DHEA and IVF

[RobstersMama]

And!! Regarding androgens.

Abstract:  Ovaries from 4-day-old mice were organ-cultured and the effects of progesterone, androstenedione and estradiol-17β on early follicular development were investigated.

Both androstenedione (40-1,000 ng/ml) and estradiol-17β (8-1,000 ng/ml) promoted proliferation of granulosa cells in developing follicles, while progesterone showed no remarkable effect. Cyproterone acetate (4,000 ng/ml), an androgen receptor antagonist, partially inhibited the granulosa cell proliferation induced by androstenedione (40 ng/ml). Dihydrotestosterone (8-1,000 ng/ml), which is not converted to estrogens, also induced proliferation of granulosa cells.

These results suggest that androgens directly promote proliferation of granulosa cells in early developing mouse follicles in vitro.

Organ-Cultured Ovaries



Yoshi-hisa Ikeda1), Yuji Hirao2) and Takashi Miyano1)

1) Department of Animal Breeding and Reproduction, Faculty of Agriculture, Kobe University
2) Department of Animal Production, Tohoku National Agricultural Experiment Station

(Received June 22, 1999)
(Accepted September 9, 1999)

[RobstersMama]

Hi Rita!!

I am so happy to hear that you have had success in the past with your treatments and have your two little ones. Great news.

If I were in your position, and just one final cycle, I personally would take 4 months off and supplement with Vitamin D and DHEA. At your age, it is highly unlikely that your hormone levels remain in a good range and that your tissue levels are high. Blood levels do not necessarily reflect tissue levels. I think your numbers show you have a good chance under the right circumstances. But I think you need to provide perfect conditions--meaning giving the undeveloped follicles the best possible chance of developing correctly over the next 4 months. And by that, I mean developing to where they have a lower chance of being defective and you having a miscarriage, as well--not just developing to a good size. Both DHEa and Vitamin D seem to help with that.

Let us know what happens next!

[RobstersMama]

Here it appears that very early, undeveloped follicles do not have a lot of androgen receptors, but large ones do. Remember that a lot of this relates to androgens in general--all made by the body from DHEA--and not just testosterone. so I am not sure that taking just testosterone or just measuring that value is particularly helpful.

Immunolocalization of androgen receptors in the canine ovary and their relation to sex steroid hormone concentrations
H Vermeirsch, P Simoens, M Coryn, and W Van den Broeck


Androgens play an essential role as autocrine or paracrine agents in ovarian follicular growth, maturation and luteinization. The aim of this study was to describe the normal cellular distribution of androgen receptors in the canine ovary at different stages of the oestrous cycle. Samples of both ovaries were obtained from 34 dogs, including six pregnant animals and three that had just produced litters. Presence of androgen receptors was visualized by immunohistochemistry on paraffin wax sections using a polyclonal antibody. Nuclear staining for androgen receptors was observed in the surface epithelium, cortical tubules, rete ovarii, follicle cells, thecal cells, luteal cells, granulosa cell cords and ovarian stroma, indicating that androgens have important roles in ovarian function in *******. In theca interna cells of tertiary follicles, androgen production seems to be more important than androgen receptivity, as immunostaining for androgen receptors in these cells was weak compared with that in other ovarian stromal cells.

In primordial and primary follicles, the immunostaining for androgen receptors was rather weak, indicating that androgens are of minor importance in early preantral follicles. In follicle cells of larger preantral and antral follicles, the immunostaining for androgen receptors increased with the stage of the follicle.

Corpora lutea expressed less immunostaining, which was not correlated with serum progesterone concentrations, although local actions of progesterone on androgen receptors in corpora lutea cannot be excluded. In general, few correlations were found between immunostaining for androgen receptors and serum sex steroid concentrations, indicating that other factors regulate androgen receptors in the canine ovary.

[RobstersMama]

More...

J Clin Endocrinol Metab. 2006 Dec 19; : 17179193 (P,S,G,E,B,D) Stage-specific expression of androgen receptor, follicle-stimulating hormone receptor and anti-Mullerian hormone type II receptor in single, isolated, human pre-antral follicles: relevance to polycystic ovaries.

[My paper] Suman Rice, Kamal Ojha, Saffron Whitehead, Helen Mason
Basic Medical Sciences, Clinical Development Sciences, Department of Obstetrics and Gynaecology, St George's, University of London, Cranmer Terrace, London SW17 ORE, UK.
Context: Recent evidence indicates that the increase in follicle numbers seen in polycystic ovary syndrome (PCOS) occurs early in folliculogenesis with androgens being a likely causative candidate. In primates and sheep, androgen excess in-utero results in ovarian changes similar to those in PCOS. There is also increasing interest in the role of anti-Müllerian hormone (AMH) in early folliculogenesis, as AMH knock-out mice have an early depletion of their stock of primordial follicles. Initiation and early folliculogenesis may therefore be under negative control by AMH and positive control by androgens. Objective: Since AMH signals exclusively through its type II receptor (AMHRII) the aim of this study was to determine and co-localise the stage-specific expression of AMHRII, androgen receptor (AR) and follicle stimulating hormone receptor (FSHR) mRNA in individual, well characterised preantral follicles. Method: Follicles were isolated from human ovarian cortex obtained from either oophorectomies or from cortical biopsies at Caesarean section. Expression of AR, FSHR and AMHRII mRNA was determined using a nested RT-PCR protocol.

Results: AR mRNA was not detected in any primordial follicles but was from the transitional stage onwards. The number of AR positive follicles increased at each progressive growth stage. The expression of AR preceded that of FSHR and only a small percentage of primary follicles expressed FSHR. AMHRII expression was rarely detected. Conclusions: This is the first study to identify the expression of AR in human transitional follicles.

Results suggest a role for androgens in promoting early follicle growth whilst challenging the hypothesis that AMH exerts a direct, inhibitory effect on follicles at this stage.

[Ritaz1964]

Hi, thans for the input.

Unfortunately,  Icant afford to wait that long.  Financialy, I need to get this cycle in before xmas.  I take Elevit whch has VitD in it.  This year was the end of trying with my own ovaries.

I guess Ill take my chances..... I do have a friend who offered to donate to me.  I cant just keep "trying with my own", IVF has taken over my life... I gotta live....

Can you tell me at what point do I stop takingDHEA during my cycle? And when should I test my blood levels again?

Thanks again..

[HQ2007]

Hi Ladies!


Just checking in quickly...

Lynn: how are you doing?

Anitasto/RobstersMama: wanted to give you quick update on my last bloodwork. I had Vit-D 25-Hydroxy and Thyroid tests. Both came out NOT in "normal" range (see below). I seem to have issue with Thyroid gland. Both of my sisters takes medication, so it does not surprise me. But, normal tests done by RE did not show any issues...

From LabCorp
Vit D, 25-Hydroxy                    26.3 (range 32-100 ng/mL)
Ferritin, Serum                        50    (range 10 - 291 ng/mL)
Thyroid Peroxidase (TPO) Ab   19  (range 0-34 IU/mL)
Antithyroglobulin Ab                 229  (range 0-40 IU/mL)
Triiodothyronine, Free, Serum   2.7   (range 2.3-4.2 pg/mL)

I think the antithyroglobulin Ab is considered auto-immune issue and possibly have lot to do with my fertility possibly? I will be seeing my GYN next week. My GYN practices "functional medicine" using alternate medicine to treat condition. I am sure he will put me on high doses of Vit D!

RobsterMama: I got cod liver oil, but it only has like 2 IU of Vit D. Did I get the right thing? What brand do you take and how much IU of D in it?

Thanks!!
HQ

[ilion]

My wife and I are curious as to a couple of things.  First, is there a difference between GNC DHEA and pharmaceutical grade in terms of absorption, response, etc.  If so, where do most of you get your DHEA?  

And second, we discovered this treatment only recently and have planned to do our sixth ivf cycle in November after six weeks on DHEA.  I've read that four months of taking the supplement is optimal.  Is it better then to wait?  She's 43 and time is obviously a factor.

Thanks for your input!

[HQ2007]

Hi,

I get my DHEA from Belmar Pharmacy, http://www.belmarpharmacy.com/pharmacy_content/s_bio/bio.htm. It is compounded DHEA I believe. I do not think GNC brand is compounded. It's the same pharmacy that CHR uses I believe. If you haven't looked through CHR website, here's the link, http://www.centerforhumanreprod.com/premature_ovaries.html. They recommend 4 months on DHEA before IVF. I have written them and gotten responses via email on doses. You can have phone consultation with them too, but there's a fee for it (~$350).

I will share my personal situation with you. I am 40, we had our first IVF in June-08. It did not work. After that, I started on DHEA. I am going to wait full 4 months before I do IVF or IUI.

My thoughts, since your wife started on DHEA already, you should consider waiting at least 3-4 months on DHEA to have it's full benefit.

Let's see what rest of the group say!


Good luck!
HQ

[RobstersMama]

It's tough to wait. I get that. I am the same age as your wife, ilion. But I think her ovaries and eggs have a good chance of getting better over the next 4 months, not worse. And if you wait, your chances very well could be MUCH better. You would save heartache, stress, and money.

Perhaps this would be a good approach. Check bloodwork--all hormones, including FSH--after 2 months and see if there are any changes. If not, maybe just start. If you see things looking a little better, give it 2 more months and then get going! (Remember that this is all just my opinion. You need to make your own decisions.)


HQ,

SO many people are deficient in Vitamin D and I think it is really important to follicular development. I hope he puts you on high doses! I have just run out of the cod liver oil capsules that I take. I will have to get some more and see what I can find. It is very important to get any thyroid issues worked out for fertility, as well. I am glad that was discovered!

[kirstier]

Hi,

I have been reading this post for months and have a question for you.  I am 40.5 years old and have been thru 2 ivf cycles in which i got pregnant but had no heart beats on ultra sound.  i started dhea and have been on it for 16 weeks now.  my fsh was 7.1 tested last week...last year it was 10.9.  obviously very happy with that result.  my question for you is about antral follicles...i had my baseline today and have 6 follicles less than 5 but three less than 10.  from your posts it sounds like you would postpone since i have three greater than 10.  do you stay on birth control during this time?  is this something you just decided on with your vast wealth of knowledge or did you read it somewhere?  I really appreciate all the information you have provided on this post, especially with the disaapointments you have had.  I know that heartbreak...

[anitasto]

Everyone – here are responses to most recent posts. I will be out sailing the open ocean for the next 4 – 5 days so I’ll check in again next week. All the best to you smart, brave and surely beautiful women.
-Anitasto

Dg223 – Hey, sounds like things are really moving along for you. I’m impressed at your T level with such a reasonable dheas level. I totally understand stepping backthe dose a little but you’re wondering if you stepped back too much. I think your level at 105 is just fine through the stim and retrieval and then if you’re doing fresh transfer I’d step it down. Your T will go down naturally during the cycle anyway because of your increase in E2. And yes, changing dosages in my experience seems to create sensitivity to the supplement and start to require more to get the same effect. So I know it’s a slightly higher than normal T but that is exactly the target I shot for when I got 10 eggs. IF, however, you wanted it at like 80 you could take the DHEA 25mg in am and 25 in pm. In my opinion the pm dose is like taking half an am dose.
Is it normal to spot 4 – 5 days before your cycle? In a perfect world, I don’t think its supposed to happen with exceptions like implantation bleeding. However, it is the timeframe that your lining is trying to break down. If I were you I’d go to your regular OB (not the fertility guy) and let her/him know and ask for a double check everything’s cool. They can check for fibroids (which can cause bleeding) and scope the uterous just to be sure there’s nothing funny in there and they’re not vested in the outcome/it’s an independent opinion which would put my mind at rest more so than with an RE. I’ve had early bleeding a long time ago but it was like around 16 days in the cycle and they did a surgery and verified endometriosis and cleaned everything out of my uterous. Then my periods were perfect ever since pretty much. Ps – spotting shouldn’t have anything to do with egg quality unless it’s spotting related to a miscarriage.
Hope this is helpful and really looking forward to hearing how everything goes for you.

Ritaz1964 – I almost cried reading your story. I’m so happy to hear of your successes and also struck by the struggles. Its fantastic that you fund an immunologist and treatment for the right testing. Really great. Here are my thoughts on your upcoming plans…
DHEA - The DHEA should definitely help with the number of embies you’re getting. As I suggest to everyone, takethe 75mg in the am or 50 in the am and 25mg in the pm. Have your DHEA-S and T tested preferably before for a baseline but at least after 2 weeks or as soon as possible after starting to give you a sense of where you are. Your T should reach its full maximum for the dosage within about 4 weeks. You want your T to be at least 80 when you do a cycle. DHEA-S may be above normal but that’s ok.
Cycle - I don’t really recommend the Gonal during suppression. Its too confusing I think for your body and I’ve never heard of this before. When you give your body confusing things it tends to react in unexpected ways. Do your suppression right after ovulation for about 12 days, go off, then start your stims. Can you post anything about Gonal during downregulation? Just sounds very funny to me.
Blood Work – If those are day 4 levels then I am concerned about your Progesterone. I’ve been lazy about units but I’m assuming these are the same units we’ve posted here in the past (you might want to check). If so, your progesterone around Day 1 – 4 should be less than 1. What you might do is do a downregulation practice the month before your cycle and then get your bloodwork on day 3 to see if the downregulation put everything where it should be. Without the downregulation its possible on dhea to have very early ovulation in a cycle/multiple ovulations in a cycle. E.g. I sometimes had a size 14 mm follicle right after ovulation…that’s just how active the ovaries were.
YES – you need dhea with numbers like FSH = 10. My FSH was 11 and I was just getting 2 eggs. You want your FSH between 4 – 7. Mine went down to 4 on the dhea.
Also, if you don’t’ already consider taking CoQ10 30mg and L-Arginine 1000mg am & pm. Finally, I presume your getting IVIG for all your cycles since discovery of the NK cells?
Hang in there, the dhea I think is going to help you at least get some more and healthier eggs.
I look forward to your updates. 

[anitasto]

Jlb71 – my pleasure.
Can you test T at any time of cycle? Yes – it doesn’t vary but its best to have it checked at the same time of the cycle so, along with other day 3 labs is good. It is somewhat lowered during/around ovulation when E2 is high.
I do not recommend stopping DHEA at any time until AFTER retrieval. This is very important….I’ll spare you the science and details unless you really want them…but maintaining your levels and consistent intake all the way through will give you better results. In my best cycle I even increased my dhea intake about 5 days into stims….
IF you stop before hand just know….things reverse very very quickly once you stop taking dhea and I wouldn’t expect improved or optimal results if you stop it before stims.
Thanks so much for your well wishes and I certainly wish you well also.
Warm regards.

RobstersMama – you’re so cool. So glad you felt my post kindly and I’m so glad you contribute so much to keep this going. I’m totally looking forward to the post of your PG. And thanks for all the science post – I wrote up a diagram of the chain reactions when I was first working on all of this and which I base blood tests on. I spoke with the scientist that found NGF increased FSHr in the granulose cells….the last link in the dhea chain of effects. It’ll be so great when all of this is published and put together and the doctors actually start teaching it and using it as standard. Until then…  Big Hugs

HQ – great to hear from you! I did some cursory reading on the antithyroglobulin Ab and yes it appears autoimmune …there are several diagnoses that come with these labs so you might want to do some reading up. Great you already have your sisters for reference…I imagine that will help a lot. I’d be curious to hear the diagnosis you get from these results. Hang tight babe – seems you’re doing a great job of staying on top of what you need.

Ilion – the most common approach is to wait. However, if you truly feel pressed, there are a couple other approaches. There’s a T patch study from Italy where they just added a T patch for 3 days in first days of stims and averaged 8 eggs. I also found that I could simply taking a higher dose of DHEA for a shorter period of time and get more eggs within a month. I honestly don’t know for sure if it’s not the ‘best’ approach since eggs actually develop over 3 months. But I have a suspicion that you can do as well with 100mg in 2 months. “If” I do another cycle that will be my approach.
HQ’s got you covered for the pharms.
Hope all goes very well for you and your wife.

Kirstier – glad you’re asking this question. Its one that’s near and dear to me. I have very strict entry criteria before a cycle in order to ensure I get best results. No follies over 6mm. With 3 over 10mm I’d definitely postpone ‘if it were me’. I kept them below 6mm after experimenting several months. I ovulated thru the birth control pills so those didn’t do the trick. Finally got my RE to call Gleicher. We finally use 2 patches switched daily starting right after ovulation for about 12- 14 days and then 3 days off and then stim.
Note – the vast wealth of knowledge is always from reading. ;) My dining room table is often hiding under the materials. ;0
Gleicher has not published his protocol but he takes free consults from other RE’s. Info at CHR.
Also, if you’ve been pg twice with no heart beat – you really might want to look into some additional blood tests just to be sure you don’t have an autoimmune issue before your next cycle. For this info which Chups and I dialoged on….just search for Chups if you haven’t read those posts already. My RE’s nurse coordinated with Repromedix…they’re phone is 800-667-8893.
Hope you can verify that egg quality is the only issue that needs to be addressed. I wish I had looked into this before my 3rd – 6th cycles.
All the best…

[Ritaz1964]

cycle:
Day 21 start sniffing synarel and taking low dose gonal f (150units), carry on until period arrives, then up dose to 450 units, then keep going until follies right size for pick up. (of course, be certain Ive ovulated with a blood test)

This is something new.  A trial was done in Turkey on a small group of women who had previously produced 4 or less eggs in a cycle.  This protocol improved egg collection rates from (on average) 2 to 6 and pregnancy stats also jumped from (on average) teen number% to 40%!!!

Okay, Im a bit older than your average chook, but if it means more eggs to start with and better odds (obviously the early start of the gonal f makes the follies waiting get more nutrients), Im all for it!

Ive done so many cycles, tried lots of different protocols... Ill give it a whirl!

Im on prednisone 25mg from day 21 plus an assortment of other vitamins and also blood thinning injections and low dose aspirin.  Im doing exactly what I did to get my last child, just the stimming protocol is different...

I think my prog was high cos this period was one I got coming off the pill, so not really a true reflection under normal natural circumstances.  

Ive had FSH levels from 6 to 10, last cycle was 6, got 4 follies.  On an FSH of 9, I got 9 follicles and my daughter with two frosties (which obviously didnt make it).  So, thats just weird.  I can only put it down to me getting older.....(and fatter)....(ooops!)

[ilion]

We have a DHEA dosage question.  My wife has been taking 50 mg of OTC for about a week and we got a perscription for compounded DHEA from our doc.  The doc and the pharmacist say that because the compunded is so much more pure and concentrated than the OTC we should go down to 5 mg (one pill) and work up from there.  So our problem is we don't really know how much to take.  It seems absurd to take ten or fifteen pills a day, but we don't want to take too little.  Does anyone have experience with this?  Advice?  Thanks!

[kirstier]

Hi Anitasto:

I hope you had a fantastic time sailing.  Sounds great!  Thank you for the information.  So, I guess the dhea continues to work even while on BCP & estrogen patches??  

[Daniflorida]

I just found out that I had my first failed IVF.  My physician told me to go on DHEA for the next 3 months and we'll try again in January.  I'm taking an over the counter organic pharmaceutically pure DHEA now.  Is there a different in the pharmaceutically pure and compounded DHEA?  My physician just said to go to GNC and get some DHEA, but he didn't say what kind to get.  I'm confused.

Also, I've been taking 75 mg a day.  I take 25 mg in the morning, 25 at lunch and 25 mg at night.  Should I be taking them all at once?

Please help!  I'm new to this whole process.

Thank you,

[HQ2007]

Daniflorida: from prior posts by Anita and others, it's recommended that you take 50mg in the morning before anything in empty stomach and 25mg at night before bed. I am not 100% sure but compounded DHEA is more pure and the exact dose in each pill I believe. I get it from Belmar Pharma, here's a link you can read about how they prepare their DHEA. , http://www.belmarpharmacy.com/pharmacy_content/s_bio/bio.htm.

ilion: From my (and other ladies here) contact with CHR in NY, prior to IVF, 75mg (50 in AM and 25 in PM) is recommended. I didn't realize they make 5mg compounded dose! Your OTC 50mg had probably lot more than 5mg of DHEA. This is just a thought, you can start with 2x5mg in AM and 1x5mg at night for a week then increase it second week. You may need to get 25mg dose pills if you are going to eventually take 75mg prior to IVF.  

Chups/RobstersMama, any thoughts for ilion?

RobstersMama: My GYN gave me liquid Vit-D that has 2000IU in just one drop! Here's the info. You may need to find a local Doc who can order it for you.  
Liqui-D3 dietaryy supplement
from Rx Vitamins, www.rxvitamins.com

Also, do any of you read/heard about low dose Naltrexone? My GYN told me to read about it. Apparently, it has impact on fertility! I am reading, will post any information I find relevant. Dr. Dr. Phil Boyle in Ireland treated patient with this for infertility. Here's a link to the LDN org if you are interested in reading, http://www.ldninfo.org/conf2006.htm.

Enjoy!
HQ

[ilion]

Thanks for your response.  We went ahead and ordered from Belmar and they suggested going back to 25mg to start and working up from there based on blood tests.

Daniflorida:  hey we're in the same boat, but after 5 failed ivfs our sixth in January will probably be our last shot.  Hope this DHEA works for everyone around here....

[pyar]

HI everyone sorry ive not been checking in lately but my last iui failed and i needed time to heal i'm gonna take some time out to try and figure where we go now i don't think i will be considered for ivf because of my stats you guys are amazing i cant get my head around how clever you all are with all the info you manage to find and understand i just don't have that level of understanding my doc now wants to try agin but with a lower dose of gonal f 150 instead of 450 as he feels i may respond the same but because i have only produced maximum 2 reasonably sized follicles he says ivf would be an even lower chance of success so i'm going to continue with 100mg of dhea as by the time my next cycle comes along i would have been on it about 5 months its just so hard to keep going after each failure god bless

[epoh]

Thank you for all your posts related to DHEA and Keto-7.  I feel like I wasted my last two IVFs since I had been taking Keto 7 instead of regular DHEA. I have since changed and hope it takes effect before I start my next, and probably last, IVF.  Just wanted to check and see if you need a prescription for the compounding DHEA?

Also, my acupuncturist recently asked if I had heard anything about HGH (Human Growth Hormone) and fertility. I have begun looking into it and did find a blog of a woman who took HGH at the same time as her stemming injections and managed to get pregnant (having had a few previous failed attempts)  Wondered if any of you had heard anything about HGH and IVF treatments?

[jlb71]

Hi Anita,

What would you say good lab values are for DHEA-S? Mine was tested at 500, which my doctor says is pretty high. My testosterone level is normal. Is it possible to have high DHEAS but not T level.  My dose has been lowered from 100mg to 25mg right before the test so I can't even imagine how high it was when I was taking 100mg. My doctor did state that high levels of DHEAS can impact egg quality and that dexamethasone can help lower the DHEAS. Have you heard anything about this. I guess this statement makes sense since most PCOS who have high levels of DHEAS also have poorer egg quality.  Also, my day 3 FSH is 6 and antral follicle count is 10. Earlier this year, fsh was 5. Not that its a significant increase, I thought the DHEA was suppose to lower my fsh and increase my antral follicle count.

Thanks for sharing your thoughts

[RobstersMama]

Hi Girls and one Guy!

I have been too busy lately to check in and can just make a quick report now.

HQ: great information about the vitamine D! Thanks!

PYAR: I am SO sorry to hear about the failed IUI. Has there been no improvement or change of any kind on DHEA for you? What terrible news. Have you tried estrogen and prog vag supp. after ovulation? I have a theory that a low estrogen level prevents the embryo from developing properly. Have you ever felt really cold during the two-week wait? I did with both of my miscarriages. With my successfel pregnancy, I felt warm. I believe that my estrogen was low those times. I can give more details if you have felt cold.

Well, I got a negative blood test result also--on day 12 post ovulation. Bummer. So I am just hanging out waiting for the cycle to start over and trying to decide what to do next. I have upped my DHEA to the recommended 50 mg in the am and 25 in the pm.  I guess I will really look like a teeneage now with zits and greasy hair--and some wrinkles!

Anyway, I will research Naltrexone HQ!

[pyar]

yes i did have a day when  i felt cold but the clinic said that my estrogen levels were  fine i will ask next time exactly what the levels were what does estrogen  and prog supp do exactly  sorry if thats a dumb  question  also when i was on 75mg dhea i had no side effects at all so just before the iui i upped to 100mg but i think i left it too late for this cycle  since being on 100mg i have had zits and greasy hair so at least its telling me its in my system hopefully doing something we'll see  next cycle sorry to hear about your negative test  did you put any weight on with the gonal i have puts tonnes on all around my tummy area i was so convinced the iui had worked all my symptons were preggas one but thats the cruel thing about all of this the meds give you exactly the same feelings

[RobstersMama]

Hi Pyar,

My doctor put me on a prog/Estr. suppl. this time and for the first one I have not felt cold. I was on prog for both of my last miscarriages and felt so COLD! I belive the high estrogen during pregnancy makes one feel warm. I believe estrogen increases at night--thus hot flashes at night, primarily, for menopause--like a fever breaking--you feel hot as your temperature comes down a bit. Remember that progesterone causes your temperature to go up. I read a study on primates where they pregnant females were deprived of all sources of estrogen. The embryos failed to develop properly and died before miscarriage. You can find the study on Google.

So, my theory is that if you feel cold, you need more estrogen and that higher levels might help the embries develop/ implant better. For what it is worth.

Hang in there, OK? Oh, and check out the information on Naltrexone on Google as related to fertility and pregnancy.

I hope this makes some sense. I am in a hurry!

[RobstersMama]

Does anyone have any GOOD news????!!!!!!!!

[RobstersMama]

Oh, PYAR--that supplement is vag. caps for after ovulation, not before. 200 mg prog and 2 mg etsr. 2x day.

[anitasto]

Ritaz1964 – great! Give it a whirl and we will be here for you. Couple questions…I’m really very curious about the Gonal before your period and a bit concerned. Did you do this with your successful pregnancy? The whole goal in my experience has been to keep them all tiny. And here’s the thing, the predominant hormone contained inside the follicle until they are about 7 – 8 mm is Testosterone. That’s what gives me more follies as my natural FSH is actually dropping.
Also – you say be sure you have ovulated with a blood test before egg pickup. Am I understanding you correctly? The Greek study was a very good one – I think Robertsmama posted it here a couple hundred posts ago (haha).
If you only got 4 follies in last cycle, especially with lower FSH, then I would point to protocol. Did you have a leader follicle? How many antral follicles did you have before starting?
I’m back from travels so I plan to post again before the end of the week. Look forward to your updates my dear.


Ilion – Your doc is being conservative I think but sounds like he is open to this which is great. I think if you just ask for the blood tests (DHEA, DHEA-S, and Testosterone) showing a low or low normal level and then let your doc know you’re up to 50mg say after like 10 days without any problems he’ll get you a new scripp so you won’t have to popp so many capsules. Also – I think you can get 50mg otc if you just want to take that instead of many 5mg caps until reasonable time has gone by to ask for higher dosage.

Kirstier – thanks. We had a great time.
I guess the dhea continues to work even while on BCP & estrogen patches??  Absolutely – the T is higher than it would be otherwise enabling your body to recruit more follicles.

Epoh – I know of a doctor here in san diego using HGH. There are mixed results it seems in studies and it tends to be expensive so it doesn’t seem a lot of docs use it. But maybe you could get your baseline HGH tested to see where you are in the spectrum?….just a thought. I haven’t used it myself but have not read anything to indicate is has any negative impact. Its most important I think that you feel you’re doing everything you can….so I just encourage reading up on it and if you think it might helpyou’re your baseline levels are not already high then seems like a very reasonable step to take. Hang in there dear….look forward to hearing your decision and updates. 

Job71 –
What would you say good lab values are for DHEA-S? In my case the best level was between 800 – 1200. Several women here have commented on high DHEA-S, including those who are prego….it’s not really an issue. Here’s my info for reference…
On 75mg dhea my DHEA-S peakedat 518 and my follicle count maxed at 6 follicles. An improvement but less than I was shooting for.
On 100mg dhea my DHEA-S rose to 1854 in a month and I had 10 follicles.
A year later after working out a thyroid issue my body had adjusted
On 150mg dhea my DHEA-S was over 861 and we had 9 even sided and same size follies.
I seriously recommend do NOT lower your dose – your gains, based one all my experience, will be lost quite quickly.
Please do not take dexamethasone and dhea-s will not negatively impact your egg quality. Dexamethasone will reduce your adrenal hormone function and it is used for PCOS who are overactive. I had a doc use it and I got just 1 – 2 eggs until I read up on it and quit using it. I asked two other docs about it – they both disagreed with its use except in PCOS. There is only one study on it and it tries to conclude improved results….but its so close and noone else picked up on it. Its just counterintuitive.
Women with PCOS do not necessarily have poor egg quality. The impact is to the pregnancy with high testosterone. Most studies show that women with PCOS do quite well in IVF.
How many follicles did you see before dhea? It is very possible you’ve only scratched the surface and if your T is ‘normal’ – this is a wide range. If it is less than 80 I don’t think you will see best potential.  
Hope this is helpful…..really looking forward to your feedback and if this is helpful. I’m concerned and want to see all your hard work so far reap success.

Robstersmama – I am so sorry to hear about your neg. You’re a hero here ….with your intelligence and determination you will certainly get there. 
Good news – I don’t know if this qualifies but I’m going to do another cycle. (eeks!) This  time with IVIG and heparin for my autoimmune discovery similar to our new gal Ritaz1964. Its been tough to decide that but a weekend in New York with my girlfriend gave me some much needed helpful psycho analysis to help make and feel confident about my decision. Looking forward to our collaboration thru it. ;)

Hugs all – I fly back from NY so if I don’t come back – check the 9:30 am flight from Kennedy (NY) to San Diego. I’m always a little nervous about these looong flights.

Best,
Anitasto

[Ritaz1964]

Holey Gacomole Batman!  Im day 18 of my cycle (been on the DHEA 4 weeks)...I have MAJOR MAJORE abdo cramps, doubled over.... I cant tell yet, if its ovulation OR th wicked witch!  I had a blood test today results tomorrow.... checking Testosterone also.  I am a greaseball with zits now! hahahahahahahahahahaha

Anita:  I did this test to check I HAVE ovulated, got rid of any follicles sitting there so I can start the SYNAREL and the GonalF (low dose).  Dont want to start onANY drugs until ovulation has occurred...
Im certain that I nly got 4 last time was due to 2things....the short flare protocol and my age... You cant get blood out of a stone,you can try to squeez it somewhat though..!!!!  This time, lond down reg protocol ith extra Gonal F to start with for a BOOST!!  

You mentioned dexamethasone and DHEA... does this also apply with PREDNISOLONE???

Did you get your numbers checked for the autoimmune?  What were your NK cells CD56 like?  WHat %???  Ive never done the IVIG, bit tricky not many Docs do it either.  We are in some respects...SOOOOO slow, yet with other things... quite advanced!

Cheers,  Rita

PS: Will update my bloods 2morrow!

[RobstersMama]

Hi Anitasto and wlecome back!

OK, now I am really stressed. I am thrilled you are doing another cycle. Everything looks so good for you that it MUST WORK!!!!!!!!!!!!!!!!!!!!!!!!!!!!! (Yes, that certainly does qualify as good news.) So, now I feel like I will be going through your cycle with you with my fingers crossed the whole time. Ahhhh!!!!!!!!!
Please give us regular updates.

Thanks for your continued encouragement. I will be jumping back on the bandwagon on Thursday. My doc is unfortunately on vacation at the moment so I am starting the cycle with another one. I hope he agrees to increase the Gonal F from 150 to something higher. My cycle just reset today, which is strange since it is day 18 post ovulation. That is unheard of for me. It is also 6 days since I stopped the prog/estr. Maybe it just takes a lot longer to clear my system than for others. I understood that one's period should come 2-5 days after stopping. Hmmmmm. I had negative pregnancy tests through the 16th days post ovul.

Ritaz,

Hang in there! Are these really cramps? Or are they more like sharp, steady pains? Are they on one side or both of your abdomen? Perhaps you should call your doc. That sounds really bad. I hope you have a TERRIFIC ovulation!!!!!!!!!!!!!!!!

Is everyone taking their vitamin D? The daily dose  recommendation has just been doubled. I am taking 2,000 units per day but might up it to 4,000 for the winter without any concerns.

Hey, my skin cleared up. Does that mean I can now take MORE DHEA?

[anitasto]

Made it back. Whew. ;)
Robstersmama - You know after my transfer with the progesterone etc. it took a whole 10 days longer to get my period. A couple other people if I recall correctly have reported similar experiences. The next cycle it came only 4 days late and now normal.
Clear skin is always nice eh? I also recall sort of a break through point where acne wasn't so much a problem...like my body balanced itself. I wouldn't jump over 100mg until you can test how your body is reacting. Have you been at that level a couple weeks and can you get tested?
I googled for a while on Vit D as you probably have, and just keep finding that too much can be toxic and 2000IU is the best level.
I had the same idea on DHEA...more of it more eggs right? I upped and upped dosage. Unfortunately, in Jan this year it did backfire and we just couldn't get a healthy cycle - my LH shot way up and nothing good comes out of that. I think you're in great shape - my humble opinion - and blood work will prove it for you.

Here's one Vit D site:
Taking high doses of vitamin D for long periods of time could weaken your bones.
http://www.eatwell.gov.uk/healthydiet/nutritionessentials/vitaminsandminerals/vitamind/#elem220580
Vitamin D toxicity can cause nausea, poor appetite, constipation, weakness, confusion, and weight loss. Sun exposure does not result in vitamin D toxicity. Vitamin D toxicity is only a possibility from high intakes of vitamin D from supplements. The Food and Nutrition Board of the Institute of Medicine has set the recommended upper intake level to 50g (2,000 IU) for children, adults, and pregnant and lactating women. Vitamin D is one of those vitamins where the right amount is essential—not too much and not too little.
http://www.diseaseproof.com/archives/healthy-food-what-are-the-health-risks-of-too-much-vitamin-d.html
Thanks for your support too Robstr....you're the best. :)

Rita -
Cramps? Yeah - its like someone is poking those ovaries into production. Don't know if yours are the same, Ritaz, but mine were similar to Robstermama's description - kind of like a slow sharp poke. I decided the hormones were waking follicles. I also understand that more active ovaries are actually larger and with hormones can grow. Haven't measured mine, but just assumed this was occurring.

I don't have NK cells and have read that your treatment described is extremely successful for NK cells. If there is an interaction between prednisolone and DHEA I would be surprised...there may be synergistic effects but I'm pressed to imagine more. All the same, the proof is in the pudding - can you keep track of your Testosterone levels? BTW - I have anticardiolipin antibodies and anti-beta-2-glycoprotein-1 for which I'm understanding this different treatment of IVIG is effective by binding to the unhealthy autoimmune enzyme rendering it innert while also adding normal immune enzymes.

Night ladies. :)

[anitasto]

Where are you? How are you??
Miss you!
Anitasto

[Ritaz1964]

I have my new bloodwork results!

LH - 50 ( I am surging now).
PROG - 5
OESTROGEN - 450
TESTOSTERONE - 1.5 (was 1.4 two weeks ago)????

Does this mean much?  Thought T would be less now,or is it variable during a cycle??  Seems I am to ovulate any moment!  I am day 19 today.....

Cramps have lessene, but feel like my insides are ultra delicate.....

Ovaroies DO enlarge it higher oestrogen values... swelling wt mny follicles.... smaller ovaries are indicative of menopause or POF...

Tell me your views..... please....


Cheers, Rita

[jessny]

Hello Ladies:

I want to thank you all for the information provided here.  It's been so informative!
I've been taking DHEA for several months now.  I was taking 75 mg for about 6 mos.  I've had 2 early miscarriages.  The last one was in July.  I then started taking 100 mg of DHEA because I didn't see any difference while I was on 75mg so I've been on 100 mg for about 2 mos.  I started an IVF cycle last week October 3 but was canceled today due to poor response.  I have only one follicle growing and 3 others that have not grown and are less than 10 in size.  Also when I started this cycle, I begun taking 150 mg of DHEA every other day.  One day I would take 100 then the next day I would take 150.  The 150 I split 100 in the am and 50 in the pm.  After this, I started getting acne on my face.  I didn't get acne while on the 100 mg only when I added the extra 50 every other day.  This month I had my levels checked on day 3:

FSH 14.1
DHEA Sulfate 353
Testosterone 65.8
Testosterone Free 12.3

I also asked for DHEA, but somehow it wasn't done.  Should I continue with the 150 every other day or should I just do 100 every day?  The free testosterone seem high, isn't it?  The report shows 1.2 - 6.6 as normal.  Any thoughts?

Thank you!
jessny

[dg223]

I have read through all your posts and you are a wealth of knowledge! I started taking 1000U of vit d3, is vit d3 ok or should I take vit D? Also, it is interesting the point you made to pyar about taking estrace in the luteal phase. I do feel quite cold and get a lot of spotting so I will try adding it in along with progesterone. (btw- it take me 4-5 days to get af after stopping prog). Do you also take the estrace vaginally as well? When do you start taking it- how many days post-ov? Good luck with your upcoming cycle, hopefully the higher doses will help. I am on my 4th month of dhea, so it will be interesting to see if it helps me when I cycle next month.

[garden4lynne]

Well, I'm back.  I know everyone is looking for good news so I'm sorry to report that my last cycle ended in a failure.  We made it about 3 weeks from transfer (of 2 'perfect' and 1 'near perfect' embryos) and while my beta numbers kept climbing (albeit slowly), the one that stuck around just wouldn't grow.  

I do want to EMPHATICALLY state thought that my DH and I are firm believers that DHEA gave us great results heading into retreival (8 eggs) - much better than any prior tries (2 and 1 egg on prior IVFs, and at most 2-3 follies on prior IUIs).  So I'm back on the regime and hoping for both the additional quantity of eggs plus better quality this time.

I'll get caught up on everyone's posts -- it's so great to see so many people taking an active interest in researching and sharing what they've found (I'm not the greatest researcher so REALLY appreciate what other's have done!!!).

Buying DHEA -- Since I know what I'll be taking (quantity of DHEA) and for how long, I'm taking the plunge and buying on-line (rather than my bi-monthly trek to the store to buy).  For those of you without a drs script (like me), I'm buying from Lifelinknet.com (have read in other chatrooms women buying DHEA here) and found that they have a buy 2 get 1 free offer.  Even with s/h this will save me almost half vs. what I was paying at The Vitamin Shoppe.

Micronized vs. Standard DHEA -- several people have asked why one vs. the other.  While I've always read that you absolutely want the Micronized stuff, it's interesting to understand why.  I found a link that provides some details:  http://www.delano.com/ReferenceArticles/Micronized-DHEA.html

Keep all that great info coming!
Lynne

[pyar]

sorry to hear your news stay strong

[Ritaz1964]

I ws also tol MICRONISED only. It  is absorbed in the body and metabolised better...  My compounding pharmacy only does it this way...

Chees, Rita

[HQ2007]

Lynn,

Sorry to hear your news. I am glad you are jumping right to next step!

I found some info on pre, peri and post implatation losses. Thought it was useful so am sharing.

http://www.illinoisivf.com/recurrent-pregnancy-loss/index-rpl.html.

I am towards the end of 4th month on DHEA! Yay! I am on my two weeks wait :-\  right now. I am doing power walking couple nights a week. Taking Armor Thyroid, started this cycle. Had ANA and APA test, but I think numbers are normal, here are the numbers:


Antinuclear Antibodoes Direct   43 (Negetive <100)
Phospolipids, Serum    206 (normal range 150-250 mg/dL) << that look normal?

Later,
HQ

[anitasto]

Hi Ritaz1964,

OK- definitely looks like a surge. That was from day 18 without any stims right? E2 is kinda high but you could have more than 1 follie in there ovulating and that would do it.
T should go up while on DHEA and it appears your T has reached its max for your dhea as it’s been near same for 2 weeks.If I assume your units are nmol/L then your T is 40.23ng/dL and at 1.5 its 43.227.   (multiply by 0.347)
My best results were at about 80 – 100pg/dL, so minimum of 2.76nmol/L.
So my view would be….you’re just getting in the healthy range and some women require more than others to get to that upper end. IF you’re just starting this cycle I would up dosage by 50mg – I’ve done that and even in short period seemed to help. If possible, then test after about 4 days and you should see increase. You can back down if it jumps too high for transfer like many here do but the extra T just makes follies I think. What was your peak E2 in previous cycle(s)?
Looking forward to hearing how things are! Keep posting eh?

Hi Jessny,
Great job on getting your labs! Because your FSH is still over 7 and your T is still in the normal range I would strike a medium if you can of 125 daily. I think its important to be consistent because your body will adjust negatively if things vary and I think give you a lower conversion rate which it appears you may be seeing already. Yes, it’s a pretty high Free T level at 12.3. Also get your IGF-1 and SHBG tested. Are you by any chance diabetic or hypoglycemic? I’m guessing your SHBG is quite low which is related to IGF (Insulin Growth Factor) which I’m not used to seeing. Not to be alarmed – just asking. The free T is what you actually want for it to be available to act on the ovaries. Low free T means you don’t have much available to do the job – its bound up by SHBG (sex hormone binding globulin). Based on Robstermama’s posts I’d just be sure for now that you’re on 200IU vit D. K? ;)

Garden4Lynne,
Jeezo – so sorry to hear your news. That must have been hard. I so feel for you. Its so great your back and plugging your dhea results. Great to hear.
You know, based on my conversations with Chups, have you considered testing for some of the antibodies associated with miscarriage? Might be worthwhile just to be sure before your next cycle to ensure the bases are covered…..
Hang in there …. so great to see some old names.


HQ2007
Hey great to see you back! Those levels look really nice. I hate to say it…there’s more to test like Killer T Cells, Anticardiolipid antibodies (a subset of phospholipids but the anti-antibodies), antibeta2 glycoprotein-1 antibodies,…. All can cause lack of implantation or mc. Let me dig mine out tomorrow and I’ll come back and post on those more. In meantime check out Repromedix which specializes in testing for rare fertility related issues. That’s where mine were done.
Also – please be careful with ArmorThyroid. I was on dhea for 2 months starting 2 years ago and things were going beautifully seeing 10 follicles. But then my T levels dropped even with same dhea dosage and during my stim cycles (3 cycles!) my follicles were just disappearing. I finally narrowed this issue down to my 35mg dose of armour thyroid. Went off it, T rose, follies showed up again and we got the 10 eggs – no more disappearing. You may not be the same but just wanted you to be aware so you can check your levels and keep a look out for this.  Curious…..how did you come to need thyroid supp.?

Cheers everybody!
Anitasto

[anitasto]

RE: specialized blood tests
Here's a link to the test requisition form which shows the tests available and commonly performed from Repromedix. With multiple failed IVF cycles or a miscarriage and especially with multiple or late term miscarriage I would consider these tests to ensure you $$ spent going forward is well spent. These tests were mostly covered by my insurance - Blue Cross.

http://www.repromedix.com/pdf/Test_Requisition.xls.pdf

[anitasto]

My story relating to autoimmunity, why autoimmunity is so harmful, and a little philosophizing....

So I heard about this through a surrogate attorney, got a local specialist who turned me on to Repromedix, ordered every test they offer on the sheet except hormones, researched all I could learn about what these antibodies do and...basically ... they're the kiss of death to both implantation, early miscarriage, late miscarriage, and heart defects based on the studies I have read. They invade and destroy the mitochondria inside cells and the mitochondria is effectively the mother of life for all cells. Once the mitochondria is damaged it cannot provide energy for the cell and the cell dies. One study placed perfect embryos in a dish with these antibodies and the embryo was destroyed - the amount of time it took was only dependent on the concentration of the antibodies. If you achieve pregnancy, these antibodies also cause blood clots which can form in the placenta and cause miscarriage when the blood is not flowing sufficiently.

I hope this is helpful and encourages you all, especially those who have failed before even when they just say its egg quality, to consider these tests so you can be certain that you are not spending money without likelihood of success. Because the great news is that, with treatment of Intravenous Imunoglobulin (IVIG) the success rates go from 1 in 10 to 7 in 10 from one study I read. My local specialist has used this four times, each one was successful after both implantation failure and as many as four consecutive miscarriages prior to IVIG and Heparin for the blood clots.

Very very few doctors are familiar with the autoimmune area of fertility and others believe it is not even relevant.......I'm told its a widely debated topic....so it is very common for them to allow up to three miscarriages and recurrent failed cycles and possibly still not bring this up. It will typically be attributed to egg quality and recommend you use a donor.

This also rang bells for me because my Dad has been hospitalized twice for deep vein thrombosis - blood clots - which is generally caused by anticardiolipin antibodies. That made me a likely candidate even further. Ironically, no one in all my fertility experiences ever asked about that type of family history. Also, I've always had blood clots in my periods. This was another clue for me once I started reading this stuff. Chups who was also tested positive for anticardiolipin antibodies also shared she had blood clots always in her periods. (hope you don't mind me repeating your story Chups)

Here's sort of a moto we seem to be adopting on this board.....

When your fertility is not working, find out why 'before' your next cycle or pregnancy. Do your homework, be assertive in your own care, and be rewarded by saving money, time, and your best chances for success.  It's good to understand that Doctors are good people and they're in a good business for profit. One way to reduce costs is to reduce extensive blood testing; one way to increase profits is to do cycles. However, as my mother always said, "Ask and you shall receive.... or, if its important to you, ask someone else."

Hang in there...and while we're at it I hope everyone has a great weekend!
Anitasto

[anitasto]

Here's a link to doctors who do provide advanced testing...

http://www.repromedix.com/physicianguide/#ca

[Ritaz1964]

I wouldnt know what my other E2 levels were (outside of cycling), cos I never botherd testing, and if I DID test, it was at day 21 to ensure Id ovulated, but that time, its a week after surge, so no real indication...am I right in assuming this?

On another topic of side effects on DHEA..... I STINK!!!  My body odour is putrid and for me to smell it myself, must be pretty bad!  Anyone else had this?  I honestly cant stand to smell myself.  I have a huge rash that wont go away in my armpits and Ive been on KENACOMB antbacterial ointment for 3 or 4 weeks now... its UGLY there!  ALso, bowel disturbances, sorry if thats TMI,but geesh..... and you suggest more!!!  Hooley Dooley, Ill be a train wreck....  as for zits, not so much on my face, but my arms and body, for sure!  

Gosh, I hope this stuff is doing its magic.... for me it feels like its FOREVER until I start cycling!............the buildup is phenomenal!, especially since its my last try.... bt Im good with that too.....  I still have more than I ever expected to have, under the circumstances.... just nice to have a winner one more time...

Testosterone was nmol/L measurement..... that paragraph you wrote has me totally and utterly bamboozled...plain english please ....... its early morning here and Im vague at the best of times!  Do you mean my body is absorbing the maximum of the DHEA Im taking and it should be a bit more????  I was under the impression that Testosterone had to be at the lower end of the normal range, you are saying it should be furhter up???  You saying T doesnt fluctuate during a mentsrual cycle???  Gosh, I wonder what my T was before taking any of the DHEA?????  Is lower testosterone better for womens well being than higher??  Does testosterone effect a womans libido, cos mine has been gone for quite some time!  I'd like for it to come back one day!!!  

My husband has his testosterone levels checked and they were just slightly below what is considered normal range..... his libido is definately on long term vacation, but IVF will do that to you also.......... or its just me and my fat butt!

Thats enough questions for now..... Im trying to absorb what you tell me, but at times, its very intense and my eyes just glaze over and brain stops.....hehehehehe

[RobstersMama]

Hi Anitasto!

Great info. from you, as always. It is so much appreciated.

Regarding the vitamin D, deficiency concerns should be on e veryone's mind, rather than toxicity concerns. Toxicity is exceedingly rare. Deficiency is exceedingly common, unfortunately, and the repercussions of that can be severe, raising the risk of MS, cancers, RA, and likely, infertility.

Recently, the dosage recommendations have been upped dramatically by many groups. For example:

"A recent review of the science reported that the tolerable upper intake level for oral vitamin D3 should be increased five-fold, from the current tolerable upper intake level (UL) in Europe and the US of 2000 International Units (IU), equivalent to 50 micrograms per day, to 10,000 IU (250 micrograms per day) (American Journal of Clinical Nutrition, March 2007, Vol. 85, pp 649-650)."

Source: American Journal of Clinical Nutrition
December 2007, Volume 86, Number 6, Pages 1657-1662

There are many more sources that say the sub-2,000IUs per day are just too low. So, I would receommend that folks get tested and up their level until they remain in the recommended range. But remember that the normal range, according to many, is also too low.

In one study of African-American women who received 800 IU per day for two years and then 2,000 IU per day for the third year, the dose was insufficient to get their blood levels over 60 ng/ml. Toxicity does not occur until levels exceeding 150 ng/mPlease note the following:

"According to several studies, 40 to 100% of U.S. and
European elderly men and women still living in
the community (not in nursing homes) are deficient
in vitamin D.7-12,15-22 More than 50% of
postmenopausal women taking medication for
osteoporosis had suboptimal levels of 25-hydroxyvitamin
D — below 30 ng per milliliter (75 nmol
per liter)."

From the Department of Medicine, Section
of Endocrinology, Nutrition, and Diabetes,
the Vitamin D, Skin, and Bone
Research Laboratory, Boston University
Medical Center, Boston. Address reprint
requests to Dr. Holick at Boston University
School of Medicine, 715 Albany St., M-1013,
Boston, MA 02118, or at ***@****.
N Engl J Med 2007;357:266-81.
Copyright © 2007 Massachusetts Medical Society

That is 40-100% are deficient! And this comes from a very well-respected journal.

I have previously cited information in this thread about the likely relationship between healthy follicle development and adequate vitamin D intake.

Please be sure you get enough vitamin D, Ladies!!!!!!

[RobstersMama]

Hi Pyar!

Come on back! I forgot to answer your quewstion. No, I did not gaid weight around the middle. But I did get a bit chunky during the cycle and then it seems to drop off during the first week of this cycle. I am on a much lower dose tham you, however!

How are you doing??

[RobstersMama]

Lynne,

I hated to get this news. I am so sorry. OK, keep plugging ahead, OK? There has to be a reason these little perfect embries are refusing to hang in there. Wishing you LOTS of luck and happy thoughts.

[RobstersMama]

Hi there, DG223,

Yes, D3 is perfect. It is the most active form. I start the vaginal supps of estrogen and prog about two days after ovulation. I think taking them caused my period to start much later this cycle. It took several days after stopping the pills.

Please let me know if you still feel cold when taking them. I have a special interest in this subject! I really believe that supplemental estrogen could make the difference in the initial embryo development and the implantation and feeling cold means the level is low. Just my theory, however!

OK, time to add my update. We started on day 3 this cycle rather than day 4 as for the last 2. (I didn't like that anyway). We started with 150 mlGonal f for the first two days--taken in the evening and the following morning -- and then moved to 187.5. (He is still very conservative!) Fingers are crossed! I am now on 100 mg DHEA per day--75 in am.

[RobstersMama]

One last thing...I am so sorry Everyone for my terrible typos!!!!!!!!!!!!!! I have been swamped lately and not taking my time.

[anitasto]

Hi Ritaz1964,

Sorry if things are techie sometimes. It’s a good point so going forward I’ll try to give the straight simple answer and then if you’re interested, the techie explaination….but optional reading. ;)
Q: “I wouldnt know what my other E2 levels were (outside of cycling), cos I never botherd testing, and if I DID test, it was at day 21 to ensure Id ovulated, but that time, its a week after surge, so no real indication...am I right in assuming this?”
A: You’re sorta right – day 21 isn’t as straightforward to read but there are still some boundaries that help to interpret it based on these norms…. if you can gimme any other E2s you have along with the cycle day and if you were on any stims or not and, if on stims, what was the dosage. Then maybe we can interpret while waiting for baseline day 3 E2. I think you’re b and c below.  BTW – if you’ve done cycles doc typically orders day 3 labs and they should have included FSH and E2 at a minimum. Yes?

E2 techie….
For a single follicle ready to ovulate E2 like day 14 will be between 100 – 250. If you have E2 at any time higher than 300 it can mean a few things….
a. You have more than one follicle in which case its simply additive…2 follies up to 400ish, 3 follies up to 600ish. The median for a single follie is 150 so fsh of 600 typically means 4 mature follicles. Make sense?
b. You have a cyst gone wild (just kidding). A lot of cysts produce E2 but not all so this is a possibility.
c. You have a high ‘baseline’ E2 which is a symptom of POA. So like on day 3 you might see E2 of 120 whereas an ideal day 3 E2 is about 40 and/or…
d. You have a low Testosterone level. High E2 seems to go hand in hand with low T; they see-saw. E2 goes way high in cycle, T will be lowered, and vice versa. I saw this repeated consistently in my cycle data which is one of the reasons I would add a little more dhea during the cycle to keep up my T.

Q: Side effects of dhea…
A: Yeah – bowels do funny things at first and DH has to evacuate if I don’t make it out first. As for BO – I don’t shower so I wouldn’t know. HAH – just kidding. Actually it smells more perfumy and that’s why I don’t remember it being bad. HAH – just kidding again. Sorry babe – I can say for sure the bowels and zits all over my arms and back were less than attractive. What we women do for….

Q: “Do you mean my body is absorbing the maximum of the DHEA Im taking and it should be a bit more???? “
A: YES. T increases within 3 days max and levels off to its max for your dhea dosage within a couple weeks.
Q: “ I was under the impression that Testosterone had to be at the lower end of the normal range, you are saying it should be further up??? “
A: YES – it needs to be high, not low. T is what the starting follicles are practically made of. If you don’t have enough, you can’t grow or fill up the follies with T.
Q: “Is lower testosterone better for women’s well being than higher?? “
A: In general, a healthy middle range of like 55 I think is good. Women with T less than 60 seem to most often fall into the POF bucket…my T is directly proportional to how many eggs I can produce up to T of 120. It’s always important to remember, people differ…this is just talking typically based on my reading and experience. We do have and I am somewhat familiar with anomolies and it seems two women on this board are anomolies…Chups appears to clearly be an anomaly but I haven’t figured that puzzle out yet. I got side tracked on the autoimmune issues we were learning of.
Q: “Does testosterone effect a womans libido?”
A: YES. My libido is typically in the bucket too. I actually sought out porn when my T was around 80 and above. DH couldn’t keep up. This is also pretty well documented in dhea and Testosterone studies relating to libido.

OK my little question queen. Love you’re writing still. You soooo make me chuckle! 

Cheerios for now
Anitasto

[anitasto]

I'm so glad you post on Vit D....I'm definitely adding it to my test list next visit and I'll post what it says.
You rock mama ;)
Anitasto

[RobstersMama]

Hi Gals!

Anitasto, please let me know how your Vit D. test comes out? New information says between 70 and 100 ng/ml is optimal.

Have you started stimming yet? My fingers are crossed and slightly purple already.
Thanks for the support, Girl.


So Everybody, an update. Today was my day 8 ultrasound. Sad, just sad. I have two follicles, although good size--and both are on the left side, which I think is my bad side. I think I have adhesions there which developed after my last miscarriage and might be interfering with the eggs entering the tube. I might have a laparoscopy next cycle to check this. Anyway, the right side is asleep--lazy sucker. All that DHEA and it does NOTHING! Maybe it doesn't have a very good blood supply since the fibroid sits on the right side and is pretty good size. Not good.

Well, I have two more days of Gonal F and another appointment on Friday. But I think this month is a wash. Just two. What a bummer. And the miscarriage rate at my age is 45% even if one of them did get lucky. So, things look very bad this month.

OK, nothing else to report.

My skin has smelled stronger since I went on the DHEA, as well. Oily skin and kind of stinky--a strong , musky smell. It has gotten much better lately, along with the zits, and I am wondering if there might be a connection between higher vitamin D and better DHEA metabolism, since I have now been supplementing with 1,000 to 2,500 IU of Vitamin D for about three months now.

Of note, Vit. D has excellent results for treating acne and for modulating the effects of high testosterone in PCOS women with respect to the cysts and follicles. Hmmmmm...connection? Sorry about all the Vit D stuff but I have been fascinated since I first read about how ridiculously many people are deficient (babies are almost always born deficient since women get so little!!) and how if help the follicles develop properly in PCOS women.

Oh, and I left this out yesterday. Vitamin D plays a huge role in cardiovascular disease. Ding! Ding! Ding!

Ok, off to do a shot.

Good news? Anyone? Anyone? Bueller?

[Ritaz1964]

buggar!

[pyar]

i'm still here just nothing to report just waiting for my next cycle have upped my dhea from 75 to 100mg i had no side effects on 75 and now  have spotty skin starting to settle now also extremly itchy legs and arms like i want to scratch my skin off  sorry you only got 2 follies but you never know its not over till the fat lady sings i also tend only to get two on the left side also nothing on the right side i'm hoping now i'm on 100 mg and have been on dhea for a good while now it wakes something up in there fingers crossed

[jessny]

Thank you for the reply. I was taking 150 mg of DHEA every other day because I only had 50 mg pills.  I've already order 25 mg pills so they should be arriving by the end of this week. In the meantime I'm taking 100mg ultra-micronized DHEA plus 25 mg Nature's Bounty brand.  It's not micronized but I figured it's only for a few days until I receive my order. I'm not diabetic or hypoglycemic, but I will have the IGF-1 and SHBG tested next time I go.  I do have Thalessemia trait so I'm always a little anemic or just border line.  I also did a CBC count last week and it did indeed show a little low.  My plan is to keep taking 125 mg and retest in about two weeks.  I will test for:
DHEA, DHEA-S, Testosterone, Free Testosterone, CBC, IGF-1 and SHBG.  Does that sound good to you?
This is my last try so I don't want to start a cycle until I know all my levels are ok.
Thank you so much for your help and I hope things are going as planned with you.

[RobstersMama]

Ritaz:

Exactly! :)

[RobstersMama]

Jessyny,

I am REALLY pulling for you with your last cycle. It is great that you are checking that everything is perfect before starting. At least you will then have a clear conscience knowing you did everything right if you don't get lucky. I think that is worth a lot with regard to this issue.

BUT let's hope you get a great result!

Pyar,

You sounds a bit down. I certainly understand that. It's hard having lazy ovaries.

I don't know what to think about that itching!

Keep us up-to-date, OK?

[jessny]

Thank you RobstersMama.  My husband and I have decide to try one more time and then move on to DE.  I'm already 44 so I have to be realistic plus I only have one ovary.  I had the other one removed when I was 13 because of a cyst.  I do want to make sure that, like you said, did everything possible. If this doesn't work then we'll just move on.  Like you, I've been on DHEA for a while now but I didn't get my levels checked until last week.  I was just taking 75 mg a day and by the results of my blood test, that doesn't seem to be enough to elevate the DHEA-S and the testosterone. I hope we hear good news from you in about two weeks!

Thank you!

[Ritaz1964]

Well, here are my day 21 or 20 results
LH = 2
E2 = 190
Prog = 15
Testos = 1.4

I ony started taking an extra 25mg of DHEA for 2 days when bloods drawn.

Waiting for Nurse at IVF clinic to call me and give me next step details...

I just WANT TO START!!!!

Cheers to all................. Rita

[Ritaz1964]

I started sniffing the synarel tonight and start the low dose puregon tomorrow... we are off!  Come on AF!!!
Next blood test will be on day 7 of full stims..... cupla weeks away..... fingers crossed SOMETHING comes of this!

Synarel makes me a cranky old bird..... oooh, perhaps I wont be so bad this time cos Im taking low dose puregon at same time.... lets see.....

Must go pop some pills!


Cheers, Rita

[DEVISTATED]

Hi, I am new to this post. I post on other topics on Medhelp and I have enjoyed the company. I have a question. I am on my 4th cycle of IVF, I am 37 and I am "unexplained" I had 2 fresh cycles and one frozen. Obviously none of them worked. My question is My doctor put me on for the first time DHEA 25 mg. 3xms a day. I started yesterday. I woke up this morning with severe chest pains and I felt like someone was sitting on my chest. At first I thought maybe a pulled muscle or I slept wrong. But It still has not gone away, I will contact the doctor tomorrow, but I was just wondering if anyone else ever felt this? Now the pain is still in the chest, but the weight I was feeling has moved to my upper back shoulder area. I am sitting here reading all of your posts and I am confused. This is a whole new world to me, and I thought I was kind of a big shot (ttc for 3 years) I have learned a lot from you girls. I was also told to get a multi vitamin with antioxidants???? I got a Women's one a day that has antioxidants in it. Any other suggestions??? I am now on the birth control pill and on Oct 27th I start Lupron and on Nov 7th I do a blood test and ultrasound then I will start Follistim and Menopur. (along with Lupron) I've never before taken Lupron with a fresh cycle only on my frozen cycle. Weird. I am afraid this time, maybe the fear of the "unknown" Thanks for reading and I would appreciate any feedback.   Linda

[RobstersMama]

Hi Linda!
I don't have any advice for you but I wanted to say WELCOME! I have no idea about your chest pains. Please tell your doctor ASAP. I understand that the DHEA takes some time to help (4-6 months in many cases), so be patient and don't get discouraged. Anitoxidants are vitamins and some minerals and some other nutrients, and even hormones. He basically wants you on a pre-natal pill, I suppose. Always a good idea. Be sure you are getting enough folic acid and iodine, as well. (and Vitamin D! :) )

Hi Rita!
So you are off and running. Great! Careful with what you sniff. Ha! Let us know how it goes, OK?

Hi Jessny,

Thanks again for your good luck wishes. My fingers are crossed for you, as well.

Hi Anitasto!

How is it going?? Have you started the cycle?

Update:
I had my check today and there are still just two good follicles on the dreaded left side and absolutely zilch on the right. I really think there is some big problem over there (on the left) so I do not have my hopes up. I don't think the eggs will make it into the tube due to adhesions--just my theory again. HCG shot today and "work" this weekend with hubby. We will see what happens after the dreaded two-week nightmare. I suppose if this cycle fails, it will be either laparoscopy for me or straight to IVF. Time to start getting mentally prepared.

[DEVISTATED]

Hi, thanks for the welcome. Chest pains went away the next day. I put a heating pad on me the night of the pains and by the time I woke up they were 90% gone. Just a fluke thing, I guess. So I have greasy hair and zits to look forward to...Yea, on top of Lupron that already gives me zits and makes me feel like a Good Year Blimp. Good Luck with your 2ww when is your test? Linda

[Ritaz1964]

I am with big whopping BLIND pimples, big red swelling lumps and they HURT... Im a "squeezer" unfortunatelY, so I just have even bigger redder lumps.
My hair.... geesh, greaseball city! and my scalp has oily clumps...sounds awful eh?
This stuff better be doing some magic!
I thought chest pains were odd..... I have not had any chest pains, apart from when I get anxious (Ive had a few anxiety attacks and  can tell you ... that is SCAREY..feel like you are having a heart attack).  So I understand chest pain worries!
My period must be soooo close...... hurry up you wicked witch, come on and lets start the show!
Silly me went and bought patterend toilet paper, now I cant tell if there are any signs of AF!!!

[DEVISTATED]

HI, It is so nice to laugh (finally) when I read a post. You are to funny. Thanks for the honesty with the so called "side affects" Like I said earlier I thought "Lupron" made me feel zity and HUGE. That is the only meds that made me really really really gross. Lucy me I start tonight on the Lupron shots. So with that and the DHEA I should be turning heads soon.......HEHE. What is next for you? Are you doing IVF? Thanks again for the laugh. Linda

[DEVISTATED]

It's me again, I just wanted to know if anyone has any experience with acupuncture. I am going to start seeing a therapist on Saturday, I've read about it all day and my doctor suggested it. It sounds good to me. But we all know where to go to get the truth about something and that is on these sites. Any advice????? Thanks. Linda

[Ritaz1964]

Acupuncture is gettng RAVE reviews here in Oz..... its like the next thing you MUST do for TTC! Very good results but you have to ge the right type of acupuncture for assistance with IVF.....  I want to give it a go, but honestly, Im running out of $$ and I need it al to support my IVF habit!

Yes, Im doing IVF +ICSI..... still no damn wicked witch, but she must be close, cos I can easily throttle the life out of anyone who annoys me!

I feel a twinge of a cramp.... perhaps the witch is coming?  OR perhps its just a bowel movement   ...gawd!!!  Fancy hoping for a period!  bizarre!!!

[ilion]

HI All,

Finally got some blood results and we're looking for some feedback.  After two weeks on 50 mg of DHEA the DHEA level was 499, T was 58, Estradiol was 40, and FSH 5.9 (!)

Should we test again this month?  And I know most take at least 75mg.  Based on these levels, should we up it?  We are planning IVF for January which would be four months on DHEA.

Many thanks!

[anitasto]

Robstersmama,

Hi Robster. Haven’t got y Vit D tested yet but will post for sure when I do. We haven’t started stimming yet and I’m having difficulty committing to a date because f the financials as well as weight gain that I resumed pretty quickly after restarting dhea. We’re planning to see family at Christmas for 2 weeks that we haven’t seen all year. I’m afraid I just won’t be all that happy if I think I look so much larger than usual. It’s taken all summer to lose ten poinds and I just put 5 pounds back on. Any thoughts you or anyone here has on this are most welcome.
What I have been focusing on is writing this book of my experiences and the dhea and other sciences that we’ve all talked about here. I hope to have a draft complete by the end of the year.

I have been thinking about one f your posts where you said that Vit D is used in PCOS women to manage their high testosterone. I hate to think this but is it possible that the Vit D is actually blocking your increase in T? Have you got the T level(s) tested? Just thinking. I am very sorry to hear there were just 2 BUT….I hope one of those little guys comes thru for you. ;)

Oh – and btw – I had a lazy left side too and used extensive acupuncture to increase blood flow along with electrical stimulation. It seemed to work for me. I’d have her stimulate only my lame left side. Hope this is helpful dahlink! ;)

Hi Jessny,

Sounds like a great strategy to get that consistent intake of dhea. And yes – your list of tests sounds very good. You are entirely welcome for any helpfulness. 

Hi Ritaz, 10/22

Thanks for posting your labs. These look really good for day 20 with the exception of the Progesterone. For healthy pregnancy the minimum desired level is 20 so I presume you’re on progesterone supplements when trying to get prego yes?
Also, your doc will surely be testing your day 3 levels of FSH and E2 before doing a cycle and if he doesn’t … well… don’t take this personally or tell him I said so…. But….he/her would just be an oddball.

Sounds like from those greasy posts you’re getting what you need on the dhea! I wish your T number was higher but for now – I am simply hoping this cycle is a wild success for you and nothing more is required. If things are not so wildly successful……xing fingers….I’ll post some suggestions which, of course will begin with some blood tests. ;)



DEVISTATED,

Sorry to hear of the elephant on your chest  and glad to hear your feeling better. I will say that while I was still on thyroid supplement that if I also drank alcohol I would have heart beats that felt it would pound out of my chest. Did you have any alcohol when you took your dhea…it also seemed like harder heart beats if I’d had a couple drinks. Also did you have your baseline dhea, dhea-s and Testosterone tested? I think this is very very important before starting these supplements.

Also, because of your recurrent failures in the IVF game – I really recommend looking into extended testing for autoimmunity to be sure you don’t have another issue that will simply not allow you to get pregnant without treatment. What were your numbers of eggs and quality? How old are you?

Hope you are well now and the elephant has left the building. (hehe)

Ilion,

Those are great numbers and yes – go up I think. Sounds like 75mg dhea will be perfect for you. You want a T at minimum of 80. Nice going on getting tests and checking to see what levels are corresponding with your dosage! Maybe I’ll join you for the Jan cycle. Still fumbling around with possible dates.


OK Ladies and Gents – ta ta for now.

[DEVISTATED]

Hi, I did not drink alcohol at all, I haven't had a drink since my wedding day 2 years ago.....Sometimes I wish I could get smashed, but I won't drink anything while on all of these meds...I am 37 in a few days. I was not tested before taking DHEA. I just asked my RE what I could do different to better my chances, due to this being my 4th IVF and maybe my last. (insurance coverage) In NJ insurance only covers 4 egg retrievals per lifetime. This will be my third, we did one frozen, but I need to do what I can to make this work, or at least die trying. I did acupuncture today and I LOOOOOOVED it. I am gonna go three times a week until my transfer and continue after my transfer, I swear it was wonderful and it was just my first time ever. A little freaky, putting needles in your ears and feet......but I don't care if they put them in my eyeballs just as long as it helps my chances...numbers of eggs were 12 last time and we froze three and put three back the others did not make it. I was told all three were good quality and my RE does not freeze unless they are good quality...and finally I think the elephant was just a pulled muscle, coincidence. Thanks for the advice, you are wonderful...Linda

[Ritaz1964]

Hiya, cant check my day 3 this time round cos Ive been on Puregon injections since day 21 and the synarel ovulation suppresant, so everything is now artifically chemically altered.  I did however get my period last Thursday, so have started on the big dose.... all set for approx 17th November egg retreival.  If enough embies, will do a day 5 blastocys transfer..... lets see what happens, this cycle is very different to anything Ive done before, so theres no knowing what will happen!  Without a doubt progesterone support is mandatory, mine has always been dodgy..... but with a full IVFstim cycle, progesterone is much more elevated.....

I havent tested my DHEA again, but will do so this Thursday cos Ive been on the 100mg dose longer..... also check to see how my oestrogen is rising... please pray its going up good!

If this dosnt work, Im not doing an IVF cycle again, will use an egg donor, Im not going to flog a dead horse.............. I've given it a fair go..... next year will be new beginnngs....... but lets hope this year has a srprise in store for us!

Cheers, Rita

[RobstersMama]

Hi Everybody,

Nothing new to add. Just in the middle of the two-week nightmare wait and I wanted to check in. I sure hate being on these hormones and feeling pregnant from the day of ovulation on! Ridiculous.

Anitasto, I am sorry to hear about the weight gain. I have not noticed this--I have lost a litte fat and gained a little muscle, if anything, but nothing dramatic. I am not sure that I would worry about weight gain at this stage in the game. Perhaps time on DHEA before your last cycle is the most important thing. You will look like hell when you are pregnant, anyway!  :) Ha Ha!

I have already considered your point on the Vit D. I suspect in my case there is no negative effect. I am judging this solely on symptoms as I won't be tested.

Nothing else to suggest here. And I can't contribute any ideas about specific lab values. Good luck, Everybody!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[pyar]

hi everybody just checking in well after my last failed iui i have been waiting for af to come to go again my last period was 08/10 so i should be due any time now yesterday would have been 28 days but i can go anything from 25 to 35 days so i'm not too worried the weired thing was last week i had a kind of none period i basically spotted all week and one day of blood but not enough for a pad just when i wiped sorry if thats tmi i was just wandering has anyone else had this kind of 'none period '

[RobstersMama]

Pyar,

Sorry to say (or glad to say!) that I have never had anything like that. I don't have any idea what could cause that. Cycles can be so weird, can't they?! You are sure that you had a negative test on your last cycle, right? If so, I don't know whether you should pay any attention to the spotting or not. I would have said that you might be pregnant but it sounds like you are sure that you are not. I think you should ask your doctor about it.

[babylove777]

Hi Anita,

Hopefully i can get thru to the right blog this time. I've been following all your posts since beginning of this year. I'm 36, tagged as POR. I've had 2 iui's & 1 ivf last year but to no avail. With iui's i only produced 1 mature follicle & with IVF 1 mature, i trying to catch up on the left ovary & 2 on right below 10. Since then I took a year off, have been going regularly for accupuncture, herbs, supplements. Changed my lifestyle & eating habits etc etc. Started taking dhea in april at 75 mg a day but jumped it up to 125 mg a day for the past few months. Just started my 2nd cycle of ivf on Nov 1st. My RE has put me on lupron flare protocol. For some reason i don't like lupron suppressing.... Anyways, I was very disappointed on my day 6 scan (after 5 days of stims). I only had 2 follies on the left - 1 about 10 & the 2nd one around 8. Two follies on the left around 7.5. Two more on right but very little & won't catch up. My antral count at baseline was only 6. I am devastated that after a whole year of preparation & hard work, I am getting the same results as if i wasn't doing anything at all???? Another thing - my e2 is rising reaallllyyyy slowly. I am wondering if i should stop dhea compeletely for the next week or so so that the follies can grow as my RE is really concerned & is saying he might cancel the cycle after tomorrow day 8 scan. Pls note that i haven't told him that i'm taking dhea as he is really against it especially during an ivf cycle... I am really in the dumps, any advice would be appreciated... I just hope the follies on the right catch up with the ones on the left.... thx for your help & advice in advance.

Babylove777

[Ritaz1964]

Well, day 8 scan revealed 8 follicles, twice as many as last time..... the DHEA must be making a big difference cos my E2 was pretty good also.... day 7 bloods E2 1600..... was 700 last cycle with only 4 follicles.

I look and feel dreadful, swollen, tender have some MASSIVE zits and the grease on my skin and hair, you could fry an egg!

My follicles have grown quicker also, they were expecting 10-12mm diameter and Ive got them from 20mm down to 7mm, and the 7mm more than likely reach maturity egg pick up scheduled this Friday!  I have another scan this wednesday but am fairly confident that trigger will be wednesday night. Only had 2 small ones 7 & mm,the rest were 14mm and higher (max 20mm).

Im doing assisted hatching again on day 3 embies and if we have enough to go on will let them go to blastocyst and transfer at day 5.

I have been taking the 100mg instead of the 75mg but havent advised the doctor yet..... I know, naughty, but my testosterone wasnt changing, but if my skin condition is anyting to go by, its doing SOMETHING!  Will ensure I add Testosterone to the next bloods to see whats the go!

So, so far the DHEA and modified protocol have made a big impact.... lets see what the eggs look like after fertilisation!

Cheers, Rita

[RobstersMama]

Rita!
Great newws!!!!!! I am so glad to hear a good result. Keep us informed, OK? Fingers crossed for you.

[babylove777]

Hi Everyone, I'm new to this and hoping for some support as i am going thru my 2nd ivf cycle at the moment. I was devastated last week as my left side only showed 2 follicles & on right side there was no activity. On day 8 scan last saturday, another follicle poped up on the left so I got somewhat hopeful as RE requires mimimum 3. Sizes were 8, 10 & 12. Went for my day 11 scan, yet another one has shown up on the left, its small though but I'm hoping it will catch up! Now I have 4 & the sizes are 8, 10, 13.5 & 16. I will do another round of stims tonite & scan tomorrow. I am so praying that the 2 small ones will catch up.... Waiting for the almighty to show a miracle. Seems like this will be my last resort as this is the most I've gotten. I have taken dhea since April of this year so that brings me to 6.5 months now. I'm still not sure if i should continue to take dhea at 100mg a day since my e2 is still rising slowly & i'm worried that the small ones will not get enough to grow so maybe stopping would give them a chance???? Any suggestions anyone??? This has been a very long and lonely road for me. Is there anything else i should do? Keeping my fingers crossed...

[RobstersMama]

Hi Babylove and welcome! It sounds like you have a good shcance this round! I don't know about cutting back on DHEA, although going to 75 after the first week of the cycle would not be a bad idea, it seems to me, you might consider 200 mg of 5-htp per day to help get your estrogen up. Good luck!

Update for me:

Back to day 2 of the cycle so everybody knows what that means! Drat. Well, I am not surprised. As a recap. I had two good-sized follicles on my left ovary with 187 mg of Gonal f for 7 days. But I think I have adhesions on that side due to pain there and the fact that my two failed pregnancies came from the right side. I think the tube is blocked there. And the right side did NOTHING! But I think the right ovary is pretty squashed behind my 5X5 cm fibroid and probably has bad circulation and bad karma. Sigh.

So, we decided to bypass any potential problems with the tube on the left and try a round of in vitro. Boy, is that expensive! I am glad I have been on DHEA for 4 months now. The doc thought we should just try another regular cycle but that is getting us no where and, as Anitasto says, figure out a potential problem, change it, and then try again (paraphrasing). The doc is REALLY sceptical and was kind enough to point out that the rate of success with IVF at my age is 8-10 percent and the risk of miscarriage in the event of a successful pregnancy is 50%. Oh, yea. But I figure that since I had one sucessful pregnancy three years ago and two miscarriages in the tenth week a year and a bit ago, I know I can get pregnant, or could anyway, rather recently. My hormones are in good shape. I am responding to stimulation, although not to an impressive degree. So, there is hope to beat those stats. Yea, I guess everyone who helped make up the stats thought exactly the same type of thing. Well, we are going for it even if the doc thinks we are morons although he did not say that! He just thinks it is a waste of money.

Is it true that i should have 4 follicles to have a decent chance in a cycle?

This month's protocol is 225 mg of Gonal F starting days 3. I will also be taking 75 mg of DHEA in the AM and 25 at night on the sly.  :)

If anyone has any suggestions, I would love to hear them.

The doc also sugested having my fibroid out and waiting 3 months to try again but I had no trouble with my pregnancy or getting pregant twice soon after with it there so I am not going that route for now. I don't believe that it is a part of the problem at the moment.

Good luck to everybody!

[RobstersMama]

Hi!!

Any Vitamin D value yet?

Any decision on your next cycle? Thinking of you!

[RobstersMama]

For your next cycle.  :)

ANTIOXIDANT TREATMENT DECREASES THE TITRE OF CIRCULATING ANTICARDIOLIPIN ANTIBODIES

D. Ferro1, G. Valesini2, F. Conti2, L. Iuliano1, L. Loffredo1, F. Violi1

1Institute of Clinical Medicine I, 2Division of Rheumatology, University 'La Sapienza', Rome, Italy

A close association between antiphospholipid antibodies and 'in vivo' markers of lipid peroxidation, has been previously demonstrated. To explore this hypothesis in antiphospholipid positive patients, we undertook an interventional study to assess if antioxidant treatment was able to affect the serum titre of anticardiolipin antibodies. We studied 14 consecutive outpatients (12 women and 2 men; ages 24 to 49) positive for anticardiolipin antibodies, with a titer ranging from 14 to 120 GPL or MPL. Six of 14 aPL positive patients were affected by primary antiphospholipid syndrome, while the remaining 8 subjects suffered from systemic lupus erythematosus. Patients positive for antiphospholipid antibodies were randomly treated with (n=7) or without (n=7) antioxidant supplementation (Vitamin E at 900 IU/day, Vitamin C at 2000 mg/day) for 4-6 weeks. Patients assigned to antioxidants showed a significant decrease of anticardiolipin antibodies titre [Median (range)32 (16-120) vs. 8 (3-100) GPL or MPL; p=0.016], prothrombin fragment 1+2 (Enzignost F1+2, Behringwerke, Marburg, Germany) (Mean+/-SD) (1.99 +/- 0.44 vs. 1.19 +/-0.34 uM; p= 0.016). In all patients treated with antioxidants, we observed a decrease of anticardiolipin antibodies titre, with a mean of -61% (range -16/-84%). No change in disease activity was observed after the treatment in this group. The decrease of anticardiolipin antibodies could be considered as an effect of antioxidant treatment, so supporting the hypothesis that oxidative stress plays a central role in the formation of anticardiolipin antibodies.

[pyar]

hi everyone af came today so i start on gonal f tom i just wanted to ask do you think i should consider upping my dose or trying a different brand or micronized dhea because the last two iui's i only produced 2/3 follicles so it doesn't seem to be having an impact on quantity or quality its difficult for me as nobody here is willing to test beyond basic infertility blood tests and i don't have the funds to go private its very expensive so i'm shooting in the dark

[babylove777]

Hi Robertsmama,

Thanks for your advice. I didn't stop taking the dhea entirely thru stims but did take it every second day. This cycle was a real tricky one. My right ovary doesn't do a thing & I've noticed that in all the previous cycles. So that cuts my chances in half.... Left ovary I had 3 antrals in the beginning but definately had a lead follicle again. End up getting 4 follicles after 7 days of stims as I mentioned in my last post. 3 out of the 4 were not growing in the beginning & then started to grow but by then the lead was already 18.5 so they triggered me last night. I know its a real risky situation but i've asked my RE to go ahead with the retrevial which is scheduled for tomorrow morning. I was running out of options as my RE now is pushing me towards DE which I'm not ready to do. He said there is no other protocol he will use on me as this was it. Its really funny cuz I've only tried 2 cycles of IVF - last year was the regular one & this year the microdose lupron flare. To say that no protocol will work on me because my ovaries are doing nothing is crazy i think. I have my fingers crossed, though its only 1 mature follicle & very less chance but i'm going to go ahead. I am really suprised that dhea didn't do much for me considering i've been on it for 6.5 months now.... Really nervous for tomorrow & praying for a miracle to happen!

[babylove777]

Sorry about the typo.... I spelled your name wrong... too exhausted after 2 full weeks of tremondous stress.....

[Ritaz1964]

Well, I had egg retreival on Friday.  This whole cycle has been the WORST ever!  Scans showed 8 follicles, I was really excited!.  E2 was good, etc... everything looked perfect.

Egg retreival was laproscopic, surgeoun didnt aspirate all follicles!!!  aaaargh...

Only two eggs retreived, lots of empty follicles!   aaarrgh....

Both fertilised though..... today day 3, both are slow, one is 5 cell, the other 3..... the three cell I can kiss goodbye... the 5 cell they are transferring today.... they say it is slow also, should be at least 6 cell by now..... stranger things have happened though.

On top of all this, discussion with my previous egg donor has gone sour and she has pulled out of helping me if this didnt work.  Has made me feel really hopeless and Im pretty sad about it all.....

So, Im left with NOTHING!

I have reached the end of the road....all Im hoping for now is a MIRACLE!

DHEA did nothing, new protocol made things worse rather than better and not all follicles retrevied... on top of all that a stitch fell out from the laproscopic incision and it continues to weep....

I look like **** and feel exactly the same....

Im 44, I give up!

[babylove777]

Hang in there Rita..... I feel your pain.....I'm really sorry to hear about what you've gone thru... I'm praying for you that the 1 embroy they transfer takes & you give us the good news 2 weeks after! I'm in the same boat as you... actually worse.. I went for a retrieval today too, they got 2 eggs, 1 was imature & they did ICSI with the mature one. Will find out tomorrow what happens... I went ahead with only 1 mature follicle this time cuz I'm reaching the end of it too.. It only takes 1 good one you know! I'm praying for you & myself & asking the Lord to show a miracle! Try to stay strong.....

[RobstersMama]

Oh, Girls. How awful. I am so very sorry to hear this news. I don't know what to say except to try to stay positive but I know that doesn't help at all.

I am going in today for my first ultrasound this cycle after 6 days of Gonal F and I am afraid they won't see much of anything. We'll see.

I wish everyone the best of luck over the next few days and hope so much for some good news!

[RobstersMama]

Well, here is my weird update. The doc saw NOTHING--no follicles, no nothing. But my uterine lining has been^stimulated, apparently indicating increased estrogen. Strange. I will get the blood results tomorrow. Then I don't know what happens next. It looks like we have thrown a lot of money away this month of Gonal F for nothing and that there is zero chance of IVF this cycle.

Bad week for us all.

[Ritaz1964]

Perhaps not so bad..... I ahve two embies transferred. Day three embies, one a bit slow, only a 4 cell, the other, much better, but a 6 cell.... was told cells looked "plump & juicy", could that be the dhea making them more robust?????  who knows, time will tell.....

By day 3 they should have been 8 cell, but 6 is conidered "fair" and there was no fragmentation.....

Hey, we do what we can eh?  

RobestersMama, your dose is probably too low on the Gonal F and only 6 days, and with your history, too early to pick up teenies, they take longer to develop in older women.....  if you lived in Oz, you could easily afford the IVF cycles..... tis a shame eh?  My out of pocket for this cycle of IVF+ICSI is $1,000, the rest, the goverment pays back.

I think what would be good is to bite the bullet and do the full stim IVF cycle... get as many as you can.... its your best chance...

My preg test is on the 1st December... prob a fizzer, but keeping my fingers crossed.  There is still HOPE!!!!  Cells looked "plump and juicy" so I see that as a big POSITIVE!!!!!

Babylove, howd ya go????

Cheers Rita

[RobstersMama]

Thanks for the info and encouragement, Rita. My doc is really reluctant to give higher Gonal F doses. What dose did you use and for how long?

Here is to the little plump and juicy one!!!!! Good luck! Please let us know. We are pulling for you!

[Ritaz1964]

Gosh I have been taking 450 units for the last 10 cycles , thats for about 12-15 days in a row.....I reckon, but thats cos I do a full IVf, not the shag at the right time situation.

I dont think they would give that dose if there wasnt an egg retreival involved.

You know what?  Try a different doctor, there are heaps around, take your dollar where it works best for you... after all, it is a business and you are paying!

[RobstersMama]

Thanks, Rita. Mine hasn't even addressed anything over 225 for Gonal F and today he said we had tried everything. Get this. This was my first IVF cycle. I have this fibroid which didn't not interfere with my one successful pregnancy nor with my two miscarriages after that. So, today, he says that he only sees one ovary (like last time--? He did mention last time that he didn't see the right ovary) and it is on top of the uterus in the middle and that he does not know if it is the right or left because he can only see one!!!!!!!!!!!!!!!! Then he said that he cannot access it with a needle through the uterus so the IVF won't work. Notice that he did NOT tell me that at the appointment when we decided to do IVF and when he wrote my prescriptions and I paid a fortune for the drugs. No, he mentions it today. I asked about doing it through a laparoscopy since I have left-side pain related to the ovary that I needed to have scoped anyway and I wanted the tube to be checked. No, he doesn't see the point. He said that based on my age, that I had tried everything and should feel good knowing that and that this was just my fate.

He did find two follicles on that ovary (who knows which one), one bigger and one smaller, but he has no idea what size it is because of the difiiculty seeing it since it is in the wrong location!! Then he said to just do the trigger shot anyway NOW and have sex tonight and this weekend and just maybe I would get lucky. Now I must say that other doctors have had difficulty seeing things with me since this fibroid gets in the way. With my first miscarriage at ten weeks, the hospital doctor could not see the pregnancy at all and though I was not pregnant (eyes roll here). Another doctor used a different attachment on the vaginal ultrasound wand and found it. My uterus is really high because of the fibroids and one has to sort of look through it to see the ovaries. Perhaps the enlarge uterus from the fibroid is way the ovary is so high. No idea but I assume that is what happened. But no one has ever mentioned this to me before.

Anyway, how can this idiot not tell me that he 1, cannot see both overies to retrieve all the eggs even if there are a lot, and 2, that he could not access the one ovary he CAN see anyway because it is over the uterus. What??!! I am so angry and upset and frustrated about this. What a total waste of money and effort. And his attitude was so demeaning and hopeless at this point. I asked what had changed so much if I had a successful birth 2.5 years ago and a pregnancy last August and another last October, which failed due to a genetic defect. Well, he just said my AMH level is low (which it is) and my FSH is high. Well, the FSH is 11. Or was a few months ago before DHEA. And that's it. Nevermind that I ovulate every single month without fail and always have and that my hormone levels are like that of a 25-year-old, in his words. What a jerk. And this guy has 30 years of experience, works in a very successful clinic and publishes studies  all the time. I am done with him. And now I am stuck with 2 injections to prevent ovulation (forgot the name) which I was prescribed for NOTHING! A total waste of money.

And since I have no idea how large the follicles are, I don't even know if I should do the trigger tonight. Is it too early since he saw nothing just 3 days ago? But I have no Gonal F left anyway, so what does it matter. I have no choice.  

[RobstersMama]

I just read a couple threads by the non-DHEA IVF girls. I think our group is doing ok considering we all have nearly dead ovaries! So far, we had three successes--Lynne, Angela, and Andrea. That is out of a group of what? About 12-15? Not too bad, I think.

[Ritaz1964]

Crikey girl, get a different doctor, he sounds an utter ***-hole!  Find the money and move on to someone more effecient.

I know of really good docs in the USA, dammit, I forget the name of the clinic, they are all over the place.....  I will search again and find the site I used to write in all the time, they were absolutely fantastic, researched NK cells, all sorts of different issues....   give me a bit of time and even I from far away can direct you to better places to go for success.....  

I am now one week since egg retreival, either my embies have hatched or they have succombed.  I know its got nothing to do with me, its the energy of the embies, my job dosnt start till later!

[Ritaz1964]

This is the site, have a squizz around, these guys are THOROUGH and dont sound like the prat you are dealing with!

http://forums.haveababy.com/

[garden4lynne]

Hi All,

Sorry to be MIA for a while but between starting a new job and cycling, all my free time and energy seem to be zapped.

I'm sorry to hear about all the bum news...

Ritaz -- sounds like we're in the same boat this cycle.  For me this cycle, after stimming 8-9 'good sized' follies, the RE retreived 4 (rest he called 'cysts' which I'm taking to mean we waited too long) and of those only one was mature.  Luckily it did fertilize and today we transferred an 8-cell.  It's just really discouraging after stimming so well (my history has never been that good) to get such poor results on retrieval.  I don't know whether to blame the RE’s retrieval skills or my body.  In my case it seems DHEA gives me great quantities but no better quality.  Arg!  I hate to say it but I feel a little better knowing I’m not the only one to have stimmed so well and retrieved so poorly -- though I wish neither one of us was in this boat.  Is this normal?  I’m starting to second guess everything and hate to say but losing faith in my RE.  Unfortunately there isn’t anyone else in the area here I’d consider going to and don’t have the ability or desire to travel out of state again. (I guess unless it was a sure thing… but there is no such thing in this IF thing.)  Anyhow, my beta is one day after yours (Dec 2)… here’s hoping we both pass that hurdle!  

RobstersMama -- as for new Res: while in theory I agree with Ritaz, I’m stumped how to find a good one.  I’ve been through 3 (one local, one out of state, and now back to a different one local).  Unfortunately since I live in a state where insurance coverage is not mandated, there are not a lot of Res here much less with great reputations (no one comes here for treatment!).  Yes, there are several around the country but that's all dependant on your ability / willingness to travel.  After 2 IVF out of town I decided to come back to a local RE (was too new of a practice I wouldn't consider before going out of town); the travel was too stressful for me (seems we cycled even when there was no value just because we were there).  The out of town was SIRM (which Ritaz mentioned via website) -- aside from their lack of success with me, the dr point-blank lied to me about reviewing my history (found out later it was never sent to him so how could he review it) and during my initial phone consult he said he thought I had high T so their protocol (which de-emphasized it) is better... how he knew that by just listening to me should have been a red flag -- I've since had it tested (prepping for DHEA) and found it was actually very low.  Anyhow, hate to bash a clinic, but also want women to go in eyes wide-open.  Also went the CCRM route (to the point of their one-day trip to test / baseline) -- they wouldn’t start without me doing a Clomid Challenge (of course didn‘t tell me that until after the trip out) -- but by that time I had done 6 Clomid cycles so knew exactly how I’d respond.  It just seemed like an unnecessary hoop to jump through (and they couldn’t give me a better reason to take the CCT than to baseline).  Hopefully you have someone else locally you can go to / trust.  Unfortunately I feel like we’re just guinea pigs in all this -- the RE’s too often don’t have a clue and are just ‘trying things out’ on us to see what happens.

Wow -- I sound really negative today… I’m sorry!  I really try not to do that (maybe it just sounds that way typed out).

OK -- so I need some sisterly wisdom… should I be concerned about my RE?  Both cycles I stimmed 8-9 follies; last time retrieved 5, this time 4; last time 3 mature /fertilized, this time 1 (despite ICSI both times).  This means they have a 25% fertilization rate with my eggs.  Seems low.  Is this normal or should I be worried?  Sorry to ramble.  I’m open to any wisdom / suggestions anyone can offer.  :-)

[DEVISTATED]

Hi, just checking in. Sounds like some of us are on the same 2ww. I had a 3 day transfer on 20-Nov. I had 10 eggs retrieved on Monday last week. I was a little disappointed, last time I had 12. I am trying like hell to stay positive. I had 7 make it out of 10 to the next day and by the third day 6. On transfer day, I only had 3, the three they transferred. I to am discouraged with my numbers. It appeared that I had an excellent stim round. I am also doing acupuncture. Love it. It really relaxes you. I'm not sure the DHEA did anything for me. As a matter of fact it seems like it did worse for me. I test on December 1st. I wish all of you the best of luck and I will be here if anyone wants to share the 2ww with me. Linda

[kirstier]

Hello all,
I am a frequent reader but have posted only a few times.  I have been on dhea since June and had similar results as ritaz1964 and garden4lynne.  i am on 3rd ivf cycle and had 8 to 9 follies with only 5 eggs retrieved.  of these 3 fertilized and one was a slow one.  the other two looked good.  first ivf 10 follies, 10 eggs, 2nd ivf 7 follies and 7 eggs.  my doc didn't seem surprised and just attributed it to aging ovaries.  (40 yrs old)  i changed to m.d. lupron flare protocol, 450 gonal f and 150 menopur.  last cycle was long lupron with 375 gonal f and 150 menopur.  he also added femara and dexamethasone this time.  my doc did give me a good pep talk though and helped my attitude during this 2ww.  i test on dec 1st.  

did your docs have much to say about reason for empty follicles?

sending positive energy to all and hope for BFP.

[pyar]

Hi guys well went to my u/s this morn i have one follie on left side meaasuring 19.5 mm one small one and something that measured 32mm i say something because they said they couldn't tell if it was a follicle or a cyst and they would know more with my blood test but when they called they said to carry on with the injections and come back monday by when they should be able to tell which it is I  had two small follies measuring just 8mm on my right side which i'm kinda pleased about although they are small on the right side usually theres nothing there so it shows at least the right side is awake at last could that be the dhea has anyone had any experiance with cysts and how this would affect my iui i'm going put the question to they main forum too as i really could do with some info my clinic tends not to be very imformative

[wendipam]

Just found this site. A little about myself. I am 42 and onto my 3rd cycle. I changed re and have traveled out to california. I think this cycle I am going to change from Ivf to Zift. I meet with an re that I really liked and meeting with another in 2 weeks. From the re that I meet with and one that I spoke with on the phone.(meeting with the other dec 10)  They say that they are finding in women over 40 better success rate with Zift then Ivf. I figured if I already failed 2 ivf cycles I need to go to another level and try something else. My Fsh is 8.1 and Amh is 2.4. Has anyone done Zift?

[pyar]

HI can i ask what is zift i have never heard of it

[Ritaz1964]

day 13 post pick up, POAS, pure as the driven snow, nothing, NADA, ZIP.... so unpregnant its not even funny!

So sick of it all, thats even un-funnier!

[Ritaz1964]

wicked witch arrived today, 2 days before the official blood test to tell me Im not pregnant!

None of this new dhea stuff made an oucne of difference....

Cheers, Rita

[garden4lynne]

I'm so sorry to hear.  I know nothing can make you feel better; but know you've got sisters out here thinking of you and sending lots of hugs your way.

Lynne

[garden4lynne]

kirstier -- welcome and good luck tomorrow!  

re: 'empty' follies -- mine weren't empty just non-fertilizable (is that a word?).  no explanation from the dr - just my ancient eggs (i'm 39).  the embryologist did show us pix of the eggs that didn't fert -- best way I can describe it is they had what looked like an egg inside an egg (a circle in the center of the egg that was about 3/4 the size of the egg); he said he didn't know what the cause was but when that is present the egg typically doesn't fertilize - he did ICSI on all the eggs and those 3 didn't fert.  I'd like a better explanation why - but there never seems to be one.  

anyhow, I'm hanging in until my Tuesday beta (though no pg symptoms for me -- had them last time with the +beta -- no not hopeful).

[garden4lynne]

Welcome!  

Not sure where you're home (country) but in the states it seems zift has pretty much gone away (from what I've read drs got better results directly placing fertilized emby in the uterus).  

That said I have a friend that did one zift (after a couple of failed IVF) - she's in earlier/mid 30s but went that route at drs suggestion because her cervix was so twisted (difficult entry even with sedation and any negative stimulation thought to cause it to contract and reject anything placed in it - e.g., emby).  She didn't have success with the zift and ended up with an re that used seaweed (pre-IVF) which over a 4-6 week period causes the cervix to expand and straighten (almost mimic a natural birth)... she's now 6 mo pg.

[garden4lynne]

sorry -- just reread you note and see you're going to CA for zift... interesting -- maybe a resurgence in the US!  I'd be interested in any research your RE has used as a basis for pursuing zift.

[DEVISTATED]

A positive note to the board. I AM PREGNANT>>> I am so excited and over the moon right now, I'm not sure what to do first. I go back on WED to do another test. My beta number is 25 11 dpt. I was concerned with the 25 but the nurse said it is normal and it should double by WED. I am cautiously optimistic. I had two tubal pregnancies since Dec 06 and I am scared for another loss. I promised myself that I would stay positive and I will. I would also like to comment on Acupuncture. It Rocks.......Absolutely wonderful, I believe with all my heart that it helped me this time.
Garden4lynne---Good luck tomorrow. Can I say to hang in there, every time is different no one pregnancy is the same. You never know. I was so sure I wasn't pregnant due to a reddish/salmon color in my discharge from the progesterone inserts and it got worse yesterday (day b4 my test) But you never know, they tell me that is normal and it could be irritation from the inserts or a late implanter!!!!!! Don't know and no one can tell me why. So for now I accepted that I am pregnant (even though I swore I wasn't) I couldn't stop crying yesterday and even this morning at my appointment and after the appointment. So what I'm trying to say is keep the hope you have and hold on to it, tight. Good Luck

Rita---I am sorry for your negative. It hurts every time like its the first time. (for me anyway) it doesn't get any easier. What is next for you?

[HQ2007]

Good morning ladies,

Just catching up on all the postings.

DEVISTATED: CONGRATS!!

Welcome new friends!

I was hoping to post good news but...I guess it is sort of good and bad news.

Last week I found I was pregnant. My first and second beta numbers were 11.9 and 22. My 3rd beta was scheduled for yesterday. But I started to spot on Sunday, followed by heavier bleeding on Monday. I didn't go for my 3rd beta.

So the good news is I can get pregnant (Anitasto, if you are reading...you are right!) Bad news is I can't stay pregnant
:(

Recently I was diagnosed with Hashimoto. I was on Armorthyroid. But my Endo wanted me to get off Armor, get tested again and start on Synthroid. I got off Armor while I was on 2WW :-/  Endo put me on Synthroid 50mg right away after I told her I was PG. I am still taking it. She will monitor my levels.

I had contacted RIA lab before I found out I was PG. I have consultation call with them on Thursday. I am determind to find out whey I can't stay PG...

So friends, we try again...

Cheers,
HQ

[Ritaz1964]

congrats DEV, good news is good for the soul!

I just wanted to say, I wish you all the luck, all of you.  I have had enough of trying.  I have my two girls and I am a happy chappy!

I am going to start removing myself from the forums relating to conception and get on with enjoying my life.

Goodbye and good luck to you all!  Hope you all get your dreams...

Rita

[DEVISTATED]

HI, BAD news, my levels went from 25 to 31. I am truly hurting right now. I am at my end also. I can't emotionally go thru this again. Good Luck to all of you, not sure what is next for me right now. I can tell you it won't be DHEA. Hang in there ladies something good has to happen RIGHT? Take care Linda

[betsyj]

Don't know if anyone is still out there but I just wanted to post my experience .   I started posting/viewing to this forum in the summer and followed it from a distance after then.     I just got my negative beta yesterday from my third IVF cycle.    I started preparing in June with accupuncture, herbs, wheatgrass, B6 and of course DHEA.   I'm 42 have no tubes and only one ovary had my other two cycles several years ago at a horrible clinic and never made it to retrieval on those.      I was so excited this round as I actually made it to transfer had four mature follicles with four beautiful eggs and all four fertilized and became four beautiful first grade embies - so of course we were absolutely positive we were going to have a baby this time but unfortunately it didn't happen.    I pretty much knew the beta would be negative because I had a very positive hpt two days before and then it went back to negative (chemical pregnancy).     I think my final verdict on DHEA is that it and all the other things I did most definitely helped with my hormones so I could get my eggs but I think something still wasn't good enough with the cytoplasmic proteins that are responsible for the growth of the emby after the 32 cell point.    If I recall correctly the woman in the initial DHEA case banked a whole bunch of embies but never had one transferred.   However, I now have no regrets - I gave it the best I could and was quite proud of my results but unfortunately they weren't good enough so now we are moving on to the donor egg/sperm donor approach as soon as we save up enough money.  

I am running out of time, I want to have a baby before I get my AARP card and besides it will kind of be like a surprise and now we joke that our kids will be standouts at the family reunions:)     I am very sad and disappointed but I have to keep looking toward the Mommy goal.    I do wish all of you the best and hope you are able to soon get exactly what you wish.

Take care all - it's nice to know that so many of us work so long and so hard for what seems to come so easy to others.

[BBond]

I had a successful IVF with CHR in NYC about two years ago, and now have a most wonderful 16-month-old girl. I am now seeking a second child, and the doctors at CHR recommended that I start DHEA as soon as I wean my child (which I have just done). I am delighted that the benefits of DHEA have been discovered and documented, and I really want the details. I've been searching the web and cannot find the actual published results anywhere.  My question is, does anyone out there have the actual numbers? what is the precentage increase in pregnancy rates for women taking DHEA? for spontaneous pregnancies and for those undergoing IVF treatment. What is the percentage decrease in embryo abnormalities? (I am 39 years old and we learned during my first IVF cycle that my fertilized eggs were of poor quality, which probably explains why three years of trying to get pregnant the old-fashioned way didn't work back in 2003-2006.)

[anitasto]

Hi Ladies,
Sorry to have been so MIA. My Mother fell ill just after my last post and is just recently having some recovery. She's older and half the country away so travel, care, and concern, etc.

Just wanted to let you know I haven't disappeared and am thinking of all of you....sorry to glean some bad news and happy to see the good news and, as always, great advise and support.

I hope to resume posting sometime in late Jan/early Feb. and look forward to a successful New Year!  

Anitasto

[AngelaSK07]

Hi Gals, it has been many months since I posted.  Recall that I took DHEA for three months before my successful IVF.  I have made to week 28 of pregnancy.

Regarding the DHEA, my AFC increased by one, but this time, for the first time, not all of my eggs fertilized.  Do not know if that was related to the DHEA or not.  The important thing is that the third time was a charm.  Am expecting baby girl in April.

[anitasto]

There are three official publications on DHEA and IVF.
Casson 2001 had just 6 women on 75mg DHEA for 8 weeks. 1 delivered twins. 17%
Balasch 2006 used Testosterone patch 3 days during stims. Went from 0% to 30% pg
Barad 2007 shows increased # of eggs and quality embryos but doesn't publish pg rate.

It appears that in some women it works and others not. You can tell by your Testosterone level within a couple weeks after starting dhea and also by monitoring the # of follicles (i look on day 25 of cycle myself) each month to see that they're increasing. If your T is rising and # follies going up then DHEA is working.

Remeber - that gets you the eggs. After that they have to implant and I now think we should all be tested for autoimmune issues to ensure our investment has the best chance. One RE in a study published suggested testing for autoimmunity after 3 failed cycles. Hmm...wonder if his wife did IVF and failed 3 times....and THEN was tested for autoimmunity.

Cheers,
Anitasto

[anitasto]

Of course I remember you. That's sooo fantastic. And thanks for your update on you DHEA results. I always had an empty follicle on DHEA but still had more full and better quality embies. Did you have info on the quality of your embryos - I suspect with your success they were better? ;)

April is such a beautiful month. My girlfriends always said having a baby in the spring is best because you have your freedom back for the summer and can get outside.
Really excited for you.
Anitasto

[cindylouise]

Hi Anitasto.  

I am new to this site.  You seem to be very knowledgable about all of this.  Do you have a medical background?  

I just fell into this category and I am sort of frustrated.  I am 35 years old and my husband has an obstructive azoospermia.  We started seeing our reproductive specialist because we need to IVF/ICSI to have children.  So, I started my cycle in December.  My FSH level is 12.2 and so they said they were going to take an agressive approach with me.  I did birth control for 15 days, then testosterone patches for 5 days, then they started me on menopur 150 IU & follistim 300 IU for three days.  The 4th and fifth day, they dropped me down half the doses for menopur and follistem.  Day 5 they did an ultrasound and I had 3 follicles and they decided to dump my cycle. Two of them were large and one was small and only in my right ovary.  I was devistated.  Before I started all of the medication, my 3 ultrasounds with the specialist showed a total of 9 eggs to 6 eggs each time and both sides produced.  The day they lowered my meds in half, my blood work showed really high estrogen in the 300's.  What does that mean?  Is that bad?  

I did a follow up appointment with my specialist yesterday and he wants me to wait 3-4 months to start again, do DHEA and then come back.  He has me taking 25mg three times a day.  Will DHEA help my system produce follicles when I start again?  I am currently taking this opportunity to do acupuncture for my FSH level and the acupuncturist also has me on herbs called Menotrol.  

This is all so frustrating for women.  I am glad I found this site.  It feels good to be able to read these posts and conversations.

Clouise.

[anitasto]

Hi Clouise,

Glad you found the site ... from what I've read I think you have reason to feel frustrated. . I'm going to comment on several points that I think are relevant.
a. While your doctor is ahead of many in recommending DHEA, he seems very strange in his cycle approach. So before you get too deep, if you haven't already, I recommend become familiar with the other docs in town... they all usually do free phone interviews, ask them what protocol they recommend.

b. Accupuncture is great too. Ask your accupuncturist who he/she thinks is the best. The accupuncturists who specialize in fertility and have been around a few years, are very clued in as most IVF patients talk to their accupuncturist. My own accupuncturist has been extremely helpful in navigating local resources.

c. you wrote "I did birth control for 15 days, then testosterone patches for 5 days, then they started me on menopur 150 IU & follistim 300 IU for three days.  The 4th and fifth day, they dropped me down half the doses for menopur and follistem.  Day 5 they did an ultrasound and I had 3 follicles and they decided to dump my cycle."
This is kinda wac.
-Menopur is typically given halfway through the cycle to avoid premature ovulation of the eggs before surgery. If its given too early it can slow progress significantly...not really what you want.
-testosterone patch is based on an italian study where they use the patch DURING stimulation NOT BEFORE for days 2 - 5 of stimulation. the egg requires T in your system to grow the eggs. When you remove it before the follicles have reached 8mm in size then the follicles die off. In two cycles my testosterone dropped off and I lost follicles. I think that's what probably happened in your case. HOWEVER - please have your thyroid function checked because over functioning thyroid I believe is associated with losing follicles.
-get your baseline DHEA-S and Testosterone checked so you can see what effect the DHEA is having for you. My FSH was 11 and I required 150mg before I got good response from it. Also, take it all in the morning and don't take more than 100mg a day unless your getting your Testosterone blood levels checked to ensure they stay in the normal range. Some people can react sensitively to this stuff while others require quite a bit more.
-with a 12.5 FSH you should be on 375IU of FSH for typically 10 days. That's just standard.
-I have never ever heard of a doc REDUCING your FSH dose when there are few follicles. They usually do just the opposite and increase the dose to try and save the cycle.

Its almost as if your cycle was designed to be cancelled from the beginning. I hate to say this, but you really have to be careful because this is a competitive industry and it is for profit. Look for a doctor that has done at least 100 cycles a year and has >45% success in the 35 - 40 age range. That's a basic criteria at least to start with.

My background is physics. I dug into researching all of this to get my own babies and am still at it.

Hang in there and best of luck to you.
Anitasto

[HQ2007]

Hi Anitasto!

Good to see you back! It’s been very quiet last month or so. Not sure what other ladies are up to. How about you? Writing your book? Getting close to finish?

I am going to see Dr. Gleicher for consultation at CHR next weeked. I have been on DHEA since July. I did manage to get PG again last Nov, but m/c before 5 weeks. I had recurrent m/c panel lab tests done with at RIA labs. Doc is recommending IVIg or Intralipids pre-O, Prednisone, Heparin and Aspirin in addition. I have apparently abnormal NK cell activity, +APA, +ANA and +ATA and DQ Alpha match with DH. Looks like I am covered with all major immune issues!

My current RE will not treat me for any of these if I were to have another IVF with him. He doesn’t think these are the reasons I had three miscarriages. He thinks it’s my age.  I want to see what Dr. Gleicher has to say. I will update after my visit.

Cheerios!
HQ

[anitasto]

Hey - great to hear from you! Congradulations on getting to the bottom of it al! How'd you go about it?? I'll look forward to hear Gleicher's feedback/opinions for sure.

Very sorry to hear about the MC.  

Just in case you're interested there are two docs I've found who several other docs have independently referred me to. Dr. Coulam (http://www.illinoisivf.com/physicians.html) appears to be like the maven of reproductive immunology and she is currently working with Dr. Acacio in Laguna, CA. (http://www.acaciofertility.com/distinct.html) on the Intralipid treatment. I had a phone consult with him this week...he's been doing DHEA for a long time (cool eh?) and very knowledgable on autoimmunity...and he actually read my records before calling me....a first.

Me? Still working on the book and boy oh boy - it's a teeth puller. Still have a few teeth left though.
Just restarted my DHEA couple weeks ago in prep for a final cycle we're considering. First testing for beta integrins in the uterin lining to cover all the bases.

Love those Cheerios! ;)
Anitasto

[cindylouise]

Hi Anitasto!  Thank you for all that information.  My husband and I are a little frustrated in deed.  My Dr. is supposed to one of the best and has written a few books.  I see Dr. Wisot in Redondo Beach, CA.  

From what you told me, it sort of upsets me that we wasted all that money on a cycle that they probably cancelled before they started.  It's upsetting for me.  After I wrote to you, I spoke with my acupuncturist and she recommended another Dr that she enjoys working with in Manhattan Beach and I have a consult on 2-10-09.  

OK, I started DHEA and he has me taking 25mg three times a day.  So, today should I start to take them all in the morning?  I started taking Vit D as well.  

Right now, my husband and I have invested a lot of time and money into our clinic and Dr.  I guess our plan is to see the referral from the acupuncturist and go over everything.  My husband wants to meet with our first Dr. after the new consult and ask questions on why he gave me this and not that.  This information you have given me has really helped me out.  I was going to cancel my consult but now I am going to keep it.  

You telling me about the T-Patches and the Menopur, it just upsets me.  He told me when they got my FSH results back that because I was at 12.2 that he wanted to take an aggressive approach.  The meds that they gave me are about 5-6 different injectables, 3-4 I never got to use.  The following week after they canceled my cycle I had a follow up appointment with the Dr to go over everything. That is when he told me to take a 3-4 month break, take DHEA and he will see me in May.  During our short discussion, he went over everything and explained a few things.  But during our conversation, he kept saying, "When you were doing the Lupron and the Follistem".  I had to correct him almost 4 times and said "You didn't give my Lupron, you gave me Menopur".  The first time I corrected him, he looked at me and said OH; yes we did give you Menopur.  Now I am thinking that they messed up.  

I will keep you posted on my new consult that I do on 2-10-09.  Thank you very much for all my information!  It has opened up my eyes.  

Cindy  Louise

[cindylouise]

Hi Anitasto!  I just repsonded to your response but had one more.  I was reading some more older posts ont his topic we are on.  

You wrote someone:

"Please do not take dexamethasone and dhea-s will not negatively impact your egg quality. Dexamethasone will reduce your adrenal hormone function and it is used for PCOS who are overactive"


My Dr. had me on Dexamethasone 2mg each evening the day I started Menopur and Follistim which was right after I stopped my T-patches.  What will the Dexamethosone do taking it?  I didn't tell my Dr because he didn't ask me ANY questions, but I have suffered from adrenal problems the past few years and have finally recovered from it.  They I started with IVF.  

I was reading a few other sites on what meds other women were taking and some were starting off with Menopur and follistim as well.  Understanding meds and what they do and why is what I am trying to accomplish now.  More knowlege is better knowlege for when I talk to my Dr.  I want to have understanding so I can ask him more questions on why and what.  

[HQ2007]

Ladies, I ran into this article today. It talks about a new procedure to check for better eggs during IVF cycle...enjoy!

http://www.time.com/time/health/article/0,8599,1874101,00.html

HQ

[tigercat30]

Hi Anitasto,

I'm new here from Germany. I had taken DHEA since February 2007 (3 * 25 mg per day). After many IVFs in Austria I was pregnant in December 2007. After 20 weeks I lost my child (Premature Rupture of Membranes, no reason was found). The child was healthy. Normally we had 7 - 9 mature eggs, 7 - 8 could be fertilized. In the successful attempt we had 7 mature eggs, all of them could be fertilized. At day 5 after puncture we had 3 blastocysts, one of them was expanded with quality BC. All were transferred. The effect of DHEA was that I had up to 16 follicles, but the number of mature eggs did not rise.

After a few months after the miscarriage we made new IVF attempts while taking 3 * 25 mg per day of DHEA. We had (only) 4 mature eggs and all could be fertilized.
Because the chances for a new pregnancy are so bad (since this month I'm 45) I've taken 3 * 50 mg per day of DHEA for one month and make a blood test at day 2 (day 3 was not possible). The values are strange:

FSH 8 U/l (3 - 12) ok
E2 17-ß-Estradiol 10,1 pg/ml (37 - 138) = 37 pmol/l (110 - 520) TOO LOW!!!
T 60 ng/dl (14 - 76) = 0,6 ug/l (<= 0.8) ok (with 75 mg DHEA I had 40 ng/dl)
DHEA-S 512 ug/dl (45 - 270) = 5,12 mg/l (0.32 - 2.40) HIGH but ok?

E2 is very low and DHEA-S high.
Is that good or not so good? What I should do?

cattiger30

[HQ2007]

Hi Anitasto,

Hope you are doing well. How was your consultation with Dr. Acacio? Are you following any protocol or doing any new tests?

Just a quick update after my consultation with Dr. Gleicher @ CHR. After looking at my lab results, he suspects adrenal issues in addition to autoimmune issues.  

I had DHEA-S and Testerone total numbers from Aug-08 and Jan-09, see below:

Aug-08
DHEA-S = 83 (range 25-220)
Testerone, total = 40 (range 20-76)

Jan-09
DHEA-S = 73
Testerone, total = 24

He upped my DHEA doses to 75mg, 25mg x 3 times/day, taking with food of after meal. This is the DHEA protocol.  I have been taking 50mg first thing in the morning since July-08. So this is a change.

Also, he ordered additional genetic tests for both DH and I. We are on TTC hold until the test result/follow-up.

[anitasto]

HI!
Sorry for the delay but I hope this response is worth the wait. You ask a very important question which I researched long ago but did not document as well so I had to do that in order to post a well researched and well organized response. It's long....but I hope you find it worthwhile.

There are a few studies of Dexamethasone (DEX) in IVF including poor responders. It is important to note these studies were conducted before the general appreciation of sex hormones on fertility. Before about 2003 it was widely thought that testosterone was bad for fertility in women. Here’s the boiled down gist of it:
There are anabolic steroids and catabolic steroids produced by the adrenal. Ideally they are in balance. With PCOS there is too much anabolic, too little catabolic. With POA there’s too much catabolic. DEX is a catabolic and so for…
a. PCOS is clearly appropriate from clinical data and theoretical basis.
b. POA has shown improvement in ‘one’ study but the mechanism is not known. Most studies are done with PCOS or normal patients.  In the one study it is asserted that IGF-1 is increased thus improving ovarian function.

UNDERSTANDING IGF-1: It is important to understand the role of IGF-1 to understand why I recommend against DEX.

IGF-1 is the precursor to the most important growth factors which ultimately make you more receptive to the FSH stimulant. IT goes like this.. IGF+ => EGF+ => NGF+ => FSH receptors+ => lower baseline FSH via feedback mechanism.

POA women are expected to have low IGF-1, PCOS ers are expected to have high IGF-1.  It is effected by low available Testosterone.

Based on my analysis, Testosterone and IGF-1 are probably the two most important elements for good response.

You ‘may’ get more IGF-1 with DEX but you will likely get LESS Testosterone because it will reduce the anabolic steroids necessary to produce testosterone.
You  ‘will’ get more IGF-1 with DHEA and you ‘will’ get more Testosterone.

Testostoner is the predominant element in antral follicles up to about 7mm in size after which Estrogen becomes dominant.

IF you do not have enough Testosterone, you will not get very many eggs EVEN IF you have higher IGF-1.

Conclusion – you may get somewhat improvement with DEX but it will not match the improvement with DHEA .

References (because I like to keep my ducky assertions in order):
(a) The effect of dexamethasone on disruption of ovarian steroid levels and receptors in female rats,
http://cat.inist.fr/?aModele=afficheN&cpsidt=17354913
(b) Dexamethasone is a potent synthetic member of the glucocorticoid class of steroid hormones. It acts as an anti-inflammatory and immunosuppressant. Its potency is about 20-30 times that of hydrocortisone and 4-5 times of prednisone.
http://en.wikipedia.org/wiki/Dexamethasone
  
(c) Low-dose dexamethasone augments the ovarian response to exogenous gonadotrophins leading to a reduction in cycle cancellation rate in a standard IVF programme
http://humrep.oxfordjournals.org/cgi/content/abstract/16/9/1861
  
(d) Dexamethasone is a member of the glucocorticoid class of hormones. This means they are steroids but, unlike the anabolic steroids that we hear about regarding sports medicine, these are "catabolic" steroids. Instead of building the body up, they are designed to break down stored resources (fats, sugars and proteins) so that they may be used as fuels in times of stress.
http://marvistavet.com/html/body_dexamethasone.html

Best,
Anitasto

[anitasto]

Welcome! Love the name!

So sorry to hear of your miscarriage. I cannot even imagine.

I went back to my own data and once had an E2 level of 11 - also too low. Fortunately I kept notes through all of this. At that time I was also on a thyroid supplement which turned out to be unnecessary and it was effecting the number of eggs being produced
After going off the thyroid supp. my E2 increased, the lowest level after that was 42, and we began to see more follicles. Later I got more eggs which all fertilized.

Sooo...the best I can think is to have your thyroid hormones (all of them - not just TSH) checked and make sure the are ALL in order - none are too high or too low. Even if they are in the normal range, if your E2 persists over more than a single month, then 'maybe' it would be worth experimenting with mild treatment for hyperthyroid and then check all these levels after a week (T might increase) and of course again on day 2 or 3. Effects are typically pretty quick in the hormone soup of life. ;)

Best of luck and I hope you'll share your results.
Anitasto

[anitasto]

I would suggest getting your DHEA-S and T tested every 2 weeks and upping your DHEA dose by 25mg every 2 weeks until your T is at least 80.
Your story is eerily similar.
1st - are you getting your DHEA from a compounding pharmacy with proven potency? This is important because your body is acting as though you're not getting any DHEA at all and so I'm very suspicious of your DHEA source. I had this exact problem. My levels went down after being on it 4 months like yours and it turned out my tabs were time release coated and passing right through my body without being absorbed.

When I got effective DHEA my T was 24 also. I was on 75mg for another 4 months but never got my T over 50. When I upped my DHEA to 150 my T came up to 100 two weeks later...I tested weekly...and stabilized there. I don't recommend doubling like that...so increase 25mg ea 2 weeks.

I always take my DHEA in the am after waking on an empty stomach. My research shows that's the best time. Also, when they want to test your DHEA, it's done fasting in the am. Indicating this is when your body produces it normally. When I want a little boost I take a bit more at night before going to bed.

Hang in there baby!
Anitasto

[anitasto]

Doc Acacio was super in our phone conversation. Apparently he's been using DHEA for a LONG time. He actually read my file completely before calling. I was really impressed as that was the first doctor who has ever read my file before calling or meeting with me.
He's using a newer treatment for autoimmune antibodies and its also less expensive and soy based rather than blood extract so its safer. I've read its results for Killer T cells but there's not a study for it on my specific antibodies.

My only challenge is that he's about an hour drive away. Also have to check his cost and if insurance will cover. A bit on the fence I guess you'd say.
In the meantime I'm on 100mg DHEA in the am after baseline T at...you guessed it...24! So tomorrow going for more blood and follie scan if I can get in.

That's it for me for now.....'night you queens of fertility! (hehe)
Anitasto

[mogo]

Dear Anitasto and others in this group,
It has made me feel so reassured and comforted to find this group!  I just found out today that my eighth IVF didn't work. I am 41 and have not taken DHEA.  Someone told me about it a few weeks ago, but I only looked into it tonight, to console myself after the news.  I am not sure if it is worth it for me to try the DHEA and then try one last cycle, or to just stop right now.  (It is such an emotionally trying and time consuming, and expensive! Hard to think about doing another one.)

Anyway, I was wondering if you, or others in this group, might provide me with some insight as to whether you think DHEA would be helpful.  

I had my day three FSH taken about 6 months ago, and it was 10.9.  However, I also had it taken on day ten and it had risen to 16.1.  Not a good sign.  But then some places don't do day 10, so I'm not really sure what that means.

The past two cycles, I had an estrogen patch on cycle day 24 followed by ganorelix on day 25, 26 and 27, then was given 600 iu follistim and 150 menopur each night until follicles were developed.  In one cycle I had six eggs, five of which fertilized.  All five were transferred on day 3.  This last cycle only four eggs were retrieved. (There were eight showing up on the ultrasound, so I was very surprised more weren't retrieved. Different doctor this time -- didn't think he was too good.)  Anyway, three of the four fertilized and were transferred on day two. These aren't very high numbers, despite the large amount of stimulants I was taking.  

So, my question is -- do you think it is worth it to try DHEA and try one more cycle?  Given my numbers, do you think DHEA could be helpful?  What tests would you recommend I get?  

Thanks so much for any insight/wisdom you can give me! I was so impressed by the information you provided on previous emails - - you sure know a lot!

All the best,
mo

[cindylouise]

Hi Anitasto ~ I have my second opinion appoitment with a new Dr today.  I just read your response to my DEX post.  Whats funny is I don't have PCOS so I am unsure as to why they gave it to me.  I wonder why they gave me everything they gave me.  Next week I meet back with my 1st Dr to go over everything including what you taught me and our second opinion.  I will keep you updated.  Thanks again for all of that information!  You are such a great suppport!

Cindy Louise

[anitasto]

Hi Mogo,

Great screen name.
I know how you feel about all those cycles. I've been through a total of 7 myself and am geering up for 'one last cycle' which, as you might have guessed, is what I said last time.
But I also said that I would only do another cycle if I found new information that was significant and could change the outcome. In my case I have an autoimmune disorder that is treatable.
In your case you need some additional hormone that will put you back to your 35 year old reproductive status. I do very much think it is at least worth trying the DHEA.
AND, what I did to make sure the next cycle would be worthwhile, I had blood tests almost weekly to make sure the DHEA was getting in and effecting my hormones. My FSH after 3 months on dhea went from 10.1 to 3.9 while my Testosterone went from a 'below normal' 17 to 'barely average' 49. I also had a scan done on day 3 with my bloodwork to see if more follies were showing up. I started with about 3 - 4 and after 4 months had 5 equal size follicles on each ovary.
So, you see, before you sign up for and sign that check for that...yet another... cycle..you can do things to make sure it will be worth it. And you should. No oneshould have to go through this without reason to hope and believe it could be successful. That's all that makes it worth it - right?

Also, since you've been through so much I'd recommend getting blood tests for any other adverse effects you could possibly have just to make sure there's nothing lurking out there that could also be effecting you. Repromedix. I don't know any other lab that does what they do - specialize in reproductive diagnostics. Just google and you'll find their website. Call them directly and they'll walk you straight through it.

So Repromedix first - before you start DHEA. Then DHEA from a reputable compounding pharmacy....I would go ahead with 100mg given your age and FSH (but that's just my thought...do your research and what you feel is appropriate...some start out at 50mg and work up as needed until Testosterone is steady at 80 - 100).

I know its like the longest mile ...or marathon... we're walking here. Just take one step at a time. :)
My thoughts are with you my dear,
Anitast

[anitasto]

My first doc gave it to all their patients as standard and I imagine many other doctors do as well. Any study it seems that totes 'good results' has the potential to result in the drug becoming part of a doc's protocol. Just depends on the doc and how rigorously they're thinking as they apply meds - at least that's my opinion. ;)

Hope your appointment goes well!
Cheers,
Anitasto

[mogo]

Dear Anitasto,

It's so helpful to be in touch with someone who has been through a similar experience to mine.  It IS like a marathon.  And sometimes you have to just stop and take a breather and take in the view around you.  I think your approach is a wise one - of only doing another if you find out more information that could positively affect the process.  That's so helpful you found out about -- and are able to treat -- the autoimmune disorder.   Did you find that out through Repromedix?  I hope so much that this next cycle will work for you. I know how it feels to go through so many.  And I am so impressed by how positive, resourceful and helpful you are to others.  Really --- you are so generous with your knowledge. Thanks so much!  

One difficulty to all this is that I'm moving to Jordan (in the Middle East) in three weeks.  I know they do IVF over there but not sure about the technology, expertise and even medicine they will have available.  I do know they don't sell DHEA over there, so I'll have to bring a bunch with me.  If anyone reading this knows of a good doctor in Jordan (or possibly Israel or Lebanon), please let me know. Or if you know of someone who might know of someone.  

Thanks again for all your help.  I'll keep you updated (and I'm sure I'll have more questions).  And the best of luck and health and positive vibes for this upcoming cycle!  

All the best,
mogo

[anitasto]

Thanks so much for your positive feedback and encouragement.
I had some initial bloodwork through Labcorp but the more extensive work wrt my autoimmune issue was with Repromedix which provided new information that Labcorp could not. Hope you have the chance to rule those things out before you go. Its hard for me to see or hear of someone going thru a cycle and finding out issues after the fact like I have.

Best of luck to you in Jordan! Wow...what an adventure it sounds like. I'm sure you'll find a great doctor there and I look forward to hearing how things are coming along for you.

Hugs for the road,
Anitasto

[ilion]

Hello all,

My wife and I were encouraged by the promise of DHEA.  We went through all the advice in this thread and still came out empty-handed.  After a few months on DHEA we retrieved about the same amount of eggs, and transfered nine (including a frozen) on day five.  We got a positive beta of 101 but it rose too slowly and we just induced a miscarriage after seven weeks.  

Sorry to be a downer, but I think people should know that DHEA is not necessarily a magic bullet.

Best of luck to all...

[HQ2007]

Hello ladies!

I wanted to chime in with Anitasto on the autoimmune tests. Recently I had full autoimmune labs done after my 3rd m/c. It was done at RIA Labs in California. After I got the tests back, I needed to famililiarize myself with all those new acronyms. There's a yahoo group for autoimmune issues. Ladies there recommend and I read the book "Is your body baby friendly" by Dr. Alan Beers. I wish I read this book a year ago. I highly highly recommend it to anyone who had even one failed IVF or m/c. Dr. Beer pioneered reproductive autoimmune tests. He is no longer living but his clinic still does autoimmune tests and treatments. You can google RIA Labs and Dr. Beers lab.

Not all REs believe in autoimmune related IVF failure or m/c. You have to find one who will support testing and treatment for autoimmune issues.

I just wish I read the book a year ago after my 2nd m/c. I wouldn't have tried for a year w/o the treatment need to keep pregnancy going.

I am currently taking DHEA and waiting for few more blood tests results. I will be seeing my current RE in few weeks to discuss treatment/protocol.

Cheers to all!
HQ

[tigercat30]

Hi Anitasto,

as you suggest, I made a blood test of my thyroid hormones. The results are normal:

TSH basal 0,73 mU/l (0,35 - 4,50)
fT3 3,5 ng/l (1,8 - 4,2)
fT4 13,9 ng/l (8,0 - 25,0)
Thyreogl.-Ak 29 U/ml < 60
TPO-Ak 20 U/ml < 60

Last Friday I made a new blood test of my hormones on day 3.
I hope that I will get results because they get not enough blood because I have deep-set veins. Our next IVF I want to start in March. Hope the values are good.

I wish you good luck for your 'one last cycle'.

tigercat30

[tigercat30]

Hi Anitasto,

the last weeks I took 100 mg DHEA in the morning, 25 mg in the afternoon and 25 mg in the evening.

The results at day 3 are:
LH 4,0 U/l (2,0 - 12,0)
FSH 6,0 U/l (3 - 12)
E2 28,6 ng/l (30 - 142) = 105 pmol/l (110 - 550)
T 0,6 ug/l (<= 0,8)
DHEA-S not enough blood
last value 512 ug/dl (45 - 270) = 5,12 mg/l (0.32 - 2.40)

At 08.03 starts the long protocol with the down regulation (Decapeptyl every day 0,1 mg until puncture). At 24.03 an ultrasound with AFC and cyst exclusion is done and at 26.03 I start the stimulation with Merional (thats a cheap and effective alternative to menogon/menopur). The dosis is 450 IU per day for the first 4 days and then 375 IU per day. At day 7 of the stimulation is an ultrasound.

I'm unsure because the dosis of merional is planned so high and my FSH is so low now. Do you think that the values for a 45 year old women are good or not so good?

I've read that you take an estrogen patch and the pill (about one year ago you wrote: Once you start, your ovaries will become very active. In order to suppress them and get best results, you need the estrogen patch. You WILL OVULATE THROUGH THE PILL. The pill is not enough to suppress your active ovaries. I start the patch right after ovulation, keep it on for 2 weeks, go off for 3 days, then start stims.
Baseline exam should have E2 less than 30 and at least 8 antral follicles all about 5 mm. You don't want a leader follicle for sure...make sure they're all less than 7 mm. This will be your best circumstance for the investment.)

Is your protocol a better alternative to the protocol of the Austrian REs? You make the AFC in the 3 days where you go off, right? Do you know when the follicles for the IVF cycle are created (that's a question of my husband).

As preparation I make two months Hypoxi training. By the training the fat at the abdomen is reduced and the abdomen is supplied better with blood. My husband goes to a doctor for TCM (acupuncture), because this improved his sperm quality. Both things we done the first time before the IVF were I become pregnant.

tigercat30

[anitasto]

Great input. Thanks so much. I'll definitely check out the book!
I look forward to hearing your test results.
Anitasto

[mogo]

Hi Anitasto, HQ, and everyone else,

Thanks for the encouragement and for the information regarding autoimmune issues. I looked up Repromedix and found that my former ivf doctor was on their recommended list, so hopefully he can help me with all the necessary tests.  I definitely want to get this done before I got to Jordan as the technology is not as good there. Thanks also for the Alan Beers book recommendation.  I'll get that to bring along with me too.  I certainly know by now that none of these are guarantees but it sure helps to be as informed as possible.  

I hope all your cycles go well! I'll be thinking of you.

Hugs,
Mo

[GinaLosAngeles]

Really glad I found this site and thread!

I just turned 44, single and am doing IVF.

About 9 months ago (at 43) I did a frozen IVF (wasn't ready). Was on Bcp (birth control pills), 6 antral follicles. then CD3 (cycle day 3) 450 Gonal F, Menopur 150 units, then Ganirelix (on CD 7 or so, can't remember). Got 11 follicles, 7 eggs, but just 2 fertilized.

Then got ready:  I did 3 IUIs with clomid. Got 3 follies one time. None worked.

In September started taking DHEA 50 mg/day from compounding pharmacy. So been on it for almost six months.

FSH levels: May '08: 15.6, Dec '08: 8, Jan '09: 11.

So just started cycle estrace priming microflare cycle. Sitll taking DHEA 50 mgs. Plus acupuncture and vitamins. Have not tested my T or DHEA levels. Plan to on Monday after reading here.

7 days after ovulation took 2 mg estrace 2 x a day. (goal of estrace is to have follicles are together...ie no primary one. seems to have worked.) Any thoughts on estrace vs. the patch for downregulation?

On CD 2 had FSH of 2.9 apparently because estrace suppresses FSH levels. (so FSH shouldn't be compared)
Had 8 antral follicles (more than last time)

On CD2 stopped estrace and started taking lupron (micro dose) two times a day: .2 of 40 mcg/.2ml

On CD4 added gonal f 450 and Menopur 250 units

Went in on CD 6 for scan. Six small follicles (2-5), and e2 of 21.

I freaked a bit because it was so low. It was yesterday so unable to talk to doctor about low E2 levels. (haven't yet told dr. about DHEA). Then I found this thread!! and see that it is because of the DHEA that my e2 is so low and the follicles are growing slowly.

Do you have any studies about DHEA impact on e2/growth rate or just personal experience?

Also RobstersMama, you mentioned about study with old ovaries put in young rats and performed like young ovaries. Do you have link to that study would be interested to read it. I couldn't find it.

Also RobstersMama, you mentioned SIRM a few times. I have read their haveababy blog. They seem very smart but their protocol of choice for older women is 180 degrees from DHEA.

That is, DHEA proponents essentially argue that androgens help follicle growth.

While SIRM asserts that androgens hurt follicle growth and they have a protocol of taking estrogen shots throughout the cycle. They don't like microdose flare because they say LH is too high which increases androgen levels.

Interesting that these two sides are so different...and studies SEEM to support both these sides.

Any thoughts? What do you think Anitasto?

Also, read on this thread that serotonin creates estrogen? True? I've been on Lexapro (serotonin reuptake inhibitor). Wondering how that affects follicles etc. Any studies?

Also, My doctor says can test T, but the LH tests are unreliable because LH levels vary throughout the day. WIll test T and DHEA on Monday.

Glad I found you guys!

Gina

[GinaLosAngeles]

Also,

Do you have any idea why Barad did not publish pregnancy rates with is DHEA study?

It is a bit concerning. Who cares if you get more eggs if none of them result in pregnancy.

Also, I see that some people (Tiger for example) are taking 150 mg of DHEA. This seems very high to me..particularly considering Anitasto's experience with high levels of DHEA. Clearly too much is not a good a thing. Also, most of the studies Barad and others are with 50 mg and 75 mg. Right?

Gina

[GinaLosAngeles]

Re: Vitamin D...
Studies have shown that IVF is more successful in the summer months than winter months. This may actually have to do with vitamin D.

Do get sun, take fish oil and eat lots of fish!

[Home555]

Hi Ladies,

I wish you all the best....I know how you all feel.  My husband & I have been trying for 6yrs now, We have done IUI's and 1 IVF, my Dr. recommended me to take DHEA, I live in Canada, so it's not FDA approved here, I ended up buying it in Buffalo.  I have been having liver pain ever since I started the DHEA, my Dr. recommened that I take 25 3 times a day before I do my next IVF in June.  
Has anyone had any liver pain when taking the DHEA?

Thanks so much!

[anitasto]

Sorry to check out for a bit on you ladies but my Mom has been ill again and I've been with her alot and postponing some of my TTC efforts. Just wanted to let you all know I'm thinking of you and wish you the best. When I return home and am more able to focus on fertility I will return, hopefully in the coming week or two.

All the best,
Anitasto

[HQ2007]

HI Anita,

Sorry to hear about your mother. Hope she is doing better now. Hope to hear from you soon after you get home.

Cheerios,
HQ

[anitasto]

Thanks so much. Mom's moving to a nursing home this week so she should be comfortable. I must say, all those images of her coming to help me with a new baby are hard to let go of. On the other hand, if things don't work, adoption will somehow be easier.

So I checked out the website on autoimmune issues. Thank you soo much! I've been writing my chapter on the autoimmune issues and its provided great background. Should get the book this week and i the meantime have read a great review by Coulam of the studies up to 2006 concluding IVIG is helpful.

How are things with you?
Anitasto

[anitasto]

Tigercat,

Sounds like you're in the optimal zone based on your labs. Congrats on your work! How's it going??

Home555,

Yes - I have had liver pain but I'm not sure if it's associated with the DHEA negatively. I just had my own liver function tests because my Mom has hemachromatosis which effects the liver and my liver function tests were elevated so we're checking iron. It wouldn't hurt to just talk to your physician, tell them about your discomfort and ask for a metabolic panel which includes liver function tests and other items related.
Hope you're doing well.

Cheers gals!
Anitasto

[anitasto]

Hi Gina,
Your last comment about how much DHEA - it is based on your Testosterone level. Some start off with base T way low and so to get T to the optimal level we test it as we go and gradually increase DHEA based on T response.

As for slower follicle growth on DHEA, a study in Italy was related and the stimulation took longer. My cycles took longer on DHEA compared to 3 cycles I did before DHEA.

Hope this helps.
If you're still out there would love to hear how its going?

Anitasto

[dg223]

Hi Anita-
I posted last summer/fall and wanted to update you and get some input. I have been a poor responder to stims in the past. I started dhea 25/day for the first 3 months, then increased to 50mg/day. I just finished an ivf cycle (450 follistim for 7 days, then ganirelix and menopur towards the end).I also took the dhea throughout the cycle. I found I had more antrals at baseline and had a better response than I have ever had. I had 6 large follicles and 2 smaller ones at retrieval, and estradiol over 1200. I triggered with ovidrel (2 syringes). I was hopeful based on my response.I stimmed for 14 days. Unfortunately they only retrieved 2, the rest were empty. Those two were immature and didnt fertilize. So in the end the quality was just as poor as before. I am anxious to do another cycle next month. Do you have any suggestions for protocol? I am increasing my dhea to 75/day. Should I take it during my cycle? Have you had experience with empty follies/ immature eggs. I am feeling hopeless...

[anitasto]

I'm so glad to hear you had a better response and I have a couple thoughts for you.
1. were they testing your LH and Progesterone during stimulation? With that many empty follicles it sounds like you may have prematurely ovulated which would result in follicles without eggs inside of them and also effect the quality of any eggs retrieved. Your Progesterone should remain below 1.2pg/ml(units have to dble check). Higher than 1.7 and you should expect no quality eggs.

2. Nix the menopur next time - it has LH AND FSH and you're already getting plenty of FSH and the LH puts you at risk of premature ovulation when you're stimming that long.

2. I've had at least one empty follicle at retrieval each time but all others were good on dhea until my last cycle in which all were empty but one like yours. Others here have had several empty follicles also.

I had a chat a while back with Dr. Acacio who has experience also with DHEA and he mentioned adverse effects after long term use. I need to ask him more about this but I think its possible and I've reached that point with elevated PRogesterone in the follicular phase. I don't think it's likely you have and maybe just need to add ganirelix earlier.
How long have you been on it?

Please have your progesterone tested before your next cycle at baseline. If it is not within follicular range - e.g. too high - talk to your doc about it and consider adding Dexamethasone and retest it the next month. But hold off on a cycle until your progesterone and LH are in normal range if they are not already.....you'll get nothing from it for sure if those are too high. This is exactly what I'm dealing with right now and have done a bit of research on it so eager to see your response and experiences.

Hang in there! - Don't feel hopeless until the fat lady sings and I wouldn't say she's sung yet my dear. Focus on the blood tests so you can have some information to tell you which way to go. I'll check back here for you frequently.
Hugs,
Anitasto

[anitasto]

Hope someone is still out there.... not quite ready to pack it in here.
Has anyone reached conclusion in there journey or still working the process?
Please do give us some updates.

Anitasto

[HQ2007]

Hi Anitasto!

I am still here and have some updates! I have been meaning to write back but was delaying until I had some more info. But, I owe you an update :)

So after I had all my Level 1-5 immune tests we were ready to TTC with new info and treatment protocol. I changed my RE. I think I mentioned I went to CHR NYC where the DHEA woman story came out of. I am under care of Dr. Norbert Gleicher.

My RE had done some additional blood and genetic tests and put me on DHEA 25mg x 3 times a day and prescription pre-natal with high folic acid plus DHA. I was told to take DHEA after meal.

My treatment protocol recommended by my RI was Prednisone, Lovenox/Heparin, Baby Aspirin and pre-conception IVIG infusion. My RE recommended similar treatment (except IVIG).

Our options were to TTC naturally with immune treatment or do IVF. We opted for a third one, IUI with immune treatment. We had a medicated IUI cycle in April. I started on Prednisone and baby aspirin at the beginning of the cycle, started Lovenox shots on IUI day, doubled the doses of Prednisone at this time. Then we had a positive PG test at 11DPO, and I started to panic! At this time, my Prednisone dose went up again. I am currently at 30mg/day. I had blood hcg tests every 48 hours. My beta was rising but at about 60% not doubling. It was 398 on 21dpo. So we went for ultrasound to make sure it was not ectopic. It wasn't and we were relieved.

Given I had elevated NK cells from prior tests and DH and I have DQ alpha match, I wanted IVIG treatment. My RE didn't think I needed IVIG because I would be fully covered with the other meds. But after I spoke to him with my concerns, he told me to get it as soon as possible.

So I had three days of IVIG infusions at 25 grams per day. It was EXPENSIVE! I am still working on trying to get reimbursement from my insurance.

This is the farthest we have come. I am still taking one day at a time but keeping positive. I have another ultrasound next week. I will keep you posted! Pray for me!

Hugs!
HQ

[anitasto]

It's soo great to hear from you AND you're PG! I'm so happy for you!
Wow - it's soo great that you found out all the autoimmune info and got through to your RE and got the IVIG.

BTW - my RE said she does IVIG monthly until delivery. Did you get that info also?

I'm really rooting for your and it sounds like things are good - I looked up the hcg references and it seems you're in normal range - understand not high normal but in good and it's rising consistently!
Another thing you could maybe look at if you're interested is your E2 levels....another indicator of healthy pregnancy....I found a study a while back but am not finding it - few minutes got me this baboon study but it has charts  http://www.biolreprod.org/cgi/reprint/49/4/737

I'm really excited for you - thank you sooo much for your update.

As for me - I've completed an initial draft of the book and sent the outline and introduction to a friend of DH this week who works with publishers.

Look forward to your next update.
Hugs to you too!!
Anitasto

[SuzanneM101]

Hey ladies! I want to thank you all for sharing your wealth of knowledge! I spent most of the day yesterday (at work!!!) reading your past posts.  The whole world of  “sub-fertility” ( I won't use the word infertile) can be overwhelming most of the time and its helpful to know that you're not alone.  I have been dealt some pretty devastating news, and I'd love to hear any thoughts you all have.  

We have been trying for almost (2) years.  After 3 Clomid IUIs, and 3 Gonadatrohpin IUIs, we needed a break. We had bounced around to a few doctors, and really just wanted a proper diagnosis. Why was this happening??!!! Well I sure got it with my current doctor. He is a Napro doctor, and wanted tons of B/W to be done.  He also put me on low-dose Naltrexone (4.5 mg) almost immediately. It has definitely improved PMS symptoms and helped improve anxiety symptoms.  He said it may take some time to see the full benefit from the Naltrexone (up to 6 months).

As for the B/W results, here goes.  My FSH, AMH, and Inhibin-B numbers are all not so great, especially considering the fact that I am 30!! Yes, 30 and I feel like I'm reproductively a ton older.   My doctor hasn't run any of the genetic tests for POF, including Fragile X, so thats next on our list.  However, I don't feel like I fit any of the Fragile X physical characteristics (and he didn't either), and nothing like this runs in my family that I'm aware of.  

B/W results (all done on a completely natural cycle):
Day 3 FSH: 11.1
Day 3 AMH: 0.4
Inihibin B: 22

Testosterone: 37
Free Testosterone: 0.2 (very low)
LH: 9.2
TSH: 1.085
Prolactin: 1.1 (I had been on Dostinex to lower this since I had a slightly elevated level about a year ago. I've stopped the Dostinex and will get this re-checked in a few weeks)
DHEA: 123
ANA: Negative
Glucose: 96 (Normal)
Adrenal Antibodies (Salivary Cortisol) – shows signs of stress (no sh&*!)

I also had estrogen and progesterone checked every other day (I looked like a heroin addict – no joke!).  My progesterone tanks shortly after ovulation, so we're starting progesterone supplements next month. After reading your posts, I went back and reviewed my pre-ovulation estrogen levels.  Those levels are elevated, which I believe would correspond to the not so great FSH values.  

Another something I want to mention is that I've had chronic jaw-line acne (hormonal) since puberty. I have to get facials every 3 weeks (out of necessity) or I'm a complete mess.  I've been on Accutane twice in my early twenties. Nothing I do seems to help with this. I was surprised when I got the BW results showing my testosterone results were low, not high.  Other than that, I always thought I was pretty healthy.

Also, I've had a laparoscopy and selective HSP.  The lap showed mild endo (< stage 1) and slightly elevated pressure in my tubes (the doctor cleaned those out as well).  He saw nothing during the procedure that was a show-stopper.  

So, with all that being said, do you all think DHEA could help? I'm not convinced that I have an actual POF issue because I always get really-size good follicles during scans and I do ovulate. I feel like there is something whacky in the whole hormone chain that is causing the problem.  Any help/insight you all can provide is greatly appreciated!! Sorry for the long post, just wanted top get all the facts out there.  Good luck ladies and best of luck to you all!!! Suzanne

[SuzanneM101]

Good morning Anita,
Thanks so much for your quick reply. I appreciate it - this fertiltiy thing is so overwheling!

I have had my antral follicle count checked on day 3 a few months back during a gonadatrophin cycle - it was either 10 or 11. I can't remember exactly.  I'm kind of between a good and bad count, just like my FSH #s have been borderline (between 9 and 11.1).   I might take a lower does of DHEA (like 50mg). Do you know of any potential side affects if you don't actually need it?!  I feel like I take so many pills now, that 1 or 2 more won't hurt!

I have a question regaridng auto-immune diseases.  I read about that on-line, but haven't exactly figured out what all that entails.  What diseases fall into this category? My RE is convinced I have some sort of adrenal issue, since my salivary cortisol test showed slight stress.  Are adrenal issues related to auto-immune diseases? I'm sorry if thats a dumb question - I'm just way out of my element here.

Also, I wanted to share a website in case you hadn't already seen it.  It has a useful chart for hormone production.  DHEA is pretty high up on the chain, so this must be why it takes a few months to get the full benefit?


Thanks so much. Have a great day! Suzanne

[SuzanneM101]

Suppose I should actually post it!

http://www.womentowomen.com/adrenalfatigue/dhea.aspx

[anitasto]

It's a pleasure to help/support where I can.
As for relations between adrenal issues and autoimmune issues I haven't looked into it. And it makes me think and wonder - could the autoimmune effect the adrenal or poor functioning adrenal lend to autoimmune issues? Hmm..chicken/egg. There is some evidence of genetic link w/ autoimmune issues - mine for example are likely genetic as my father has had blood clots and both uncles had strokes. These are strongly associated with antiphospholipid antibody syndrome which I have.  

I think your plan of 50mg dhea sounds really good given 10 follies are visible. Many of us only see like 2 - 4 follies. And please if you can track your DHEA-S, Testosterone, and SHBG before starting and again after a couple weeks to be sure levels reflect that you're absorbing the dhea and get a sense of how your body is converting it. The SHBG should go down allowing for more free T.

I know this process is wearing. That's why it's so important to be fully tested up front so you don't unnecesarily spend your precious energy in any direction that could be less than successful. If you do full autoimmune testing you'll be covering an important basis.

A hug for support and a cheer for your smart and determined efforts Suzanne. Hang in there girl! ;)
Anita

[SuzanneM101]

Hi Anita-
DHEA is fast acting! I have been taking it for (2) weeks and have had the best response to date.  I had (2) big follicles at 13.8 and 14.0 on CD10 (estradiol - 210) on Gonal-F (75 units).  I didn't trigger till CD14 so they both would have been nice 'n plump! I did have some B/W checked again as well. My RE suggested I stop or cut back on DHEA - I had a pretty strong response. The first thing he asked me was how I felt about twins - bring 'em on!

Before DHEA:
Testosterone: 37
Free Testosterone: 0.2 (very low)  
DHEA: 123

After 2 weeks on 50 mg DHEA (normal range in ())
Testosterone: 93 (14-76)
Free Testosterone: 1.0 (0.0 - 2.2)
DHEA: 542 (45-270)

I cut back to 25mg per day since this BW was done.  Do you know if its bad to have these values too high? I was just thrilled with the great response I had so I was leery about stopping all together. I've felt more at peace as well with this whole thing this cycle - much less anxious. Must be all those good supplements or I'm just getting beat down.  :)

Thanks so much - You girls rock! Suzanne

[Frisbe]

Hi, Suzanne,

I tried DHEA at different points. When I started it with 25 mg, it completely has no effects on my follicles and embryos. I then up it to 50 mg and I can see improvement after 4 months of this higher dosage.

I think that you should not drop the DHEA to 25 mg at this point. I have a similar situation like you. My body absorbed it very quickly and the DHEA level even went up to over 900 and the Testosterone to over 300. However, the levels adjusted themselves the following month without dropping the dosage. DHEA-S dropped to around 400 and T was a little bit over 100.

Many RE just do not know enough of the DHEA and they tend to discard it or be super cautious.

Good luck,

Frisbe

[ElizabethS152]

Hi Anitasto,
I have been reading this forum for about a year and really appreciate your knowledge and experience with DHEA.  I am a 44 year old female that easily conceived a son at age 40 and delivered at 41.  Since 9/07 I have been TTC another child.  I got pregnant again in August 2008, but had a miscarriage at 12 weeks after seeing a heartbeat.  My OB says my only problem is egg quality due to my age, so I started taking DHEA on 2/24/09 at 50 mg am and 25 mg pm.  On 3/17/09 I increased the dose to 75 mg at 630 am with water and no food until 900 am, and 25 mg at 630 pm after dinner.  Before DHEA my day 3 FSH was good - 10/24/07 it was 5.7 and 3/17/08 it was 8.5.  I finally persuaded my OB to perform current day 3 labs that you said should be done on DHEA, but he said he would only do it once and he would not do free T or DHEA.  My day 3 labs on 6/5/09 were:
Testosterone 55.1 ng/dL
FSH 6.4 mIU/ml
Estradiol-6  24.3 pg/mL
DHEA sulfate 603.1 ug/dL
I am taking Belmar Pharmacy DHEA which is 12 hour sustained release.  The pharmacy says they do not sell immediate release.  I am a bit concerned about that since you said it is absorbed better in the morning.  My questions are:  Should I increase my dose?  We are TTC naturally and my cycles are every 28 days.  I believe I read previously that you said for a natural conception, you recommend to get your T to 80.  I am considering increasing my dose to 125 mg/day with 100mg am and 25 mg pm.  Also want to get your opinion on the sustained release Belmar DHEA if you don't mind. I will not be able to get any more labs, so I am going to use this lab as a basis for dosing and will probably stay with Belmar DHEA.  
I really hope you can answer my questions. I value your input.
Liz

[anitasto]

Hi Suzanne,

I hate to disagree with Frisbe but I there are negative issues that can come with too high for too long Testosterone. And I've generally suggested getting T into the mid range after retrieval.

After my level was between 90 - 120 for a full cycle we had good eggs retrieved and frozen. After that we wanted to do another cycle to bank more embryos. My progesterone has been elevated ever since even on day 3 and even after going off dhea for 6 months. I believe this was a result of being on too much for too long.

Now I am of the opinion that greater than a hundred is fine for a cycle but it should be lowered to within the normal range between cycles.

Frisbe - I suggest your amazing response while great in some ways is important to temper to avoid eventual negative impacts. Our bodies will always counteract changes and really big changes can bring on a really big counteraction.

Glad you're both having good experiences though. Congradulations and as always I look forward to your progress.
Sincerely,
Anitasto

[anitasto]

Hi Liz,

Thanks for sharing your circumstances and I'm very happy this forum has been helpful.
I think if I were in your shoes I would agree and add the 25mg as you are considering but I would get it over the counter at a health food store that won't be extended release. The efficacy will be lower but you just need that bit more in the am I think will make a noticable difference.

But please allow me to caution because your labs are really very good and if your Estrogen goes much lower - it lowers on dhea - your body can shoot up in FSH in an effort to bring back some basic estrogen - at least my body did that.

If you can get continual E2 and FSH labs at least you can watch out for this.
Just curious - is there a reason your doctor doesn't do labs?

If your E2 does go too low then you could get a low dose estrogen supplement that you'll take throughout your cycle. This is common for women with too low of estrogen and can keep things in balance. Estrogen is also important for implantation so the supplement would be beneficial when you concieve. Ideally day 3 estrogen is like 45.

Also if you don't already have a baseline follicle count, you could request a scan to count the number of follicles you have on day 26 of your cycle. It would help to identify how productive your ovaries are. I know most go for day 3 but your follicles are recruited in the luteal phase and begin to fall off before your period starts. A healthy count for me as a low older producer was 8 - 10 follicles.

I know that's alot to think about but I hope some of it is helpful for you. It's truely encouraging to hear someone your age with those good numbers.

Hoping the very best for you!
Anita

[ElizabethS152]

Hi Anita,
Thank you so much for your reply.  

I am confused about DHEA decreasing estrogen because I thought it would increase estrogen.  Can you comment on that?  What I have read says that DHEA increases T, E2, and progesterone.  I believe you, especially if you experienced it, I just don't understand it.  Since that is the case, I am really going to have to think about increasing the DHEA dose.  I am already concerned that DHEA is decreasing my endometrium.  My periods have always been 5 days, but dropped to 4 on DHEA, and now my last was 3 days, which has me really concerned.  I have read that other women had shorter, lighter periods on DHEA, but isn't that a problem?  I am assuming that the endometrium is thinner if your period is shorter and lighter.  Do you think the endometrium could become thinner on DHEA?  Before DHEA, I had a 21 day ultrasound and my lining was fine (don't have the exact number right now).

My OB will not do labs because he doses hormones by women's symptoms because he says hormones have a wide therapeutic range.  Furthermore, he does not believe DHEA works.  I live in a small community and we have no RE's and the OB's here are traditional.  I am ok with not having labs done because it is difficult for me to find time to see my OB anyway.  I will just monitor my body.  Yes labs would be nice, but I will do the best I can without them.

My OB prescribed Estrace 1 mg for days 1-5 of my cycle to increase my endometrium before we did the scan and saw that it was thick enough.  What do you think of this dosing?  Do you know what OB's normally prescribe to increase endometrium, which estrogen, dose and frequency?

I had a day 21 scan done last year and showed lots of follies before DHEA.  OB says I have lots of follies, but they are just too old.  I was hoping to improve that with DHEA.  

I do not want to take too many medications, so I am not sure what I will do at this time, but I thank you so much for your input.  My main concern is that DHEA is decreasing my lining, and I hope you can tell me if this happened to you or anyone you know.  

Would you still increase the DHEA dose to 125 mg/day if you could not have lab monitoring and if your periods were getting shorter?

By the way, are you going to let us know what you are doing on your TTC journey?
Thanks for your help, and best of luck to you also,
Liz

[SuzanneM101]

Hi ladies -
Thanks for the good advice.  Just had an u/s today and my response this cycle wasn't as good as last cycle.  Last cycle I was on 50mg of DHEA and this cycle I was on 25mg.  My Dr. had suggested I cut back due to elevated T and DHEA levels. I asked my doctor today and he said it wasn't unsafe that were high, but could be if sustained for a long period of time.  What are your alls thoughts on a higher dose the first 2 weeks of your cycle (before ovulation) to help get better eggs and then ratchet it down the last 2 weeks? Just wondered if anyone had luck with doing something like this or if its better to keep it consistent.  Thanks ladies!

[Frisbe]

Thanks Anitasto. Good to hear from you again. I totally agree with you that we should not keep the T too high. I check my T every month to make sure it is not too high. I was suggested by my doctor to see whether the body could adjust itself the next month after it was high for one month. The best cycles that I had were when T was a bit over 100 and DHEA-S was around 400 to 600. Since I am only taking 50 mg per day, I feel that it is still kind of safe. When I was taking 25 mg, it did not do a thing for me.

However, my egg quality is OK now but I have immune issues. I do not know whether I should use a surrogate or continue to try. I am 44 and not much time left.

How long have you been on DHEA? Did you see any negative effects after being on it for too long? I started taking it again since December last year. It has been 6 months now.

Frisbe

[SHR65]

I'm living in Israel and Dr Jehoshua Dor is one of the top IVF guys in Tel Aviv.  He holds a private clinic three times a week from 7pm till midnight and the initial consultation fee is around $250 which includes an ultrasound scan.  His whole cost for IVF is around $2000 per cycle excluding meds.
You can fly from Amman to Tel Aviv in 25 minutes so it's an easy trip.

[42FAITH07]

Hello!  I am new to this forum.. bare with me..  

I have some questions on DHEA.. Do you need to be tested  before taking DHEA?   I would like to start ASAP, but if you think that I should tested first?  

I have had 3 failed cycles, all are due to my age, follicle factor.  I am 42.  

[Ally1973]

Hello - I have recently started taking DHEA again after a while off it. I was actually prescribed it by my Dr here in the UK and he tested my DHEA, Testosterone, FSH and Estrogen before I started so that he could see the rise/ fall of these hormones after 3 months. For me I really wanted to know if my FSH went down so that was important to me but I think that the testosterone and DHEA are the most important baselines to get (I hope someone much more experienced will correct me if I am wrong!!)

I took it last year for a few months - just 50mg but nothing much happened, I am a very extreme case though who has been diagnosed with POF with CD FSH of 40 but recent random FSH of 100, I also havent had my period now for almost 4 months. About 3 weeks ago I started on 100mg of DHEA (50 at 8am and 50 at 12 midday - micronised bought from DHEA.com). My baseline testosterone was 0.6 nmol (range 0.2 -2.90) and my DHEA was 4.8 umol (range 0.26 - 11.00). I started again as 2 women I know in London who have AMH of 0.1 (like me) and very high FSH started taking 100mg and also Predisterone (25mg) and have both conceived. Neither responded to stims or got to EC! Just wanted to share this info with this very interesting board. Maybe there is nothing in it but who knows??

If anyone has any info that they think I should know then of course I would be so happy to hear it!!

Luck and love to all those on this very difficult rollercoaster xx

[virgo2121]

I have been prescribed DHEA 0f 75mg per day at my request. Doctor didn’t really know what it would do but gave me it anyway 

I am just starting a flare cycle IVF and do not know whether to start now in the knowledge that by egg collection in two weeks it wouldn’t have made a great difference but in the hope that if unsuccessful at least I would have started the four month prep stage recommended.  Only concern is that I have read that you only take up until egg retrieval. Is this correct?

If so I assume you would not take again until you know preg test result? If this is correct I have also read that DHEA soon disappears out of the system and as such I assume the four month period would have to start all over again. Please advise, I want to start DHEAS ASAP to get the prep period underway but do not want to do it if the break will put me back to square one.

If I start now I will have about 14 days taking it, egg collection and 2WW so potentially a two week break in between re commencing dependant on answers above. Would it do any harm to start taking and continue right through egg collection and until I know preg test result?

Many thanks for reading and any replies will be very much appreciated.

[pudster]

I've just had some fertility blood tests done on CD3, can anyone interpret them for me please. I am thinking of using DHEA but unsure if it will help me.

FSH - 6.1 U/L
LF - 4.8 U/L
Oestradiol - 914 pmol/l
Prolactin - 237 IU/ml
DHEA - 0.7 umol/L
Anti Mullerian - 8.00 pmol/L

many thanks

[virgo2121]

I too would be interested in some interpretation of the below results as reading through previous posts I cannot believe some people DHEAS are 800 plus when mine is so low but well within range. Are people using different units to measure? Confused :-(

Taken on day 1 of cycle:


Testosterone: 0.7 nmol/L       (0.2-2.9)

FAI:  200                        (26 -110) - commets say levels can be elevated with Oestrogen and i just stopped taking Progynova (Oestrogen) 2 days before so not sure if this is due to that. What compliactions would high levels pose?


Any help would be gratefully apprecated :-)

[pudster]

Hi Virgo

It gets confusing as some measurements are in USA and some UK.  Mine are Uk, I got them done at LFC.  I have started taking 25mg of micronised DHEA on CD1, its only been 3 days and I can feel my left ovary twitching, whats going on there!!

Pudster

[virgo2121]

Hi Pudster,

Thanks for that, I wondered why some are so sky high. Mine are done in Western Oz so unsure if that is the same as USA.
I decided not to start mine just yet becaue nobody had replied :-) I figured if I had to start them then stop after transfer for two weeks it may interrupt the build up and put me right back to square one. Here is hoping I wouldnt need them after all but if i do I will start on next day one. I have been advised to take 25mg three times a day which seems to be the usual dosage I believe.

I have just realised that i did not post all my results. I could have sworn I had done but here they are again:

SHBG  >200 nmol/L (26 -110) May be high due to Oestrogen???

FAI should have read <1  (0.51 - 6.5)

DHEAS 3.9   umol/L (1.65 - 9.15)

Androstenedione 4.3 nmol/L (1 - 11.5)

Free Testosterone 3.3 pmol/L (4.39) bit low so not sure what to do about that.

Testosterone 0.7 nmol/L   (0.2 - 2.9)

Virgo :-)

[PawSafe]

Hi All: I just wanted to add my success story (and ask for some SSBD!)  

I was 39 before we decided to have children.  We never "tried" much on our own, just went off the pill and right to the RE due to my "advanced age".  I quickly had 3 miscarriages (possibly due to clomid which can cause a thin uterine lining in many women over 35).  More cycles with injections, Gonal F, Folastim, etc.  Nothing.  We decided to try IVF (read: were pushed and bullied into it) even though I was getting pregnant fairly easily.  IVF failed, I responded poorly and had to go on the highest dose of everything possible to get a response and even then:  9 follies, 5 eggs, 3 good embies, BFN...  and I was now over 40.  We changed clinics and two REs would not even see me unless I used donor eggs.  (I was also doing acupuncture and various other alternative methods throughout this whole process)

I went to see a recurrent pregnancy loss specialist and put together a final plan since things were not looking good: 3 more injection cycles + DHEA 75mg (and a myriad of other supplements).  I chose the DHEA on my own and did not discuss with anyone.  The first cycle with half the dose of IVF meds at a new RE (who was pretty hopeless, TBH), I produced 13 follicles!  He was shocked.  So was I.  I was on DHEA for 60 days at this point but it's the only thing I changed and what a great change.  We did the IUI even tho I had so many follicles but still - BFN.  The 2nd cycle was in Sept of 07. I halved the meds again (on my own b/c this RE was known for getting women pregnant with way too many embies and 13 follies was way too many in my book - I also have a PhD and a lot of medical training and I figured I had nothing to lose anyway)  SO... this cycle was now at 1/4 the amount of IVF meds and I produced 4 follies.  All grew at amazingly similar rate, did the IUI and on June 4th, 2008, and I gave birth to a beautiful and perfect little boy at the age of 41.  He's now 14 months and I am 42 years.  AND...we're starting another cycle now that I have stopped nursing.  I found out last week that my inhibin B is 31.  That's *very* low, altho my FSH is 8.9 and everything else looks "good". The RE now wonders if my ovarian reserve wasn't an issue before and might account for some of my problems before.  Who knows what it all means.  Also, he doesn't know about the DHEA yet and is very negative about our chances for another success, nearly as bad as when I first showed up in his office 2+ years ago but he's an aggressive guy who won't give up until I say when so I like him  :)  

So, I am back on the DHEA with a vengeance and we'll see how things go.  I did get pregnant naturally a few months ago but that ended at 8 weeks so I am quite hopeful with the DHEA added back in, that things have a chance of working out again.  I can only do my best.

Notes:  

DHEA has had no side effects for me.  I am a psychologist in private practice and work with lots of older women with fertility issues.  I give them all info on DHEA.  Most of them use it and I rarely hear of negative side effects except acne and one woman says it makes her aggressive right before she ovulates.  I buy mine from Vitacost.com b/c they're cheap and the cheap kind seems to work the same for my clients.  It's all I've ever used.  Overall, I see so many good results, big changes in follicle counts, better pregnancy/delivery rates, etc. so I am a firm believer.  

Of my clients who discuss DHEA with their REs, the response it overwhelmingly negative and discouraging.  I used to tell everyone to be sure to talk it over with their REs after I gave them the info or web links but I don't suggest that any more since I've had clients who were warned that if they used DHEA the RE would no longer treat them.   A colleague of mine had clients be told by her RE that she would not be treated if she used fish oil (!) let alone DHEA.  That's just sad.  So, now I leave it to their own discretion.  In an ideal world everything would be open for discussion and consideration but the practice of medicine doesn't often work that way.  My clients also tend to be at the end of their ropes already and they don't need more negativity piled on top of the long list of failures most of them already have  -- hence the visit to the psychologist  :)  If they want to discuss it with the RE, great and if they want to do bloodwork, great.  For those of us running out of options and/or money, DHEA is a pretty safe and very inexpensive one to add to the arsenal IMHO.   I have not yet seen anyone use DHEA and have any problems.  

My injection cycles were with Bravelle and Menopur (also helps egg quality, I am told).  I have a 44 y.o client who is pregnant now with the same RE, same meds and the DHEA (has not told the RE about the DHEA).

DH has no issues and is a bit younger.

I believe the DHEA is the reason I have my wonderful and healthy son.   Just wanted to share a hopeful story with everyone and send out plenty of sticky vibes.    

-Deb

[Marinapos]

Hi Deb

Please could you advise me - how much of the injections were you on daily of the Bravelle and Menopur, and also how did you take the DHEA - did you take it all in the mornings or did you take 25mg three times per day.

[virgo2121]

Hi Pawsafe,

Congratulations and a great big thank you for taking the time to post this positive news here.

I am not sure if you are able to assist with an earlier query I posted (nobody answered my query :-(  ) Re the DHEA, do you continue taking it right the way through each cycle? I read that it is not to be used if pregnant but of course in the luteal phase we do not know if we are pregnant or not until onset of menses arrives Arrrghhhhhh.

I would be so grateful if you could respond or anybody else that knows.

Thanks :-)

[Kideol]

This forum is of such great info on DHEA.  
I am in Canada and my doctor believes that DHEA is the answer to my (and all his pateints) problems.
I have been on 75mg of micronized DHEA since December 12th 2008. I had a bit of acne and now 9 months later the acne is quite severe and unrelenting.  I can live with the acne.  My question is; is this an indication that I have been taking it for too long?  I asked my clinic to run a testerone test and it took many weeks to get the results.  And I was told to the Testertone level was fine.  I am going to press to get the specific details.  I am on day 2 today and will be going for my Day 3 bloodwork tomorrow.  My FSH levels are as follows:
January 26th  2009  14
March 4th 2009   15
April 8th 2009    9.1
May 8th 2009     10
June 8th 2009     8
July 4th 2009    6.4
August 11th 2009     9.5
I have had 3 chemical pregnancies; August 2008, November 2008 and January 2009.  I started DHEA 75mg/day since Dec 12th 2008.  And we have done 2 IUI since starting.  The 3 chemical pregnancies were all natural pregnancies.  We are looking to do IVF in the very near future as I was 40 in April.  I have taken Femara 2.5mg April, May, June and August.  I have not done injectables (yet) and am concerned about my testerone levels.  I will get the details tomorrow on my CD 3 bloodwork.  My question; with the facial ACNE getting worst is this an indication that I am on too much DHEA? Or have been on it for too long? 9 months!
I am also on CoEn Q10 800mg day (started May 19th 2009).
In all of your great experience and knowledge; is their an ideal time frame to be on DHEA before IVF?  Is there any contrindication of being on DHEA and Q10?  

[txgirl1070]

I've been taking 50mg of DHEA in the a.m. and 25 in the p.m. for about a month now. I was told I have POF, with an antral folicle count of two this past visit to the RE. My FSH was 13.4 and he was pretty brutal about my chances. I'm not ready to give up, hence my taking the DHEA. My husband and I will likely try IVF in December and I'm hoping by then the DHEA will have made a difference. Many thanks for your informative posts.

[LMA920]

Hi I am new but have been reading for awhile. Just had my CD3 tests done. I have been taking DHEA for 4 months. (75mg every am)

DHEA Sulfate 406
FSH 10.9
Progesterone 5.9
TSH .72
Prolactin 7.0

T hasnt come back yet.  Would love to know what you ladies think of these numbers. Is the DHEA too high? I am 34 yrs old.
Thanks!

[virgo2121]

A couple of months ago I posted the below blood results to see if anyone thought they were okay. Nobody replied. I now have had a further test after taking DHEA for two months (micronised). Are these numbers okay. My results are in oz so I guess the range is different..... please help someone.

TWO MONTHS AGO BEFORE DHEA:

SHBG  >200 nmol/L (26 -110) May be high due to Oestrogen???

FAI should have read 43 nmol/L (26 -110)

FAI = 10  (0.51 - 6.5)

DHEAS = 13.2   umol/L (1.65 - 9.15)

Androstenedione 14.1 nmol/L (1 - 11.5)

Free Testosterone 65.9 pmol/L (4.39) bit low so not sure what to do about that.

Testosterone 4.2 nmol/L   (0.2 - 2.9)

My prolactin was also 677 mIU/L (range = 25 - 628)

Would high prolactin be an effect of taking DHEA?

Please respond ASAP as I am starting another IVF cycle this week :-)

Thanks

[virgo2121]

Not sure what happened with last message but it all got muddled up.  Here are results again

TWO MONTHS AGO BEFORE DHEA:

SHBG  >200 nmol/L (26 -110) May be high due to Oestrogen???

FAI = <1  (0.51 - 6.5)

DHEAS 3.9   umol/L (1.65 - 9.15)

Androstenedione 4.3 nmol/L (1 - 11.5)

Free Testosterone 3.3 pmol/L (4.39) bit low so not sure what to do about that.

Testosterone 0.7 nmol/L   (0.2 - 2.9)

TWO MONTHS AFTER DHEA:

SHBG = 43 nmol/L (26 -110)

FAI = 10  (0.51 - 6.5)

DHEAS = 13.2   umol/L (1.65 - 9.15)

Androstenedione 14.1 nmol/L (1 - 11.5)

Free Testosterone 65.9 pmol/L (4.39) bit low so not sure what to do about that.

Testosterone 4.2 nmol/L   (0.2 - 2.9)

My prolactin was also 677 mIU/L (range = 25 - 628)

Would high prolactin be an effect of taking DHEA?

Please respond ASAP as I am starting another IVF cycle this week :-)

Thanks

[skooby_mom]

Does anyone know any REs in South Florida that are open to use the DHEA therapy? All of my teststerone levels were perfect so my RE said that it wasn't accepted in the field yet and he wouldn't go there with me.

Thanks

[SophieHopeful42]

Hi,
Thank you for posting your story and advice.  I am 42  going on 43 and I make eggs that don't grow larger than 7 to 9mm about 3 at a time. Once I grew a 20mm once. I am on Menopur injectables. I have done 3 cycles. We can't afford IVF but our insurance covers injectables so we are trying that first.  I also have hashimoto's disease. I would like to try the DHEA, but wondered how long you take it?  Do you take it through the pregnancy if you do get pregnant?
Thanks for answering.
Best wishes,
Sophie