Short answer: Probably not much. A 2024 Cochrane review of 28 randomized trials, mostly in women who respond poorly to IVF stimulation, found DHEA likely makes little to no difference to live birth or ongoing pregnancy (9 trials, 1,433 women) or to clinical pregnancy. Testosterone pre-treatment, studied in separate trials, likely improved live birth. Neither lowered miscarriage, and the evidence was of moderate to very low certainty.
DHEA (dehydroepiandrosterone) is a steroid hormone that the NIH Office of Dietary Supplements (ODS) says can be converted into testosterone and estradiol. In the US it is sold as a supplement. The idea behind giving DHEA or testosterone before IVF is that androgens may help small follicles respond to the stimulation medicines, giving more eggs and a better chance of pregnancy. Most trials enrolled "poor responders", women who make few eggs on standard IVF protocols. In men, ODS reports no evidence that DHEA raises strength, lean body mass or testosterone.
The 2024 update (Naik and colleagues) included 28 randomized trials with 1,533 women in treatment groups and 1,469 in control groups. All but three trials were in poor responders.
| Outcome | DHEA | Testosterone |
|---|---|---|
| Live birth or ongoing pregnancy | Likely little to no difference (OR 1.30, 9 trials, 1,433 women) | Likely improved (OR 2.53, 8 trials, 716 women) |
| What that means | From 12% to somewhere between 12% and 20% | From 10% to somewhere between 15% and 30% |
| Clinical pregnancy | Likely little to no difference (13 trials) | Likely increased (13 trials) |
| Miscarriage | Likely not lowered | Likely not lowered |
| Multiple pregnancy | Very uncertain | Very uncertain |
The authors rated the evidence moderate to very low certainty. The main problems were lack of blinding, poor reporting of methods, and small trials with few events. Data on side effects were sparse.
The review supports the view that DHEA does not clearly change the chance of a baby for poor responders, while short testosterone pre-treatment looks more promising, though the best length of treatment is not known. Testosterone for this use is a prescription given by the clinic, not a supplement.
DHEA is a hormone even when sold as a supplement. ODS says that over several months it raises testosterone levels in women, which can cause acne and facial hair growth, and that its safety is not well studied. Anyone thinking about it can ask the fertility clinic first. See the DHEA page for general information.
Pre-treatment usually runs on a schedule tied to the start of stimulation. Dose Track can hold the pre-treatment, the stimulation injections and trigger timing in one list, which is useful when a cycle is reviewed with the clinic afterward.
Read more on Dose Track: DHEA · Female fertility · Gonadotropin · Follistim vs Gonal-f