DHEA Dosage - What Is the Ideal Dehydroepiandrosterone Dose in IVF?
DHEA is taken as a supplement to help women increase their pregnancy chances, but how does CHR determine what DHEA dosage to recommend for each patient?
Typical Dosage for Women with Diminished Ovarian Reserve
For women with DOR, the generally recommended DHEA dosage for female fertility purposes is 75 mg daily, which is split into three 25mg doses (to keep a stable supply in the body and avoid an upset stomach. Supplementation is usually started at least 6-8 weeks prior to the planned start of IVF cycles, so that it has enough time to improve the ovarian environment when the follicles are still small and growing. Supplementation is stopped once a woman has conceived, as the body produces enough DHEA during pregnancy. Because some women take longer than others to convert DHEA into androgens (and androgens are what really matters for egg quality), the time to get pregnant after supplementation will be different for each woman.
CHR Individualizes Dosage and Duration
It is important to note that by itself, DHEA for fertility is unlikely to be effective for women with diminished ovarian reserve who are trying to conceive. To maximize every woman's pregnancy chances, CHR adjusts each patient’s DHEA dosage and duration of supplementation and incorporates it into a well-designed fertility treatment framework. This framework includes an ovarian stimulation protocol tailored to each woman's needs, precisely timing the hCG trigger shots (what we call Highly Individualized Egg Retrieval, or HIER), as well as proactively identifying and managing any contributing infertility factors.
One important way in which CHR physicians maximize the DHEA’s benefits is to carefully monitor testosterone and SHBG (sex hormone binding globulin) levels: CHR’s recent research has shown that women whose androgen levels rise while on supplementation have higher pregnancy rates than those whose androgen levels remain low. CHR physicians now closely monitor the patients’ androgen (testosterone) and SHBG levels and adjust DHEA dosage up or down in order to help the androgen levels reach the optimal range before the start of IVF cycles.
For women whose androgen levels stay persistently low, CHR physicians sometimes prescribe direct testosterone supplementation in order to enrich the ovarian environment. However, CHR’s preference is always to start with DHEA. Because each organ takes as much of this weak hormone it needs and converts it to just enough testosterone, using DHEA instead of testosterone directly comes with lower risk of flooding the body with too much androgen, as well as fewer side effects.
Supplementation should always be done under the supervision of a physician, as the hormone can interact with some prescription drugs and affect some medical conditions like diabetes, mood disorders, and estrogen-sensitive cancers.
Contact CHR if you are interested in learning more about using DHEA for IVF, what dosage is right for you, or if you’re interested in scheduling an appointment with one of our experts. You can also see more videos on DHEA in our video gallery.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.