– Melatonin, Vitamin D and Dehydroepiandrosterone (DHEA) –

 

 

How and why I prepped for IVF round 2 and the difference it made

 

 

 

Last time, I explained that I needed to start taking methylfolate and CoQ10 as part of my recommended treatment, in addition to a good all-round multivitamin. Here are the other supplements I was advised to take as part of my fertility treatment.

 

 

Melatonin

 

If you’ve ever heard of melatonin, you may be aware of its most common use as a sleep aid. Until I started IVF, I’d never heard of it being used to improve egg quality. As it turns out, the case for melatonin as a supportive supplement as part of IVF is already pretty strong and rapidly gaining ground. Melatonin is something of a multi-tasker, involved in the regulation of biological rhythm (think wake-sleep), reproduction, metabolism and even metabolism. It’s also a potent antioxidant.1

 

Remember when I mentioned oxidative stress and free radicals as key causes of DNA damage and poor egg quality in my previous post? By now, you might be sensing something of a common thread between some of the supplements that we may be advised to take. Many of them tackle the same issue from different angles: how to improve egg quality and or yield. Although more large-scale trials are needed (they’re always needed in an ever-evolving field like reproductive medicine), evidence so far indicates that melatonin boosts the number of eggs collected, how many of them are actually mature and the number of good quality embryos that result.2 The evidence for whether melatonin consistently improves clinical pregnancy and live birth rates is mixed, however.1,2 Given how important preparing for egg collection and reducing oxidative stress are, and with the hope of a great night’s sleep, I felt quite comfortable taking the melatonin. Fortunately or unfortunately with the dose of melatonin used as part of fertility treatment, I didn’t notice much of an impact on my sleep!

 

 

Vitamin D

 

Being of Indian origin and living in the Northern Hemisphere, I’ve been taking extra vitamin D for years. Vitamin D is a fat-soluble vitamin that is naturally present in a few foods such as oily fish and cheese, used to fortify food like cereal and milk, and is available as a dietary supplement. It is also produced naturally when ultraviolet (UV) rays from sunlight strikes our skin and triggers vitamin D synthesis. Vitamin D deficiency is associated with numerous health problems including bone weakness (osteoporosis), immune dysfunction and an increased risk of miscarriage. People with darker skin (more melanin), or those with limited sun exposure or medical conditions associated with fat malabsorption are at increased risk of vitamin D deficiency, so it’s important to not fall short when it can be treated relatively simply.3,4

 

 

Dehydroepiandrosterone (DHEA)

 

This was one supplement that I didn’t take during round 1 but I did in the run up to round 2. The human body naturally makes DHEA, an important steroid hormone precursor that is produced mainly by your adrenal glands, but also the ovaries, testes and the brain. It is converted to male and female sex hormones including testosterone and oestrogen. Natural DHEA levels peak in early adulthood and then slowly fall as you age. For these reasons, there have been a lot of rumours and theories that DHEA can be used as an anti-ageing supplement or to improve physical fitness, but medical science is yet to prove any of this.5

 

But what medical science has found is that DHEA may improve egg yield and quality in women with diminished ovarian reserve (DOR). Exactly how this happens is still not quite clear but some of the actions that DHEA may have include supporting and regulating hormone function, influencing ovarian follicle growth, and reducing age-related chromosomal abnormalities within the eggs.5

 

So did any or all of this make a difference?

 

I had my homework cut out for me. Methylfolate, CoQ10, melatonin, vitamin D and now DHEA. Oh, and a good multivitamin. My diet was deemed fine to begin with but I did make it a point of eating more oily fish. I had to take responsibility for myself and my own health, because I knew the drugs alone would only take me so far, irrespective of the ultimate outcome.

 

Before I knew it, I’d had the baseline scan,  the injections started and we got to egg collection much faster than the first time. The run up and recovery were also more manageable. Overall I just felt and did much better.

 

And our little embryos? We did better.

 

We’re not out of the woods yet. But our embryos and I are better and stronger this time, and giving this everything we’ve got.

 

I’m honoured to have been invited to share my experiences as part of the “Lifestyle and fertility, including nutrition” webinar, on 21st May, which will be presented by Dr. Geetha Venkat, Dr. Norbert Gleicher and fellow pharmacist Mrs. Poonam Shah. In addition to invaluable insight from world-leading experts, I hope that what I can offer, both from a scientific perspective and being a patient will be of some help to you on your journey.

 

See you there!

 

To register for the webinar, please click here.

 

References:

1. Espino J, et al. Impact of melatonin supplementation in women with unexplained infertility undergoing fertility treatment. Antioxidants (Basel). 2019; 8(9):338;

2. Lu KL, et al. Melatonin application in assisted reproductive technology: a systematic review and meta-analysis of randomized trials. Front Endocrinol (Lausanne) 2020; 27;11:160;

3. National Institutes of Health. Office of Dietary Supplements. Vitamin D Factsheet. Available at: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Accessed 09 May 2021;

4. Mumford SL, et al. Lancet Diabetes Endocrinol 2018; 6(9):725–732; 5. Fouany MR and Sharara FI. Is there a role for DHEA supplementation in women with diminished ovarian reserve? J Assist Reprod Genet 2013; 30(9):1239–1244.