10/15/2026
We get lots of questions about our use of DHEA in fertility & pregnancy so I thought I would share this paper. First off let me say, I've had the pleasure & honor of working with both Dr. Boyle & Dr. Stanford, the latter with whom I published research. They are incredible pioneers in the field of Restorative Reproductive Medicine. Here's why we use DHEA. Internally, it converts to estrogen & testosterone. You may think DHEA/testosterone are bad things in pregnancy as they are androgens (male-type hormones), but only if levels are abnormally high over time, which we monitor very closely. DHEA impressively raises estradiol levels faster & better than taking estrogen exogenously (through patch or pill/we prefer patch due to decreased clotting risk). Low estradiol as well as low progesterone are implicated in miscarriage. So here's our approach:
📈Baseline cortisol, estradiol, progesterone, testosterone & DHEA on all patients pre-pregnancy.
📈Those patients who are high on DHEA and/or testosterone, we don't use DHEA, we use estradiol supplementation if indicated.
📈Once pregnant, we do QUAD testing on everyone as soon as they notify us they are pregnant (hCG, progesterone, DHEA & estradiol)
📈We make individualized decisions on which one to use based on the patient's past & current hormone levels (typically we don't use DHEA in PCOS/PMOS pts).
📈If we use DHEA and levels get out of range of normal or patient has side effects (acne etc), then we discontinue DHEA
📈Monitoring & treating BOTH estradiol & progesterone deficiency has been a game-changer in reducing miscarriage risk using hormone-support-in-pregnancy protocols (not what Quest /LabCorp says are normal)
📈Most patients only need DHEA support in the first trimester
📈No sexual abnormalities in the children born after DHEA support followed out to 7 years.
📈This should only be used by practitioners trained in these protocols & someone who is trained in hormone testing & treating (most general OBs are not, just like they are not trained in IVF protocols)
📈Who should consider this? Pts with infertility, miscarriage, pregnancy complications, irregular cycles.
📈Link below