DHEA and Growth Hormone in IVF: What the Evidence Says
Key Takeaways
For low responders and women with Diminished Ovarian Reserve (DOR), DHEA and Growth Hormone (GH) have no clear proven benefit on live birth rates (LBR). DHEA may change oocyte yield, and GH may change stimulation measures, but the LIGHT trial and current ESHRE guidance do not support routine use. Optimizing the primary stimulation strategy and identifying cycle bottlenecks remain central.
Key evidence: Cochrane Systematic Review — Androgens & Adjuvants in IVF (2024) ESHRE Guideline — Ovarian Stimulation in ART LIGHT randomized controlled trial — Growth Hormone in poor responders
When preparing for IVF after a diagnosis of diminished ovarian reserve (DOR) or a previous low response to stimulation, it is natural to look for an extra option. DHEA and Growth Hormone (GH) are often discussed in patient forums and online groups.
However, high-quality evidence has not shown a clear live-birth benefit for either treatment. DHEA may change intermediate measures such as the number of retrieved oocytes, while studies of GH have reported changes in stimulation measures. The current ESHRE guideline update does not recommend DHEA for low responders and says GH is probably not recommended for them. The HFEA assessment of androgen supplementation rates DHEA as an unproven add-on for relevant poor-response or diminished-reserve outcomes; it does not rate GH.
Video: DHEA and Growth Hormone in IVF for Poor Responders
(Note: This video features English and Arabic voiceovers and subtitles. You can choose your preferred audio track and subtitles directly in the YouTube player settings.)
What are DHEA and Growth Hormone in IVF?
DHEA and Growth Hormone have been studied as experimental adjuvant therapies before or during ovarian stimulation. The proposed rationale is to influence follicle development, but a biological explanation does not establish a meaningful clinical benefit.
- DHEA (Dehydroepiandrosterone): An androgenic steroid pro-hormone produced by the adrenal glands and ovaries. It can be converted into active androgens; the proposed effect on early follicles remains a biological hypothesis rather than proof of improved live birth.
- Growth Hormone (GH): Acts directly and through Insulin-like Growth Factor 1 (IGF-1). Proposed effects on granulosa-cell responsiveness and follicular development have not established a reliable improvement in live birth.
Does DHEA improve IVF success rates?
DHEA has not shown a clear improvement in live birth in well-conducted trials, even though some studies report a small numerical change in retrieved oocytes.
A comprehensive 2024 Cochrane Systematic Review (Naik et al.) evaluating 28 randomized controlled trials (3,002 women) found little to no meaningful effect of DHEA on live birth (OR 1.30, 95% CI 0.95–1.76). After trials at high risk of bias were excluded, the estimate was 1.08 (95% CI 0.75–1.54). Because the confidence interval still crosses no effect, this analysis does not show a clear clinical benefit.
Furthermore, claims that DHEA reduces embryo aneuploidy (chromosomal errors) remain unproven in prospective genetic trials.
Does Growth Hormone (GH) help poor responders?
Some studies of Growth Hormone have reported changes in stimulation dose or timing, but these intermediate differences have not translated into a clear live-birth benefit for low responders.
The landmark double-blind randomized controlled trial on this topic—the LIGHT study (Norman et al., 2019)—found a live birth rate of 14.5% in the GH group versus 13.7% in the placebo group, a difference that was neither statistically nor clinically significant.
For DHEA and growth hormone specifically, this review by Conforti et al. did not establish a clear live-birth benefit. It did find a live-birth signal for testosterone, but that result does not make testosterone a routine treatment; current ESHRE guidance says testosterone is probably not recommended for low responders.
Comparing DHEA vs. Growth Hormone
The following table summarizes the comparative clinical evidence for DHEA and Growth Hormone:
| Clinical Parameter | DHEA | Growth Hormone (GH) |
|---|---|---|
| Live-birth outcome | No clear benefit shown in current randomized evidence | No clear benefit shown in the LIGHT trial or current guidance |
| Current evidence status | ESHRE does not recommend routine use for low responders | ESHRE says GH is probably not recommended for low responders |
| How to interpret secondary findings | Changes in egg numbers do not establish a live-birth benefit | Changes in stimulation measures do not establish a live-birth benefit |
Side effects and safety considerations
Both substances are active hormonal agents. Their risks, interactions and suitability should be reviewed with the treating clinician:
- DHEA risks: DHEA can cause androgenic effects such as acne, oily skin, hair loss and unwanted hair growth. Evidence about metabolic and longer-term safety in IVF is limited. Androgen supplementation is generally stopped when stimulation starts or, at the latest, before embryo transfer; do not start or continue it during pregnancy without medical advice.
- Growth Hormone risks: GH can cause fluid retention, joint symptoms and changes in glucose tolerance. Its use in reproductive medicine is off-label in many settings, so the decision should be individualized, especially when glucose regulation is a concern.
Professional guidelines (ESHRE, ASRM, HFEA)
Major international reproductive medicine bodies advise against the routine prescription of these adjuvants:
- ESHRE 2025 update: DHEA is not recommended for low responders; GH is probably not recommended for low responders. The terminology has shifted from “poor response” to “low response” in the updated guideline.
- ASRM Practice Committee: The 2018 guideline focuses on mild versus conventional ovarian stimulation for poor responders. It should not be presented as direct evidence that DHEA or GH should be used routinely.
- HFEA (UK): On its androgen-supplementation page, DHEA is rated black for live birth and egg number in women with poor ovarian response or diminished ovarian reserve, meaning the reviewed evidence shows no effect on those outcomes. The same page rates testosterone grey because evidence is insufficient, and it does not rate GH.
Dr. Aksoy’s Approach: Identifying Bottlenecks Instead of Stacking Adjuvants
Related Reading
- Antioxidants & Supplements for Oocyte Quality (CoQ10, Melatonin, NAC)
- How Many Eggs Do You Need for IVF Success?
- Fresh vs. Frozen Embryo Transfer: Clinical Evidence
Frequently Asked Questions
Can DHEA or Growth Hormone prevent IVF cycle cancellation?
While small observational reports suggested lower cancellation rates, rigorous randomized controlled trials show no consistent evidence that DHEA or GH prevents cancellation or improves final delivery rates.
How long before IVF should DHEA be taken?
Studies evaluating DHEA often started it 8 to 12 weeks before stimulation. This describes study protocols, not a recommendation to start DHEA without medical advice.
What are the alternatives for poor responders?
The next step is usually a review of the previous cycle and an individualized discussion of stimulation strategy, follicle synchronisation and whether oocyte or embryo banking fits the patient’s time and treatment priorities. The options depend on the clinical context; no single protocol is suitable for everyone.
Sources
- Naik S, Lepine S, Nagels HE, et al. Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction technology. Cochrane Database of Systematic Reviews 2024;(6):CD009749.
- Norman RJ, Alvino H, Hull LM, et al. Human growth hormone for poor responders: a randomized placebo-controlled trial provides no evidence for improved live birth rate. Reproductive BioMedicine Online 2019;38(6):908–915.
- Conforti A, et al. Therapeutic management in women with a diminished ovarian reserve: a systematic review and meta-analysis of randomized controlled trials. Fertility and Sterility 2025;123(3):457–476.
- European Society of Human Reproduction and Embryology (ESHRE). ESHRE guideline: ovarian stimulation for IVF/ICSI — an update in 2025. Human Reproduction 2026;41(4).
- Human Fertilisation and Embryology Authority (HFEA). Androgen supplementation.
- Practice Committee of the American Society for Reproductive Medicine (ASRM). Comparison of pregnancy rates for poor responders using IVF with mild ovarian stimulation versus conventional IVF: a guideline. Fertility and Sterility 2018;109(6):993–999.
Add as a Preferred Source on Google
You can add draksoyivf.com as one of your preferred health information sources on Google.
The content has been created by Dr. Senai Aksoy and medically approved.