DHEA: What you need to know

Here at Creation Acupuncture, we’re dedicated to helping you explore all possible ways to improve your fertility levels. One area you might be interested in DHEA treatment, which has been linked to improving fertility outcomes, particularly for women with diminished ovarian reserve (DOR).      

But what is DHEA and how is it linked to pregnancy?                                     

                                                                                                                                                                                                            About DHEA

DHEA (dehydroepiandrosterone) is a naturally occurring steroid hormone made by your adrenal glands, which are above your kidneys. It’s crucial for producing other important hormones like testosterone and estrogen, and it plays a role in immunity, mood and energy.

Levels peak in young adulthood and then decline with age.

So, what is the link between DHEA and pregnancy? Would you be suited to a supplement with DHEA for low AMH (Anti-Müllerian Hormone)? Who are the best candidates for such treatment? And what risks are there?

How it Affects Pregnancy

The ovaries use DHEA to produce testosterone and oestrogen. This precursor hormone has been linked in scientific studies to improving the quantity of eggs. 

Since DHEA declines with age and has a vital role in hormone production, it has been used in clinical studies to slow age-related fertility problems and increase testosterone.

It has also been found to be low in women with autoimmunity and poor ovarian function. For example, if the ovaries cannot produce enough DHEA, testosterone production lowers which impairs the early stage of egg development. This results in fewer follicles being recruited each month and fewer arriving at the stage that they would produce AMH.

You may have sufficient dormant eggs in reserve but they have failed to be recruited each month, leading to a low follicle count and a low AMH.

DHEA has the most benefit for early stage follicles that are at least three months from ovulation.

How do I know if I need DHEA?

DHEA is a prescription-only medication in the UK. Your fertility consultant may therefore prescribe it if you have low levels of the hormone DHEA- sulphate. This can be tested by a standard blood test either at your fertility clinic or from the online blood testing service, such as those offered by Medicheck. 

Who Can Benefit From DHEA?

• IVF patients diagnosed with diminished ovarian reserve

• Patients over the age of 40

• Women who produced few eggs in a previous IVF cycle

• Low DHEA-Sulphate blood test

When not to take DHEA:

• You should not take DHEA if it’s less than 1 month prior to you starting IVF. This is because high levels of DHEA in the final stages of egg production impair rather than support the development or quality of eggs.

• DHEA should be started at least 3 months before trying to conceive naturally or before IVF. It should be stopped one month prior to both. It is a preparation supplement rather than one suited for continuous use. 

• DHEA also isn’t recommended for women with fibroids or endometriosis since it increases oestrogen production. However, some clinics do recommend it for short term use with good results for egg production.

• DHEA isn’t usually recommended for women with PCOS as DHEA increases the level of testosterone and PCOS is characterised by high androgens. However, there does exist a subcategory of PCOS patients who have low testosterone levels. DHEA has been able to help these patients as reported by Dr Gleicher at the Centre of Human Reproduction.

DHEA and preventing a miscarriage                                                                                                                      

Some evidence shows that DHEA may reduce chromosomal abnormalities in eggs which increases the chance of a successful pregnancy according to Fett (2023).

What do studies on DHEA show?

Previous research has found this type of treatment increased the number of eggs produced during IVF in 5 women (Baylor University). Furthermore, randomised controlled trials in 2016 and 2018 showed that DHEA given for at least 3 months improved pregnancy rates in IVF.

Case studies have also shown women with premature ovarian failure or premature ovarian insufficiency who were given repeated treatment with DHEA resumed normal cycles and conceived naturally. 

However, while some meta analyses showed significant benefits of DHEA, some did not.

I hope this helps to shed some light on why you might be prescribed DHEA and why it would not be recommended for you. Whatever stage you’re at in your journey, our clinic in Wolverhampton is happy to offer more information on the types of support available.

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