 2. Once you trigger final oocyte maturation with hCG or GnRH agonist, follicular development shifts from FSH-dependent growth to the final maturation cascade 1. At this point, DHEA's mechanism of action is no longer relevant, making the trigger day the logical stopping point 1.
DHEA Treatment Duration Before IVF
For context on when to start DHEA (though not your primary question):
- Minimum pretreatment duration: 8 weeks before starting the IVF cycle 3, 4
- Optimal duration: 3-4 months of supplementation shows the most robust improvements 5, 2
- Continue through stimulation: Maintain DHEA throughout gonadotropin stimulation until trigger 1, 3
Expected Benefits You've Achieved by Trigger Day
By the time you reach trigger, DHEA supplementation has already accomplished its goals:
- Increased antral follicle count 2
- Higher number of retrieved oocytes 4, 5
- Improved oocyte quality and maturation rates 4, 5
- More embryos available for transfer 5
- Reduced cycle cancellation rates 4
Critical Pitfall to Avoid
Do not confuse DHEA discontinuation timing with anticoagulation management. If you are on anticoagulation therapy for any reason (such as antiphospholipid syndrome), those medications have completely different stopping schedules that are independent of DHEA 1:
- Low-dose aspirin stops 3 days before retrieval 1
- LMWH stops 12-24 hours before retrieval 1
- DHEA still stops on trigger day regardless of anticoagulation status 1
What Happens After Retrieval
DHEA is not restarted after egg retrieval 1. The supplement's role is limited to the pre-stimulation and stimulation phases to optimize follicular development 2. Luteal support after retrieval uses progesterone and sometimes low-dose hCG, not DHEA 6.