DHEA for Fertility Support Female

DHEA is a hormone precursor studied as a way to improve egg supply, mostly in women who respond poorly to IVF drugs. A 2024 Cochrane review of 28 randomised trials of DHEA or testosterone found that DHEA likely results in little to no difference in live birth or ongoing pregnancy (Naik 2024). The largest double-blind trial, in 821 poor responders, found live birth in 8.8% of women on DHEA and 9.0% on placebo (Wang Z 2022).

ESHRE's 2025 ovarian stimulation guideline gives a strong recommendation against DHEA before or during stimulation, for low responders and for normal responders alike, on low-quality evidence (ESHRE 2025); its 2020 edition likewise recommended none of the adjuvants it reviewed, DHEA included (ESHRE 2020). Every randomised trial we reviewed enrolled women having IVF, so there is no randomised evidence on DHEA for women trying to conceive without treatment. The same evidence is covered from the infertility angle on DHEA for female infertility.

The body converts DHEA into testosterone and estrogen. In meta-analyses of general populations rather than IVF patients, oral DHEA raised testosterone by about 28 ng/dL (42 publications), with larger rises in women, at doses above 50 mg a day, and in courses of 12 weeks or less (Li 2020), and raised estradiol by about 7 pg/mL, most clearly in older and postmenopausal women (Zhu Y 2021).

The theory is that androgens help follicles respond to stimulation drugs, so more eggs are collected (Naik 2024). Among randomised trials, DHEA raised antral follicle count by about 1.2 (Zhang 2023), and a 2025 meta-analysis found about 0.6 more eggs collected in women with diminished ovarian reserve (Conforti 2025).

A hormone rise and a few extra follicles are not a baby. In the randomised-only analysis that found more follicles, the number of oocytes retrieved, clinical pregnancy and live birth did not differ (Zhang 2023). In the DITTO double-blind trial, egg-development markers in granulosa and cumulus cells were similar with DHEA and placebo (Narkwichean 2017).

In women with premature ovarian insufficiency, 12 months of DHEA did not bring back regular periods or change AMH, FSH or antral follicle count (Wong 2018). Live birth is the outcome that matters, and on that the best evidence is null.

Most of the smaller trials with a stated dose used 75 mg of DHEA a day, started 8 to 12 weeks or more before IVF stimulation and sometimes continued through the cycle (Kara 2014; Narkwichean 2017; Wiser 2010; Tartagni 2015). The largest trial gave it for 4 to 12 weeks and its abstract does not state the dose (Wang Z 2022). Two studies used 25 mg three times a day, for 12 weeks in normal responders (Yeung 2016) and for 12 months in premature ovarian insufficiency (Wong 2018).

No dose has been shown to improve live birth, so there is no evidence-based dose to recommend. The label dose of any supplement may differ from the trial doses.

The 2024 Cochrane review pooled 9 trials (1,433 women) for live birth or ongoing pregnancy: OR 1.30, 95% CI 0.95 to 1.76, moderate certainty. For a woman with a 12% chance on placebo, that means a likely rate between 12% and 20%. DHEA likely also made little to no difference to clinical pregnancy (OR 1.18, 95% CI 0.93 to 1.49) and did not decrease miscarriage (OR 0.85, 95% CI 0.53 to 1.37). The reviewers noted that trials mostly lacked blinding (Naik 2024).

In the largest double-blind trial, 36 of 410 women (8.8%) on DHEA and 37 of 411 (9.0%) on placebo had a live birth (relative risk 0.98, 95% CI 0.63 to 1.51), with no difference in oocytes retrieved, clinical pregnancy, pregnancy loss or cumulative live births (Wang Z 2022). A meta-analysis restricted to randomised trials also found no live-birth difference (Zhang 2023).

A small trial in 33 poor responders without a placebo reported live birth in 23.1% with DHEA versus 4.0% without (P = 0.05) (Wiser 2010). A meta-analysis mixing randomised, case-control and cohort studies found more oocytes (1.09 more on average), higher clinical pregnancy (RR 1.35) and ongoing pregnancy (RR 1.82), but no difference in live birth (RR 1.35, 95% CI 0.94 to 1.94) (Wang J 2023). A network meta-analysis of 16 randomised trials (2,323 women) found DHEA improved clinical pregnancy (OR 1.92, 95% CI 1.16 to 3.16) and implantation (Zhu F 2023).

These signals did not carry through to live birth in the Cochrane review, the randomised-only analysis (Zhang 2023) or the 821-woman blinded trial. The Zhang analysis did find fewer miscarriages with DHEA in randomised trials (RR 0.46, 95% CI 0.29 to 0.73), whereas the Cochrane review found no decrease, so that finding is unsettled.

In 72 women with a normal antral follicle count, 12 weeks of DHEA raised blood DHEA-S and testosterone but did not change antral follicle count, AMH, FSH, ovarian response or IVF outcomes versus placebo (Yeung 2016). A smaller double-blind trial in 52 women with normal reserve reported more live births with DHEA (P<0.05), but its abstract gives no counts (Tartagni 2015), and ESHRE gives a strong recommendation against DHEA for normal responders (ESHRE 2025).

In 38 women with premature ovarian insufficiency, 12 months of DHEA did not restore periods or change ovarian reserve markers (Wong 2018).

In the Cochrane review, testosterone pre-treatment likely improved live birth in poor responders (OR 2.53, 95% CI 1.61 to 3.99), and a 2025 meta-analysis in diminished ovarian reserve agreed (OR 2.19) (Naik 2024; Conforti 2025). ESHRE's 2025 guideline still says testosterone is probably not recommended for low responders, a conditional recommendation (ESHRE 2025). It is a prescription decision for a fertility specialist.

For supplements, a network meta-analysis ranked CoQ10 best for live birth in poor responders (OR 2.36, 95% CI 1.07 to 5.38) (Zhu F 2023). See CoQ10, myo-inositol and folate for female fertility, and female infertility for the condition itself.

DHEA is a hormone precursor, so it acts like a mild androgen. In women, androgenic side effects such as skin changes, acne and unwanted hair growth (hirsutism) are the usual complaints, and they appeared more often than with placebo in a review of trials (Wierman 2022; Mayo Clinic 2026). In meta-analyses of general populations, DHEA lowered HDL cholesterol in women by about 5 mg/dL, with no change in total cholesterol, LDL or triglycerides (Qin 2020).

In 12 months of use in women with premature ovarian insufficiency, no serious side effects were reported (Wong 2018), and adverse events in the IVF trials were sparse and minor (Naik 2024). The Cochrane reviewers called for better adverse-event reporting. Mayo Clinic advises that high doses or long use might raise the risk of hormone-sensitive cancers, though more research is needed, and that anyone with a hormone-sensitive cancer should not use DHEA (Mayo Clinic 2026); an endocrinology review likewise called DHEA contraindicated in women with a history of breast cancer (Wierman 2022).

DHEA was taken before and sometimes during stimulation with standard IVF drugs in the trials (Wiser 2010), but interactions were not formally studied. Because the body converts it into testosterone and estrogen (Wierman 2022), it changes the hormone picture your clinic monitors. Mayo Clinic advises against combining DHEA with estrogen, which might cause symptoms of excess estrogen such as nausea, headache and insomnia (Mayo Clinic 2026).