Meta-analysis combines results of 16 studies on DHEA supplementation before IVF

A 2025 meta-analysis combined the results of 16 studies on DHEA for IVF patients, finding no improvement in live birth rates, but improvements in clinical pregnancies, endometrial thickness and the number of eggs retrieved.

DHEA (Dehydroepiandrosterone) is a naturally occurring steroid hormone produced by the adrenal glands that acts as a precursor to sex hormones like testosterone and estrogen. Its levels decline with age and it can be given as a supplement to improve ovarian function and fertility outcomes.

This post is a summary of a study by Huang et al. (2025), who combined the results of 16 studies on the use of DHEA for patients undergoing IVF.

Only RCTs were included, which were conducted between 2010 and 2022, and the primary outcome was the live birth rate. The studies included patients with different diagnoses, with most being poor responders or with DOR. The dosage was consistent between studies, at 75 mg/day, between 4 to 18 weeks before ovarian stimulation for IVF.

You can visit this page to get an overview of all the studies included in this meta-analysis, along with links to the original research.

Note that it’s important to discuss DHEA supplementation with your doctor, and to monitor hormone levels as needed.

For more background on supplement use, check out my post Improving egg quality with supplements. It might also be a good idea to review the glossary for odds ratio (doesn’t count toward paywall).

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DHEA didn’t improve live birth rates overall

Live birth rate: Based on 10 studies, DHEA before IVF didn’t increase the chance of live birth or ongoing pregnancy rates (although it was close to being significant — odds ratio [95% CI]: 1.33 [0.98-1.82]). This was based on low quality of evidence.

The above results were based on all the patients in the 10 studies that reported live birth rates, finding that there was no statistically significant increase in live births when women took DHEA before IVF.

They did multiple subgroup analyses, where they split the patients in the studies up into different groups. The number of patients in these groups were smaller, so there’s less confidence in the results, but the results are more specific to certain types of patients:

• Based on age: No improvement in live births for women 40 or younger (odds ratio 1.17 [0.83-1.65]), but there was a 2.49-times increase in the odds of live birth for women >40 (odds ratio [95% CI]: 2.49 [1.16-5.36], based on 2 studies).
• Diagnosis: No improvements in live births for women with POR, normal responders, or endometriosis.
• Treatment duration: No improvement in live births for those taking DHEA for 12 weeks, 4-12 weeks or 6-18 weeks, but there was a 2.23-times increase in the odds of live birth for those taking DHEA for 8 weeks (odds ratio [95% CI]: 2.23 [1.07-4.66], based on 2 studies).

All in all, DHEA didn’t increase live birth rates among all patients, but it did for certain groups: women 40 or older, and those who took it for 8 weeks (at 75 mg/day).

DHEA improved clinical pregnancies overall

Clinical pregnancy rate: Based on 15 studies, DHEA before IVF increased the odds of clinical pregnancy by 1.34 times vs no DHEA (24.3% vs 19.6%, odds ratio [95% CI]: 1.34 [1.08-1.67], 1949 participants, I2= 20%). This was based on low quality of evidence.

This was based on all the patients, and they broke the studies up into different groups:

• Age: No increase in clinical pregnancies with 40 or younger (although it was close to being significant — odds ratio [95% CI]: 1.25 [0.99-1.57]), but there was a 2.53-times increase in the odds of pregnancy for >40 (odds ratio [95% CI]: 2.53 [1.25-5.13]).
• Diagnosis: No improvement in clinical pregnancies in patients with POR, normal responders or endometriosis, but there was a 1.51-times increase in the odds of pregnancy with DOR patients (odds ratio [95% CI]: 1.51 [1.02-2.23]).
• Duration of treatment: There were no increases in clinical pregnancies with patients who taking DHEA for 4-12 weeks or 6-18 weeks, but there was a 1.67-times increase in the odds of pregnancy for those taking DHEA for 8 weeks and 12 weeks (odds ratio [95% CI]: 1.67 [1.02-2.71], 1.40 [1.04-1.88]). This suggests that a minimum of 8 weeks is needed for a benefit with DHEA.

All in all, DHEA did increase clinical pregnancies among all patients studied here, specifically for those >40, who had DOR, and who took it for 8 and 12 weeks before ovarian stimulation.

Other outcomes with DHEA

• Endometrial thickness. Across 7 studies, there was an average 0.93 mm increase in endometrial thickness at the time of hCG administration (mean difference [95% CI]: 0.93 [0.27-1.60], 559 participants, I2= 81%), particularly for normal responders and for those taking DHEA for 8 weeks. Quality of evidence was low. Due to the high heterogeneity here (I2= 81%), the researchers performed a separate analysis and found that the results were “unstable,” likely due to inconsistencies in how endometrial thickness was measured.
• Miscarriage rate. No change with DHEA across 6 studies, and no difference in the different subgroups. Quality of evidence was low.
• Number of eggs retrieved. Across 15 studies, there was an average of 0.73 more eggs retrieved with DHEA (odds ratio [95% CI]: 0.73 [0.36-1.1], 1829 participants, I2= 70%), particularly for patients with DOR, <40 or younger and >40, and for those who took DHEA for 8 weeks or 12 weeks. Quality of evidence was low.
• Number of mature eggs. Across 8 studies, there was an average of 0.56 more mature eggs (odds ratio [95% CI]: 0.56 [0.06-1.18], 842 participants, I2= 97%), particularly for those with DOR and for those >40. Quality of evidence was very low.
• Number of fertilized eggs. Across 8 studies, there was an average of 0.48 more fertilized eggs (odds ratio [95% CI]: 0.48 [0.1-0.87], 1077 participants, I2= 53%), particularly those with endometriosis and for those taking DHEA for 12 weeks. Quality of evidence was low.
• Number of good quality embryos. Across 8 studies, there was an average of 0.65 more good quality embryos (odds ratio [95% CI]: 0.65 [0.27-1.03], 1063 participants, I2= 79%), particularly for those with DOR or endometriosis, for those taking DHEA for 12 weeks, and for those 40 and younger or >40. Quality of evidence was low.
• Adverse events. Across 10 studies, there were no serious adverse events reported with DHEA, except increased sebum production (oily skin), slight acne or hirsutism (excess hair around mouth and chin).

Conclusions

This study found that DHEA:

• didn’t improve live birth rates (this was the primary outcome of the study).
• improved clinical pregnancy rates.
• improved endometrial thickness (although the researchers were less confident in this result).
• improved the number of eggs retrieved, the number of mature eggs, the number of fertilized eggs and the number of good quality embryos.

For the clinical pregnancy rate, which included the most data, benefits of DHEA were mostly seen in patients >40, who had DOR and who took DHEA for 8 or 12 weeks before starting ovarian stimulation.

A 2015 Cochrane review (reviewed in this post) found that DHEA improved live births and clinical pregnancy rates, however this was only in poor responders. A further analysis that removed biased studies showed that the live birth rate was no longer significant.

The authors note that there was a high amount of variability between the studies (heterogeneity), as a result of different patient diagnoses, ovarian stimulation protocols and DHEA treatment duration. This can create the inconsistent results we’re seeing in this study! This, combined with low sample sizes and low quality of evidence, led to the researchers to call for better quality studies and conclude that these results should be interpreted with caution.

Note that it’s important to discuss DHEA supplementation with your doctor, and to monitor hormone levels as needed.

I’ll also note that DHEA’s popularity may be partly driven by renowned reproductive endocrinologist Norbert Gleicher’s endorsement, as reported by The Washington Post, which poses a conflict of interest given his ownership of Fertility Nutraceuticals, a company that sells DHEA. Additionally, the author of “It Starts with the Egg” served as a consultant for his company in 2020 and endorses his brand, WaPo reports.

Reference

Huang L, Gao Y, Liang S, Jiang M. Administration of dehydroepiandrosterone improves endometrial thickness in women undergoing IVF/ICSI: a systematic review and meta-analysis. J Ovarian Res. 2025 Feb 20;18(1):35. doi: 10.1186/s13048-024-01581-3. PMID: 39980032; PMCID: PMC11843996.

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About Embryoman

Embryoman (Sean Lauber) is a former embryologist and the founder of Remembryo, an IVF research and fertility education website. After working in an IVF lab in the US, he returned to Canada and now focuses on making fertility research more accessible. He holds a Master’s in Immunology and launched Remembryo in 2018 to help patients and professionals make sense of IVF research. Sean shares weekly study updates on Facebook, Instagram, and Reddit regularly. He also answers questions on Reddit or in his private Facebook group.

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