Dehydroepiandrosterone (DHEA) is a steroid hormone produced naturally by the adrenal glands, ovaries, and testes. As a precursor, DHEA serves as the raw material the body uses to synthesize other reproductive hormones, including testosterone and estrogen. Since DHEA levels naturally peak in a person’s 20s and decline significantly with age, supplementing this hormone is a topic of interest in reproductive medicine. This article explores whether DHEA supplementation can increase the chances of achieving pregnancy naturally.
Understanding DHEA’s Function in Ovarian Health
DHEA’s primary role in reproductive function stems from its conversion into androgens within the ovaries. Adequate levels of these androgens, such as testosterone, are crucial for the earliest stages of egg development. Specifically, androgens support the growth of small follicles (pre-antral and early antral follicles) from which mature eggs are eventually selected.
This androgen support enhances the ovarian environment by increasing the expression of Follicle-Stimulating Hormone (FSH) receptors on developing follicles. Improving responsiveness to FSH helps mobilize a larger and healthier cohort of eggs each cycle. DHEA is also thought to improve egg quality, possibly by supporting mitochondrial function and reducing cellular stress within the oocyte.
Scientific Evidence Supporting Natural Conception
While DHEA is most frequently studied as an adjunct therapy for women undergoing in vitro fertilization (IVF), some clinical observations provide direct evidence for its potential to support unassisted pregnancy. This evidence often comes from studies involving women with diminished ovarian reserve (DOR) who were prescribed DHEA in preparation for an IVF cycle. In these cases, some women experienced a spontaneous pregnancy before they even began their scheduled assisted reproductive treatment.
In one notable study, researchers observed a significant increase in spontaneous conception rates among women with poor ovarian function who were taking DHEA. For women over 40 receiving DHEA, the spontaneous pregnancy rate reached over 21%, compared to a much lower rate of about 4% in a comparable control group not taking the supplement. A separate analysis of young women classified as poor responders also demonstrated spontaneous ongoing pregnancies after DHEA supplementation. These unexpected results suggest that the improved ovarian function and egg quality facilitated by DHEA may be enough to overcome fertility challenges in some individuals.
The proposed mechanism for this improvement is directly related to egg quality. DHEA supplementation is believed to reduce the rate of aneuploidy, which refers to chromosomal abnormalities in the egg that are the leading cause of early miscarriage. By supporting the development of genetically healthier eggs, DHEA may increase the chance of conception and reduce the risk of early pregnancy loss. This effect is especially relevant for women of advanced reproductive age, whose egg quality naturally declines.
Despite these promising findings, the available data primarily comes from small, non-randomized studies focused on a very specific population: women with diagnosed ovarian function issues. While DHEA shows considerable promise, more large-scale, randomized controlled trials are needed to definitively confirm its efficacy for the general population seeking natural conception. The current evidence, however, offers a reasonable basis for its use in specific cases under medical guidance, as it suggests the potential for improved follicular health and spontaneous ovulation.
Necessary Medical and Safety Considerations
Because DHEA is a hormone precursor that alters the body’s endocrine system, it should never be taken without medical supervision, especially when trying to conceive. A healthcare provider specializing in reproductive endocrinology can determine if a patient’s current DHEA or androgen levels indicate a need for supplementation. This initial testing is crucial because DHEA is not appropriate for everyone and may be contraindicated in certain conditions.
The typical dosage used in most fertility-related studies is 75 milligrams of micronized DHEA per day, usually divided into three 25-milligram doses taken throughout the day. This split dosing helps maintain a more stable level of the hormone in the bloodstream. The supplement must be taken consistently for a minimum of 60 to 90 days before a noticeable improvement in ovarian function can be expected, as this timeframe aligns with the natural development cycle of a follicle.
Potential side effects are generally mild and are related to the increase in androgen levels. These may include oily skin, acne, facial hair growth (hirsutism), or thinning hair on the scalp. These effects are typically reversible upon reducing the dosage or discontinuing the supplement. It is also important for consumers to recognize that DHEA is classified as a dietary supplement and is not regulated by the U.S. Food and Drug Administration (FDA) for fertility treatment. This lack of regulation means the quality and concentration of over-the-counter products can vary significantly, underscoring the need for guidance from a trusted medical professional.