Journal of South Asian Federation of Obstetrics and Gynaecology
Volume 12 | Issue 1 | Year 2020

Dehydroepiandrosterone: Is it a Magic Drug?

Neharika Malhotra1, Jaideep Malhotra2, Keshav Malhotra3, Shally Gupta4

1–4Rainbow IVF, Rainbow Hospitals, Agra, Uttar Pradesh, India

Corresponding Author: Jaideep Malhotra, Rainbow IVF, Rainbow Hospitals, Agra, Uttar Pradesh, India, Phone: +91 9897033335 e-mail: jaideepmalhotraagra@gmail.com

How to cite this article Malhotra N, Malhotra J, Malhotra K, et al. Dehydroepiandrosterone: Is it a Magic Drug? J South Asian Feder Obst Gynae 2020;12(1):59–61.

Source of support: Nil

Conflict of interest: None


With infertility populations in the developed world rapidly aging, treatment of diminished ovarian reserve (DOR) assumes increasing clinical importance. In developing countries like India, many patients due to economic and cultural restraints are not able to afford ovum donation or other assisted reproductive techniques. Thus, the possibility of a significant improvement in ovarian response with such an intervention in cases of DOR seems to be very promising. Our findings show only an improvement in anti-mullerian hormone (AMH) levels and antral follicle count in women with poor ovarian reserve, which was statistically significant. But we need a bigger sampling size.

Keywords: Anti-mullerian hormone, Dehydroepiandrosterone, Infertility, Poor ovarian reserve..


As we know infertility populations is rising all over the world, managing diminished ovarian reserve (DOR) is very important.

Many studies have been reported to have improve outcome with dehydroepiandrosterone (DHEA) pretreatment.

Diminished ovarian reserve is where the ovaries lose it capability to act in a desired manner affecting reproductive outcome.

Anti-mullerian Hormone

  • There is no specific time for the test.
  • Low values of anti-mullerian hormone (AMH) are associated with poor ovarian response but it does not predict failure to conceive.

AFC (Antral Follicle Count) Ideally to be Seen on Day 2/Day 3

  • Number of visible follicles (2–10 mm) during transvaginal ultrasound.
  • Performed on cycle days 2–5.
  • Number of antral follicles correlates with ovarian response to stimulation.
  • Does not predict failure to conceive.


Dehydroepiandrosterone is an endogenous steroid hormone.

It is produced in the adrenal glands (zona reticularis) and the gonads, and functions predominantly as a metabolic intermediate in the biosynthesis of the androgen and estrogen sex steroids.

Dehydroepiandrosterone does show many effects on reproduction and has a binding effect on an array of receptors (Fig. 1).


We still are unsure of the direct mechanism of DHEA on ovary.




Fig. 1: Synthesis of dehydroepiandrosterone


Primary Outcome

  • Improvement in serum AMH level.
  • Improvement in antral follicle count.

Secondary Outcome

  • Determined whether there was a difference in the effect of DHEA supplementation between younger and older patients with diminished ovarian reserve.





The sample size is small so we need to further study to draw significant conclusions.

Table 1: Study statistics
Age groupBaseline AMH (mean ± SD) (ng/mL)AMH after 3 months (mean ± SD) (ng/mL)Mean difference (95% confidence interval)p value
<35 years (n = 14)1 ± 0.321.4 ± 0.280.4 (0.16–0.66)0.001
≥35 years (n = 16)0.78 ± 0.230.97 ± 0.240.19 (0.02–0.35)0.003
Table 2: Our study statistics
Age groupBaseline AFC (mean ± SD)AFC after 3 months (mean ± SD)Mean difference (95% confidence interval)p value
<35 years (n = 14)2.14 ± 0.663.57 ± 0.941.4 (0.79–2.06)0.001
≥35 years (n = 16)1.63 ± 0.812.00 ± 0.730.38 (0.05–0.70)0.02

Fig. 2: Comparison of AMH levels before and after DHEA supplementation for 3 months


Fig. 3: Comparison of AFC levels before and after DHEA supplementation for 3 months


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