Dehydroepiandrosterone (DHEA) is a naturally occurring steroid hormone precursor that is often taken as a supplement by individuals attempting to conceive. The body primarily produces DHEA in the adrenal glands, using it as a building block to synthesize potent sex hormones, including testosterone and estrogens. Many people begin DHEA supplementation under the guidance of a reproductive specialist to improve egg quality or ovarian function before pregnancy. Once conception is achieved, continuing this supplement becomes a concern due to the changing hormonal needs of the body and the safety of the developing fetus.
Why DHEA is Used for Fertility
DHEA is commonly utilized in fertility settings to address issues like Diminished Ovarian Reserve (DOR) or Poor Ovarian Response (POR) during assisted reproductive technology (ART) cycles. Women diagnosed with DOR often have lower-than-expected levels of DHEA and testosterone, which are thought to contribute to suboptimal egg development. Supplementation aims to restore these levels to a range seen in younger, more fertile women.
The proposed mechanism involves DHEA converting to androgens, which can promote the growth of pre-antral follicles and potentially reduce the rate of follicle death. Evidence suggests that a course of DHEA supplementation, often 75 mg per day for at least two months, may increase the yield of oocytes, improve embryo quality, and raise clinical pregnancy rates in certain patient groups.
Critical Timing for Discontinuation
The consensus among reproductive endocrinologists is that DHEA supplementation should cease immediately upon confirmation of pregnancy. This action is taken because the supplement’s intended therapeutic effect—improving ovarian function and egg quality—is no longer necessary once conception has occurred. Confirmation of pregnancy typically involves a positive home urine test followed by a blood test to measure human chorionic gonadotropin (hCG). In clinical practice, some specialists recommend continuing DHEA until a second, rising hCG blood test confirms the pregnancy is progressing appropriately.
If a person is trying to conceive naturally without close clinical monitoring, stopping the supplement as soon as the first positive home test is seen is the safest precautionary measure. It is highly recommended that a clear discontinuation plan be established with the supervising physician before the start of any cycle in which conception is possible. Given that many individuals do not realize they are pregnant until four to six weeks into gestation, some early exposure to DHEA is common. If a positive test is discovered later in the first trimester, the supplement should be stopped immediately, and the physician should be notified for consultation.
Potential Effects of Continued Use
Medical professionals advise stopping DHEA primarily due to the lack of extensive safety data from human clinical trials on its use during gestation. The primary concern relates to DHEA’s role as a precursor to androgens, commonly known as male hormones. Continued DHEA use in pregnancy could theoretically lead to higher-than-normal androgen levels in the maternal bloodstream. Excessive androgen exposure during the development of a female fetus is associated with a theoretical risk of virilization, which involves the development of male-like characteristics. While the risk from typical preconception doses is considered low, medical caution dictates avoiding any unnecessary hormone supplements.
The precautionary principle is applied because the potential for serious developmental effects, even if rare, outweighs any benefit once pregnancy is established. The body naturally increases its own DHEA production significantly during pregnancy, using it to synthesize estriol, a hormone important for placental development and maintaining a healthy pregnancy. Therefore, continuing the supplement would be adding an unmonitored and unneeded amount to the high levels the body is already producing. For this reason, and because the supplement’s original purpose is complete, stopping DHEA is the standard and safest course of action to protect the developing fetus.