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DHEA and IVF
hi all.  has anyone who had prior failed IVF, used DHEA after that and become pregnant.  Im almost 40 and had a failed IVF.  I've read on other forums that DHEA helps when you are aging.  Any suceess stories out there please.

thanks
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I have been on 75 mg of DHEA for 4 months from my doctor and we will begin an IVF cycle next month. I am also taking 2 mg of TotalDHEA which a holistic doctor prescribed to take with it for better absorption.

I can never remember to take it (plus everything else) 3 times a day and normally take it all at once. Is that bad?

The only side effect that I've seen is my face has broken out badly, but the doctor told me to expect that.

I have very few follicles (1-2) in every IVF/IUI we have attempted. The doctor sees this as our last go.

I'm a bit concerned just because the doctor has never had anything to do with DHEA before, and I hope we're doing things right.

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Taking DHEA is new for me too and I really believe it helped me conceive in Feb though I had a miscarriage. I am 40 and maybe my egg quality was poor but I had taken the DHEA for less than 3 months when I conceived. I am still on it and like yourself hope it has helped. Believe and have faith it will help!!! Even though there were times you forgot to take it don't worry taking it for 4 months is great. I wish you all the best for your IVF please keep in touch and let me know how things go.
BTW how old are you and how long have you been TTC?
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I'm 36, and have been trying since age 32. I have one 14 year old son. In 2005 I conceived a beautiful baby girl who unfortunately was diagnosed with trisomy 18. I carried her to term, but she was stillborn. Since then we have been unable to conceive. The doctors believe that I have a low ovarian reserve, which is so mindnumbing. I just don't understand what would cause it. Part of me really thinks it is the stress of everything that happened, now compounded with being unable to conceive. My family history includes all sorts of women who have conceived late in life. Pregnancies and deliveries themselves, even with Amara, are really easy for me. Maybe I'm just in denial, but I don't get it. I'm really hoping the DHEA will make a difference. I believe that doctors have given up hope and this is their "last shot." We are going on the patch this month and then trying for an IVF in May. It's the last protocol they haven't tried. I've never had more than 2 follicles. Thanks for the note.
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Your story is touching. You've already been through so much and I hope DHEA is your answer. I'm so out of it. What is the "patch"? I have two children 18 and 13. I remarried and my current husband has no children of his own so I understand your frustration once being able to conceive and then being told we CAN'T!!!!!!.  After what you've been through I can see why you were stressed. I too get so stressed at times I hardley want to talk to anyone. I will keep you in my prayers for your IVF in May. I wish you and your DH a successful IVF cycle, a successful, healthy pregnancy and a safe delivery. You deserve this........ honestly you do.
Please keep in touch
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DHEA for low fertilization rate??
Hi, I'm glad found this site just recently...
I had two failed ICSI in the last 6 months, each time produced 7 eggs, 5-6 matured ones but with fair or poor quality.  First time none of them was fertilized and second time we had one fertilized with no fragmentation 6 cell transferred at day 3 but BFN.  We have several male issue here as well.  My first RE said it's the egg quality due to my age (39) and he refused to retreat me anymore if I don't move to DE.  So I went to a second RE and also was told don't waste time and use DE.  They don't think there is consistent and large evidence that DHEA will work.  My antral count (no stim) dropped from ~10 six months ago to now ~4 after two ivfs in last 6 months.  I am taking DHEA now and along with acupucture and herbs, and  I am trying to find a RE or convince my current RE to give me one more chance (seems they all want to just do DE).  Anyone can share some their similar experiences and thoughts, or support?
Thanks
BNF
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hello, who is your Fertility specialist?  Im nearly 40 and about to undergo my second IVF.  I intend going to Dr Joubert at Pretoria East hospital, i hope and pray that he's not negative about the age issue because im not yet prepared for a Donor Egg lecture. Please tell me.  My first specialist was Dr Pentz at Kloof hospital.
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Hi Ladies – Long time! Sorry about that! Here are responses to your questions. This is a long one but I hope I’ve answered all your questions. And I promise to log in here more often! 

Desperado:  Congradulations on the conception but terribly sorry to hear about the miscarriage. Hang in there babe – you’ll get a babe yet. My recommendation is mortgage the house for IVF and PGD before time runs out. ;)  see response to your Qs  #1 and #2 below.

Shayla: taking more is good. With your enthusiasm you’ll do great! Good luck! You are #3 below

Julie 1615: yes they have proven increased quality of embryos. Got to centerforhumanreproduction and read up there and/or follow the link to their published study. Hair loss is EXTREMELY rare with DHEA. DHEA shouldn’t be compared to acupuncture – do them BOTH. You are #5, 6, and 7 below. Best to you too!

Frisbe: what a great name! I know how you felt…I felt the same way when I read the published research by Casson and Gleicher in 2000 and 2006 respectively. Be sure to ignore the naysayers sweety. You’ll find them everywhere. My husband calls doctors and nurses technicians instead of scientists. Even my own RE, despite all his support, still doesn’t recommend it outright to new patients. Doctors are most often extremely slow to change and embrace new protocols and they are afraid of doing more harm than good when wading into the abyss. Some goodies for you in  #8, 9, 10, 11 below. And see #2 – 4 for your second questions. I’ll look forward to hearing your updates!

Blondemacb: I think its fine to take all at once in the morning but work at 100mg first if you go that route. Yes…my back and face broke out….but scrubbing with those hand scrubby gloves from Target helped somewhat. For you….I REALLY recommend counting your antral follicles before starting your last cycle. I had DOC scan me on day 15 and day 27 before my period for 3 months. Each month on DHEA I had 2 more until I had 10 antral follicles after my Testosterone had been up consistently for like 2 or 3 months. We were in the same boat as you…..on our last try and couldn’t take a chance of wasting it without seeing a minimum of 8 antral follicles before we said GO. See #12 below about the patch….this is important for you.

BNF:  My Dear you are in a common predicament with many of us poor responders. If you can’t find a high quality doc to take you here’s a suggestion….challenge your doctor to scan your ovaries on day 20 and 27 of your cycle. Ask if he sees more activity will he reconsider. I promise you my dear he will see more follies and when you do IVF all of your mature eggs will fertilize. I’ve done 3 cycles and every mature egg I’ve gotten has fertilized normally. Also had a friend do the 100mg/day in the am for just a month and she got 4 eggs, all fertilized normally, and she’s got  the BFP! Hang in there….I would put $$ that you’ll be in another cycle within 2 – 3 months.





1. DHEA DOES WEAR OFF. I’ve been on high doses for a long time and within 2 weeks of stopping the DHEA altogether my testosterone level returned to its original very low level. My ovarian function has slowed visibly via ultrasound in one month. At this rate I am guessing that 4 – 6 weeks off DHEA after 4 months on it will return you to COMPLETEly original condition.
2. STOP DHEA BEFORE EMBRYO TRANSFER. DHEA increases your testosterone and high testosterone is a common cause of miscarriage. This is also reflected in the higher than normal miscarriage rate at CHR when they studied DHEA.
3. IF YOU DON”T HAVE 4 MONTHS TAKE MORE. In general I don’t think that 25mg 3x/day is going to work for more than 50% of women. If you get eggs and are just improving quality then I think it could be enough. If you get very few or no eggs then I recommend 100mg/day once in the morning. I would not take any more than 150 mg. I have experimented all the way up to 450mg/day and prematurely ovulated despite the proper injections to avoid it.
4. TAKE IT IN THE MORNING. After much research and my own switch from 3x/day to just the am I believe DHEA is primarily absorbed and converted to DHEA-S in the morning. So I took it 8am daily in my, what I’ll call second phase of experimenting. My Testosterone only then began to rise quite nicely and consistently and antral follicle count increase soon followed.
5. EMBRYO QUALITY YES, CHROMOSOME QUALITY STILL UNKNOWN. Note – you can have a normal chromosome setup in an embryo and also have  crappy embryonic (fluid) health. We know DHEA improves the fluid health but its not yet clear if you would get a higher number of PGD quality. Its also interesting to note that miscarriage can be higher with DHEA.
6. HAIR LOSS IS EXTREMELY RARE. Hair loss can occur with very very high levels of testosterone….like over 200ng/dl I believe. If you have few or no eggs then you likely have very very low testosterone and DHEA up to 150 mg/day should not raise your testosterone over 120ng/dl. Everyone is different so best to find a doc that will throw in DHEA-S and T to your blood work just to see that you’re not having some strange hyper reaction and getting very high Testosterone levels. These blood tests are very inexpensive.
7. DHEA BEST WITH ACCUPUNCTURE AND BABY ASPIRIN. Because DHEA increases your testosterone your red blood cell count will increase thus actually thickening your blood. So it is really good to do it with BABY ASPIRIN AND ACCUPUNCTURE to thin the blood a bit and get it over to your ovaries. Poor responders, in conjunction with low testosterone, can also have poor blood supply to the ovaries reducing your response and Accupuncture can take care of that.
8. TEST TESTOSTERONE AND DHEA-S ON DAY 1-2 & 14, AND ESTROGEN AND FSH ON DAY 1-2. Best if you can get these tests before you start for baseline. After a week on DHEA your DHEA-S should increase significantly, like anywhere from 50 to 100%. It WILL go well above normal but this had no ill effect on me even over 2000ug/dl. Get you lab results printed from your doctor and keep track. Don’t just take the verbal…’you’re above normal…within range…etc.’ you typically get from doc. Track this yourself because the docs do not have a basis in publication for evaluating this data.
9. BASELINE ESTROGEN GOES DOWN on DHEA. Poor responders typically have elevated baseline estrogen. DHEA can and should cut that elevated level in half after 2 months.
10. BASELINE FSH GOES DOWN on DHEA. Again..poor responders typically have elevated baseline FSH. I’ll spare you the biochem and just tell you that mine went from 11 to 3.5 and stayed there around 3 while on DHEA. There is a direct correlation between these and increasing your Testosterone level via DHEA.
11. ALCOHOL INTERFERES WITH DHEA-S – DON”T DRINK AND DO DHEA.
12. ESTROGEN PATCH TO DOWNREGULATE OVARIES BEFORE STIMMING. I ovulated through the pill 2 months straight while on DHEA and the doc wouldn’t believe it until he saw it. Another friend had the same experience. Finally my doc got advice from GLeicher who did the study. The only way to downregulate your ovaries once you’ve gotten higher testosterone from DHEA is the ESTROGEN PATCH. I had to use 2 patches and switch them every day just to keep all the follies at less than 7 mm before stimming.
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Hello!

Thank you so much for your long very informative response. I had my day 2 ultrasound, etc. yesterday...with only 4 antral. However, I looked back at my antrals for the past 7 (wow, it's been that long with 4 iuis and 3 stopped ivfs) and I've had more than 4 only once when I had 9, and that time I only ended up with 1 actually growing. Last time I had 3 antral and 2 grew. I think I'm going to wait and see and hope that I have 3 out of 4...that is the magic number for them going through with an ivf...I need 3 eggs to grow. I'm hoping the DHEA will help.

What my biggest concern is is that the center, who is one of the leading fertility clinics around and are really based on research, do not have any experience with dhea. Myself and another woman are the first there. They wouldn't do a blood test for DHEA, stating there wasn't anything they would learn from it. :-( I'm really bummed about that.

I just started clomid last night. I've tried every cocktail mix there is thus far. What cocktail mixes worked for you best with DHEA?

J
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I totally understand what you're dealing with. None of the REs are doing bloodwork because the studies published, other than CASSON in 2000 didn't track blood levels so they have nothing to go on. I tracked my blood for almost 2 years and 4 cycles. Please trust me tracking your blood is important and you need to just be firm and tell them you want it. They will give it to you if you demonstrate determination.  Tell them its very very important to you that they test DHEA-S and Testosterone (T) free and total at least bi-weekly and your FSH and E2 on day 2 of cycle. You will likely find your T in the low range to start. I recommend taking DHEA at doses increasing by 25mg every 2 weeks until you can see your T close to 100ng/dl. And get the lab report print out from them...and track this yourself. This is your money and your baby....I firmly believe you need to find a doctor who will at least allow you to test your DHEA-S and T twice a month until you start your cycle. I rolled over to doctors for 3 cycles and lots of $$ and failure before I finally went on the search for a doctor who would work with me.


I just had a transfer yesterday of 2 hatching pgd quality blasts out of 5 tested at age 41. 2 years ago I couldn't even get more than 2 embies past day 3. The DHEA and your Testosterone levels are all the difference in making those healthy eggs.

Sounds like you're heading in the right direction. Hang in there! :)
anitasto
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You are such an inspiration. Please keep us posted since you just had your transfer. I will pray for you to get your BFP. You've prepared yourself so well for this journey. You have given us so much hope and information and it's greatly appreciated. You deserve this and I believe it's going to happen you WILL be rewarded for all your hard work.
Take care and keep hope alive.
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thanks sooo much for your kind and encouraging words...which have brought tears to my eyes. So few folk understand what a journey this has been. Promise i'll keep posting.
Today ...8 dpo/3dp5dt... I started cramping and have been for the past several hours. based on other 2ww blogs from ppts this seems a good sign. :)   oh - btw - the embies are both boys! dh is cautiously optimistic but happy so far.

how are u my dear? would love 2 hear how ur doing.



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I'm sad to report that our 2 hatching embryos didn't quite take. HCG of 2 today at 15dpo or 10dp 5det.

We still have 5 embies on ice that are actually younger than these. Hard to imagine what can beet hatching embies.

Still a big believe in DHEA so hang in there ladies. These were PGD tested hatchers at 5 days and I was 41 at collection time. Nurses said that hardly ever even happens for donors. Those results, even though my uterus didn't hold on to them, are worth the effort if it helps others succeed.

Wishing you all well and lots of follies....
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Thank you very much for the support and inspiration. This past IVF cycle, with a Clomid/ganirelix cocktail I ended up with only one follicle (later one more sort of appeared that was hazy) and they turned the IVF into an IUI. I have been doing acupuncture religiously along with the DHEA this cycle. They did the IUI on Monday and I'm crossing my fingers and doing a lot of deep breathing. My acupuncturist wants me to try a lot of visualization so I've been scouring the net for fertilization/implantation pictures.

Based on some things mentioned, I stopped taking the DHEA however for right now as I had read about the possible miscarriage link. I will start taking it again if this doesn't work out and I will increase my dose to 100. Is that what I should do? What do you recommend?

All my doctors still refuse to do any DHEA or testosterone testing, so I'll have to experiment blind. My doctor told me that he no longer feels i am an IVF candidate as I have never had more than 1 or 2 follicles develop to the appropriate size, but wants me to keep trying IUIs or move to a donor.

I'm at the point where I just want to try some more alternate options. Doctors don't seem to know much, except for "hey, here is a new cocktail." My doc did agree that if I wanted I could try one more time, possibly on the Femera cocktail which I haven't tried yet. I"ve tried every other drug combo there is.

What drug combos have worked best for you? Good luck on your journey. :-)

Jenn
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Hi Jenn,

I'm really hopeful for you that your IUI was successful. I can suggest a couple of things for you..
a. try going to your regular family physician and ask for a hormone panel. I did this with my physician who was a woman, brought her a print out of the case study by Gleicher of the 42 year old with 60+ frozen embryos, and she was all over it. She gave me blank bloodwork sheets so I could get tests whenever I wanted.
b. If the number of follies hasn't increased with 75 mg/day I would definitely increase dosage if this cycle isn't successful. I can tell you that 75mg/day sort of helped for me but when I picked it up increasing about 25mg/month to over 200mg/day I got a cycle with 10 eggs. Turned out 5 were mature and 2 of those were the PGD normal embryos I spoke of last. That puts us at 40% quality. Not too shabby.
BUT...before taking ALOT of DHEA....its really important to be sure you're not sending your Testosterone through the roof. If you get pounding heart and shortness of breath your near the ceiling.

Hang in there Jenn and let me know how things turn out. :)
Hugs for now,
Anitasto
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I am a physician.  Started trying at 33y.  No success.  Countless IUI's.  One failed IVF cycle and one cancelled.  At 35y I was told to think about egg donors and they were willing to continue IVF but since I was a poor responder they did not think it would work.  
For the second IVF cycle I had already started having acupuncture and taking their herbs.  After leaning of the poor quality of the eggs retrieved...I sat in bed and researched poor responders.  I came across the information on DHEA.  My RE knows Casson and spoke with him about his study.  He is a believer in DHEA.  I started 25mg 3x day and in six weeks was pregnant.  We had a miscarriage at 10 weeks.  Went back on DHEA.  Three months after starting it up again my antral follicle count was much improved.  Few weeks later found out was pregnant again.  My RE wants to do a study on it since he saw the positive effects first hand.  He was very willing to try what I wanted to do and encourage you all to find an RE that wants to work with you.  
I am 31 weeks pregnant with a baby girl and am soo excited.  
I used the same DHEA from the Casson study, from Belmar Pharmacy...you can order by phone and they mail it out the next day or two.  I had acne and hair loss.  Controlled it with alternating 25mg 2xd and 3xd.  My side effects we well controlled.  
I had testosterone levels checked and they were high but not problematic and since my RE was working with me on this experiment he was watching and checking regularly.  
I continued acupuncture.
Hope this helps.  Wish you luck.  It is such a hard road to do what we have all done to get pregnant!
P

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Hi Puglies and Antitasto, when you were taking DHEA, did you notice that your menstrual period changed?  I have been taking DHEA for two months and now I have very light periods whereas they used to be heavy.
(I go for my third IVF round now.  Supression in June, stim in July (middle-long protocol)).  

Thanks,
Angela
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Did any of you that used DHEA have normal FSH levels but low antral follicle count?  If so, did DHEA improve the AFC even though your FSH levels were already in the okay range?

Thanks,
Angela
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My FSH was borderline elevated.  Upper limits of normal on some scales and one point high on other scales.  And I had low antral follicle count.  The months wasted playing with IUI I had normal everything.  My cycle only changed to go back to 30days which it had shortened to 28days with IUI.  
We were waiting for Jan for another round of IVF when I got pregnant in Nov.  So mine ended up a spontaneous pregnancy.  
Good luck with third round!!  How long have you been on DHEA??
P
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I started taking the DHEA about a month and a half ago.  I calculate that by the time I stim, I will have been on DHEA for around 3 months.  
I am an American living in Germany.  The docs here a little conservative.  I just turned 41 and felt I did not have any time to lose so I started DHEA on my own (I bought DHEA when I went home to the States, Natrol brand, because a prescription is required for it here in Europe).  
P, I am so scared to do what I am doing, but at 41, I am in the corner and worry I cannot afford NOT to take DHEA, especially if it will do something about my antral follicle count and maybe improve oocyte quality.
I was happy to have found your posting and see your reply.  Gals like you make me feel less alone in all this.

Angela
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I was not scared, just reaching giving up.  We were ok with donor eggs because all I was my husbands baby and I could have that either way.  DHEA was not scary or hard to take.  But I had resources that many do not.  If my RE was not helpful, I could have figured it out on my own.  But if you look at DHEA, there are many people who take it for various reasons.  I would be scared to take more than 75mg/d.  It is a hormone.  But if you have been on it for 3 months than you must be doing well on it.  In the studies they use it three times a day.  I hope that is how you are taking it.  
Does your RE know you are taking it?  
The whole process is insane.  It is hard to take all the pills and injections and feel like a failure.  I kept trying to be optimistic and tried to remember all I needed was one good egg.  But I am not optimistic by nature.  It was hard.  
GOOD LUCK!
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