When you first come into our fertility clinic, one of the first things that I do is run through any medication you on, and this includes supplements.
Supplements and fertility are one of the major bug bears that I have, and I’m going to climb on my high horse (and probably be shot down, but that’s ok).
Our fertility clients are one of the most vulnerable areas of practice that we work in. This is because a sense of desperation has crept in, and clients will pay any amount for any supplement that will remotely increase the chance of a viable pregnancy. We have Tik Tok shop, high street health shops, the illegal drug market , ebay and unqualified persons prescribing supplements for pure profit, not your health. And the latest case I have come across, an IVF clinic prescribing supplements that will inherently affect the viability of a pregnancy.
I often use my water bottle that sits on my desk, to explain this to clients. If I had to say that my water bottle contains a magic potion that will get you pregnant, but it costs £1000… the most common answer is ‘we’ll take 2 thank you’, and we have a good laugh as I go through your supplements and ask why you are taking them. I then look at your DUTCH and blood results and we go through your magic potions to see what you should be taking and where we can supplement or take things out.
I am very open in saying that I personally believe all health professionals should work in endocrinology for at least a year to see how hormones affect the body. It is a fundamental element of health and wellbeing, and being able to see past the common ‘within range’ blood results, and being able to interpret results that are relative to the individual. What is normal and what is the range they looking at?
And this gets me onto my next point, not all clients are equal. Everyone is different. Every client should have a differential diagnosis and be treated as an individual. Lets go back to the fertility clinic scenario. A same sex couple is undergoing IVF. Therefore one partner undergoing IVF for egg collection, they will be using donor sperm, and then reciprocal embryo transfer to the other partner. Simples?
Not really. The one partner has a low AMH level and will be undergoing the egg collection, and the reciprocal partner has PCOS who will have the embryo transfer.
The IVF clinic has prescribed DHEA for both partners. I watched them on their video blog showing a bottle of pure encapsulations DHEA and saying they don’t really know why they taking it, but the clinic prescribed it so they both taking it. The only good thing I could see was that they were using a good brand. Anyone worth their weight working in fertility knows the effects of DHEA and PCOS. Yes absolutely, for low AMH research has shown the effects of DHEA on this, but why are both partners prescribed this, and at what dosage?
Why would you prescribe DHEA to someone with an endocrine condition such as PCOS without delving deeper into the hormones of an individual? PCOS is known to have elevated DHEA levels and you supplementing this further, therefore possibly effecting the wanted outcome of a viable pregnancy post transfer, as the metabolization of DHEA and the feedback mechanisms effect more hormones in the body. One little supplement could do a whole lot of harm!
It really does boggle my mind.
So as I climb back off down my box, or was it a high horse?, this is a reminder to challenge anything in fertility if you are not sure. If you told to take a drug or supplement – ask why, what is the differential diagnosis and how will this assist/effect you. If you are told ‘we don’t have enough time for this’, ‘we don’t do those tests’, ‘your results are within range’, stand your ground. Ask the questions and push for an answer.
So, in summary:
Is your infertility really unexplained, or is it misunderstood?