Clinical application of dehydroepiandrosterone in reproduction: A review of the evidence.

The effect of dehydroepiandrosterone (DHEA) therapy on improvement of reproduction outcome is uncertain. Many earlier studies have shown conflicting results. Therefore, a review of the literature is needed to explore the role of DHEA in reproduction. We conducted a literature search of MEDLINE (Ovid) and Pub-Med (2000-June 2014) for all relevant articles that included the terms "dehydroepiandrosterone," "DHEA," and "in vitro fertilization." Among the search-identified articles, seven prospective self-controlled studies and four retrospective case-control studies showed DHEA as an adjuvant therapy able to improve in vitro fertilization outcomes in poor responders (women with diminished ovarian reserve and/or poor ovarian response). However, four randomized controlled trials did not support the benefit of DHEA therapy for poor responders. By contrast, one prospective randomized study showed that DHEA might be beneficial to reproduction in women without diminished ovarian reserve (normal responders). In summary, a review of the previously published studies does not provide clear evidence that DHEA can be a useful treatment to improve ovarian function in poor responders.