* Author Topic: Help - DHEA usage has caused elevated DHEA-S & testosterone levels.. 😕  (Read 1807 times)

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Offline Passion4baking

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Hi lemongrass,

Simulated meds were talked about right from the start, in fact, it was kinda talked about as if there was no other option.

It's only after I asked for information regarding DE that they even mentioned a natural cycle as an option. I was just gathering information, so turns out, the more you ask the more you get told.

But you can't ask what you don't know to ask about, right?! xx

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    Offline Uber Barrens Club

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    Hi everyone, can I jump into this thread?  I too have been diagnosed with low ovarian reserve (and low AMH) and have been taking DHEA for 2.5 months, and I have a question for you all: did your consultants automatically recommend a stimulated IVF cycle?  Mine recommended natural cycle and I've just finished an unsuccessful round (my first) where, disastrously, there was no egg to collect!  At least with stimulated cycle you should have at least something to work with ...

    Hi lemongrass

    I also have very low AMH, and high FSH, as you can see from my signature

    What is your FSH?

    Us high FSH / low AMH ladies are harder to stimulate, so it can be the case that blasting our ovaries with massive doses of stims doesnít elicit any more eggs than very mild stims or indeed natural cycle IVF. If you only get one or two eggs max with or without the stims, then better to go without the drugs and get the same quantity, possibly with better quality

    That said, I have high FSH, and my consultant tried me on a high-stims short protocol: I knew going in that my high FSH and low AMH meant we were likely to get very few eggs, and it was possible I wouldnít respond at all (in which case weíd know that  high stims werenít right for me)

    However, we started on max dose of Gonal-F (450iu), and dropped down to 300iu after 4 days, and then to 225iu after another 3 days - and at EC 2 weeks ago we got 7 eggs, of which 6 were mature.  My consultant was absolutely astonished, as my scans suggested we were going to get a bumper crop of 4 (which would have been a cracking result given my FSH/AMH). Apparently my ovaries had (his words) a Ďproductive weekendí between the last scan and collection day

    Now, I should add that as we had to freeze my eggs unfertilised, due to issues with obtaining a fresh sample on the day, we donít get know about quality - and quality is what counts.  Iím hoping that the DHEA, CoQ10, Melatonin and my age are on my side, and weíll get decent fertilisation - but we just donít know, as itís possible my high FSH will mean Iíve got crap quality as well as quantity. In which case a mild stims protocol with fewer, but hopefully better, eggs, may be appropriate next time. Donít know yet!

    So, the answer is, I guess, it depends.  For me, my consultant felt it was worth trying a max stims protocol at the outset, as blood tests only tell you so much - itís the response to stimulation thatís really the best diagnostic exercise. We felt you donít know unless you try. But that doesnít mean a high stims protocol is necessarily right for you. But I would def speak to your Dr when you have your post-cycle review consultation, and discuss this with them, to see what they recommend next time.

    Clinics like Create and the Lister are highly recommended for us low AMH girls.  And I can speak very highly of my consultant, who operates as a boutique satellite clinic to CRM London (heís lead clinician for reproductive medicine @ Barts, but I see him privately). Might be worth having consultations with other clinics to see what they say, as second opinions can be helpful when planning next steps

    xx

    Offline Orchid-1

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    lemongrass - I changed clinics and they suggested natural cycle because I don't seem to respond well to steroids also because I had good lining and some follicles of a certain size.

    Also short protocols and mild IVFs recommended for ladies with low AMH, I think. Long protocols and down regulation may suppress your ovaries. It is all a balancing act. I am sure some of the other ladies will come on and give better info.

    I had a stimulated cycle for my first IVF and it did not work. However everyone's body reacts differently. It depends on your baseline scan and how many follicles you have, what size they are etc.

    As Banana says - second opinions are very useful. x

    Offline Uber Barrens Club

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    Yep, just to add to Orchid, my consultant said absolutely not to down regulate me, as he didn't want to risk over suppressing me.  So we went for a short protocol stimmed cycle, and only added in the antagonist once I had follies of a minimum size.  He said he'd take a similar approach for our upcoming FET - wouldn't down regulate me, and we'd go straight into the medicated FET off a natural cycle. So no down reg drugs, no birth control pills. Nothing that could suppress my ovaries and potentially risk them not bouncing back...

    Offline lemongrass

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    Thanks so much for your quick and helpful replies, ladies - really appreciate it.  I don't think my consultant said anything about FSH at our earlier meeting - only AMH (though I have since read about FSH being associated with low AMH ...)  We have a follow-up meeting with our consultant on Friday and if I am not happy with her responses to my questions I will consider alternative clinics. 
    I am quite interested in bananafish's comment: "blood tests only tell you so much - itís the response to stimulation thatís really the best diagnostic exercise".  Subject to what our consultant says about suppression of ovaries (that doesn't sound good!) it seems to me that seeing as I produced no egg with natural cycle ivf it would be worth trying stimulation.  I have a good lining, apparently, and all was looking good until they actually did egg collection and found that the dominant follicle, which had reached a mature size, did not contain an egg. (It contained cumulus cells, which normally suggests an egg, but no actual egg ...)  Arrrgghhh   

    Offline CrazyHorse

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    Hi, lemongrass, I'm sorry to hear you had a disappointing result on your natural IVF cycle. Something else to keep in mind is that eggs can be lost in the collection process as well, even by skilled practitioners. Collection of a mature egg is proof that your follicle matured an egg successfully, but failure to collect an egg is not proof that the follicle was empty.  ^hugme^

    I agree with you, though, that trying stims (perhaps mild ones) is probably a reasonable approach.