I am currently waiting to start two back-to-back IVF cycles, with the first one starting in mid-May.
In an impromptu call, our consultant suggested taking DHEA, starting as soon as possible. He said he may not help in the first cycle (which will be in three weeks) but may help the second one (which will be in seven weeks).
I am of "advanced maternal age" (38 yo), had 9 eggs collected in my previous cycle (max medication dose), and I may indeed be a poor responder.
While I am not sure DHEA will have a positive impact (since I will take it for less than 12 weeks), I am also scared that it may be detrimental for egg quality, if not really needed -- I don't think they are going to test it.
Does anyone have any insight?
Also, any idea of the cost? They told me that the clinic can supply me with it.
Thanks in advance xx
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You’re best off buying it yourself from iherb in the US - so much cheaper. I get the brand MRM. When I started taking it I also started conceiving naturally. I am 37 and low amh. You are best off testing your own dhea levels on medichecks as it’s not good to take if your dhea is already high. If you order your test online now, it should come by Tuesday then you can post of off wed and should have results by Friday. Can also test your testosterone too, to make sure that’s not too high. This has all been discussed a fair few times over the last month or two and you can share your results on here for advice. Good luck!xx
What happens if I take it and my DHEA level is already high?
The problem of testing is that if I lose a week for the test, and let's say a week for sourcing it, in the end, it will be useless because I will take it only for one and five weeks, respectively (six seems to be the minimum to have an effect)
Hey lovely. I get your query and the timeframe you are working towards. Others who have actually taken it will also have insight I’m sure. I looked into taking this but I wanted to test my levels before doing so. I used medichecks to check my levels and as I was in the normal range, I, personally didn’t want to take any more. I was concerned with messing with my cycles or having any other effects whilst heading into a cycle. My personal opinion of course. Good luck with your decision x
If I may ask, was it suggested by your consultant? What was your AMH/FSH? As I was answering BBHH1 below, most of the studies show positive or no effect (never negative) but were always in poor responders.
What effects were you scared of? I am very worried regarding embryo quality (it has always been low in my previous cycles and I don't want to make it worse).
No my consultant did not suggest it. They wouldn’t recommend any supplements to me. Some people have had adverse effects to DHEA on here and I’ve taken supplements before that have made me ill and also affected my cycle length. DHEA is only recommended for a short period of time which suggests it does have an effect on the body and knowing my history with drugs and supplements it would probs be me! Everyone reacts to things differently. As I didn’t need it as my results showed I was in the normal range, I decided I didn’t want to risk it. Like I say, some people have taken it and think it’s had a positive effect but it wasn’t for me personally.
I see what you mean. I am really crossed by this. My consultant told me that it may be useless due to the timeframe, but never spoken about being harmful (but I did not openly ask). The nurse said that the side effects are limited, and mostly in people which had also side effects from stims (which I had not, despite being at the highest possible dose in my last cycle).
Thanks a lot for your answers, I will dig more in the forum to get stories from the women who took it xxx
That’s interesting about only reacting if you reacted to stim drugs. I’ve had just about all the side effects going from IVF drugs I think as I seem to be very sensitive to drugs. My last transfer knocked me completely for six. If you’ve been fine then poss worth considering for you. Good luck x
I have been very lucky regarding this, the only problem I had to face was constipation, but this was kind of easy to solve!Just saw that you are currently pregnant: congratulations!!!
Most studies show improvement nothing that have shown to be detrimental. It can always hurt someone on the way but chances of helping are much much greater than hurting. It’s worth it to take it. Best
This is exactly what I was reading, either improvement or no effect, but patients on DHEA have never show worse results than controls -- as also suggested by the consultant.
However, most of the studies were carried out on individuals with very low ovarian reserve (AHM < 2, mine should be ~9) and/or high FSH (mine is <7). What confused me is that in this forum most of the people seem to test it and I started wondering whether taking it with levels in the normal range was problematic, if you know what I mean.
If I may ask, are you taking it? If yes, what is your AMH/FSH?
I tested before, my androgens were low. I responded well and now they are very high. Which seems to be good. I’m more in the category of lower AMH and higher FSH than you are. So for me it was a no brainer. I agree with your concerns from your blood tests but also you are 38yo, so...
No one will be able to give the perfect answer to you, it’s about what risk you are more comfortable taking...
The real problem is that I don't know the risks of taking it when not needed -- I cannot find any study on this and the timeframe is really stressing me, which makes me also completely unable to think clearly! So far, I cannot find any risk in taking it when needed -- which is good!
"but also you are 38yo, so..." this is also what my consultant said, I should have asked whether it can be harmful but I was too overwhelmed by the call, and never investigate or thought about DHEA before 🤯
There is no evidence that it harms, but also no proof that it doesn’t. You did not find reassurance in the studies because there isn’t. You’ll have to decide with that knowledge. It sucks but it is what it is. For what it’s worth you are likely to responde well to meds and have good chances regardless. So look at the bright side!
Well, info non disclosed before: considering my history I am not going to respond well to meds, and I will not have good chances -- this will be my fourth fresh cycle, with 8 embryos previously transferred leading to 1 miscarriage at 6w+5, 1 chemical pregnancy, and too many failures. Last cycle (and the next one) I was on the highest medication dose possible, and what I got were three low-quality embryos and further failures (sorry for the rant).
Knowing that you had that many failures then I think 100% you should take DHEA. I would go further and say I think you should wait to start the cycles after taking DHEA and CoQ10 for 6 weeks. It does not increase numbers but quality of embryos. You already tried enough without it. Potential benefits outweigh the risks, good benefit risk ratio.
Make sure Vit D is good.
Do early retrieval lead follicle 16-18mm.
Fresh day 3 transfer are better for low prognostic patients
Look at all immunology, thrombotic factors and endocrine problems.
Male factor rule out
Genetics of you and partner, not the embryos no PGA
I have already tested VitD (good levels, I am also supplementing it, so I guess this helps), thrombotic factors (taken Clexane on my previous transfers), endocrine problems (euthyroid with anti-TPO Ab, I'm currently on levothyroxine), and both myself and my partner have a normal karyotype (at least that!). I have been on CoQ10 600xday for the last 15 months.
The plan to do two back-to-back cycles (possibly three, it will depend on the final costs for these two, which are still not clear to me), followed by the ERA/EMMA/ALICE test (the last tests I miss) and then start transferring all my not-PGS embryo (call me a fool, but I don't trust PGS). Really not sure whether I should postpone this by one month, both consultants I spoke with were adamant about starting ASAP.
I am a bit sceptical of immunology, but I may throw this as well with the ERA test, just to be on the safe side.
You are not a fool and not the only one to not believe in PGS.
For me ERA does make sense. The implantation window is a few days and a changing transfer a couple of hours won’t change anything.
I think ASAP once you ovaries are optimized with DHEA. It’s worth it to wait. Fertility decrease slowly and that one month it’s not a big deal, the DHEA effect will more than compensate for that.
Immunology it’s a real thing and you should test for antiphospholipid syndrome. It is a recognized factor and treatment has shown to help. NK cell very controversial and I wouldn’t do it.
Think about it again, fresh is better and with your history you can transfer 2-3 embryos at once
I've been tested for antiphospholipid syndrome, that how they found my clotting issue and put me on Clexane.Ragarding ASAP. I will think about it.
In the UK the max number of embryos one can transfer is two, but it is recommended to stick with one if having antiphospholipid syndrome (still transferred two at my last cycle because the quality was so poor...)
You can undoubtedly have a worse cycle if you don't need dhea. Important to get levels tested first. Ive done four cycles (I have high amh aged 40), I had the least amount of eggs in cycle 2 taking dhea in cycle 2 (age 38). We ended up with 13 eggs and only 1 blast. Whilst I did get pregnant, it ended in mmc at 9 weeks. All my other cycles not taking dhea I've had on average 19 eggs a cycle. X
Thanks for shared. So you took DHEA for your second cycle getting the worse results? Did you test your level before taking it? May I ask what was your AMH? We have the same age (I am also 38).
Just watched this centerforhumanreprod.com/do... abd read their studies they think it really does improve quality of eggs and give to all women over 40
Thanks for sharing! I am still <40, but my response has not been great, mostly regarding quality (quantity should be ok for my age, with 3x5days embryos collected at my last cycle.). Have you taken it? Where your level tested?
Have not taken it as I am having a cycle right now and only just find out about it if this is BFN then I will defo be taking it as I am 41 42 in 6 months
I will ask dr to check my AMH levels again and ask if they are low but will defo be taking just trying to find out about dosage prob will start with 25mg per day
I have read on here before that with dhea levels testing, your ‘normal range’ will be for your current age and the actual point of more dhea is to get your levels to a normal range for a woman i her 20s, which is much higher than a 38 year old. I’ve not fact checked this but have heard it a lot.
I took dhea for back to back cycles and like you, started taking it too late for it to have an effect on the first cycle. Our second cycle by far was the best in terms of 5 day embryos, but perhaps more interesting is that we pgs tested our embryos and the proportion of viable embryos was far better in the second cycle. So I believe it helps quality, at least it did for me. Also the cycles were better than the cycle I did when I was 34 (amh was 22). I’m 38 now and amh is 7.
It makes sense, and I think this is why my clinic doesn't test it: levels at 38 would surely not be "optimal". If I may ask, for how many weeks you took it for your first and then for your second cycle? Did you do any other changes in the protocol? Was the first cycle still better than the one you had at 34? Someone here suggested postponing my back-to-back cycles to let DHEA have an effect, but my consultant wants me to start ASAP.
I can’t quite remember but think it was 3 or 4 weeks before the first one then 10-12 or so weeks until the second one. The first cycle was similar to my cycle at 34.
34 - 10 eggs ... 6 blasts ... one baby
38a - 8 eggs ... 5 blasts... 2 pgs normal
38b - 12 eggs... 7 blasts... 4 pgs normal
I got pregnant from the first try with the pgs embryo.
My clinic also had me taking zomacton growth hormone in the back to backs.
I really don't know what to think about this. I skimmed through the literature and (as usual) while some studies identify an increase of live birth (that is the outcome I care about!) other just observed increased clinical parameters (number of eggs collected, fertilisation rate, quality of the embryos...). Plus most of these are in >40yo with very low AMH (<2).
Besides cost, does growth hormone have any risk? Someone here in the forum spoke about carpal tunnel (?) and I read an increase of some kind of cancers (but I would take it for such a short period).... Did your consultant mention anything?
Good questions - to be honest I just went with my clinic as they have such great success rates and I didn’t want it to not work and then look back and say, I wish I had done x, or y. You know? I didn’t read too much into it aside from being fairly educated about what I was taking. I honestly do still think it would have worked out well for me had I not taken them. I guess it’s totally optional and perhaps something to keep in mind for the second of the back to backs if you feel you need? It’s so so hard to make decisions on everything isn’t it. Xxx
That's a very wise suggestion. I may discuss this during the review of my first cycle! What clinic were you with? I think you may need to PM this info, otherwise will be advertisement,
Hey, can’t help on the dhea but noticed you said you’re on levothyroxine. It’s really worth getting your levels checked if you haven’t already. Although the official guidelines say tsh should be under 2.5 my endocrinologist has said under 1 is better. You also need to increase dose by 25mcg as soon as pregnant as baby requires extra - has that been mentioned to you? Good luck!
Yes, my levels are tested every three months and have always been around 0.7 (last time they were 0.3!) The GP also told me I will be tested again as soon as I get pregnant! Thanks for pointing this out! xxx
I did a cycle before taking dhea and had no eggs at egg retrieval. After taking it I got three embryos and got pregnant (ended in miscarriage). I think for me it has helped. I have been taking it for a year now. I am 37, poor responder and low amh. Starting a new cycle next week hopefully. I also take curcumin, ubiquinol, profertil, vitamin d, vitamin c, zinc and magnesium. I never tested dhea levels as clinic never told me to but after reading people's comments I will ask if I need to. From my experience it has helped me.
Thanks for sharing and sorry to hear about your miscarriage. If I may ask, for how long have you taken it before the cycle that gave you three embryos? xxx
I've been taking DHEA for approx 6/7 weeks now and although I haven't had a round of IVF yet since taking it, I have noticed my cycle this past month become regular and I also ovulated which has never happened naturally before so it must be doing something good. I've got diminished ovarian reserve, thyroid antibody, endometriosis and I'm 32 - hoping it helps for my next ivf cycle in August (this will be my 3rd cycle).I'm sorry this post isn't an awful lot of help, but I just wanted to let you know that I have noticed positive changes in a short space of time. Good Luck and keep us updated x
No, my consultant didn't suggest it, I suggested it to him but he just dismisses everything (I'm NHS funded and feel like I'm just on a conveyor belt, I don't feel my consultant is that bothered). My last consultation with him to sort out a plan for ivf lasted less than 6 minutes so I'm just taking the dhea without my clinic knowing. I did start on 3 x 25mg per day but my skin went very oily, and I was getting spots so I felt that might have been an indication that my dhea levels were to high so just take 25mg per day now. Hope this helps. Xx
I am taking DHEA after two cycles with no viable embryos. I’m a strange case though as I have a very high AMH due to pcos, so it’s purely quality. To be honest I’m trying this before I move on to egg donor. My third stims cycle starts in 2 weeks. I did test my dhea which was on the low side of normal, so I started on 50mg, then it went sky high so dropped to 25mg, then when tested was still a little high so dropped to one 25 every other day. I’m hoping this will still help, I think it’s better to be in normal range than too high, who knows what that’ll do to a stims cycle. All my testing done through medichecks and cross checked by private endocrinologist. Can you call the clinic and say you’d be more comfortable if you had your dhea monitored? And ask more questions on what happens if it goes sky high? Xx
Was DHEA recommended for you? My understanding is that DHEA is contraindicated for PCOS. I think for PCOS it is meant to be harmful as the issue is too much androgens and DHEA is an androgen. The reason they found DHEA was trying to mimic the high recruitment found in PCOS patients - thought was androgen supplements would give non-PCOS patients better egg recruitment.
The reason why some check androgen levels before using DHEA is to rule out undiagnosed PCOS or other high-androgen disorder.
Hi, I have PCOS but not high androgens (I also don’t have high egg recruitment as a result) - It’s not always the case. People with lean PCOS often actually have low androgens, and the CHR in the US regularly use it for PCOS patients. My endocrinologist confirmed my androgen levels were on the low side of normal and worth a try taking a small monitored dose to see if it helped. My androgen levels have been under control. I’ll use it this cycle and see if it makes a difference, if it doesn’t, I’ll stop. My cycles have been so rubbish I don’t feel I have anything to lose at this point! Thanks 😊
The way that DHEA works is to increase your testosterone level. So if your testosterone level is normal and you take DHEA, there is a risk of your testosterone level becoming too high. High testosterone levels can have a detrimental effect on the developing egg. So it’s not right to say that there is no risk of harm in taking DHEA. Most of the work looking at use of DHEA for fertility has been by the Centre fir Human Reproduction in the US, they have some very good info on their website. In the US it’s common practice to check DHEA and testosterone before starting DHEA, and during taking it to monitor levels. Unfortunately this is not common practice here in the UK, clinics either say don’t take it, or just take it. I read up a lot before taking DHEA, I started taking less than the widely recommended dose of 25mg three times daily, I started on 25mg twice daily. When I checked my levels after starting my testosterone was very high. I eventually ended up on 25mg once daily to keep my testosterone level in the right place. A lot of people order from Biovea and it can come quickly in some cases (though with both iherb and Biovea it can also take a long time to get to the UK).This is quite a good summary of the use of DHEA - itstartswiththeegg.com/faq/...
I took DHEA for over 12 months in the end, and through 3 dismal IVF cycles. I would take it again but for me, along with all the other supplements I took, I don’t think it was the magic bullet I wanted it to be...
Thanks for your answer. Can you please point me to something about the fact that high testosterone can have a detrimental effect on the developing eggs? I am also on a lot of supplements, and honestly, I am not sure any is doing any good... xxx
And this talks about the effects of high androgen (testosterone) on follicles and eggs, as seen in PCOS. Obviously I’m not saying you have PCOS, but in PCOS testosterone level is high and this is what you would achieve if your dose of DHEA was higher than what you need - centerforhumanreprod.com/fe...
Also just wanted to say, I am a vet, I read an absolute ton of papers on DHEA before deciding to take it myself. If you mr testosterone level is low, I think it’s worthwhile taking for sure.
I started taking DHEA in early November after my first OVF cycle in October in preparation for my next IVF in Jan/Feb. I am 44 with an AMH of 6.9. My first cycle only yielded 5 eggs, one of which was immature. 3 fertilised and only one got as far as making a very fragile poorest quality almost blastocyst. We had planned to do PGTA testing as wanted to try to avoid another miscarriage due to chromosomal abnormalities but this almost blastocyst wasn't good enough quality to be able to test or freeze and because I hadn't been taking progesterone we couldn't try transferring it. In the end it arrested overnight on Day 5 anyway. I then read It Starts With The Egg and agreed with my consultant that I would take DHEA, Impryl, Omega 3 and vitamin D. I also upped my intake of Q10 to 300mg twice daily. My second cycle resulted in 6 eggs, 2 of which were immature, 3 fertilised, 2 made it to blastocysts and were transferred. Sadly I didn't get pregnant though. Cycle 3, we tried New Hope IVF or mild/Gentle IVF which is meant to give fewer eggs but better quality. We got 3 eggs, 1 of which was immature, 1 of which fertilised properly and resulted in a top quality embryo which was transferred as a Day 2 transfer but sadly didn't get pregnant. I certainly feel that the supplements I have taken have improved my egg quality from that first cycle. How much of that is DHEA I couldn't say. I have my follow up call with the consultant tomorrow where he will tell me I am old and pretty much past it and I will ask him lots of questions including whether it is safe for me to continue taking DHEA. The only side effects I have heard of are great skin, spots, dark hair on face etc and deeper voice and increased libido and happiness. I have had the increased libido and slightly darker fine hair above my lip but nothing I can't bleach or wax away easily and the occasional spot. They do also make me feel happier which is a bonus. I am worried about the deeper voice especially for singing but I hope this would just be a temporary thing. If I was getting all those side effects though, I would think I was probably taking too much. Definitely worth speaking to someone at your clinic about it and getting tested if there is a definite level to compare it with. All the best with the rest of your journey xx
That should be IVF not OVF and greasy skin not great skin! Overall I am pleased I took DHEA. I will only be asking about continuing to take it because I will have been on it for 6 months.
Thanks for your long answer. Yes, it is very difficult to say whether different results depend on the supplement we are taking (and on which of them, I am also on a big cocktail of pills) or in changes of protocol, or in randomness (as my doctor believes). I have already a deep voice and some dark hair on my chin, I hope this doesn't mean my testosterone is already high... I also hope that DHEA will not make it much worse. On the other hand, I will welcome extra libido and, even more, happiness.
I will speak again with the clinic tomorrow, hoping my doctor is available!
Not had ivf but I decided to take Dhea I had no tests prior I had 2 mc before and I was 37/38 I took lots of supplements ubiquinol pqq etc I took for 3 mths and conceived the 3rd mth after my last mc but I found this pregnancy the weakest of the 3 I again mc at 12w but I had some bleeding on and off the sac was abnormal they couldn’t find the yolk sac at first thought it was ectopic.
I can’t say it was the supplements either way I think they possibly helped to conceive quicker but didn’t help with egg quality. I got fertility tests after I have a low amh so guessing was ok to take.
But I’ve since conceived at 40 naturally taking nothing.
It's a difficult one, especially for older women. I was on the verge of taking it but had my levels tested with medichecks and I'm within the normal range (currently awaiting my testosterone and blood glucose NHS test results). As its an actual hormone increasing it unnecessarily may do more harm than good. A while ago I sought advice on this forum and was told it can increase facial hair and cause insomnia if taken when not needed. I spoke with my NHS consultant who said he wouldn't even recommend it if my levels were low as the data isn't conclusive (not sure I agree but my levels were fine do I'll hold off). Defo have it checked independently, one thing I've learnt is to arm yourself with information, ask questions and challenge anything you feel uncomfortable with xx
If the problem would only be extra facial hair and insomnia I would be happy taking it. My actual worry is that it may decrease the embryo quality (not even sure where this paranoia stems from). This is a really tough decision that need to be taken very quickly (and my brain doesn't work well under stress)
Those are just the external side effects, not sure what it does internally if you don't need it, possible more bad than good. Medichecks has a quick turn around via post or you can visit one of their practitioners to have it tested. I'd strongly suggested doing that (unless your clinic has already tested for it). Hormone balance is extremely important when ttc.
This is really interesting as I have had the same thoughts lately I have just started on dhea for my next IVF around. I'm 38 with low amh and don't get many eggs.I did test my levels first and they were on the low side hence supplementing. I started off with just a very low dose 25 every other day and my testosterone skyrocketed so I'm now just taking it twice a week and we'll get blood test results soon
. I have seen on forums that a lot of consultants to advice to take it and they don't say to test levels so I have the same thoughts of you as how harmful can it be then if consultants are advising 75 mg a day without testing? but then I am on a few forums and everyone says that too high testosterone levels are bad for your eggs that's the main reason not suitable for everyone.
Too much dhea can cause testosterone to get too high and negatively affect the quality of your eggs I think it comes from PCOS women having high levels of testosterone and supposedly poorer quality eggs but then I see PCOS women get really good quality embryos all the time. It would be good to see studies or evidence of too much testosterone being bad..
I quickly looked at the literature but I could not find any study on testosterone and embryo quality, only studies supplementing testosterone in poor responder and noticing, sometimes, an improvement -- but this is not really answering our question xxx
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