If you are infertile or work in the world of fertility you know the hot topics of the day. Some current ones are ERA, age, immune testing, sperm DNA fragmentation, and PRP.
Every now and again a hot fertility topic will spill into mainstream media and this week DHEA spilled over.
The Washington Post wrote about DHEA. DHEA was first studied and then touted by Dr. Norbert Gleicher. Dr. Gleicher first published a case report in 2005 of a woman who took DHEA continuously for several months and did multiple IVF cycles. Each cycle saw a better and better egg health and yield, prompting Dr. Gleicher to believe DHEA might have an impact on egg yield and quality. Then in 2006 studied 25 women who underwent IVF and had a poor response, then took DHEA for an average of 17 weeks and did IVF again. He found their second IVF cycle had more fertilized eggs, more embryos and high embryo grades.
This prompted many of us to explore the use of DHEA. More studies were done - many showing no benefit and many showing a small benefit.
Dr. Gleicher owns a supplement company that makes DHEA and shares a patent on DHEA's use in fertility. He is a controversial figure, as noted in the Washington Post article. USA federal regulators asked him to change the language on his marketing materials that were over stating the benefit of DHEA. He also has crossed ethical lines in telling patients to purchase his brand of supplements.
Nevertheless, if we weed through the controversy about the business and ethical practices of Dr. Gleicher to what matters: does DHEA help women with low ovarian reserve (low egg count)?
It probably does help a bit. It’s fairly cheap. In the USA it is sold over the counter. In Canada a prescription is required. In the words of Dr. Gleicher “it’s inexpensive and practically risk free.”
I don’t think women should take it for years, but taking 75mg orally for a few weeks or months before an IVF cycle, I believe there is enough evidence that is can help women with low egg counts, particularly those over 40.
[As a side note, the Washington Post article mentions his clinic’s pregnancy rates and their oldest live birth. These are lower than many clinics (including us) and we also have helped a 47 year old woman use her own eggs to achieve a health child. Just an FYI!]
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