DHEA is still very controversial. A few years ago a few very small powered studies were published on the matter. None were prospective though and it had kind of “fallen by the wayside” Recently new interest has been shown in the matter, especially in the U.S. Large randomized studies are however needed on the matter in order to determine whether it does make a difference or not. It might have no benefit at all for all we know. The side effect profile, if taken with supervision, is very low and therefore some institutions are of the feeling that one has nothing to loose in taking it now or at least until we have more evidence as to its effect.

- Week 32 answers kindly provided by Dr. Stephan Volschenk -

The issue with this question is to understand the significance of FSH. The reasons for high FSH levels above the value of 10 are numerous. In most cases nothing can be done about it This is mainly due to the fact that the ovary is running on “empty” – follicle depletion. Therefore, the high FSH is not the” problem”, so to speak, but purely an indication of a problem in the ovary – running out of eggs. Therefore, the only way to reduce the FSH level would be to “supply” the ovary with more oocytes, which is humanly not possible. The outcome in the book being referred to in the question, is indeed possible, but unlikely due to lifestyle or diet factors. It is a well known fact that patients with premature ovarian dysfunction, even ones that have stopped ovulating and menstruating all together, still have a 10% chance of ovulating a good quality oocyte and have a successful conception.Therfore, if you are one of those 10%, as far as you are concerned, it is 100%. This happens per chance however, without any intervention. This is because the ovary that is running on reserve will not respond to any kind of stimulation anymore.

- Week 14 answers kindly provided by Dr. Stephan Volschenk -

The reference range of the mentioned tests do differ from lab to lab, depending on the assays used and units used to express the findings. When looking at results, one therefore has to see the complete picture. Hormone profiles, from an infertility point of view , only have meaning when done on day 2 or 3 of the menstrual cycle. Outside of this window period, the results have no significance at all. From that point of view the following is of significance:

1) 17B Oestradiol – Less than 200
2) FSH – Less than 10
3) LH – Less than 10
4) Prolactin and thyroid within the normal range of the laboratory used
5) In our clinic AMH levels of 1.1 and above would be in keeping with a fair to good chance

- Week 5 answers kindly provided by Dr. Stephan Volschenk -