Ghost and anyone: Can you tell me about DHEA and fertility?

[imstillhopeful]

Hi, Ghost and everyone!

I have heard so much about DHEA and fertility. I am a low ovarian reserve, AMH .02, FSH 12.5 (but now is 9), two IVF cycle trys none to ER/ET (first - they didn't grow enough after 18 days of stimming and I ovulated on my own; second - one follie of 5 was ready which lead to canceled cycle) and poor responder.

My RE says at 34 I have the ovaries of a 42 year old. I have heard that DHEA can help with the quality and quantity of the eggs. After so much research, I would like to take Vitex, Acai, Omega3, CoQ10 and DHEA for the next four months. I am also planning on changing my diet. My concern is if there is any harm in taking DHEA. Have you heard or know of any harm or beneifts to taking this? My RE is old fashioned and I am not sure if he will be onboard with this but at this point I amready to try. He feels donor is next. My theory is why wouldn't I try something new before that step (which I am not ready for)?

If anyone is taking or has taken DHEA, please let me know how it worked for you. Thanks!

[Ghost]

Hi, Ghost and everyone!

I have heard so much about DHEA and fertility. I am a low ovarian reserve, AMH .02, FSH 12.5 (but now is 9), two IVF cycle trys none to ER/ET (first - they didn't grow enough after 18 days of stimming and I ovulated on my own; second - one follie of 5 was ready which lead to canceled cycle) and poor responder.

My RE says at 34 I have the ovaries of a 42 year old. I have heard that DHEA can help with the quality and quantity of the eggs. After so much research, I would like to take Vitex, Acai, Omega3, CoQ10 and DHEA for the next four months. I am also planning on changing my diet. My concern is if there is any harm in taking DHEA. Have you heard or know of any harm or beneifts to taking this? My RE is old fashioned and I am not sure if he will be onboard with this but at this point I amready to try. He feels donor is next. My theory is why wouldn't I try something new before that step (which I am not ready for)?

If anyone is taking or has taken DHEA, please let me know how it worked for you. Thanks!

Maturing ovarian follicles produce estradiol, and estradiol is part of a feedback loop to the hypothalamus to regulate pituitary FSH. Therefore an increase in FSH flags a decrease in follicles and impending ovarian failure.

AMH is part of an internal feedback mechanism within the ovary, perhaps the mechanism that prevents all the very early follicles from maturing simultaneously. It is not well understood yet, but it is clear that low AMH corresponds with a low reserve of antral follicles.

Testosterone might interfere with AMH, and therefore allow more follicle to develop. Maybe.

How to get more testosterone? Well, you could take testosterone, as there are patches for it. One study reported that women who applied testosterone patches had much greater ovarian response. That report was several years ago, and the same researchers have not followed up with such enthusiasm since, nor has anyone else. So maybe it works, but maybe not. If it does work, it should probably be applied early on and for several weeks before the stimulated cycle. It takes weeks for a primordial follicle to become an antral follicle. Unfortunately, the study I mentioned only tried it for about one week before stim.

Other ways to produce testosterone are to take DHEA or to take hCG. DHEA is similar to testosterone and I believe there is some conversion to testosterone, but I'm not sure exactly how it works. hCG promotes the release of testosterone within the ovary.

Testosterone has side effects, mostly in making women more male-like. It makes them more aggressive, increases libido (sexual desire), and can cause hair loss on the head and the growth of hair on the face. So if you want to be a grouchy, horny, bald, bearded pregnant woman, this may be the protocol for you.

There are some companies pushing to get testosterone products approved for long-term treatment of low sexual desire in women. But I don't know anyone who has ever tried testosterone for several weeks in women seeking fertility treatment. They have tried DHEA that way, and reported the women were often conceiving on their own while waiting for IVF treatment. I suppose the increased libido perhaps combined with the follicular effect may have helped.

Some believe that testosterone harms the eggs. I'm not sure what evidence there is for this. Perhaps they say that because PCO patients are famous for lousy eggs and often have elevated testosterone. But there are many factors at work, and that may be only coincidence brought on by other factors. Or maybe testosterone really does harm the eggs. I don't know.

In other words, we don't really know, and the progress is not as fast as it could be. There is a Dr. Gleicher in New York who has been pushing the DHEA idea for many years. He is already convinced, but most other REs are not convinced yet.

[imstillhopeful]

Thanks! This is all great information!! I bought the DHEA but I am not planning on using it until I talk to my accupuncturist and RE. I feel like it won't harm anything but like you said, there are some different thinking.

Thanks so much!

[Ghost]

Thanks! This is all great information!! I bought the DHEA but I am not planning on using it until I talk to my accupuncturist and RE. I feel like it won't harm anything but like you said, there are some different thinking.

Thanks so much!

I should have added that part. Yes, get approval from your RE (not your acupuncturist) before starting any medications or supplements prior to or during an IVF cycle. Some of them, if they act as claimed, would ruin the cycle.

Also note that the studies of DHEA did not use the over the counter stuff, but used prescription-grade DHEA.

[imstillhopeful]

Thanks! I am just so worried that my RE will say no to anything other than meds and that bothers me. But I made an appointment today so I'll cross my fingers that he'll be open to other things. I am not ready for Donor Egg and he says it's my only method. I can't beileve that to be true. But I'll see what he says.

Thanks again![/quote]

[IVFinNJ]

imstillhopeful - I started taking 25mg of DHEA 3 times a day about six months ago and unfortunately, have not seen a benefit. The only side effect I suffered from was my voice. It got a little deeper and would crack constantly, it sounded like I hadn't slept in days. I stopped taking it after my last BFN and have seen a little improvement but my voice is still not the same.

That is just my personal experience, others have had a different outcome.

Best of luck and Happy Holidays!!

[imstillhopeful]

Thanks for responding, IVFinNJ. I was wondering... did your RE prescribe it to you or did you just start taking it?

[IVFinNJ]

My RE never mentioned it, even after my poor response to stims. After reading about it, I asked him if it was ok and he said yes, he is not convinced it helps but it would not hurt anything. He recommended the dose of 25mg 3x day. Since it was inexpensive (about $10 for 90 pills), I decided to give it a try.

I know what you mean about donor eggs. The first time my RE mentioned it, I was shocked...thinking, how dare you mention that...it was very hard to hear.

Best of luck to you!!!!