DHEA Use and IVF Success
DHEA (dihydroepiandosterone) is an adrenal hormone that helps the body produce testosterone and oestrogen. In particular, it is considered the main precursor of male hormones (androgens). Publications on DHEA have appeared in the database since 2015.
DHEA is used as a supplement in IVF treatment, especially in patients with low ovarian reserve (low ovarian reserve - DOR). Although the definition of DOR is not clear, it is usually based on the Bologna criteria. In this case, it can be defined as being 40 years of age or older, low follicle count in the ovary (low antral follicle, AFC), low AMH levels, low response to previous treatments, previous cancellation of the cycle (treatment) due to low ovarian response or collection of less than 4 eggs despite previous ovarian stimulation.
Women diagnosed with DOR respond poorly to ovarian stimulation (the first step in IVF treatment). 5-18% of IVF treatment cases respond poorly to medication. IVF success rates of these patients are around 2-4%.
For these reasons, DOR is the most challenging part of assisted reproductive treatment and clinicians try to use different methods in order to overcome this problem. This may include increasing the dose of gonadotropins (FSH-LH) or trying different treatment options. None of these options gives the desired success. DHEA is currently used by 26% of IVF specialists to support treatment. There is no consensus that DHEA use increases pregnancy rates. However, numerous trustworthy publications suggest that DHEA use before treatment significantly increases pregnancy rates.
In the said studies, 25 mg to 75 mg DHEA was used and the duration of treatment was between 6 weeks and 12 weeks. Although data suggests that it increases pregnancy rates, there is no difference in the number of eggs collected, miscarriage rates and cycle cancellations with the group that do not use DHEA.