Many of our patients have asked us about DHEA.
Dehydroepiandrosterone (DHEA) is a naturally-occurring hormone that is produced by the adrenal gland. It can be considered simplistically to be a vitamin for the ovaries. Its primary function is to produce estrogen and testosterone. Recently, these supplements have been used in the treatment of premature ovarian aging.
Accumulating evidence suggests that DHEA supplements improve ovarian function, increase pregnancy chances and, by reducing chromosomal problems, lower miscarriage rates. Over time, it also appears to improve ovarian reserve.
We consider using DHEA in any patient over 39 and others with evidence of diminished ovarian reserve. Ideally, the supplement is given three times a day for at least six weeks prior to ovulation induction for IVF. There are no known side effects.
These supplements are available over the counter, but may contain only small amounts of active compound. David Barad, MD, a local expert in this area, recommends this website as a reliable source.
There are many remedies to choose from regarding advanced reproductive age or diminished/low ovarian reserve. Our preference is to stick with evidence-based recommendations. Among older women during IVF, there is always the latest fad amongst doctors for low responders. Initial studies promoting the latest protocol are usually not supported by robust prospective studies. The evidence for DHEA is not strong, but it is improving.
A 2014 study added evidence to the idea that DHEA is a real help. Our clinic has been rewarded with pregnancies in some ladies with advanced age when IVF has failed previously. We think DHEA gets some of the credit. We await even stronger studies in the future. The gold standard large randomized clinical trial has not been performed. It is not magic, but it is potentially helpful if it is not terribly expensive.
If you have low or diminished ovarian reserve and are considering IUI or IVF, we recommend DHEA to many of our patients to help their eggs be the best they can be.