Hi all, I've just had a BFN from my 4th cycle. We only had one embryo, and it was a day 4 transfer.
Previous to that, we froze one embryo from a previous cycle. My 3rd round was cancelled due to poor response to meds (we tried a new stim, and my body didn't like it).
First and second rounds were NHS and resulted in 4 eggs, none fertilised and 6 eggs, 2 fertilised, two transferred at day 2, BFN.
This will most likely be our last try as I'm now 41 and there are slight improvements with each round, but I'm beginning to feel we're throwing money away on something that may never work.
I've had my DHEA and testosterone levels tested, which were both fine, but I'm now wondering if I'd still benefit from taking a small dose and monitoring my dhea and testosterone levels every 4 weeks.
We planned the next cycle for May/June so that we give our bodies a chance to renew and give DHEA a chance to take effect.
I wanted to know if anyone a similar age to me and amh (just under 4 pmol) saw an increase in follicles/eggs/embryos.
I was always a firm believer I wouldn't take it as I didn't need it but after reading a few studies, it seems worth a shot.
What is everyone's opinion?
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ebonyebene
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So sorry for your BFN... it just gets harder every time, I know 😢 DHEA is an interesting one... and tricky, even just to get hold of it seems, after the post yesterday about having police cautions for trying to bring it in!! I took DHEA properly after my 3rd cycle wasn't great (this was in June last year). I'd had a real drop in terms of follicle development from my 2nd cycle which was 18 months before that, so was worried my (already fairly poor!) fertility had really dropped off a cliff. I wanted to see if I could get a better result for our 4th try, and asked the consultant about a few things. He dismissed some of them but did say DHEA was worth a try, if I wanted to give it a go, as although there is no good evidence it does anything, he's anecdotally seen women in early 40s have good results on it. So I decided why not. From what I read, the usual dose of 75mg per day seems to be too high for lots of women. So I started off on 25 a day for a couple of weeks, then went up to 50 a day, and every few days I'd take 75. Not v. scientific! I tested my DHEA level with medichecks home test, towards the end of August, and it came back at 10.5. That's actually what I was aiming for, not to have average levels for a 40 year old but to RAISE your levels to what is normal for a woman in her 20s. So when I got that level I reduced down to 25 a day again, just to maintain it. But as I say, it's a bit controversial: some women swear it was a game-changer for them, some take it and don't see a difference, some take it and don't get on with it at all. If you do take it, I'd definitely get yourself a test to monitor how your levels are doing, as you don't want to go too high and knock-off other hormones. I took it 'properly' for about 10 weeks, which I think is about what they recommend (a month, for instance, isn't enough, they say). I did a few other small things for my cycle in Sept/Oct, but this was the main change, and it was actually my best cycle yet. So I do wonder if the DHEA was the main factor behind a better egg development and fertilisation result. I've still not had a BFP, and am waiting for the result of extra tests before we transfer one of the other 2 frozen. But the fact we got 3 to freeze that cycle which is by far the best result I've had (though who knows, could be total chance!) xx
What you've written is exactly how I was going to approach it and the same rationale.
I'm hoping it's a game changer as I can't physically and emotionally take anymore and want to move on with my life.
The inconsistent advice on its use by consultants is also interesting. I've found many are quick to recommend PGTA testing for older when there isn't much evidence to support its conclusive and the only evidence available is for women under 37 yet with a drug like this, which I'm my opinion has the same amount of evidence, its not widely recommended. I wonder if this is because a clinic can't profit from the use of this drug or contribute to wider research needed for PGTS testing for older women.
I've spoken to many older women on various platforms regarding all aspects of treatment and a few specialists. I usually believe the opinions of older women over specialists because we've done a shit tonne of research on everything possible and have to face discrimination from clinics due to our age so we literally hit the ground running ready to challenge and try anything.
When you're over 40 clinics tend to push DE without exploring other options because it affects their stats.
Hopefully I can start DHEA after my bleed and monitor its effects closely.
Thank you so much for your detailed response; it helped me make a decision.
I am tempted to agree that the clinics push PGTA and my cynical mind also says, it's for financial reasons... they need these add-ons to make more profits. I mean, look, if you have 5 or 6 embryos waiting for you then it might make sense to test them all and avoid the expense and heartache, but for lots of older women, if you did the testing for each a) it costs a fortune and b) you might never transfer anything! Plus there is so much scepticism about how reliable the testing is. Whereas DHEA, it's pretty cheap, and my view was, why not. I agree with Daisy below though in saying it's always best to let your clinic know you're taking it. My consultant didn't go to the level or suggesting a dose or procuring it for me, that was all on me, but he did know (and as above, he actually said off-record it was worth a try if I wanted to go for it, as he had similar cases to mine where it seemed to really help). It's one of those things where people have SUCH different views. If you search past posts on DHEA, you have those who absolutely love it and believe it's what got them their baby, but you also have cases where it really caused people problems and even stopped them ovulation for a while etc. So definitely one to take with caution but I know you know that 😘 It's all very hard, even yesterday I was reading another post on here recommending supplements I've actually not even heard of, and immediately I was like right, I gotta get this! 😆 I also totally agree with you that clinics definitely push DEs once we reach a certain age, and it's hard... I know it's likely that most of my eggs are rubbish, but if only there was a way to know for sure without paying a fortune to test embryos and then having them possibly scrapped when they might actually have made it if not deemed 'abnormal' under PGT 😩 xx
1000% with everything you've said. I've informed my coordinator of our intention to take it, and of course, she's stated there's no evidence to suggest it works.
I'll defo let my consultant know, start on a low dose and monitor my bloods.
I had a look at my previous test results for both dhea and testosterone serum which were actually good but not optimal so I'm hoping with careful dosing and lifestyle changes it'll put me at the top end of the ranges for both.
If your levels were normal I personally wouldn’t take it without your consultant telling you it’s ok. I took it without it being prescribed and had terrible trouble. I got really greasy (skin and hair) then my hair started falling out, I had terrible insomnia and my cycles went mental. It was awful and took about six months to fix
It’s a powerful drug and shouldn’t be messed with x
This was why I refused to take it before; I was scared it would completely mess with everything else. Did you test prior and during taking it? I plan to start a very low dose with frequent blood tests; the minute it's elevated, I'd stop.
Hi ebonyebene sorry to hear the bad news 😕, I am more or less in same boat.At 41 we started IVF privately and first stim went ok but not great, only 3 eggs of which 2 fertilised to day 5.
We were doing batching + PGS so rested a bit and then had another mild stim cycle of which 3 eggs were collected and 1 reached day 5 blastocyst.
Third cycle I introduced DHEA and CoQ10 but wasn't really advised to monitor it so was taking 75 per day and at a certain period red patches started appearing all over my body and no itching or anything but just seemed wrong to me and clinic couldn’t even tell why was it happening.
My egg collection was in few days so I didn’t stopped but out of that cycle I got only 1 egg which didn’t reach day 5.
So after 3 cycles + PGS i was left with 2 embryos. One FET (Bfn) and one more try left.
The cycle I put all in resulted with less eggs and even less quality and not sure was it of my age or was it because of too much medication for too long for me.
🤨
But it’s worth trying I would say as long as you monitor closely your blood levels and get the approval from your clinic/consultant.
I agree, is so hard to tell whether supplements or poor egg/spem/embryo quality ate to blame for a BFN and trying to get to the bottom of it is expensive, time consuming and even when you have private treatment it seems consultants don't offer much advice as to what can be adjusted and just blame poor egg quality.
I've been on loads of supplements for nearly 18 months and feel I need to scale back a bit and concentrate on the main ones since I'll introduce DHEA.
I’m the same age as you and I’m actually pregnant on my second FET. Sad thing is I don’t have a record of what my AMH was all I know was that it was fine. We got a round free on nhs due to my partners sperm quality being up and down. Is the issue you think definitely with you and not him? Given you had embryos and none fertilised (and I guess they didn’t try icsi) it seems like you might have an issue with the sperm and eggs - I don’t know much about genetic issues but there are a lot of people on here that mention nk cells and what can be done about it. Have they not suggested testing the genetics? FYI my ivf was done at 39 I had 10 eggs 9 fertilised, 3 made it to 5 day blasts, but all got frozen as I had polyps. But still my age was not too far from yours. If AMH is low there are apparently things you can do - it starts with an egg is a book people have recommended
AMH is one of those indicators clinics love to focus on to determine sucess when there are so many other indicators.
Our issues are essentially egg quality because of my age and my hubby has poor motility and morphology so icis was always done.
I've read it starts with an egg and have been on loads of supplements and drastically changed our lifestyle. To a degree it worked with my second NHS cycle and I got 15 follicles but because I was 4lb overweight they denied treatment. It pretty much went down hill after that and stress drastically reduced my follicle count the following month.
Have they tested your eggs to find out if it’s poor egg quality? You can definitely improve egg quality by losing weight (I’m afraid it is quite a factor) - caffeine is also a bit fertility offender. Your partner can improve his sperm by exercising, multi vitamins and walnuts and Brazil nuts are apparently good too. It’s really annoying you got to the stage of growing follicles then they denied treatment!! They should have worked that out sooner. I hope you have some luck soon 🤞
To my knowledge, there isn't a test to determine egg quality; kind of depends on how and if it fertilises and on what day an embryo arrests. I also think weight can be an issue if it affects your hormones as plenty of plus sized woman get pregnant naturally.
Unfortunately I went to drastic measure to lose weight which, in hindsight, I'd never recommend or do again.
Hopefully with the changes and dha we'll get a better results for our last round.
Hi ebonyebene! I am not familiar with DHEA since I haven’t used it, but I was a poor responder like you.. I was 39 when I did all 3 rounds of IVF. First round - 4 eggs, 1 blastocyst, BFN. Second round- 3 eggs, 1 embryo on day 3, BFN. Third round- 4 eggs, 2 top quality blastocysts and one of them is my precious baby boy born 4 weeks ago! In all 3 cycles I was on 450 of menopur and the only difference in the 3rd cycle was 2 tablets of dexamethasone of 0.5mg each day during stimulation, according to this article. academic.oup.com/humrep/art... I was investigating steroids due to high NK cells that I have, and I have found the research that shows that steroids also help the stimulation in low responders. I am quite sure it helped me with the overall quality of my eggs in that cycle. I continued taking the same dose in the 2WW and after getting BFP, I switched to prednisolone of 20mg until 12 weeks.. I am pretty confident that thanks to dexamethasone & prednisolone I became a mother. Good luck!! D.
Thank you, I'll defo have a read of the article this weekend.
I'll also look into NK cells, too. it's such a minefield and others have said instead of going through all the tests, just see if you can get steroids and antibiotics to kill any potential infection.
I'll defo look into those tables as well, someone also recommended estrogen priming too.
i am a bit of a DHEA flag bearer on this website well, firstly, regarding the data - it is pretty strong! I analyse medical data as part of my job and there is an analysis of 8 trials that shows a signficantly increased rate of live birth in patients taking DHEA. In fertility studies, this is actually super hard to show and so I find these results quite impressive. I can send you the link if you want. On a personal note, i took it after a pretty bad round at the age of 42 even with quite good amh - my next cycle after 3 months of DHEA was noticeably better and resulted in my son, who was born when i was 44 years old. The same thing happened for my friend who got my leftover pills - she had a history of recurrent miscarriage and was also 43 when she took it and after 3 months of taking it she was pregnant with her son
I would also say - take the dose that was studied in the clinical trials (25mg three times daily, or if you have bad side effects, then 25mg twice daily can also be somewhat effective) as it needs to be at a certain strength to work. It doesn't matter that your DHEA levels are normal - that was not a factor for inclusion in the studies so it obviously is not something that the researchers thought was important. And also, make sure it is micronized. Good luck!
There is also a clinic in then US (CHR is its name I think) who specialize in treating older women, and they really think that for older women you need to treat the ovaries for a few months before retrieval. They also do this thing called early egg retrieval which seems to have had some success in older women (at least 43 years of age): ncbi.nlm.nih.gov/pmc/articl....
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well, firstly, regarding the data - it is pretty strong! I analyse medical data as part of my job and there is an analysis of 8 trials that shows a signficantly increased rate of live birth in patients taking DHEA. In fertility studies, this is actually super hard to show and so I find these results quite impressive. I can send you the link if you want. On a personal note, i took it after a pretty bad round at the age of 42 even with quite good amh - my next cycle after 3 months of DHEA was noticeably better and resulted in my son, who was born when i was 44 years old. The same thing happened for my friend who got my leftover pills - she had a history of recurrent miscarriage and was also 43 when she took it and after 3 months of taking it she was pregnant with her son 
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