DHEA and Fertility

Intervention #7.2 DHEA
 
Fact Check

  • DHEA is a hormone with possible serious side effects.
  • DHEA has been used by 26% of clinics in patients with diminished ovarian reserve.
  • More high quality research is needed to ascertain the impact of DHEA in fertility.
  • NICE (2016) doesn’t recommend the use of DHEA as adjuvant in IVF protocols.

What is DHEA?


DHEA stands for Dehydroepiandrosterone. It is an androgenic hormone mainly produced by the reticular zone of the adrenal glands. It is an essential prohormone in ovarian follicular steroidogenesis.
DHEA supplementation has been used in women who are poor responders to ovarian stimulation. Poor responders correspond to 9–24% of patients undergoing IVF, resulting in low pregnancy rates 2 and 4%.

Criteria for poor responders to ovarian stimulation:
  • Age above 40.
  • The number of oocytes previously recovered in previous cycles of IVF less than or equal to three.
  • Low ovarian reserve test scores.

The mechanism of action of DHEA supplementation is unclear.

DHEA Supplementation Side Effects:
  • Acne
  • Hair loss
  • Male pattern hair growth (may be irreversible process)
  • Alteration of voice tone (may be irreversible process)
  • Reduction of HDL
  • Hepatic dysfunction
  • High Blood Pressure
  • Psychotic symptoms
  • Seizures
  • Palpitations

DHEA is usually administered in 25 mg doses, three times a day.

Some studies found DHEA improved egg quality and pregnancy rates whilst others haven’t.

About 26% of IVF clinics in different countries use DHEA supplementation protocols in women with diminished ovarian reserve.

The FDA considers DHEA a nutritional supplement, while a prescription is required in most European countries.

The commercial DHEA products currently available are manufactured from yams, however the purity and potency of the commercially available products are not known, with content ranging from 0 % to 150 % of the labelled amount.

There is no consensus on the optimal or the maximal dose of DHEA, nor the duration of use, though most studies did not exceed 6 months

effects of dhea supplementation to improve ovarian response and ivf outcomes
Source: https://www.intechopen.com/books/advances-in-testosterone-action/effects-of-dehydroepiandrosterone-dhea-supplementation-to-improve-ovarian-response-and-ivf-outcomes-