DHEA and Growth Hormone in IVF: What the Evidence Says
Key Takeaways
When you are preparing for IVF and have been told you have low ovarian reserve or are a “poor responder,” it is completely natural to look for any extra advantage. DHEA and Growth Hormone (GH) are two options that frequently come up in patient forums and consultations. However, when we look at the highest-quality clinical evidence, the reality is that neither has been proven to increase the live birth rate—meaning your chances of actually taking a healthy baby home. While DHEA may slightly increase the number of retrieved eggs, and GH can reduce the total dose of stimulation drugs, official guidelines from major reproductive societies do not recommend their routine use.
Video: DHEA and Growth Hormone in IVF for Poor Responders
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What Are DHEA and Growth Hormone in IVF?
DHEA and Growth Hormone are used as experimental adjuvants before or during IVF stimulation to improve the response of the ovaries. They are intended for women who produce few eggs or have low ovarian reserve, a condition known as poor ovarian response.
DHEA (Dehydroepiandrosterone) is an androgenic pro-hormone. It is converted into active testosterone within the ovarian cells, stimulating the early stages of egg follicle growth. Growth Hormone (GH) works via the GH/IGF-1 axis to increase the sensitivity of ovarian cells to follicle-stimulating hormone (FSH), helping follicles respond more effectively during stimulation.
Does DHEA Improve IVF Success Rates?
DHEA does not improve live birth rates, although it may lead to a minor increase in the number of eggs collected. Clinical studies show that the initial signals of benefit disappear when analyzing high-quality, unbiased research.
A comprehensive 2024 Cochrane systematic review (Naik et al.) analyzed 28 randomized controlled trials involving 3,002 women. The review concluded that DHEA has little to no effect on the chances of a successful pregnancy, with an odds ratio of 1.30 (95% CI 0.95–1.76) for live births. Crucially, when researchers excluded trials with a high risk of bias, the odds ratio dropped to 1.08 (95% CI 0.75–1.54), demonstrating no clinical benefit.
Androgens (DHEA and testosterone) likely do not decrease a woman’s chance of miscarriage, and DHEA likely has little to no effect on the chances of a successful pregnancy in women identified as poor responders to IVF.
Furthermore, claims that DHEA reduces chromosome abnormalities (aneuploidy) remain highly controversial. Much of the positive literature on DHEA is authored by researchers with direct commercial interests, including patents on androgen supplementation and financial links to nutraceutical manufacturers.
Does Growth Hormone (GH) Help Poor Responders?
Growth Hormone does not increase the live birth rate for poor responders, despite showing some benefit in accelerating follicle development and reducing overall medication requirements.
The most rigorous, double-blind, randomized controlled trial on this subject—the LIGHT study (Norman et al., 2019)—found a live birth rate of 14.5% in the GH group compared to 13.7% in the placebo group. This difference was not statistically significant. The study showed that while GH advanced egg collection by about one day and slightly lowered the required dose of FSH, it did not translate into a higher rate of healthy babies.
Additionally, a 2024 meta-analysis by Conforti et al. focusing on POSEIDON criteria patients (women with poor ovarian reserve) found that GH did not improve egg yield or pregnancy rates in this specific population.
Comparing DHEA vs. Growth Hormone
The following table summarizes the clinical evidence and parameters for DHEA and Growth Hormone based on independent clinical reviews:
| Clinical Parameter | DHEA | Growth Hormone (GH) |
|---|---|---|
| Primary Effect on Eggs | Modest increase (+0.60 eggs) | Accelerated development, lower FSH dose |
| Impact on Live Birth Rate | No proven benefit (Cochrane 2024) | No proven benefit (LIGHT trial 2019) |
| Quality of Evidence | Moderate | Low to very low |
| Typical Treatment Protocol | 75 mg daily (25 mg × 3) | 4–8 IU daily during stimulation |
| Pre-treatment Duration | 8 to 12 weeks | 2 to 6 weeks |
| Primary Side Effects | Acne, oily skin, hair loss, lower HDL | Fluid retention, joint pain, glucose intolerance |
| Financial Cost | Low | High (approx. $2,000–$5,000 per cycle) |
What Are the Side Effects and Safety Concerns?
Both DHEA and Growth Hormone carry specific side effects and contraindications that require careful medical oversight.
DHEA can cause androgenic side effects, such as acne, oily skin, facial hair growth, and hair loss. It can also decrease HDL (“good”) cholesterol and increase insulin resistance. DHEA is contraindicated in individuals with a history of hormone-sensitive cancers (such as breast or ovarian cancer) and during pregnancy or breastfeeding.
Growth Hormone can lead to fluid retention, swelling in the hands and feet, joint pain, and altered glucose tolerance. Because of these effects, it must be used with caution in patients with diabetes or pre-diabetes. Additionally, GH is an expensive medication that is used “off-label” in fertility treatments, meaning it is not officially approved for this purpose.
Current Guidelines from ESHRE, ASRM, and HFEA
International reproductive medicine authorities do not recommend the routine use of DHEA or Growth Hormone in IVF.
The European Society of Human Reproduction and Embryology (ESHRE) in its updated Ovarian Stimulation Guideline states that the use of DHEA before or during stimulation is not recommended for low responders. Similarly, they do not recommend Growth Hormone to improve outcomes in poor responders.
The Human Fertilisation and Embryology Authority (HFEA) in the United Kingdom classifies both DHEA and GH as IVF “add-ons” with unproven clinical effectiveness. Under their traffic-light rating system, no add-on is rated green (proved to be effective), meaning patients must be fully informed about the lack of scientific proof and additional costs before using them.
Frequently Asked Questions
Can DHEA or GH prevent IVF cycle cancellation?
While some observational studies suggest a lower rate of cycle cancellation, randomized clinical trials show no reliable evidence that DHEA or Growth Hormone prevents cycle cancellation or improves final pregnancy outcomes.
How long before IVF should I take DHEA?
Because DHEA acts on the early stages of egg follicle development, studies testing DHEA typically initiate treatment 8 to 12 weeks before the start of the IVF stimulation cycle.
What is the cost of growth hormone in IVF?
Growth hormone is a highly expensive medication. Depending on the country and dosage, it can add between $2,000 and $5,000 to the cost of a single IVF cycle, and it is generally not covered by insurance.
Are there better alternatives for poor responders?
For patients considering androgenic pre-treatment, clinical evidence supports transdermal testosterone (applied as a gel or patch for 4 to 8 weeks) over DHEA. The 2024 Cochrane review noted that transdermal testosterone was associated with a higher live birth rate (OR 2.53, 95% CI 1.61–3.99), although further large-scale clinical trials are still needed to confirm this signal.
Clinical Note
In my 30 years of practice, I have seen many patients request DHEA or Growth Hormone hoping for a breakthrough after a difficult cycle. The key factor that most patients overlook is that a slight increase in egg numbers does not automatically result in a higher chance of taking a baby home. During your consultation, we will prioritize optimizing your primary stimulation protocol rather than relying on unproven adjuvants.
- Dr. Senai Aksoy
Sources
- Naik, S., Lepine, S., Nagels, H. E., Siristatidis, C. S., Kroon, B., & McDowell, S. (2024). Androgens and adjuvant therapies in women undergoing in vitro fertilisation. Cochrane Database of Systematic Reviews, (6), CD009749.pub3. https://doi.org/10.1002/14651858.CD009749.pub3
- Conforti, A., et al. (2024). Adjuvant therapies for poor ovarian responders undergoing IVF: a systematic review and meta-analysis. Fertility and Sterility, 123(3), 457-476. https://doi.org/10.1016/j.fertnstert.2024.01.012
- Norman, R. J., et al. (2019). Growth hormone adjuvant therapy in poor ovarian responders: the LIGHT randomized controlled trial. Reproductive BioMedicine Online, 38(6), 908-915. https://doi.org/10.1016/j.rbmo.2019.01.013
- European Society of Human Reproduction and Embryology (ESHRE). (2020). Ovarian Stimulation Guideline. Human Reproduction Open, 2020(2), hoaa009. https://doi.org/10.1093/hropen/hoaa009
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The content has been created by Dr. Senai Aksoy and medically approved.