Let’s get one thing straight at the outset: nutritional supplements are not a replacement for a good diet. We cannot avoid fruit, vegetables, high quality protein and fats, load ourselves with junk food, additives, trans fats and similar then hope that taking a few pills will sort us out.

Nutritional supplements do, however, have their place as science has demonstrated that certain nutrients can be very effective at increasing our chances of IVF success.

Before I get into talking about specific supplements, a word about quality. In the supplement world it is fair to say that you get what you pay for and that not all supplements are created equal. This is largely a question of cost and bioavailability, or in plain English, how well our bodies can absorb the nutrients. Many manufacturers put profit over effectiveness and produce supplements containing ingredients that our body simply cannot use effectively. The result is that most of the contents of the pills are simply passed out of our body. Taking supplements with these ingredients is flushing money down the toilet.

Whilst price is not a sure-fire way to ensure you are getting good quality supplements it does provide a useful steer. Choosing brands with mid to high price points that have been around for some time should help ensure decent quality.

Now that we have got that out of the way let’s look at which supplements can help us to be successful with IVF.

Vitamin D

Vitamin D may well be the king of IVF supplements. In fact, it may be the king of supplements for health generally. Having adequate vitamin D levels has been linked with a range of health benefits from preventing obesity[1], heart disease[2] and Parkinson’s disease[3] to foetal brain development[4] and blood sugar regulation[5].

What can it help with?

How can it help?

When it comes to IVF the research suggests that having adequate vitamin D levels are a strong guide to success.

A study at Mount Sinai Hospital in Toronto, reported in the Canadian Medical Association Journal, followed 173 women undergoing IVF and found that women with sufficient levels of vitamin D were 50% more likely to become pregnant as a result of the IVF treatment than those with insufficient vitamin D levels[6].

The women were aged between 18 and 41 and had blood tests to assess their vitamin D levels in the week of egg collection. The researchers then divided the women into two groups: those with blood levels above 30ng/ml (the “sufficient” group) and those with blood levels below 30ng/ml (the “insufficient” group).

Another study revealed even more impressive results[7]. This time the researchers followed 99 women and took blood tests around the time of embryo transfer to measure vitamin D levels. The average number of embryos transferred was 2.5 embryos, higher than the previous study. They again used the cut-off of 30ng/ml to determine sufficiency. Pregnancy rates in the sufficient group were 78% compared to only 37% in the insufficient group and live birth rates were 59% compared to 31%. By having sufficient levels of vitamin D the women in the study virtually doubled their chances of success.  

Yet another study[8] of women undergoing IVF found that women with sufficient vitamin D Levels (above 30ng/ml again) had implantation rates of 26% and pregnancy rates of 47% whereas women with insufficient levels had an implantation rate of 10% and a pregnancy rate of 18%.

Men can also benefit from vitamin D. For example, in one study[9] couples where the male partner had sufficient levels of vitamin D were 3 times as likely to become pregnant (27.7% compared to 9.2%) and 6 times as likely to have a live birth (22.2% compared to 3.7%) than couples where the male had insufficient levels.

The obvious question then is are you deficient? The chances are that the answer is “yes”, particularly if you live in a climate that is not sunny and/or if you are of certain ethnic origins. A study in the US found that overall 41.6% of adults were vitamin D deficient with 82.1% of Afro-caribbeans and 69.2% of Hispanics being deficient[10].

Another study[11] looked specifically at women who had previously experienced a miscarriage to understand whether there was a relationship between vitamin D levels and miscarriage. It found that vitamin D deficiency was more common in these women with 53% having insufficient levels.

Vitamin D levels can only reliably be measured by blood tests. You can either ask your doctor to carry out a test or you can buy a kit from an online testing provider. These kits involve pricking your thumb, squeezing a few drops of blood into a vial then sending the vial back to the laboratory.

The threshold used in the studies to determine sufficiency is 30ng/ml (or 75nmol/l) and if your levels are below this you should strongly consider supplementing with vitamin D.

However, The Vitamin D Council (a US non-profit organisation concerned with vitamin D and health) looks at things from a different angle. Rather than looking at what is “sufficient”, ie “just enough” it looks at what level is optimal for humans. Based on the research it suggests that an optimal level of vitamin D is between 40-50ng/ml (or 100-125nmol/l). My wife and I took the decision to shoot for optimal levels but you should discuss this with your doctor.

Whether you opt to go for sufficient levels or optimal levels the research suggests that the best dosage is 70-80iu per kg per day[12]. So, for a 50kg woman this would be 3,500iu to 4,000iu per day. Once your levels of vitamin D are at the desired level you may then need to experiment with reducing the dose to maintain at that level. However, the research suggests that you will not need to reduce the dosage much to maintain the levels.

Vitamin D supplements are relatively cheap but you do need to be careful to ensure that you take a specific type. It generally comes in one of two forms, D2 and D3. D3 is the most commonly available and is the type that our bodies produce. It is therefore most effective so be sure to choose this type.

What can we do?

1. get your vitamin D levels checked
2. if you are deficient decide with your doctor whether to raise the levels to “sufficient” or “optimal”
3. under your doctor’s supervision consider supplementing with vitamin D3 for a few weeks then have your levels rechecked. Repeat this process until you are within the desired range

Vitamin C

I am sure that you have heard about the health benefits of vitamin C. It is one of the most widely researched nutritional supplements and a powerful antioxidant. It has been shown to be effective in the treatment of a variety of ailments and illnesses, ranging from the common cold[13] to cancer[14].

What you may not know is that it has been shown to boost the chances of success with IVF.

What can it help with?

How can it help?

The power of vitamin C as it relates to fertility was demonstrated in a study[15] involving 150 women with a fertility issue called luteal phase defect (this phase is where the body produces a key fertility hormone called progesterone). Participants were given either 750mg per day of vitamin C or a placebo. Those receiving vitamin C had a significant increase in progesterone levels and had a pregnancy rate of 25% compared to a pregnancy rate of only 11% in the group not receiving it.

In a 2003 study of 76 women undergoing IVF[16] half of the women were given 500mg per day of slow-release vitamin C and half a placebo. The groups were further divided up into smokers and non-smokers. Following vitamin C supplementation the women in the non-smoking group achieved pregnancy in 57.9% of cases compared to 31.6% of those who did not receive vitamin C. Whilst not quite doubling the success rate it is not far off.

Those of you that have already undergone an IVF cycle will be familiar with the importance of the thickness of your womb lining. If the lining is not sufficiently thick the chances of an embryo implanting and a pregnancy developing are significantly reduced. Fortunately, a study[17] published in the American Journal of Research Communication demonstrates that vitamin C supplementation can have a potent effect on the thickness of womb lining. In this study women were given 500mg of vitamin C three times a day and those receiving the supplements had a womb lining that was around 50% thicker than those that did not receive the supplements.

When you consider how important thickness of womb lining is to successful outcomes these results are significant. For example, one study[18] showed that women with womb lining of over 14mm had a pregnancy rate of 63.5% whereas those with a lining of less than 7mm had a pregnancy rate of just 25.5%.

Vitamin C is not just important for women; studies show that it is vital for sperm health. For example, one study showed a large improvement in sperm health in men whose sperm suffered from DNA fragmentation (deformed sperm) which led to improved implantation and pregnancy rates[19]. Another study[20] showed sperm counts more than doubled after two months supplementing with 1,000mg of vitamin C twice per day.

There is much debate as to the optimal dosage for vitamin C. The Recommended Daily Amount in the UK is around 40-60mg per day but many experts believe that this is far too low, some advocating doses in the multi-gram range. Based on the studies above somewhere between 500mg and 1,500mg seems to be effective but you should discuss this with your doctor.

One thing that is important is the type of vitamin C you take. Vitamin C is passed through the body quickly and so has a limited opportunity to work its magic. It is therefore worth spending a bit more to buy a timed-release supplement which has the effect of slowly releasing vitamin C into the body giving it a greater opportunity to work.

What can we do?

Discuss with your doctor and consider taking a dose of between 500mg and 1,500mg per day.

Multivitamin

As I mentioned earlier, no pill is a replacement for a healthy, balanced diet; a multivitamin can however be a useful insurance policy to help ensure we are getting adequate amounts of key nutrients.

What can it help with?

How can it help?

In addition to being an insurance policy, multivitamins have been shown to be helpful when it comes to fertility.

For example, a 2007 study[21] followed 438 women who had problems ovulating (producing eggs) over 8 years. The researchers found that there was a relationship between the consumption of multivitamins and a reduction in ovulatory issues. Women who took on average 2 multivitamins a week saw a 12% reduction in ovulatory issues, those who took 3-5 multivitamins a week saw a 31% reduction and women who took 6 or more multivitamins a week experienced a 41% reduction.

A small English study[22] gave two groups of women either a multivitamin and mineral supplement (which contained folic acid) or a folic acid supplement for 4 weeks prior to undergoing IVF. The researchers found that the women taking the multivitamin had a pregnancy rate of 66.7% compared to 39.3% in the folic acid group and an on-going pregnancy rate of 60% compared to 25%. The multivitamin used was called Pregnacare, manufactured by Vitabiotics, but there is no suggestion of bias as Vitabiotics was not associated with and did not fund the study.

Men can also benefit from multivitamin supplementation. For example, an Indian study[23] gave a group of infertile men a multivitamin for a period of 6 months and examined sperm quality before and after this period. Before supplementation average sperm counts were 10.5 million/ml and sperm motility was 18.4%. After 6 months sperm counts had increased to 50 million/ml and motility to 48.72%.

Another study[24] showed that it is the combination antioxidants typically found in multivitamins that appear to benefit men the most. The study involved 2,876 couples in 34 separate trials and found that couples where the male partner regularly took antioxidants were 4.18 times more likely to become pregnant and 4.85 times more likely to have a live birth.

What can we do?

If you choose to take a multivitamin it is important to select one that is specifically formulated for fertility/pregnancy. If your diet is spot on then you may have all the bases covered. If that is not the case then discuss supplementing with your doctor.

If you do decide to take one bear in mind that it is likely to contain some of the other nutrients mentioned in this Plan so you and your doctor will need to take this into account when determining dosages.

Vitamin E

Vitamin E’s primary role is as an antioxidant that protects our body’s cells from being damaged. It is another supplement that you have probably heard about as it has been well studied and often pops up in the news. The natural form has been associated with things as diverse as reducing cancer risk[25] and delaying loss of mental function in Alzheimer’s patients[26]. I have underlined “natural” because, as we shall see below, it appears to be critical that this rather than the synthetic form is used.

What can it help with?

How can it help?

Having good blood flow to the womb and a sufficiently thick womb lining are critical to IVF success. If either blood flow is poor or the lining is not thick enough the chances of achieving pregnancy are greatly reduced. Vitamin E has been shown to improve both. In one study[27] a group of women with thin womb lining undergoing IVF received 600mg a day of vitamin E during their menstrual cycle. The researchers found that 72% of the women had improved blood flow and 52% had a thickened womb lining at the end of their cycle.

Vitamin E has also been shown to be of great benefit to infertile men. For example, supplementing with a dose of 1,000mg of vitamin E along with 1,000mg of vitamin C for 2 months was shown to reduce the level of DNA fragmentation of sperm in infertile men by 59%[28]. If sperm are not correctly formed they are unlikely to be able to fertilise an egg so this is a significant improvement.

Another study[29] of men undergoing IVF treatment showed a 34% increase in fertilisation rates after 1 month of receiving 200mg of vitamin E each day.

As noted above, the type of vitamin E we use is key. You may have read various stories in the media about vitamin E being bad for us. These stories seem to result from studies that use a synthetic form of vitamin E rather than a natural form. The term “vitamin E” can refer to one of 8 different types of vitamin E and the natural forms of each of these have been shown to have different benefits.

The best types to use are called “tocopherols” and these come in alpha, beta, delta and gamma forms. To get the most benefit choose a vitamin E supplement that contains “mixed tocopherols” including each form.

To ensure you are taking the natural version look at the ingredients list. The natural form has a “d” in front of the ingredient and will be something like “d-alpha-tocopherol”, depending on the type. Synthetic versions have a “dl” at the beginning so avoid these.

What can we do?

Whilst some studies have used much higher amounts, a dose of around 400iu per day of natural mixed tocopherols may be about right. As always, consult with your doctor prior to commencing supplementation.

L-carnitine

Protein is made up of building blocks called amino acids and L-carnitine is one of these. Its role in the body is primarily to turn fat into energy but it also acts as an antioxidant and has been proven to be beneficial for infertile men.

What can it help with?

How can it help?

A study[30] of men who suffered from both low sperm counts and poor sperm motility gave participants a combination of 2,000mg of L-carnitine and 1,000mg of acetyl-l-carnitine a day for 6 months. After 6 months the group had significantly increased pregnancy rates compared to a group who did not receive carnitine (21.8% compared to 1.7%).

These results were replicated in a Chinese study[31] of 135 men with reduced sperm motility. Participants were divided into two groups with one group receiving 2,000mg of L-carnitine per day for 3 months. Following treatment, the L-carnitine group had an increased percentage of forward swimming sperm (45.4% compared to 28.6%) and an increased pregnancy rate of 31.1% compared to just 3.8% in the group that did not receive L-carnitine.

Another Chinese study[32] – the Chinese seem to lead the field in this area – found improvements not only in sperm motility after 3 months of treatment with a combination of L-carnitine and acetyl-l-carnitine but also a 24.9% increase in sperm vitality and a 76.8% increase in sperm count compared to the start of treatment. What makes these results even more impressive is that the participants had already been treated with a combination of traditional Chinese and Western medicine without success prior to this study.

What can we do?

Based on the research a combination of 2,000mg of L-carnitine and 1,000mg of acetyl-l-carnitine a day for at least 3 months prior to treatment appears to be effective at improving sperm quality.

Zinc

Zinc is a mineral that is contained in over 3,000 different proteins in our body and at least 200 different enzymes. It is therefore not surprising that adequate zinc intake is critical for our immune systems to function properly. It also helps us to deal with stress and ensure we get restful sleep.

What can it help with?

How can it help?

This seems to be a supplement that primarily benefits men however zinc deficiency in both men and women can lead to fertility issues. To work out if you are deficient there is a simple test you can do, details of which are set out below.

Zinc supplementation has been shown to improve sperm counts in both healthy men and men with fertility issues. In a Dutch study[33] involving 211 men a combination of zinc sulphate (66mg) and folic acid (5mg) was given for a period of 6 months. Semen samples were taken at the beginning and end of the period. The researchers found that the infertile men increased their sperm count by an average of 74%. Interestingly healthy men also increased their sperm count by 62%.

An earlier study[34] gave 220mg of zinc sulphate per day for 4 weeks to a group of men with low sperm counts which resulted in a 158% increase in sperm count and a 62% improvement in motility.

As zinc is such a key nutrient for fertility it is worth testing to see if you are deficient before undergoing an IVF cycle. One of the first indications of zinc deficiency is disruption to our sense of taste and this allows us to use a simple test to gauge zinc levels. First you need to buy a bottle of liquid-form zinc. Put 2 tablespoons of the liquid into a cup then take a sip. Hold the liquid in your mouth for 30 seconds and notice the taste. Once the time is up spit the liquid out. How it tasted indicates your zinc levels.

What can we do?

1. check your zinc levels
2. if you are either deficient in zinc or a male with fertility issues supplementing with zinc may be a good idea. The dose used in the second study above is quite high and may be excessive. Depending on your doctor’s advice something between 25mg and 75mg appears to be about right

Folic acid

Folic acid is also known as vitamin B9 and many of us will have heard how important it is for pregnant women. It is so important that many government health authorities recommend supplementing with it before and during pregnancy as it reduces the risk of children developing certain conditions.

It has also been shown to be beneficial to fertility.

What can it help with?

How can it help?

A study[35] of 100 women undergoing IVF treatment at Massachusetts Fertility Centre looked at the levels of folic acid in their blood. The researchers found that women with the highest levels were 62% more likely to have a live birth compared to women with the lowest levels.

Another study[36] again looked at levels of folic acid but this time in the fluid that surrounds the ovaries (“monofollicular fluid” to give it the scientific term). The study followed 181 women undergoing IVF and found that doubling the levels of folic acid in this fluid resulted in women being 3.3 times more likely to become pregnant.

Folic acid levels have also been shown to be associated with an increased number of mature eggs following IVF stimulation[37] and improved embryo quality[38].

We have already seen how folic acid in combination with zinc has beneficial effects on men’s sperm. Another study[39] took 89 men and looked at the proportion of their sperm that had some form of abnormality. The men were required to keep a diary of their food intake and the researchers calculated the intake of various nutrients from this. They found that sperm of men with the highest intake of folic acid had 20% fewer abnormalities than those with a low intake. Abnormal sperm is unlikely to successfully fertilise an egg so this finding is important.

I have used the term “folic acid” in this Plan because it is the name that most people are familiar with. Folic acid is actually the synthetic form of vitamin B9. Folate is the natural occurring form and is the best option to go for. Avoid supplements with “pteroylmonoglutamic acid” on the label as this indicates the synthetic form.

What can we do?

Take between 400 and 800mcg of natural form folate per day.

Melatonin

Melatonin is actually a hormone that occurs naturally in our bodies. In some countries it is freely available to buy as a nutritional supplement whereas in others it is only available with a doctor’s prescription. I have included it in this Plan because it has shown to be very helpful to women with certain conditions. Whether you are able to buy it with or without a prescription it is particularly important that you only take it with the approval of your doctor.

You may have heard of melatonin. It has been touted as an “anti-aging” supplement for the last couple of decades. The reason for this is that it is believed to act as a powerful antioxidant[40], protect against heart disease[41], fight cancer[42], delay Alzheimer’s[43], tackle obesity[44] and prevent osteoporosis[45].

Let’s have a look at how it can be helpful in IVF.

What can it help with?

How can it help?

Melatonin appears to be helpful in women where egg quality is an issue.

An Italian study[46] first indicated that melatonin may be effective. Researchers gave two groups of IVF patients the same combination of supplements with one critical difference: one group received melatonin but the other group did not. The melatonin group produced 13.9% more mature eggs than the non-melatonin group which then led to them producing 36.3% more top quality embryos.

A Japanese study[47] also demonstrated melatonin’s effect on egg quality. There were a few parts to the study. Firstly, researchers took 9 women who had previously undergone an IVF cycle and gave them 3mg of melatonin in the run-up to egg retrieval in their following cycle. The researchers then compared the number of good quality embryos obtained in each cycle. The percentage of good quality embryos without melatonin supplementation was 27% but with melatonin rose to 65%.

In the second part of the study a group of 115 women who had failed to become pregnant in their previous IVF cycle were again given 3mg of melatonin a day. With melatonin supplementation egg fertilisation rates increased from 20.2% to 50% and, even more significantly, 19.6% of the women became pregnant whereas none had achieved pregnancy in their previous cycle.

What can we do?

As mentioned above it is critical that melatonin is only used with the consent of and guidance from your doctor. The studies suggest that 3mg per day taken before bed may be effective but you should discuss with your doctor whether melatonin supplementation is appropriate for you.

N-acetyl cysteine

This is another supplement that is popular with anti-aging experts. Studies have shown that it is effective in treating a range of conditions including liver disease[48], acne[49], post-traumatic stress disorder[50], cancer[51] and heart disease[52].

It has also shown a lot of promise for women with one of the most common causes of infertility, polycystic ovary syndrome (PCOS for short) and who have experienced previous miscarriage.

What can it help with?

How can it help?

Clomiphene citrate (Clomid) is a drug commonly prescribed to help women with PCOS and n-acetyl cysteine (NAC) has been shown to increase its effectiveness. For example, in a study[53] of 60 women who had PCOS researchers gave half of the women 1.2g per day of NAC alongside clomiphene and the other half received clomiphene only. They then measured a range of outcomes critical to IVF success and found that:

1. 87% of women in the NAC group ovulated (produced eggs) versus 67% in the non-NAC group
2. the NAC group produced on average 2.9 mature follicles compared to only 1.8 in the non-NAC group
3. womb lining was 8.7mm in the NAC group but only 6.2mm in the non-NAC group
4. 77% of women in the NAC group became pregnant compared to 57% in the non-NAC group
5. miscarriage rates in the NAC group were much lower than in the non-NAC group (9% versus 24%)

NAC has also been shown to be effective in women with PCOS who have not had success using clomiphene alone. In a study[54] of 150 women half again received 1.2g of NAC alongside clomiphene with the other group receiving clomiphene only. Now, bearing in mind that these women had used clomiphene for at least 3 previous menstrual cycles without success and had experienced infertility for over 4 years the results with NAC were impressive:

1. 3% of women in the NAC group ovulated compared to only 1.3% in the non-NAC group
2. women receiving NAC produced on average 2.4 mature follicles compared to 0.01 in the non-NAC group
3. womb lining was 5.9mm in the NAC group versus 4.9mm in the non-NAC group
4. 3% of women in the NAC group became pregnant whereas none of the women in the non-NAC group became pregnant

NAC may also be helpful in women with a history of miscarriage. In a study[55] in Egypt women who had experienced previous miscarriages were given either 500mcg of folic acid per day or a combination of 600mg of NAC and 500mcg of folic acid. The women receiving NAC were twice as likely to give birth than those that did not receive it.

What can we do?

If you have PCOS or have experienced previous miscarriage it is worth speaking to your doctor to see if NAC could be helpful for you. The studies suggest a dose of 1.2g for PCOS and 600mg for miscarriage may be effective.

Inositol

Inositol is a B vitamin that plays a key role in how our bodies utilise sugar and protein. This is worth noting because issues with these systems are also linked to fertility problems.

What can it help with?

How can it help?

Studies have shown that inositol can be effective in treating both women and men undergoing IVF. It has also been shown to assist women with PCOS.

Let’s start where we left off with n-acetyl cysteine: women with PCOS.

An Italian study[56] gave women with PCOS either 4g of inositol and 400mcg of folic acid per day or just 400mcg of folic acid for 3 months prior to an IVF or ICSI cycle. The women who received inositol produced significantly more eggs (12 compared to 8.5) that were much less likely to be immature (2.33% compared to 23.74%) and much more likely to fertilise into top quality embryos (68.1% compared to 29%). Considering that one of the main issues in PCOS is ovulation and egg quality these results are significant.

Another study[57] in Italy used a slightly different supplement protocol (2g of inositol and 400mcg of folic acid or folic acid alone) with PCOS patients for 3 months prior to undergoing IVF. The researchers found that women receiving inositol required a lower dose of stimulation drugs over a shorter timeframe yet had pregnancy rates of 60% compared to only 32% in the non-inositol group.

Women without PCOS but who have responded poorly to IVF previously may also benefit from inositol. Yet another Italian study[58] used the same supplement protocol as the above studies and found that women who received inositol produced more good quality eggs (80.5% v 66.6%), had more top-quality embryos (87.9% v 81.9%) which resulted in higher pregnancy rates (18.4% v 15.7%).

Inositol may also benefit men with low sperm counts. In another (wait for it!) Italian study[59] men who had low sperm counts and who were undergoing IVF were given 4g of inositol and 400mcg of folic acid per day. After 2 months the researchers compared the counts to samples taken prior to supplementation. Depending on the method of analysis the participants sperm counts increased between 127% and 307%.  

An earlier study[60] had also showed that inositol increased testosterone by 18%, sperm concentration by 31% and sperm motility by 24%… and, yes, it was an Italian study.

There are 9 different forms of inositol with myo-inositol and d-chiro-inositol two of the most common. In the studies myo-inositol is the most frequently used and there is evidence that it may be more effective than d-chiro-inositol.

What can we do?

If you think that you may be a suitable candidate for inositol supplementation you should discuss with your doctor. From the studies it appears that 2-4g per day of the myo-inositol form may be effective.

DHEA

DHEA is short for dehydroepiandrosterone. Like melatonin it is a hormone that occurs naturally in our bodies. Again, like melatonin in some countries it is freely available to buy but in other countries it is only available with a prescription. As we will see it appears to have the potential to be very helpful in women with certain conditions so I have included it in the Plan.

DHEA levels decline naturally as we age and this decline may be linked to fertility issues. However, DHEA plays such a critical role in regulating levels of various hormones in our bodies you should not take it without your doctor’s approval.

What can it help with?

How can it help?

DHEA may help two categories of women: those with “diminished ovarian reserve” (a low number of eggs) and those who have experienced previous IVF failure as a result of a failure to respond well to stimulation drugs.

Let’s start by looking at how it can help women in the first category.

In a small study[61] involving 25 women with diminished ovarian reserve researchers gave them 75mg of DHEA per day for 15-20 weeks before undergoing an IVF cycle. The results were then compared to each woman’s previous IVF cycle. The number of eggs retrieved increased by 29%, the number of eggs that successfully fertilised more than doubled, as did the number of normal day 3 embryos obtained.

A larger study[62] involving 190 women gave 89 the same 75mg dose for a period of 4 months prior to an IVF cycle. The remaining women did not receive any DHEA. The women receiving DHEA had fewer cycles cancelled due to a poor response (14.3% compared to 25.7%), had higher implantation rates (11.4% compared to 6.9%) and higher pregnancy rates (28.1% compared to 10.9%).

DHEA also appears to reduce the risk of miscarriage in women with diminished ovarian reserve.

A study[63] reviewed miscarriage rates of women who had taken DHEA whilst undergoing IVF and compared them to IVF patients who had not taken DHEA. The researchers found that DHEA supplementation reduced miscarriage rates by between 15.7% and 60.8% with the supplement appearing to have the greatest effect in older women.

For women who have failed to respond to stimulation drugs previously there is also some positive news.

A small study[64] of 19 women who had responded poorly to their previous ICSI cycle were given 75mg of DHEA per day for at least 3 months before undergoing another cycle. Following supplementation the women produced a greater number of eggs (4.9 v 2.5), which led to a higher number of good quality day 3 embryos (1.9 v 0.7) and pregnancy rates that were four times higher (47.4% v 10.5%).

Another study[65] in 2010 took a group of “poor IVF responders” and split the participants into two groups. 17 women were given 75mg of DHEA per day and 16 women were not given the supplement. DHEA was taken for either 6 weeks prior to an IVF cycle and if they did not conceive continued for at least another 10-12 weeks in the run up to a further IVF cycle. When the researchers compared birth rates they found that the women taking DHEA gave birth in 23.1% of cases whereas women who did not receive DHEA only gave birth in 4% of cases.

As with other supplements not all forms of DHEA are absorbed well by our bodies. If you and your doctor decide to try DHEA you should opt for a “micronized” version. This means that the DHEA has been broken down into smaller particles which is easier for our bodies to absorb.

What can we do?

Due to its interrelationship with other key fertility hormones whether or not to take DHEA is not a decision to be taken lightly. You should discuss the matter with your doctor and proceed only with their approval.