I have found so many great sites relating to IVF I wanted to share them with others who'd like to make use of them.
I've also added information that I've found in my quest as a poor responder, which maybe of use to someone else out there who finds that basic IVF isn't everything that they hoped for.
I will be adding to this page regularly especially when new information in the exciting world of IVF emerges.
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DHEA - Dehydroepiandrosterone
This is a promising possible addition to the treatment for IVF poor responders. I will add more information to this page as it becomes available.
Here is a link to an amazing study being performed by the Centre for Human Reproduction in Chicago. Check in on this site regularly as they add new information about their study monthly. The most recent update is 20 October 2005.
The first small study showing some promise for using DHEA
Science Central - the lady who we can all thank for DHEA
The following are questions I have asked Dr Norbert Gleicher and his exact responses:
Is the dosage 75 mg per day?:
Yes, 75mg is daily and we usually prescribe it as 50mg in AM and 25 mg in PM.
Period of time to be taking DHEA before trying another stim cycle:
DHEA peaks in its effects after at least 4 months (maybe even a little later). Consequently, if the patient’s age allow it, we will wait for 3-4 months before starting a cycle. In this waiting period we have seen more spontaneous pregnancies than in subsequent IVF cycles. We, therefore, encourage relationships during this time. If patients are over age 43, and we don’t have time to wait, we try to get at least one month of DHEA in before cycle start.
What protocol do you put the patients on after they have been treated with DHEA:
We always use a microdose GnRH-agonist protocol, followed by stimulation with 600 IU of gonadotropins daily, with those split between FSH (450 IU) and hMG (150 IU). If patients are above age 42, we do not pretreat with OCPs; if they are younger, we do.
What is the treatment with OCP's before hand? Is that birth control pills? And why do you treat with these?
We pretreat most patients with 10-14 days of Aygestin, though this is not absolutely necessary and, indeed, in many, especially older, patients we don’t do this because of its depressive effects on the ovary. The potential benefit is less cyst formation and therefore less cycle cancellations for cysts. (Aygestin is a form of progestin, a synthetic substance that chemically resembles progesterone, that may be prescribed in ovulation induction therapies to inhibit ovulation and quiet the ovaries in advance of egg stimulation using injectable hormones. This "down time" helps the ovaries respond better to treatment. In much the same way that oral contraceptives prevent pregnancy by inhibiting normal ovulation, Aygestin is used in IVF and related procedures to turn off the body's natural ovulatory cycle).
When do patients stop taking DHEA?:
"Patients stop their DHEA once they have a confirmed positive pregnancy test".
Does DHEA cause any problems to a developing fetus?:
"There is no evidence to suggest that DHEA is harmful. PCOD patients, who get pregnant all the time, have very high DHEA levels".
"Pregnancy, itself, is a high DHEA state since the placenta is a "DHEA factory."
Is there any change to the luteal phase support with DHEA?:
"DHEA does not change the routine luteal phase support".
Have any of your patients to date suffered any adverse side effects from taking 75mg of DHEA per day?
The one side effect we have seen in transitional acne.
Will I need some kind of monitoring (ie blood tests) whilst taking DHEA?
We don’t recommend any blood tests because normal ranges for DHEA are very wide. We do recommend, however, that our patients be sexually active while taking DHEA as we have seen a very significant number of spontaneous pregnancies in patients waiting to go into IVF.
Not sure that I want to know the answer to this question, but here goes, have there been any of your patients who have shown no improvement in cycles after being treated with DHEA?
Yes, there are some patients who don’t respond but they are more frequently seen amongst the older patients.
I know that number of eggs retrieved relates strongly with the success rate with IVF, does this apply to those taking and responding well with DHEA?
Retrieved egg numbers, indeed, correlate to success in pregnancy.
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Some information that anyone who has had repeated IVF failures or just been trying to concieve for some time may like to check out.
Coenzyme Q10
Vitex
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