# Advice please! PCOS but told to take DHEA for egg quality due to age?



## Charlottots (Mar 30, 2016)

I hope someone out there can help.... We just had a consultation after 2nd failed ICSI cycle. During the cycle we got 11 eggs, 7 fertilised but only 2 medium quality day 5 blasts. First cycle we only got 5 eggs and 1 x 3 day embryo. Protocol was changed to microdose flare for 2nd cycle and i started metformin, which improved numbers but our consultant says the reason the second cycle failed in his opinion is due to poor embryo quality due to my age (3. 
As I have PCOS they expect a better response than I give during stimming so believe i may have ageing eggs chromosomally abnormal. I know that age and PCOS can give poor egg quality and my mum had menopause at 37 so could have earlier ageing eggs. The dr recommended and gave me dhea tablets to take to help with the quality. He said we need to ignore the pcos and focus on my age to treat the eggs. I haven't yet taken any dhea because I have only read that they should not be taken with pcos due to making testosterone symptoms worse.
Has anyone taken dhea with pcos to improve egg quality? I cannot find any information other than telling me not to take it!! I don't want to go bald as well as being fat and not having any babies!!
Please any advice would be gratefully received I am torturing myself with this decision...


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## maybebaybee (Apr 17, 2016)

I am a bit older than you, and also have PCOS. I've been on metformin for years. I chose not to take DHEA, although my clinic said I could if I wanted to. They said it can lead to ovarian cysts and empty follicles. Instead, they recommended I add Inositol powder, 2 grams twice per day, and CoQ10, 300 mg per day to help with both PCOS and egg quality. I added those 2 months prior to cycling. We also went with a lower-dose stim with FSH only (no LH). I am now 5 weeks pregnant with my first ever BFP, and cautiously optimistic.

There are some other DHEA threads here  that you might want to read. Some ladies swear by it so I think you have to read up as much as you can and make the choice as to what's best for you. Good luck with your next cycle!


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## Charlottots (Mar 30, 2016)

Hi Maybebaybee, thanks very much for your reply - congratulations on your BFP 
I have been following the egg quality diet for a few months now, including as you recommend inositol, coQ10, and also ALA. I just started including N acetyl cysteine as well, which is supposed to help. I am open to trying the dhea but not if it has irreversible side effects. I have been googling like crazy to find some data about taking this with pcos but to no avail. I'll have a look on here at what people think.
Good luck with your pregnancy x


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## Angedelight (Aug 17, 2012)

Hi
I have PCOS. I take all the supplements that are recommended in the book by Rebecca Fett 'It Starts With The Egg'. There are recommendations specifically for people with PCOS and all about improving quality. 
I currently take:
Inositol (as maybebaybee mentioned)
Coq10 but in ubiquinol form
Omega 3
Alpha Lipoic acid
Metformin
Melatonin.
We are yet to see if they make a difference to quality as been taking all this since April and not doing another cycle until November.
I thought you would generally have raised testosterone with PCOS and you shouldn't take DHEA until you have your levels tested so you know what to take. Have a read of the book I mentioned. I've contacted Serum as our next clinic of call and they said everything I was taking for egg quality was fine and they said to add in the melatonin.
Good luck! 
X


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## Hopefulshell (Mar 14, 2013)

Hi

I have pcos and followed a strict fertility diet for six months as devised by a specialist in fertility nutrition. DH did the diet with me and we managed to achieve top quality blastocysts on the next cycle. My clinic also switched to an agonist protocol (I had the opposite problem of over stimming and being at high risk of OHSS). It's impossible to know how much the diet helped versus the change in meds but it did seem coincidental that we got the best crop after following the diet rigidly for six months ... Our nutritionist did prescribe different supplements too but I personally chose the more natural diet route. 

Despite being diagnosed with pcos I've always been refused Metformin. It seems different medics approach this condition differently which isn't always helpful for us patients! Sorry I don't have any advice on dhea but thought I'd just share my approach as a fellow pcos sufferer of a similar age. If your consultant has recommended you take dhea but you are concerned about its side effects I'd be inclined to talk it through with your dr as they are best placed to offer professional advice. Google will just present you with the scary worst-case-scenario headlines. 

Best of luck with your next steps.

X


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## Charlottots (Mar 30, 2016)

Thanks for all the input ladies! I think I am doing the best I can as am also doing what you all recommend (basically the Rebecca Fetts egg quality diet). I have decided to get my testosterone and dhea levels checked before making a decision on taking dhea, I don't want to make things worse. 
It's all a bit of a gamble isn't it? I feel like I rattle like a pill bottle these days with all the supplements!
I wish you all the very best of luck with your treatments too xxx


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## Uber Barrens Club (Jun 6, 2015)

I would definitely recommend getting your levels checked - it seems very counter intuitive to take DHEA with PCOS as essentially PCOS is associated with hyper-androgenism, so more testosterone is usually going to make egg quality worse

DHEA is normally for women with DOR - where androgen levels are too low, and there aren’t enough follicles

Women with PCOS normally have androgen levels that are too high, resulting in too many follicles

I would get the following tested
total testosterone
DHEAS
SHBG
free testosterone

I followed all the advice regarding diet and supplements from ‘It starts with the egg’, ate high protein /low carb, did acupuncture etc in the run up to my first two cycles - my egg quality was total crap

In the run up to my 3rd cycle I was eating complete rubbish - unbeknownst to me my PCOS had somehow returned, and I’d been eating basically the worst possible diet for PCOS. I didn’t realise I was going to be allowed to cycle again so soon after my MC (and as I was technically miscarrying for 6 weeks, due to retained products, I rationalised that I could eat chocolate digestives for every meal until I was un-pregnant-ed). I drank caffeine, ate tonnes of sugar - I even ended up going out to get absolutely hammered one Sat night, not realising I was going to be starting stims 5 days later

We discovered my ovaries were grossly polycystic again (my AMH had gone up over FORTY times in the space of 8 months), my LH was through the roof (very very bad for egg quality) and I’d been eating the worst diet for PCOS imaginable. I asked my consultant if we should delay the cycle as my lifestyle hadn’t exactly been optimal. He said OK, it wasn’t ideal, but the impact on my egg quality was likely to be minimal: he said egg quality was primarily determined by two things:
- age (can’t do anything about that one)
- the ovarian environment created by the stims (in the Drs hands with that one)

Well, turned out he was right, as my egg and embryo quality was my best yet
First two cycles put together I had 24 eggs and only one chromosomally normal embryo (which I miscarried) - my frozen blasts were all genetically abnormal 

Third cycle I got 28 eggs and 6 chromosomally normal embryos!

There’s no question that low GL diet, antioxidant supplements and insulin sensitisers like inositol and metformin are beneficial for egg quality

But my experience showed that the hormonal ovarian environment is key.  DHEA will definitely affect the hormonal ovarian environment, so you want to be sure that you’re a good candidate for taking it first


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## Gulnaz (Dec 6, 2012)

Hi

I have the same problem with having PCOS and poor egg quality.
I tried the DHEA tablets but found i got terrible acne around my neck and plus only after taking them had i read thry are not to be taken by PCOS sufferers. It was advised by the clinic on our 2nd faild cycle. As you we get a good number of mature eggs but after ICSI they dwindle.
I am taking most of the tablets and vitamins you all have mentioned but have found sticking to a low-carb diet the worst part. Cannot stick to it. Is it the low GI diet you ladies follow?? At present i am taking a multivit, coq10 300mg, omega 3, melatonin and metformin. Is there anything else i should add? 
Thank you

Naz xx


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## Charlottots (Mar 30, 2016)

Hi all

Thanks for the advice banana fish.  I am going to get my levels checked. I am also following the advice in 'it starts with the egg' and I think it is largely the egg environment. Although i have Pcos i dont respond like i should to stims so that's why the doc thinks pcos is less of a factor than my age. 
Gulnaz I have been following low GI but they say the Mediterranean diet is good for fertility as is anti inflammatory ...not the pasta and pizza though lol! It's hard with temptation all around and especially when you feel low. The metformin should help keep insulin levels in check but you do have to lay off the carbs


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## LisaL29 (Apr 5, 2012)

I too have pcos

My cycles have always been 4,6,8 mths apart and once disappeared for a year having to be brought on with provera

From Oct 15 I started with
Inositol
Alpha Lipic Acid
Multi vitamin
B6
B12
Vit c
Folic
And acica honey a teaspoon morn & night and I feel it is this that's made the difference 

My cycles from March (started honey in Jan 16) are 6 wks apart with ovulation discharge and ovary cramps accompanying 

I have never had 6 wk cycles ever!

Next month im armed with a bbt thermometer, opk clear blue dual hormone indicator to see what and when is happening with me.  I honestly feel the acica honey has been this change to my cycles

Another herb I came across is tribulus?  I haven't tried it but have read it can restore ovulation, Im thinking of trying it but I'm cautious as things are going well I don't want to change anything!

My recommendation to add to any supplements is the acica honey


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