Swobidu Health

Thank you to everyone who participated in the fertility and high-risk pregnancy web chat. Our experts have taken the time to respond to all questions that they were not able to get to during the original chat session. see below for the answers to your most pressing questions, or visit the chat page to read the complete list of answers, along with the transcript of the live chat.

Q. Adriane – I’m 42 and not sure if I can still have a child. Do I see a gynecologist or go to fertility specialist right away? also what test do I need to ask for? my periods are starting to be irregular.

A. Dr. Lee – see your gynecologist for a preliminary evaluation and then the two of you can decide what the next step is.

Q. Cathleen – I’ve gotten pregnant twice with Clomid and IUI – I had two miscarriages. I’m 41 and I can get pregnant; I just can’t stay pregnant. Are there other options than IVF?

A. Dr. Mann – Believe it or not, two miscarriages are still within normal population statistics. However, given your tender age, it might be worth doing a little investigating to see if there is anything preventing you from carrying outside of the first trimester. first, be reassured that most miscarriages are abnormal pregnancies and usually due to abnormal chromosome make up. A risk for chromosomes problems increases with age but in 5 percent of couples, one partner may carry a rearrangement that can predispose to recurrent miscarriage so it may be worth having your chromosomes checked. Sometimes miscarriages are related to abnormalities in the shape of the uterus. It might be worth having a study of your uterus performed. There are some uncommon medical conditions that can be screened for as well. I would recommend that you seek an evaluation with a fertility specialist given that IVF is in your line of thinking. they can complete the work up and assess your ovarian reserve as well as time is of the essence. Hope this helps!

Q. Donna – my husband and I are very sexually active and his sperm count is high, but I can’t get pregnant. Are there any positions which allow the sperm to travel faster? my vagina usually swells after intercourse; is that a bad sign?

A. Dr. Lee – How old are you and how long have you been trying to get pregnant? Having intercourse every other night instead of every night may increase your chances of pregnancy. Position should not be a problem with normal sperm motility. Slight swelling of the vagina should not be a problem.

Q. Erica – When going to a reproductive specialist following testing and treatment from the gynecologist (blood work and HSG), will the reproductive specialist redo all of the testing before starting treatment? my insurance does not cover infertility treatments so I’m worried it can get a little costly. The testing by the gynecologist showed that I wasn’t ovulating but my tubes and ovarian reserve were all fine. I’ve ovulated twice with Clomid, but still haven’t conceived.

A. Dr. Lee – If the tests have been done recently, they should not have to be repeated. A third cycle of Clomid is reasonable, but if you’re not pregnant within three to four cycles, it may be time to move on to other options.

Q. Guest – at 29 with no kids, what can I ask my doctor to look for?

A. Dr. Lee – Are you trying to get pregnant now? at age 29, I would give it a year of trying before I did any testing.

Q. Guest – Do you need prescription prenatal vitamins or is there an over-the-counter product? I’m 41 and have never been pregnant.

A. Dr. Lee – Over-the-counter prenatal vitamins have slightly less folic acid than their prescription counterparts, but are fine to take.

Q. Guest – hi, I am 42 years old and I still want a child. Is it too late to have a baby? I still have my menstruation regularly. who do I need to see to find out if I have good eggs and what type of test should I ask for?

A. Dr. Lee – Many 42-year-olds can still get pregnant. Testing of ovarian reserve may help answer some of your questions. This can be done with a blood test. Remember that 40 percent of infertility is male factor, 40 percent is female factor, and 20 percent is a combination of male and female factors.

Q. Guest – I am 26 years old and my husband and I have been trying for five months. Many of our friends got pregnant within the first month of trying and I’m feeling disappointed as I have been charting and making sure we have intercourse during the fertile days of my cycle. my charts show that I am ovulating, but we’ve had no luck yet. Is there anything else I can do to help my chances? We’ve also been using pre-seed lubricant that is supposed to support sperm, not harm it like other lubes.

A. Dr. Lee – Only 50 percent of couples are pregnant after six months of trying. Eighty-five percent will be pregnant at one year. we don’t usually start testing until about a year at your age. It is very frustrating not to get pregnant when you start trying. Remember it’s either the people who get pregnant the first month or the people who can’t get pregnant that you hear about. The rest are quiet.

Q. Jennifer – my husband and I have been trying to conceive for two years now. The doctor says he has slow-moving sperm; he has a good count though. I believe my irregularity is a problem also. He has been taking vitamins for men and I have been taking prenatal vitamins. Are there any herbal vitamins you can suggest since we are tight on money at this time?

A. Dr. Lee – A prenatal vitamin would be my recommendation for you. Talk with your doctor about your irregular cycles to make sure you are ovulating. Q. Jennifer H. – my husband and I have been trying to get pregnant for a year now. I have had several false-positive home pregnancy tests, what could cause this?

A. Dr. Lee – Home pregnancy tests can be falsely positive when your LH levels are high. I recommend you wait to take a home pregnancy test until you are at least five days late for your period. This helps prevent the false-positives and the falsely raised hopes.

Q. Katie – Every time I ovulate, I get an intense pressure feeling on my right side that can last up to a day. It is not cramping though. can this be harmful? Or is it natural to have this? I know some people get cramping when they ovulate, but this is different. could it be related to cysts?

A. Dr. Lee – Many women experience this kind of discomfort at ovulation. It may vary from side to side or always be on the same side.

Q. Kim – I have had an endometrial ablation performed. However, I desire to conceive. can this be done?

A. Dr. Lee – There have been successful pregnancies after endometrial ablation. Talk with your doctor about this.

Q. Kim – I’m thinking about getting pregnant, yet I had my tubes tied. can I have this reversed?

A. Dr. Lee – It is possible to have a tubal ligation reversed, but the success rate depends on the procedure and the amount of tube damaged by the ligation. IVF can also be done to avoid the tubes.

Q. Lisa – I am 32 and have delivered one child at term by c-section due to pelvic disproportion in 1999. since then, I have had three miscarriages and have been diagnosed with an incompetent cervix that they think was cause by a LEEP and cone biopsy that I had in 1999 and 2000. The last miscarriage I had, a cervical cerclage was placed and the miscarriage was due to an infection. after the last miscarriage I was treated with Lupron for endometriosis. I have been trying to get pregnant for about two years without any luck. would a fertility specialist be who I need to see in regards to the Lupron and how it affected my fertility? also is there a doctor that I can see before I got pregnant that would be able to address the incompetent cervix?

A. Dr. Mann – Lupron will prevent you from becoming pregnant, so if you’re looking to become pregnant, you must discontinue the Lupron as soon as possible. A pre-conceptional consultation with a perinatologist or a maternal fetal medicine specialist would be wise with respect to the incompetent cervix issue. you should bring your medical records from each of your prior pregnancies; that way a plan of care can be established before undertaking your next pregnancy. Good luck!

Q. Lucie – I have had three miscarriages in the past. my doctors think I had a condition where my body forms blood clots and my progesterone is always real low when I first get pregnant. my doctors asked me to lose weight, which I have, and my husband’s sperm count is fine, but now we can’t seem to get pregnant. What do you suggest we try?

A. Dr. Mann – If achieving pregnancy is the issue, I would seek care with a fertility specialist. they can also evaluate you for other possible causes of recurrent pregnancy loss. The more modern thinking about low progesterone is that it is the sign of a failing pregnancy and not the cause of pregnancy failure. Nevertheless supplemental progesterone won’t hurt but it can delay an inevitable miscarriage. Additionally, most true clotting disorders are associated with pregnancy loss after 10 weeks. but a specialist would need to review your records to specifically advise you on what was found in your case.

Q. Martha – I am 36 years old and am currently 29 weeks pregnant with my first child. my husband and I would like to have at least three children and my question is after this baby comes in early December, when will my body be ready to start trying for baby number two? It took us a year to get pregnant with this baby and though I have never miscarried, I know the risk of miscarriage increases as I get older. Thank you in advance for your response!

A. Dr. Mann – first of all, you are young! Given that most of my patients are over 40, you are swimming in the shallower end of the age pool. we strongly recommend that you wait at least 12 months from your last delivery to your next conception. Data shows that shorter pregnancy intervals that this increase the risk for pre-term birth, small babies and adverse neurologic outcomes such as CP and learning disabilities. so enjoy your new baby for a while!

Q. Missy – I’m a 35-year-old woman with two miscarriages and one myomectomy surgery behind me. I recently found out I am pregnant and live in constant fear of another miscarriage. What are my chances of delivering a live full-term baby?

A. Dr. Mann – It depends on how many weeks you are now. If you are over 12 weeks, 96-97 percent.

Q. Nia – I have fibroids and a cyst on my ovary, can I still get pregnant?

A. Dr. Lee – you can still get pregnant, but carrying the pregnancy to term may be a problem if the fibroids are pushing into the uterine cavity.

Q. Rachel – I’m 27 years old and about 16 weeks along with twins. What are the chances of me carrying the twins to full term without bed rest? What can I do now to avoid bed rest?

A. Dr. Mann – The only predictor of your ability of carrying twins to term is having had a prior term delivery of a single baby. Fifty percent of women carrying twins do experience pre-term labor. However, prophylactic bed rest has not proven to be of any benefit. The best thing you can do is be vigilant in your care with your obstetrician or perinatologist. they will review with you signs and symptoms of possible pre-term labor and monitor the behavior of your cervix. Best of luck!

Q. Rebecca – can my diet affect fertility? If so what could I eat more of to improve it?

A. Dr. Lee – A well-balanced diet will help you be in the best shape for pregnancy. Prenatal vitamins with folic acid will decrease the risk of birth defects and should be started once pregnancy is planned.

Q. Rebecca – How can I deal with the depression of being unable to conceive?

A. Dr. Lee – This is not uncommon. A group called Resolve through Sharing may help you find other women in the same situation you can talk with. There are also therapists who help women deal with infertility issues.

Q. Shelly – we have been trying for five months and I have been off the pill for eight months. I have been charting and it shows I have been ovulating and we have been having intercourse during my fertile window and using pre-seed. Is there anything else I can do?

A. Dr. Lee – Give yourself some time. Only 50 percent of couples are pregnant at six months of trying. If you are under 35, you can wait another six months before beginning testing.

Q. Shon – I am turning 36 in a couple of months and I’m in a monogamous relationship. I just found out that I have fibroids. could the fibroids in any way affect my fertility for when I am ready to have a baby?

A. Dr. Lee – The location and size of the fibroids will determine whether they will be a problem. Talk with your doctor about whether treatment is needed or whether observation is all that is needed at this time. Remember that your fertility declines as you get older and pregnancy may not happen if you wait too long.

Q. Tammy – I am 42. Is this too old to try and have a baby?

A. Dr. Mann – It depends on your ovarian reserve. Your ovarian reserve as measured by your AMH, which can be assessed by your gynecologist or fertility specialist, can be predictive of your ability to become pregnant. If you are fertile, being 42 at delivery carries some genetic risks for the fetus, as well as maternal risks but if you are in good health, you have excellent chances for a healthy outcome.

Q. Tasha – hi. I am 27 and cannot seem to get pregnant. I have been having unprotected sex with my spouse for years and nothing has happened.

A. HealthWatchMD – It is time to see a fertility expert after that many years of trying.

Q. Tina – What is Clomid?

A. HealthWatchMD – Clomid is a drug that helps with ovulation.

Q. TJ – The hub and I have been trying for 2.5 years and I feel hopeless. There is no specific diagnosis other than “unexplained infertility.” after being sent to a specialist, we decided that it was all just not affordable. Just want to say appreciate this chat because it’s nice to be heard. This is a lonely journey sometimes.

A. HealthWatchMD – The journey can be very lonely. Resolve through Sharing is a group that can give you a place to talk about this with others in the same predicament.

Q. Tracey – I am five days past having a D&C. How soon is too soon to try for another baby?

A. Dr. Mann – you need to wait two to three cycles. The lining of the uterus needs to repair and regenerate itself so that another pregnancy implantation can be successful. Rushing may result in another miscarriage. be patient!

Q. Tracey – I am having emotional mood swings after having a D&C. my doctor has sent me home with estrogen patches. Is this safe? I desperately want to conceive again.

A. Dr. Lee – Mood swings are common after pregnancy loss. The patches are safe to use if your hormones are out of balance.

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