DHEA for Infertility

What the Evidence Actually Shows

By Dr. Pamela Frank, BSc(Hons), ND – Published August 2026

DHEA (dehydroepiandrosterone) is one of the most searched supplements in fertility circles, and one of the most inconsistently understood. Patients often arrive having read that it “worked for someone” on a forum, without knowing that DHEA is a hormone precursor, not a general fertility vitamin, and that the research on it is genuinely mixed rather than uniformly positive. Here is what the evidence supports, where it doesn’t, and who should avoid it.

What DHEA Actually Is

DHEA is an androgen precursor produced mainly by the adrenal glands (75-90%), and to a lesser extent the ovaries. It converts into androstenedione, which turns into testosterone and, downstream, into estrogen (estradiol). The theory behind supplementing it in diminished ovarian reserve is that low-grade androgen exposure inside the follicle may improve the microenvironment that antral follicles develop in, not that it “creates” new eggs, since a woman’s total egg count is fixed from birth.

Where the Evidence Is Reasonably Supportive

The strongest and most consistent signal is around miscarriage rate and embryo yield in women with diminished ovarian reserve, rather than live birth rate across the board:

• A 2009 case-control study of 73 DHEA-supplemented pregnancies at two North American IVF centres found a significantly lower age-adjusted miscarriage rate compared with a national IVF database, though the study was retrospective and not randomized.¹
• A prospective randomized trial in poor responders found that DHEA pretreatment before ovarian stimulation was associated with a higher chance of clinical pregnancy compared with no pretreatment, though the sample size was modest.²
• A 2023 meta-analysis of randomized trials in women with diminished ovarian reserve or poor ovarian response found DHEA supplementation was associated with improvements in some IVF outcome measures, while noting substantial heterogeneity across the included trials.³
• An earlier 2017 systematic review reached a broadly similar conclusion: some benefit signal in DOR populations, but not strong enough to be considered definitive across all outcome measures.⁴

Where the Evidence Pushes Back

This is the part patients are rarely shown, and it matters for setting realistic expectations:

• A well-designed double-blind, placebo-controlled trial (the DITTO trial) in women with predicted poor ovarian response found that DHEA pretreatment did not improve ovarian stimulation response, oocyte quality, or live birth rate compared with placebo.⁵
• Several individual RCTs summarized in a 2024 systematic review found no significant difference between DHEA and control groups in oocytes retrieved, clinical pregnancy rate, or live birth rate, even where fertilization rate trended favourably.⁶

Put plainly: DHEA is not an intervention with guaranteed benefit. The most honest summary of the literature is that it may help a subset of women with diminished ovarian reserve, likely through modest improvements in oocyte/embryo quality markers, but it does not reliably move the needle on live birth rate across unselected populations, and at least one rigorous placebo-controlled trial found no benefit at all.

Who DHEA Is Usually Considered For

In practice, DHEA is most often discussed for:

• Diagnosed diminished ovarian reserve (low AMH, elevated FSH, low antral follicle count)
• Women preparing for an IVF cycle who have had a prior poor response to stimulation
• Premature ovarian insufficiency, where baseline androgen levels are often already low

It is not a general-purpose fertility supplement for women with normal ovarian reserve, unexplained infertility, or PCOS; in PCOS, androgen levels are typically already elevated, and adding more is not appropriate.

Dosing, Duration, and Monitoring

Studies typically use 25 mg three times daily (75 mg/day total) for a minimum of 12 weeks before an IVF cycle, reflecting the time needed for a cohort of antral follicles to mature. Shorter courses are unlikely to have any measurable effect given normal follicle development timelines.

DHEA is a hormone, not an inert supplement. Naturopathic doctors in Ontario cannot prescribe any oral hormone therapy, including DHEA.

Appropriate use requires baseline and follow-up testing, including DHEA-S, total and free testosterone, and a lipid panel, since supraphysiologic dosing can cause acne, oily skin, hirsutism, or unfavourable changes in cholesterol. This is not something to dose based on internet forums; it should be monitored the way any androgen therapy would be.

Frequently Asked Questions About DHEA for Fertility

How long before IVF should I start taking DHEA?

Most of the research protocols use a minimum of 12 weeks of supplementation before an IVF cycle. This reflects the time it takes for a cohort of antral follicles to develop, since DHEA is thought to act on follicles early in their growth, not on eggs already close to ovulation.

Can DHEA cause side effects?

Yes. Because it’s an androgen precursor, common side effects include acne, oily skin, and hirsutism (excess facial or body hair growth). Less commonly, it can shift cholesterol levels unfavourably. This is why baseline and follow-up bloodwork is part of appropriate use, not optional.

Is DHEA right for someone with PCOS?

Generally, no. PCOS is typically associated with already-elevated androgen levels, and adding an androgen precursor on top of that is not appropriate. DHEA is studied specifically in diminished ovarian reserve, a very different hormonal picture.

Does DHEA improve egg quality?

Some studies suggest modest improvements in oocyte and embryo quality markers in women with diminished ovarian reserve, but the strongest, most rigorously designed placebo-controlled trial to date found no significant improvement in oocyte quality or live birth rate. The honest answer is that the evidence is suggestive, not conclusive.

Do I need a prescription for DHEA in Ontario?

DHEA is not supposed to be available over the counter in Ontario. Despite this, some unscrupulous health food stores or practitioners may sell it. But just because it is “available” to you, that doesn’t make it “appropriate for you.”

Given that it’s a hormone with real physiological effects and documented side effects, it should be used under medical supervision with baseline testing and appropriate dosing, not self-prescribed based on what worked for someone else.

Naturopathic doctors in Ontario cannot prescribe any oral hormone therapy, including DHEA.

The Bottom Line

DHEA has a plausible mechanism and a body of research that leans cautiously favourable specifically for diminished ovarian reserve, but the evidence is inconsistent. The best-designed placebo-controlled trial found no benefit, and it is not appropriate for everyone. Whether it makes sense for a given patient depends on ovarian reserve testing, androgen levels, and where someone is in their treatment timeline.

If you’re considering it, this is a conversation to have with your fertility clinic with testing in hand, not a supplement to start blindly.

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References on DHEA for Infertility

1. Gleicher N, Ryan E, Weghofer A, Blanco-Mejia S, Barad DH. Miscarriage rates after dehydroepiandrosterone (DHEA) supplementation in women with diminished ovarian reserve: a case control study. Reprod Biol Endocrinol. 2009 Oct 7;7:108. doi: 10.1186/1477-7827-7-108. PMID: 19811650; PMCID: PMC2764711.
2. Wiser A, Gonen O, Ghetler Y, Shavit T, Berkovitz A, Shulman A. Addition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study. Hum Reprod. 2010 Oct;25(10):2496-500. doi: 10.1093/humrep/deq220. Epub 2010 Aug 21. PMID: 20729538.
3. Zhang J, Jia H, Diao F, Ma X, Liu J, Cui Y. Efficacy of dehydroepiandrosterone priming in women with poor ovarian response undergoing IVF/ICSI: a meta-analysis. Front Endocrinol (Lausanne). 2023 Jun 9;14:1156280. doi: 10.3389/fendo.2023.1156280. PMID: 37361534; PMCID: PMC10288189.
4. Qin JC, Fan L, Qin AP. The effect of dehydroepiandrosterone (DHEA) supplementation on women with diminished ovarian reserve (DOR) in IVF cycle: Evidence from a meta-analysis. J Gynecol Obstet Hum Reprod. 2017 Jan;46(1):1-7. doi: 10.1016/j.jgyn.2016.01.002. Epub 2016 May 19. PMID: 28403950.
5. Narkwichean A, Maalouf W, Campbell BK, Jayaprakasan K. Efficacy of dehydroepiandrosterone to improve ovarian response in women with diminished ovarian reserve: a meta-analysis. Reprod Biol Endocrinol. 2013 May 16;11:44. doi: 10.1186/1477-7827-11-44. PMID: 23680224; PMCID: PMC3663765.
6. Gleicher N, Barad DH. Dehydroepiandrosterone (DHEA) supplementation in diminished ovarian reserve (DOR). Reprod Biol Endocrinol. 2011 May 17;9:67. doi: 10.1186/1477-7827-9-67. PMID: 21586137; PMCID: PMC3112409.
7. Traish AM, Kang HP, Saad F, Guay AT. Dehydroepiandrosterone (DHEA)–a precursor steroid or an active hormone in human physiology. J Sex Med. 2011 Nov;8(11):2960-82; quiz 2983. doi: 10.1111/j.1743-6109.2011.02523.x.
8. Malik N, Kriplani A, Agarwal N, Bhatla N, Kachhawa G, Yadav RK. Dehydroepiandrosterone as an adjunct to gonadotropins in infertile Indian women with premature ovarian aging: A pilot study. J Hum Reprod Sci. 2015 Jul-Sep;8(3):135-41. doi: 10.4103/0974-1208.165142.
9. Singh N, Zangmo R, Kumar S, Roy KK, Sharma JB, Malhotra N, Vanamail P. A prospective study on role of dehydroepiandrosterone (DHEA) on improving the ovarian reserve markers in infertile patients with poor ovarian reserve. Gynecol Endocrinol. 2013 Nov;29(11):989-92. doi: 10.3109/09513590.2013.824957. Epub 2013 Sep 4.

Medical Disclaimer: The information on this website is provided for educational and informational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. It is not a substitute for professional medical advice, diagnosis, or treatment from a licensed healthcare provider. Use of this website or communication with this clinic does not establish a doctor–patient relationship. Always seek the advice of your physician, naturopathic doctor, or other qualified healthcare professional regarding any medical condition or before making changes to your health care.

By Dr. Pamela Frank, BSc(Hons), ND