Will IVF treatment and pregnancy irreversibly accelerate androgenetic alopecia? Can anything slow it down or help during/after?

At age 39 with infertility, as a couple we have a tough decision re: whether to proceed with IVF as our last chance (despite low odds) for a baby. This is now agonizingly harder as I have realized I have progressive, diffuse hair loss. No-one notices (yet) but my scalp shows more on top and sides, with a larger part. I see finer hairs being shed. I've seen my tiny vellus hairs magnified at hair clinics. We want a family but I am *TERRIFED* of quickly balding from IVF hormones and pregnancy. Help!

Doctor Answers 3

IVF and pregnancy - is hair loss possible?

This is a great great question. Of course, I can't comment on your specific scalp without seeing your scalp and knowing all your details. But here are some generalizations. I hope they help.

Please don't focus on the magnified vellus hairs at hair clinics. Way too many people are made to feel overly terrified above and beyond a normal, healthy worry. Comments about "plugged follicles, dead follicles" and 'lack of blood flow' are all too common. Unfortunately, with high power magnification, any story can be told. 

You're wise to gather information. The challenge is 'interpreting' it all. Be sure to sit down with your dermatologist to review.  Yes, some medications used in IVF can cause hair loss and yes pregnancy and delivery can accelerate AGA for some women. It's common in my practice for women to contemplate not going through IVF or not getting pregnant to avoid hair loss. It's way more common to have these feelings that many believe. So many share your feelings. The ultimate decision is left up to the patient but I generally advise patients if they want a family to go for this first and we'll address hair issues second. An aggressive plan can be started after delivery. If someone has aggressive hair loss and powerful hair loss genes,  IVF/pregnancy is not going to alter anything long term.  Hair thinning is going to occur regardless. If you are 39 and nobody notices (yet), you don't fit in that category of aggressive genes. Those are women with significant hair loss by 30.   But with an aggressive treatment plan it's likely there can be some slowing of this whole process. 

You'll want to speak to your dermatologist for specific recommendations. For my patients with AGA undergoing IVF or considering pregnancy, I generally advise:

1. Get the iron levels up now. Well above 60 as they may drop in pregnancy

2. Get TSH in the 0.5 to 2.5 range. If one takes biotin, be sure to stop biotin before getting these tests done as it messes up thyroid tests.

3. Control seborrheic dermatitis aggressively now with antidandruff shampoos

4. Get on a prenatal vitamin. This is good for hair and good for the baby. Be sure to speak to you ob-gyne or family doc about what vitamin is right for you. 

5. As your dermatologist if low level laser is a good option for you. Many options for AGA, including minoxidil, spironolactone and PRP can't be used for women considering pregnancy, but I often advise low level laser.

Thanks again for the question.

Decision to have a hair transplant

Clearly, you have many things on your plate. Having a hair transplant which is done under a local anesthetic, can be done anytime, but it may be appropriate to wait out the IVF until this process is complete. 

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 25 reviews

See an Expert for Options--Hair Loss Treatment and Pregnancy

I recommend a consultation with a hair loss expert to go over your condition and options. There is some hair loss after pregnancy as the hormone levels shift, but it does level out again. PRP and progesterone injections are good options after pregnancy and/or hair transplantation. See an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

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