DHEA ( or dehydroepiandrosterone) is a hormonal supplement gaining attention and momentum in the infertility community as a new treatment that helps improve female egg quality, and consequently can help improve pregnancy rates via IVF.
Is DHEA just another fad treatment, or can it actually help women with infertility get pregnant?
Fertility specialists mainly use DHEA to treat women with diminished ovarian reserve (also known as DOR). Diminished ovarian reserve is caused by
- Premature ovarian aging (in younger women)
- Natural ovarian aging (in older women)
A woman’s ovarian reserve (how well her ovaries produce mature, high quality eggs) naturally declines with age during menopause. Unfortunately some women experience a decline in their ovarian function during their child bearing years – this is known as premature ovarian aging (or POA).
POA affects around 10% of women and it can be detrimental to pregnancy chances. When a woman has POA she will produce lower quality eggs, which leads to the production of lower quality embryos. Lower quality embryos have a lesser chance of successful implantation via IVF and a higher rate of miscarriage, when compared with high quality embryos.
How DHEA affects fertility
The key to treating POA is improving egg quality.
Once female egg quality improves, so will the quality of the embryo – 95% of embryo quality relies on egg quality. This is where DHEA plays its part.
DHEA is important to egg quality as it helps more follicles make it through to the last stage of egg maturation. When a woman has POA, few follicles make it through to this mature stage. At this stage a woman’s eggs are treated with fertility medications (to improve egg quality) when undergoing infertility treatment; therefore, for optimal treatment, it’s desirable that she a high number of eggs for the medication to work on. One of the most important hormones that facilitate the survival of a woman’s eggs to this mature stage is the hormone androgen – DHEA is a type of androgen.
DHEA is the lifeboat ensuring that eggs make it through to this last important stage.
In the video below, Dr. Norbert Gleicher, internationally recognized fertility specialist and researcher from CHR New York, explains premature ovarian aging and DHEA use.
Current knowledge about DHEA
Although DHEA is a relatively new infertility treatment, there’s a wealth of clinical research out there to support its use to improve pregnancy chances when used during IVF. There are also ongoing clinical trials, of which we will see the results in a few years to come. For the moment, from a clinical research point of view, the outlook for DHEA use in premature ovarian aging looks good.
Will DHEA help you get pregnant?
There’s no such thing as a miracle treatment for infertility that can guarantee pregnancy (even though we’d all love one). If you have diminished ovarian reserve, DHEA supplementation, in addition to careful management by your fertility specialist, could be a great option to help improve your pregnancy chances.
Current research supporting DHEA use:
- Gleicher N and Barad DH,Increased oocyte production after treatment with dehydroepiandrosterone. Fertil Steril 2005;84(3):756.
- Barad DH and Gleicher N,Effects of dehydroepiandrosterone on oocyte and embryo yields, embryo grade and cell number in IVF. Hum Reprod 2006;21(11):2845-9.
- Barad DH, et al, Update on the use of dehydroepiandrosterone supplementation among women with diminished ovarian reserve. J Assist Reprod Genet 007;24(12):629-34.
- Gleicher N, et al,Miscarriage rates after dehydroepiandrosterone (DHEA) supplementation in women with diminished ovarian reserve: a case control study. Reprod Biol Endocrinol 2009;7(7):108.
- Gleicher N, et al,Improvement in diminished ovarian reserve after dehydroepiandrosterone supplementation. Reprod Biomed Online 2010;21(3):440-3.
- Gleicher N, et al,Dehydroepiandrosterone (DHEA) reduces embryo aneuploidy: direct evidence from preimplantation genetic screening (PGS). Reprod Biol Endocrinol 2010;10(8):140.
- Gleicher N and Barad DH,Dehydroepiandrosterone (DHEA) supplementation in diminished ovarian reserve (DOR). Reprod Biol Endocrinol 2011;17(9):6