Tag Archives: DHEA

The DHEA Debacle

04 Thursday Jan 2018

Posted by in IVF #5, Uncategorized

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DHEA. It’s that supplement that’s often touted as a magical egg quality enhancer, and it seems there’s some good research to back that up. That doesn’t mean it’s good for everybody, and I’ve learned that the hard way.

I first read about DHEA in the book, “It Starts with the Egg,” which is a great book for women who are looking to improve egg quality and enhance fertility. Like every good student, I diligently read every word. Still, I was uncertain about DHEA as I knew it impacted hormones. My doubt was quickly set aside when my RE recommended I take it, along with a laundry list of other supplements, to help improve my egg quality when I first went back to him to begin the IVF process again at age 39 (and 8 months). I assumed that because my RE told me to take it that I should. Not really my smartest move. The problem is that my RE never tested my testosterone, which DHEA can increase.

I didn’t think much about it during my first IVF for baby #2. We got a PGS normal embryo and I thought all was well. After the FET failed we went right into another egg retrieval. When that one was a bust – resulting in zero blastocysts – I began wondering about my testosterone level. At the consultation to prepare for yet another egg retrieval I asked my RE about testing my level and he said we could. Then, unexpectedly, we changed protocols and started stimulation meds that same day. So there wasn’t any time for testing. During a monitoring appointment I asked the physician assistant who was doing my ultrasound if we could get that test done, and she said that it wouldn’t be good to do mid-stim cycle because my hormones would be all over the place. After that one failed too, I brought up the topic again with my RE. That time we had time to test as I waited for my period to start. I got the results on cycle day 1, which was also the day I began my meds for this current round of IVF.

When the results came back they were high. My intuition was correct. Honestly, I was irritated that they never bothered to test this before and I regret not testing it from the very beginning. The RE instructed me to stop DHEA cold turkey that day. I was told that high testosterone “could” suppress follicle growth and “possibly” negatively impact egg quality, though there aren’t definitive answers on this. He also said that my testosterone level would drop back to normal quickly, so that by the following week when my follicles are doing the majority of their growth, there won’t be a negative impact. What I didn’t ask was, “is the damage to my egg quality already done?” I’m thinking that since eggs take about 3 months to mature, it might not have been good that for the majority of those 3 months my testosterone was high. But I don’t know what, if any, impact testosterone could have at that early stage. I’ll hold that question for the next consultation if it comes to that.

I decided not to worry about this as I’m going forward with the cycle anyway, since the potential impact is really an unknown. There’s nothing I can do about it now. I’m hoping that I stopped in time to mitigate any significant harmful effect, and keeping my fingers crossed for finding that golden egg.

Tonight is my trigger shot for a retrieval on Friday morning. We are expecting about 7 eggs based on my follicle count and size. I feel like an old pro at this egg retrieval thing, but I hope this can be my last one.

Flexibility: The IVF Way

03 Tuesday Oct 2017

Posted by in IVF #3

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Just when you think you have a plan and feel comfortable with what’s coming, at least in terms of IVF, something changes. IVF is truly a lesson in flexibility and patience. As I type this, I’m on cycle day 37 just waiting around for my period to start so that I can begin my stimulation medications for IVF #3. I never thought I’d see a cycle day 37. In fact, through the years of dealing with infertility the longest cycle I’ve had was 29 days. So I didn’t see this one coming. Because I’ve never had the experience of a lengthy cycle or missing periods, I didn’t even know that there was something my doctor could do to jump start my period. It just wasn’t on my radar. Finally, after sending my nurse email after email saying that I’m still waiting, she mentioned that I could come in for an ultrasound and get some help to start my period. And my first thought was, “Seriously??!! Why didn’t you tell me that a week ago?”

 

There’s something cruel about waiting for your period when what you really want is a baby. For someone like me who isn’t used to this, unlike my infertile sisters with PCOS, a late period is what we’re all hoping for – the more days that pass with no bleeding, the more hope you have that you are pregnant. So despite my best efforts to not get overly hopeful for a miracle natural pregnancy before starting my IVF cycle (don’t we all hope to be that unicorn!), I did get just a teeny bit sucked into that excitement. My husband was completely sucked in and thought for sure I was pregnant. Poor guy. But after a few fantasy days of hopeful thinking, I read a few things online that suggested that DHEA can alter your cycle length. After that, I quickly began thinking DHEA might have lengthened my cycle and my hope for a natural pregnancy faded. I did, however, pee on a stick to confirm that I wasn’t pregnant before talking to my nurse. And, just like every pregnancy test I’ve ever taken, it was stark white. You know, glowing so white you need sun glasses. My nurse actually had me stop taking DHEA to try to bring on my period.

 

Unfortunately, a week after stopping DHEA, still no period had presented itself. So today I went into the RE office for an ultrasound to see what could be causing this delay. Ultrasound results showed a thick lining and no ovarian cysts, which is good news. My RE said that I just didn’t ovulate, so my body wasn’t signaled to begin a period. Apparently this happens to about 6 -10% of women every month. He thought it might be related to the fact that my hormones have been on a roller coaster ride due to the resent IVF and FET cycles, but didn’t specifically blame it on DHEA. So lucky me. I was prescribed Provera, which is a oral progesterone, to start my cycle. Instead of the typical 5 or 10 days of Provera, I’m going to be on it for a whopping 20 days in order to keep my ovaries “quiet” until it is time for me to start my stimulation medications based on when my RE’s lab is ready for my egg retrieval. I’m a little nervous about being on Provera for this long, but I’m going to have to trust my RE on this one. Also, I was instructed to begin DHEA again for egg quality. I hope that week off wasn’t too detrimental. But I’m not going to worry about it because I can’t go back in time and change it. I think my ability to worry less about things outside of my control is improving with time and practice (something we get a lot of during this process). Well, at least improving a little bit.

 

So instead of having my egg retrieval next week when I had expected based on the plan that was developed during my last consultation, I’m delayed about a month. Now I’m anticipating egg retrieval early in November, and if we have a healthy embryo, a transfer in early December. And that’s if there are no more surprises. I think to most people a month delay would seem like no big deal. But we infertility warriors get it. Well, I guess we’ll be canceling our trip to visit my family in December. Life really revolves around IVF, doesn’t it?