Part 2 of 3: DHEA for Improving Egg Quality

In the past several years I’ve seen quite an increase in the number of my patients whose doctors recommend they try DHEA for improving egg quality. Leading centers such as CCRM in Denver and CHR here in New York routinely recommend their patients with egg quality concerns take it for several months leading up to an IVF cycle. Here I hope to tell you a little about what DHEA is and how it might help.
DHEA is a substance naturally present in the body that is a precursor to several hormones, including estrogen and testosterone. Recent research has found that women who took DHEA for 3-4 months prior to an IVF cycle using gonadotropins (injectable ovary stimulators) had dramatically increased fertilization and pregnancy rates. Women also reported side effects of feeling stronger, a higher libido, better memory and feeling mentally sharper. This is consistent with studies that have found higher DHEA levels in those with higher concentration and memory function.

Researchers are only recently hypothesizing that the eggs themselves don’t age or decrease in quality, but the environment in which they mature does (which then has an effect on egg quality). Keep in mind, follicle development and egg maturation isn’t limited to the time from menses to ovulation: the entire process is ongoing and takes approximately 300 days, from primordial follicle to ovulation. As you can imagine, there are many things that can influence the final product (the egg which is ovulated) in this period of time. Researchers believe that increased DHEA levels improves the environment in which the eggs are developing, and can actually decrease chromosomal abnormalities (thereby decreasing miscarriage rates), improve ovarian function and improve pregnancy and live birth rates.

Who might benefit from DHEA supplementation? How long would I need to take DHEA?

In theory, women with high FSH and/or low AMH levels, regardless of age, as well as women with multiple miscarriages due to chromosomal abnormalities may benefit from DHEA. However in research, at this point the only studies conducted have involved women who are also undergoing stimulation with injectable gonadotropins (such as Follistim or Menapur) for IVF cycles. These women have had increased numbers of eggs retrieved and fertilized after taking DHEA for 4 months prior to an IVF cycle.

Who should steer clear of DHEA?

Since DHEA has the potential to increase testosterone levels quite a bit, women with PCOS or other conditions where testosterone is already elevated may actually worsen if they increase DHEA. Always tell your Reproductive Endocrinologist or GYN if you are taking DHEA, and have your hormone levels monitored closely, as everyone responds differently.

STUDIES AND ARTICLES ON DHEA FOR EGG QUALITY

CHR’s Summary of Research

USC Article: Basics of Female Egg Quality

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