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Friday, December 30, 2005

Semen analysis

My husband and I having been trying to get pregnant for almost two years now, and he had a sperm count done. I cant understand what the report says and I don't want to wait until we go to the specialist next month. What does this mean?

TEST RESULT
SA, VOLUME 1.0
SA, VISCOSITY NORMAL
SA, COLOR WHITE
SA, APPEARANCE CLOUDY
SA, PH 8.5 (FLAG: H)
SA, INITIALSMEAR 60
SA, 1 HOUR 40
SA, 3 HOUR 30 (FLAG: L)

Thank You,
Rebecca

Dear Rebecca,

I don't have enough information to tell you exactly what it means since I don't know the reference values from that particular lab. However, it appears that although the pH is high and the 3 hour sample has a low number, the semen analysis is otherwise normal.

Sincerely,
Amy

Pregnancy after LEEP

In November 2004 I had a loop cone biopsy on my cervix. In September 2005 I had to have the procedure again. Both times the doctor has said to wait a year before becoming pregnant. What happens if I do become pregnant before the year is up? I really don't want to wait anymore.

Thanks,
Jessica

Dear Jessica,

It is important to wait until your cervix is completely healed before getting pregnant, because of the risk of premature delivery due to a damaged cervix. Complete healing usually takes about 3 months or so. You should talk to your doctor about why he or she wants you to wait longer. You can also visit another doctor for a second opinion.

Sincerely,
Amy

Mammogram in early pregnancy

Dear Dr. Amy,

I was exposed to radiation before I knew that I was pregnant. I had a mammogram. My LMP was 11-12-05 and the exposure occured on 11-30-05.

C

Dear C,

The risk of radiation exposure from a mammogram in early pregnancy are theoretical. I am not aware of any cases in which a connection between a mammogram and birth defects was established.

Sincerely,
Amy

First prenatal visit

How soon after you find out that you are pregnant should you make a doctor's appointment?

L

Dear L,

You should call for an appointment shortly after finding out you are pregnant, but you don't need to see the doctor until about 10 weeks of pregnancy.

Sincerely,
Amy

Thursday, December 29, 2005

Running during pregnancy

I love to run and I am only four weeks along. Can i still do the same workouts?

Thanks,
M

Dear M,

You can continue working out, but the rules of exercise are different in pregnancy. You should listen carefully to your body and never "work through the pain". If it hurts or makes you uncomfortable in any way, you should stop.

Be sure to discuss this with your obstetrician. He or she can give you specific recommendations based on your history.

Sincerely,
Amy

Getting pregnant with PCOS

Me and my fiance want to have children. They told me a little over a year ago that I have polycystic ovarian disease and that the only way for me to be able to have children is to be on fertility drugs for three to six months. Is this really the only way for us to be able to conceive because we know those are expensive and we can't really afford those right now and then what if we get them and they don't even work?


Lindsay and Michael

Dear Lindsay and Michael,

It is possible to get pregnant without fertility drugs when you have PCOS. However, the chances of this happening depend on how often you ovulate (release an egg). If you have very few periods a year, the chance of getting pregnant is quite low unless you take medication. However, if you skip a period only occasionally, the chance of getting pregnant is much higher.

If you have been trying for more than a year without success, it is likely that you will need medication to get pregnant. It is true that these drugs are extremely expensive, and there is no guarantee that they will work. However, there is a much greater chance of getting pregnant using medication than without medication.

Sincerely,
Amy

Paternity testing during pregnancy

Hello Dr. Amy,

I was wondering if it was possible to check the blood type of a baby during a pregnancy and if so how early can this be done.This would be to determine who the father is.

Monica

Dear Monica,

As far as I know, there is no way to do paternity testing until the baby is born.

Sincerely,
Amy

Mitral valve prolapse in pregnancy

Dr. Amy

I was diagnosed a few years ago with mitral valve prolapse. While I am rarely bothered by it, and when I am it is usually a mild flutter, I am concerned that being pregnant will either worsen or cause serious long-term effects on my heart. This causes me great concern. Do you have any information that may lessen my fears? Thanks so much for your time!

Jennifer

Dear Jennifer,

Mitral valve usually does not have an impact in pregnancy. In fact, MVP sometimes improves during pregnancy.

There is some disagreement about the need for antibiotics during childbirth. You should talk this over with the doctor who cares for your heart.

Sincerely,
Amy

Tuesday, December 27, 2005

TTC for over a year

Hello Dr. Amy,

I have endometriosis stage 3. I have been TTC for a year and a half now with no luck. I’ve had a test done on my mucous, which the doctor told me was killing the sperm. What causes this and is there anything I can do to fix it? I recently had an IUI done but it did not take. Please help.

Thank you,
Kristie

Dear Kristie,

It sounds like there is a least two problems that can lead to infertility and there could be more. You should make an appointment with an infertility specialist for a complete evaluation. He or she will be able to diagnose the problem and recommend the appropriate treatment so you can get pregnant.

Sincerely,
Amy

Headaches and dizziness in pregnancy

I am currently 17 weeks pregnant. I haven't had an easy time so far. I've noticed that over the past week that between my bad blurred vision, pounding headaches and lightheadedness. I am worried. I drink lots of water, take my vitamins and rest when i need to. Is there anything i can do or take for this?

Thanks,
Steph

Dear Steph,

You need to talk to your doctor about this and be seen, preferably today. These are not normal pregnancy symptoms and could be a sign of high blood pressure, which would need to be treated.

Sincerely,
Amy

Gastroenteritis

I am 5 weeks pregnant and my 2 year old son has come down with gastro (vomiting). I am worried that if I catch it, which is very likely, that it will harm the pregnancy.

N

Dear N,

You are not necessarily going to get your son's illness because you may already have immunity to it. Even if you do get gastroenteritis, it should not harm the pregnancy. Just be sure to drink plenty of fluid. If you have trouble keeping fluid down, you should talk it over with your doctor.

Sincerely,
Amy

Abdominal swelling

I am 45 years old and have four children. I had my tubes tied nearly 3 years ago after the birth of my last child. I had a uterine ablation last summer. I've had one period since the procedure and none since then.

About six weeks abo my stomach started swelling a bit. About a month ago my stomach swelled noticably and I started to have what felt like fetal kicking. I have had one urine and one blood test for pregnancy; both were negative. My stomach continues to swell and now the "kicking" is strong and frequent enough for other people to see it.

Neither my GP or my obstetrician has done a pelvic exam but just tell me pregnancy is impossible. I have an MRI scheduled for later this week. Will this tell me what is going on? I'm very frustrated.

A

Dear A,

First of all, your doctor should have done a pelvic exam. He or she could have gotten a lot of information from that.

Second, a pregnancy is extremely unlikely. I would be more concerned about a medical problem like a growth on the ovary, which often causes significant abdominal swelling as the first sign.

An MRI (or an ultrasound) should be able to tell you what is going on.

Sincerely,
Amy

Incompetent cervix

Hi Dr Amy,

I had a miscarriage this year in January . It was caused by incompetent cervix. If I was pregnant again, do I have to have the cerclage put in? Do I have to be on complete bedrest?

Shania

Dear Shania,

Incompetent cervix is a diagnosis that is made after two painless miscarriages in the 2nd trimester of pregnancy.

If you had a miscarriage in the first trimester, or if you had a miscarriage accompanied by pain, or if you had a miscarriage of a pregnancy with a genetic abnormality, it would not be incompetent cervix.

If you truly have incompetent cervix, you would need to have a cerclage and you might need to be on bedrest. You may want to get a second opinion from a perinatologist (a specialist in high risk pregnancy) to find out the best options for you.

Sincerely,
Amy

Monday, December 26, 2005

Retroverted uterus

Does a retroverted uterus affect fertility?

N

Dear N,

About 10% of women have a retroverted uterus. This usually has no impact on fertility.

Sincerely,
Amy

Old mattress and parasites

Dr. Amy,

I got a free twin bed from some people who I don't know for my 9 year old's bedroom. I am leery about using this bed that was given to me. Can scabies or crabs travel from the mattress to the box springs? I'm thinking of using our mattress, and their box springs. I don't want to put our family through a night mare, we just can't reallyafford a new bed right now. Thank you for your time.

Jody

Dear Jody,

Scabies, head lice and pubic lice require close contact with humans to survive. If the bedding has been stored away from human beings for over a month, it should be free of scabies and lice. Nonetheless, you should talk to your child's pediatrician before you use the mattress or box spring.

Sincerely,
Amy

Moderate dysplasia

Hi Dr. Amy,

My daughter recently learned that she has genital warts. Of course, the next news she received is that her pap smear has come back with "moderately abnormal cells," the description given to her by the family doctor. She will be referred to a gynecologist after Christmas.

I have researched HPV, genital warts, pap smears, dysplasia, and cervical cancer, but I am wondering if you could give me some insight as to how serious "moderately abnormal cells" might be.

Thank you,
A very concerned mother

Dear Concerned Mother,

The first thing to keep in mind is that a Pap smear is a screening test. That means that it identifies women who are at risk of abnormal cervical cells (dysplasia), but does not make a diagnosis. Women with abnormal Pap smears need to have colposcopy and biopsies to find out exactly what is going on.

Colposcopy is just like a speculum exam, but the doctor looks at the cervix through a magnifying scope. The doctor can identify area of potentially abnormal cells and remove them (biopsy) for analysis. The pathologist, looking at the tissue under the microscpe, can tell whether the cells are abnormal and whether the abnormality is mild, moderate or severe. The abnormality can be more or less severe than that seen on the Pap smear.

Moderate and severely abnormal cells must be treated (either by freezing or surgery) to make sure that they don't progress to cervical cancer. Then your daughter will need to be monitored carefully in the years to come to be sure that the abnormalities do not come back.

Sincerely,
Amy

Ephedrine in pregnancy

Dear Dr. Amy:

I have been taking diet pills with ephedrine the last 6 months and I just found out that I am pregnant. I am addicted to them. I want to know if the pills will effect my pregnancy? What should I do to keep my weight down during my pregnancy? I tend to go on crash diets. That really affected my metabolism and I am depended on this pills. What should I do?

A

Dear A,

You need to see an doctor (preferably an obstetrician) to find out if the ephedrine has had an effect on your baby. Ephedrine in pregnancy can cause birth defects. You need to be under the care of a doctor to gradually reduce the amount of ephedrine you are taking until you are off of it.

Ephedrine abuse is dangerous for anyone, not just pregnant women. Ephedrine can cause heart attacks, stroke and death.

You should consider seeing a mental health professional for help with this addiction and for help with the eating disorder that may be underlying the addiction.

Please arrange for medical care as soon as possible. If you do not have your own doctor, you can visit a clinic or a local hospital.

Sincerely,
Amy

Saturday, December 24, 2005

Should I have sex with my boyfriend?

I'm 15 and have my first boyfriend. He wants to have sex, but I'm not sure. He said he wants a baby and I do want a baby loads, but I'm not sure.

C

Dear C,

Let's consider the risks and benefits for you if you have sex with your boyfriend.

The risks include;

getting pregnant
getting a sexually transmitted disease that can be treated
getting an incurable sexually transmitted disease like herpes or genital warts
an increased risk of becoming fertile from a sexually transmitted disease
an increased risk of developing cervical cancer later in life
being disappointed in yourself for betraying your values
feeling used when your boyfriend eventually leaves you.

Now the benefits: Hmmm, I can't think of a single benefit for you. It certainly won't help you hold on to your boyfriend; sex never does, since he can always sleep with someone else. Furthermore, if a guy cares for you (instead of just caring about his pleasure), he would never push you into doing something you aren't sure about. The more he pushes, the more you can be sure that he doesn't care about you and will dump you when he gets what he wants.

So, what should you do. You should say "No".

I have taken care of thousands of women over the course of my career. I have never heard anyone say that they wish they had had sex earlier. However, I have met hundreds who have wished they had waited. You will never regret waiting until you are older, and you could literally ruin your life by giving in.

Sincerely,
Amy

Parental rights when teen has abnormal Pap smear

My daughter had a pap smear two weeks ago. Her doctor called and wants her to call. It's about the examination she did and can not talk to anyone about it except my daughter. She's sixteen.

My question is what result of a exam/pap smear is a doctor legally bound to just discuss with her patient. Also, I know they test for cancer, pregnancy and venereal disease. What else do they test for? I would really appreciate any information.

Thanks,
Carin

Dear Carin,

The doctor is legally bound NOT to discuss any medical information about pregnancy, sexually transmitted diseases, etc. unless the teen age patient gives her permission. If you want to get information directly from the doctor, your daughter will need to fill out a special form. Otherwise, you can get the information directly from your daughter.

A pregnancy test is not a part of a routine examination and would only be ordered if there was a reason to do so.

Sincerely,
Amy

Diabetes in pregnancy

I'm 20 weeks and i'm a diabetic. My doctor say's the baby is too big. What could that mean?

A

Dear A,

You did not mention whether you were a diabetic before pregnancy or whether pregnancy brought on diabetes. However, since it is too early in pregnancy for you to have been tested for gestational diabetes, I assume that you mean that you were a diabetic before pregnancy.

Women who have diabetes are at increased risk for a variety of complications in pregnancy. The risk is much greater if your blood sugars are not under tight control. Sometimes, the size of the baby can be an indication of whether your sugars are in good control. So, a large baby raises the possibility that you need tighter control.

Your doctor should arrange for you to see a nutritionist regularly, and you must stick to the diet. You need to be testing your blood sugars at least 4 times a day, and increasing your insulin as necessary. An acceptable blood sugar in pregnancy is much lower than an acceptable blood sugar when you are not pregnant.

A large baby also raises the possibility that the baby will be too big for a vaginal delivery and that you may need a C-section. Talk this over with your doctor.

Sincerely,
Amy

Thursday, December 22, 2005

Treatment of chlamydia

Hi Dr. Amy,

I found out yesterday that I have chlamydia. I took the 4 antibotic pills last night, as directed by my doctor. I'm talking with my partner tonight so that he can get tested as well. How long after taking the antibiotics is it safe to have protected sex again? And if he and I are committed to each other, how long until we can have sex without a condom?

Thanks,
Shari

Dear Shari,

You can have sex again when both of you have completed treatment.

Sincerely,

Amy

Pain during orgasm

Dr Amy,
I have been experiencing pain in my lower left abdominal area during orgasm. There is no pain during sexual activity just during orgasm lasting up to 15-20 minutes afterwards. I have been tested for a hernia and the test was negative. Any thoughts?

CB

Dear CB,

Only someone who examines you can tell you what is going on. You should make an appointment for a GYN exam.

Sincerely,

Amy

Trying to get pregnant while nursing

I have a 9 month old son, and I am still nursing 4 times a day. I have not yet gotten a period, and I am wondering what my chances are of conceiving. I know that I can conceive if I would catch my first ovulation, but I am not sure how I would know when I do ovulate for the first time since I have not had a period since May of 2004. Are there any signs I should watch for? Or, do I just need to be patient, because I don’t want to have to choose between weaning my son and getting pregnant again. Any advice would be appreciated.

Mandi

Dear Mandi,

There's really no way to know if you will ovulate while you are still nursing or if you will have to wait until you wean your son.

Sincerely,
Amy

Mildly complex ovarian cyst

Dear Dr. Amy,

I recently went to the emergency room with abdominal pain. The doctor performed an ultrasound and I presented with a mildly complex ovarian cyst that is the same size as my right ovary. I also have a polyp in my uterus which was picked up on a previous ultrasound but for some reason the ultrasound at the emergency room did not pick up.

My obgyn doctor put me on Yasmin to stop excessive periods (my period would last 11 days and 7 days later I would have another one). I had become borderline anemic from the blood loss. I’ve been on Yasmin for 5 weeks and everything was going well until three days ago when I experienced abdominal pain, bleeding (not heavy), lower back pain, and some stomach upset. Cramps were quite severe yesterday. The nurse at my doctors office said to take 400 – 600 milligrams of ibuprofen every eight hours and see how it goes.

I am still bleeding and have cramps and lower back pain today. Abdominal pain and lower back pain is in the center small of my back and center lower abdomen which seems odd as it is my right ovary that is affected. The ultrasound at the hospital did not show endometriosis.

I am 50 years old and am now a little worried about the new symptoms which are lower back pain and upset stomach. I have a vaginal ultrasound scheduled for January 13th. Is it safe to wait that long and should I be concerned?

Thank you so much.

Diane

Dear Diane,

It sounds like you may need a second opinion. My first concern would be the ovarian cyst. At your age, any cyst should be promptly and thoroughly investigated to be sure that it is not ovarian cancer. It's not clear whether the pain and other symptoms are related or represent a different problem. In any case, it makes sense to have the vaginal ultrasound sooner than Jan. 13. Talk it over with your doctor.

Sincerely,
Amy

Wednesday, December 21, 2005

Multiple miscarriages

Dear Dr. Amy,

My fiance and I have been trying for the past year to have a child of our own. I have two boys myself ages 5 and 3 but we would really enjoy one that is biologically both of ours. Just last week I had my third miscarriage. This concerns me and I don't understand why we can't conceive together.

I have heard about blood types not mixing properly. How likely is it? I have also been asked if I thought whether or not I could only carry just one sex of child. Is this a possibility?

We want nothing more than to have a child we can call ours and never thought the process would be this difficult. Help please.

Desperately trying,
M

Dear M,

Have you had 3 miscarriage over the last several years, or 3 miscarriages within the last year. The chance of miscarriage in any given pregnancy is approximately 20%, so it is possible for one woman to have 2 or 3 miscarriages without any cause for concern. However, if you have had 3 miscarriages in a row with your fiance, there is likely to be a problem of some kind. In that case, the best thing to do would be to consult an infertility specialist (they are also experts in miscarriages).

Repeated miscarriages are not caused by blood types failing to mix and there is no condition in which a woman can only carry a child of a certain sex, so you don't need to be concerned about that. Repeated miscarriages can be cause by genetic problems and hormonal problems, and, occasionally, immune problems.

Sincerely,
Amy

Tuesday, December 20, 2005

Medication and male infertility

Dr. Amy:

Can you please tell me if the medication, Soma (Muscle Relaxer) and Tramadol (Anti-inflammatory) used to subside pain for a herniated disk, can cause infertility on the male side? Female side takes no medication only pre-natal vitamins.

Thanks
Nikki

Dear Nikki,

As far as I could determine, neither Soma nor Tramadol is associated with male infertility.

Sincerely,
Amy

White bumps

Hi,

When I was shaving I found some slightly raised white bumps of different sizes between my vagina and my anus. I thought that they were just irritated spots from the previous time I shaved but when I scraped at them to make them go away the skin came off very easily and they started to bleed and the skin was a little thick and hard. These spots dont hurt in any way and they only bled a little and today I cant even really tell where they had been except the skin there is a little bit sensitive.

I've never had anything like this before so I'm pretty worried about it, but I did have precancerous cells on my cervix and just had a follow up colposcopy done last Thursday. Do you think it could have been from that? Thank you for taking the time to read this.

A

Dear A,

I'm not sure what those bumps could be. Only someone who examines you can tell what's going on. It could be something as simple as a rash from shaving or it could be from an infection of some kind. Hopefully, your doctor will be able to tell you why this happened.

Sincerely,
Amy

Monday, December 19, 2005

Bleeding during sex

Dear Dr. Amy,


I am 18 years old and on birth control. Everytime my boyfriend and I have sex I start bleeding. What does that mean?

T

Dear T,

I'm not sure why you are having bleeding. You should make an appointment with a gynecologist to find out the cause of the bleeding.

Sincerely,

Amy

Triple screen test

Hi Dr. Amy!

I am a little over 12 weeks pregnant right now, and at my next appointment (at 16 weeks) my doctor told me I will be given the option of having a triple screen test done. Could you please explain to me what this is and what exactly I will be tested for? Thanks so much for your time and help!

Sincerely,
Haley

Dear Haley,

The triple screen test detects whether your baby is at increased risk of Down's Syndrome or spina bifida (a spinal defect that often causes paralysis). It is a valuable test because if shows increased risk, you can have further testing (an amniocentesis or an ultrasound) to find out if your baby does or does not have one of these problems.

It is only a screening test, though, and that means that most babies who are identified as having increased risk do not actually have either problem. Therefore, if your test result demonstrates increased risk, you shouldn't panic. The odds are high that further testing will show that the baby is just fine.

Sincerely,

Amy

Clomid and male fertility

Hi Dr. Amy,

What are my chances of conceiving naturally w/out taking any fertility meds? I've been dx with PCOS.

Can Clomid be used to treat low sperm count? My Dr. suggested that my husband might need to take clomid to help him out with his sperm count. I was doing some research on the net to learn a lil bit more about this b4 we decided if we want to give it a try but I could'nt find anything as to how he (my husband) would have to take Clomid.
Please help!!

Thanks in advance,
Wanna B a Mommy

Dear Wanna,

The chance of getting pregnant with PCOS depend on how often you ovulate. If you rarely have a period, the chance of getting pregnant without medication is low.

Clomid does not have a high success rate in treating low sperm count. The best thing to do would be for your husband to see a urologist who specializes in male infertility. He can do the appropriate testing and recommend the best treatment.

Sincerely,

Amy

Nipple discharge

Dr Amy,


Hi I have never been pregnant or had any miscarriages that I know of. we are TTC and I am at day 18 in my cycle 5dpo. I am writting because I was examining my breasts as usual, when I noticed clear/white discharge from both my nipples upon gentle sqeezing. Is this normal for non-pregnant women or is this a potential sign of pregnancy? I just was at my OBGYN last week and she said everything looked normal, but I have never had anything like this before on my prior BSE. Just looking for some medical advice, thank you for your time.

Concerned,
Beth

Dear Beth,

Nipple discharge is not a typical sign of pregnancy. You should talk this over with your doctor and see if she wants to order an additional tests.

Sincerely,

Amy

IUD

Dr. Amy,

I have had so many pregnancy scares here lately. I decided to quit taking my birth control pill. My husband and I can never remember to use a condom though. We have a 14 month old daughter and we are not ready for another baby right now, maybe in a few years.

I am considering getting an IUD like Mirena. I am kind of scared that it will decrease my chances of getting pregnant in the future. Is this true? I am also wondering that since I had a Caeseran Section with the birth of my daughter if I can even get an IUD? Are these really that safe and wonderful than the companies make them out to be? Can you please help me? Thank You so much for your time! I really do appreciate it!

Kristin

Dear Kristin,

The IUD is a safe and effective method of birth control. However, many doctors feel that it should only be used by women who have completed their families. That's because the IUD can increase the risk of a pelvic infection that might scar your fallopian tubes. You should talk this over with your doctor.

A previous C-section has no effect on an IUD.

Sincerely,
Amy

Sunday, December 18, 2005

Hydrocodone in pregnancy

I am probably about a month or two pregnant. I just found out yesterday. I have been taking hydrocodone. If I stop now will everything be all right with my baby? I take probably about 3 or 4 a day.
I

Dear I,

Narcotics in small amounts are usually safe in pregnancy. You need to talk to your doctor about cutting back gradually. It is extremely difficult to stop abruptly.

Depending on the reasons why you need narcotics, you may be able to continue them throughout pregnancy, but only someone who is familiar with your medical situation could advise you.

Sincerely,
Amy

Getting pregnant after abnormal Pap smear

My daughter is going through the second round of precancer tests for irregularities in a pap test. She is wants to get pregnant. Will this precancer condition be negatively impacted by getting pregnant?

J

Dear J,

Getting pregnant will not affect the abnormal cells on her cervix, but it might affect the treatment. She should wait until she finishes the testing and has any treatment that is necessary, since it is much more difficult to treat abnormal cervical cells during pregnancy.

Sincerely,
Amy

Saturday, December 17, 2005

Trisomy 22

Dr. Amy,

I am a recurrent miscarrier. I have had 3 thus far. My first was a complete miscarriage at 6.5 weeks after a fetal heartbeat was detected. The second was a blighted ovum at 8 weeks. The third and most recent happened at 8 weeks after also seeing a fetal heartbeat. The pathology report lists the cause as Trisomy 22.

What are the chances of this happening again and have you heard of this being a cause of recurrent miscarriage? I have been referred to a reproductive endocrinologist for further tests but really fear that I will never have a child. Thank you for answering and for all that you do.

Suzanne

Dear Suzanne,

Genetic defects can be a cause of recurrent miscarriage. Genetic testing will be able to tell you if this is the case in your situation and whether it is treatable.

A reproductive endocrinologist is definitely the best person to see for this problem. He or she will be able to explain all possible causes, treatments and chances of success.

Good luck.

Sincerely,
Amy

High blood pressure in pregnancy

I am 7 weeks pregnant and have high blood pressure. Does this make me high risk?

Thank you,
Lawanda

Dear Lawanda,

High blood pressure before pregnancy can increase the risks to both you and your baby during pregnancy. Starting prenatal care right away, going to all your appointments for careful monitoring, and taking any blood pressure medications needed should reduce the risk of developing any problems.

Sincerely,
Amy

Pregnancy and thyroid disease

My husband and I have been trying to get pregnant for six months and I have thyroid disease (low). How long will it take to get pregnant.

T

Dear T,

You should not even try to get pregnant until you are sure that your thyroid disease is well controlled. Thyroid disease can interfere with your ability to get pregnant, and it can also cause very serious medical problems in an unborn baby if it is not properly treated.

If you have not had thryroid testing recently, you should have it repeated and make sure any medication is at the appropriate dose BEFORE trying to get pregnant.

If your thryroid disease is well controlled, it should not affect your ability to get pregnant.

Sincerely,
Amy

Getting pregnant after Norplant removal

Hi,

I would like to have a baby now. I have 2 kids age 10 & 7 (girl & boy) andI am 27 but seem to can't fall pregnant. I had the "rod" in my arm but had that removed in March of 2005. I did get my period as normal until May but it has stopped. I have seen the doctor and they took tests and I had an ultrasound done, but everything came back fine. Can you give me an idea of what might be wrong.

P

Dear P,

There may not be anything wrong. It can take up to a year after Norplant removal for you to ovulate regularly again. You can't get pregnant until you ovulate.

Sincerely,
Amy

Thursday, December 15, 2005

Tatoos in pregnancy

Why shouldn't you get tatooed while you are pregnant?

Billie

Dear Billie,

Getting a tatoo puts you and your unborn baby at risk for getting serious diseases like hepatitis B and HIV.

Sincerely,
Amy

Renal dysplasia

I had a baby about a month ago and she passed away shortly after birth. She had mutilcystic renal dysplasia, and Potter syndrome IIA. The doctors can't be sure it won't happen again in another pregnancy.

My partner wants to try again and I'm very scared. I see a doctor next week for a check-up and they want to go over the autopsy with us. If they offer genetic testing should we get it done and do you know how long that will take?

Very Concerned,
Danielle

Dear Danielle,

I am so sorry to hear about the loss of your daughter.

Multicystic renal dysplasia can be associated with other birth defects. The autopsy will reveal whether your daughter had other birth defects and that will help predict the chances of that it could happen again in a future pregnancy.

Genetic testing can also be very helpful in determining whether a genetic problem was responsible for your daughter's kidney disease. Often genetic testing will give information about the chances of a having the same problem in a future pregnancy.

After your meeting next week, you will have a much better idea what to expect.

Sincerely,
Amy

Positive pregnancy test after miscarriage

On 23rd November I was told that I had had a miscarriage. I bled heavilyfor 10 days then peetered off to nothing. This is 18 days after I was told I had miscarried but I took a pregnancy test this morning and it is still showing up positive. When I had my second blood test on 25/11, my HCG levels were around 200, which apparently is low. I am very confused as to whether I could still be pregnant or not.

Thanks,
Jo

Dear Jo,

A home pregnancy test can be positive for weeks after a miscarriage so it is not a reliable way to tell what is going on. You need to have another blood HCG level to distinguish between the old pregnancy and a possible new pregnancy. If the blood HCG level has not changed much since 25/11, it raises the possibility of an ectopic (tubal) pregnancy. This is a serious condition, so talk to your doctor about the results of your test and what it means.

Sincerely,
Amy

Luteal phase

Hello Dr Amy,

Can you please advise what the "Luteal Phase Length" is?

It has been mentioned in the "Due Date Calculator" and I don't actually know what the item is.

In particular they ask for the "Average Luteal Phase Length"

Regards,
Brooke

Dear Brooke,

The menstrual cycle is divided into two parts, the proliferative phase from the first day of your period until ovulation, and the luteal phase, from ovulation to the beginning of the next period.

Almost all women have a luteal phase length of 14 days. Women who have a condition known as luteal phase defect have a luteal phase significantly shorter than 14 days. These women may have difficulty getting pregnant and are at increased risk of having miscarriages.

Sincerely,
Amy

Wednesday, December 14, 2005

Withdrawal bleeding

Is withdrawal bleeding still considered a period?

T

Dear T,

Yes, withdrawal bleeding (bleeding after taking progesterone) is considered a period. It is a period without ovulating beforehand.

Sincerely,
Amy

Pregnancy after removal of fallopian tube

About a year ago I had a tubal pregnancy and they removed one of my fallopian tubes. Can I still get pregnant?

K

Dear K,

Yes, if you have at least one ovary and one tube, you can get pregnant. If you have had a tubal pregnancy in the past, there is at least a 10% chance of having another one. When you do get pregnant, you should talk to a doctor as soon as possible so you can be monitored to be sure that you don't have another tubal pregnancy.

Sincerely,
Amy

Late period

Dear Dr. Amy,

I recently started having sex without condoms (we're trying to get pregnant) and for the first time in almost 10 years I missed my period. I am relatively regular (28-33 days). I have taken 4 at home pregnancy tests and they were all negative. I went to the Dr. and they gave me another urine test and blood test and the results were negative. The Dr. prescribed Provera for 5 days. Is it common to prescribe provera? How soon after finishing the medication can I expect my period?

Thank you in advance,
B.

Dear B.,

Provera is often used to stimulate a period in women who have not had a period in months. It is not usually used just because a single period is late.

A late period when you are trying to conceive is often a sign of a chemical pregnancy. A chemical pregnancy is another name for an extremely early miscarriage. Chemical pregnancies are very common and they have no impact on future pregnancies.

You did not mention how late your period is, but if it is only a matter of days, it is reasonable to wait until it returns spontaneously, rather than taking medication.

When you take Provera, you usually get a very heavy period within 7-10 days of finishing the medication.

Sincerely,
Amy

Ovarian cysts

Dear Dr. Amy,

I am currently taking birth control pills (Estrostep Fe). My periods come regular every month and are very light. On Dec. 5th I received my period and it was extremely painful and extremely heavy (clots). The heavy bleeding last for about two days.

Because of the heavy bleeding and pain I went to get a transvaginal ultrasound. The report that came back stated I had a retroverted uterus. My right ovary measures 2.7 x 1.7 x 1.5 cm and contains a cyst measuring 1.4 x 0.9 x 0.8 cm with a single thin internal septation. A mildly complex hemorrhagic cyst is favored. The left ovary measures 4.9 x 4.3 x 2.9 cm and contains a cyst measuring 4.2 x 2.3 x 3.6cm with a tiny peripheral septation. No significant free fluid is identified in the posterior cul-de-sac.

I have never had a cyst before and b/c I am birth control I figured one shouldn't have developed. I have brought this to my GYN attention and she doesn't seem concerned however I am. I though the purpose of the pill was to help prevent cysts and the cyst on the left ovary is a good 1.5 cm bigger than the actually ovary b/c the cyst and the left ovary measures 4.9x4.3x2.9 combined.

My doctor wants to take the wait and see approach. I am 28 years and definitely want to have kids and do not want to lose any of my reproductive organs. I am wondering if I should get another opinion or take another transvaginal ultrasound in a few weeks. I am concerned because for the last two weeks I have been having a lot of back pain, dull ache in thighs, breast pain and pain in my left shoulder and arm. I also have a fibroid(myoma) measuring 3.2x3.0x2.8 which I feel from time to time. My doctor states if the cyst was 5cm then it would be cause for concern is that true?

Nicky

Dear Nicky,

You are correct that birth control pills prevent certain kinds of ovarian cysts, but they do not prevent all ovarian cysts. The Pill can prevent simple cysts associated with ovulation. It has no impact on any other cysts.

So there are a number of reasons to be concerned:

The cysts are not simple cysts; both contain septations.
You have cysts on both sides.
You have additional symptoms (which may or may not be related).

At a minimum, these cysts should be followed closely with repeat ultrasounds. It would also be reasonable to get a second opinion if you are not comfortable with your doctor's plan.

None of this means that these cysts necessarily represent anything serious. However, it warrants further investigation.

Sincerely,
Amy

Tuesday, December 13, 2005

Hearing your own heartbeat

Dear Dr Amy,

Can you hear your own heart beat when using a doppler?

S

Dear Stephanie,

Yes, you can hear your own heartbeat with the doppler. You can tell the difference between your heartbeat and the baby's heartbeat is by the rate. Your heartbeat should be in the range of 80 beats per minute. The baby's heart rate should between between 120-160 beats per minute.

Sincerely,
Amy

Getting pregnant after miscarriage and ectopic

My partner and I have been trying for a baby for a a couple of years. I have gotten pregnant twice. The first time was a miscarriage and second was an ectopic that went away by itself, so they didn't need to take any thing out. We still want a baby but it just hasnt happened yet. Is there anything we should be doing?

D

Dear D,

It really depends on the timing of everything that has happened. It can take up to a year for a normal couple to get pregnant. If you have been trying for two years, and got pregnant in each of those years, there is probably nothing wrong and you can continue trying.

However, if you have gone for more than 12 months without getting pregnant, it is time to visit a gynecologist or an infertility specialist. He or she will order tests to find out what is wrong and recommend treatment.

Sincerely,
Amy

Monday, December 12, 2005

Clomid and ovulation

Dear Dr. Amy,


My husband and I have been trying to conceive for over a year now. I went to a local gyno to see what he would have to say and he said I was not ovulating, so he prescribed Clomid, and to take it on days 5-9. I was advised to try the ovulation predictor kits on Day 10 til I got the double line indicating that I would ovulate with in 24-36hrs,

I never got those lines. I took 7 different tests. Is it possible that I did ovulate and the tests just couldn’t predict it cause of the Clomid? If it did work what are the possibilties of twins?

Confused & Tired

Dear Confused & Tired,

Clomid does not intefere with the ovulation tests, so it sounds like you did not ovulate. That is not surprising because the dose of Clomid often has to be adjusted upwards until it works properly. The doctor will usually prescribe a low dose of Clomid at the beginning and then continue to raise it gradually until you do ovulate.

The chance of multiple birth on Clomid is about 10%

Sincerely,

Amy

Not pregnant after 8 months

Dear Dr Amy,

I have been married for 8 months, and my husband and I decided that we would start trying for a baby straight away.

I have always suffered from very painful and debilitating periods, and was diagnosed with endometriosis. I had an operation, which helped ease my symptoms, but over time they have returned. The doctors always mentioned that endrometriosis can cause infertility.

I have had 2 abortions in the past and have also had chlamydia. Would chlamydia cause me to be infertile, or damage my reproductive system? Alternatively, would chlamydia in my husbands system for a period of 2-3 years cause him to be infertile?

My husband got someone pregnant when he was 25.

Please help as I am very concerned.

Kind Regards,
Anonymous

Dear Anonymous,

It is not yet clear that you have an infertility problem since you have not been trying for long enough. It can take up to a year for normal couples to get pregnant.

If you do not get pregnant after a year of trying, you should consider making an appointment with a gynecologist for an evaluation. The abortions are not a risk factor for infertility, but both endometriosis and chlamydia can cause or contribute to infertility by leading to scarring or, in the case of chlamydia, by blocking the fallopian tubes.

A gynecologist will recommend tests to determine the cause of the problem, and treatment to help you get pregnant.

Sincerely,
Amy

No period for 5 months

Dear Dr. Amy,
I have not had a period 5 months. My gyno has done countless pregnancy test and ultrasounds and we have found nothing. The doctor stated to me that I am not pregnant and proceeded to place me on medroxyprogesterone in order for my period to come down. It did not work.

The doctor has then placed me on the Nuva Ring in order to regulate my hormones. I have no pregnancy symptoms except for the fact that my abdomen seems more firm but my gyno says its gas. I also had a pap smear that came back abnormal for HPV and I will be getting further testing this week. Can you please give me some insight on what can possibly be going on?

D

Dear D,

Without examining you and knowing more about you, I cannot tell what is going on. However, I do think it needs to be investigated further with tests for hormone levels. I am also concerned that you did not get a period in response to Provera (medroxyprogesterone). You may need a higher dose to stimulate your period. If your gynecologist is stumped, you may need to get a second opinion. Someone should be able to diagnose the problem.

Sincerely,
Amy

Saturday, December 10, 2005

Missed a period at age 48

I am 48 years of age, this month for the first time ever (apart from pregnancy) I have no period, I had a tubal ligation 7 years ago so its unlikely I am pregnant. Can you help please?

P

Dear P,

The chances of pregnancy after a tubal ligation are very small, but they are not zero, so you should check a pregnancy test to be sure.

If a pregnancy test is negative, the most likely reason for missing your period is that you are approaching menopause. Menopause usually begins with increasingly irregular periods. Eventually (it could take years), you will have no periods at all. You can talk this over with your doctor.

Sincerely,
Amy

Male fertility and age

Hello Dr. Amy,

My husband and I just started to try to conceive. Until what age can a man be fertile? He is 60 and i am 26. Does that matter ?

Thank you,
Joelle

Dear Joelle,

Male fertility declines with age, but not a great deal. It appears that it can take longer for a woman to get pregnant if her partner is over age 50 and there is a slight increase in risk of having a baby with a genetic problem.

Sincerely,

Amy

Friday, December 09, 2005

Oral ovulation test

Dr Amy,

I recently had a miscarriage in Sept, and I am now trying to conceive. Since I have an irregular period I decided to purchase ovulating tests.

I came across this ovulation test called Maybe Mom. You test every morning and instead of urine you use your saliva and look through a microscope. It is supposed to measure the salt in your saliva and that is what predicts if you are ovulating or not.

I've been testing for about 1 1/2 months already and I seem to be ovulating every 6 to 7 days. Is that possible? Is it true that the salts in a woman saliva increase when ovulating and creates a fern like pattern when you are ovulating and you could see it through a microscope?.

Thank you and I appreciate your help.

Sincerely,
Eve

Dear Eve,

I could find no scientific evidence that saliva tests are useful in predicting ovulation. Your experience seems to confirm this, since no one can ovulate every 6-7 days.

If you think you need to track ovulation because your periods are very irregular, you can use ovulation predictor kits, which are quite accurate.

If you have very irregular periods and are having difficulty getting pregnant, you should make an appointment with a gynecologist for an evaluation.

Sincerely,
Amy

Irregular periods and fertility

Dear Amy,


I have been trying to get pregnant for months now and still nothing. I dont get my period every month the way I am supposed to. Even though i dont get my period do i still ovulate every month and can i still get pregnant?


S

Dear S,

If you don't get your period, that means that you are not ovulating and it is impossible to get pregnant without ovulating. You should make an appointment with a gynecologist to find out what is going on and whether treatment can improve your chances of getting pregnant.

Sincerely,
Amy

Do you need parental approval for birth control?

Hello,

I am 17 years old i wanted to know if i could get birth control by myself without my paraents knowing and about how much does it usually cost?

K

Dear K,

The rules vary from state to state, but in most states you can get birth control without parental consent. You can check with Planned Parenthood (on the web at www.plannedparenthood.org or in the phone book) about the rules in your state and the costs in your state.

You can also buy condoms in the drugstore or supermarket. No prescription is needed and they also protect you against sexually transmitted diseases.

Sincerely,
Amy

Ritalin and male fertility

Dr. Amy,


My husband takes ritalin every day. Does this drug being a controlled substance have any effect on his fertility or sperm, or can it in any way effect his ability to get me pregnant?Thanks.

Stacey

Dear Stacey,

As far as I could determine, there is no evidence that Ritalin affects male fertility. However, your husband should talk to his doctor about this to be absolutely sure.

Sincerely,

Amy

Thursday, December 08, 2005

Chlamydia

Just a few days ago I found out I had chlamydia and never cheated on my boyfriend. He on the other hand has and got another girl pregnant.

He said he went to the doctors office and said that he didn't have it. Is it any way possible that you can find out results the same day and could he not have and I just have it. Chlamydia does come from just sex doesnt it.

Very Concerned

Dear Very Concerned,

It doesn't matter what he says. He needs to be treated, too. If he told a doctor that his partner had chlamydia, the doctor would have given him antibiotics. You can tell him that untreated chlamydia can cause fertility problems in men.

Sincerely,
Amy

Does Prozac or Buspar cause a false positive pregnancy test?

I have a question for my sister. She currently take Prozac and Buspar. Today she took a pregnancy test and it was posititve. Is there a chance that the medication she takes could give her a false postitive.?

She is 38 year old with a 19 son, and is freaking out a little about this.

Thank you,
B

Dear B,

As far as I could determine, neither of these medications is associated with false positive pregnancy tests. She should ask her doctor for a blood pregnancy test just to be sure.

Sincerely,
Amy

Spotting at 52

A year ago, I started taking Prempro because my periods had become very erratic and I was having a great many hot flashes. I was first on the higher dosage of Prempro and seemed to get period after period. My doctor ordered a sonogram to make sure everything was ok because he said I should not be having periods on Prempro. I asked to have the precription changed to low dosage. After that, I had no more periods and haven't had any since May, 2005.

Approximately 3 weeks ago, I noticed that my breasts were tender. I worried about that thinking malignancy but I had just had a mamogram. Around Thanksgiving I noticed my waist feeling thick (I'm very slender) and felt bloated.

Last night, Dec. 5, I went to the bathroom and to my amazement I wiped blood. I don't have a full fledged period but I am spotting. I am 52 years old and will be 53 in January. Is there a chance that I could be pregnant?

K

Dear K,

Pregnancy would be extremely unlikely since it sounds like you have already gone through menopause.

It does sound like there is something wrong though, and it should be investigated soon. You need to make an appointment with a gynecologist to be sure that you do not have abnormal cells in your uterus that could be causing the bleeding, or abnormal cells elsewhere that are causing your other symptoms.

Sincerely,
Amy

Glucophage and infertility

Dear Dr. Amy,

I found out about six months ago that my testosterone level was too high, which explains why I rarely get a period. My doctor put me on glucophage, which I really haven't faithfully taken everyday like I should be. My husband and I have been trying to conceive for almost two years now. Does having high testosterone mean I can't get pregnant? What are some things I should be doing? Why can't I get pregnant? Help!!!

Sincerely,
Amber

Dear Amber,

The glucophage is the treatment for your infertility and you have not been taking the treatment.

A high testosterone level is often associated with polycystic ovary syndrome (PCOS). The symptoms of PCOS include very irregular periods, excess body hair, and a number of different hormone imbalances. Women with PCOS don't have regular periods because they ovulate (release an egg) only rarely. Since you can only get pregnant if you ovulate, women with PCOS often have a great deal of trouble getting pregnant.

Research has shown that glucophage (also known as metformin), can improve some of the hormone imbalances and promote regular (monthly) ovulation. If you ovulate regularly, your chances of getting pregnant rise dramatically.

It sounds like the first step should be taking the medication as directed and seeing if it will work for you.

Sincerely,
Amy

Wednesday, December 07, 2005

Late period after IUD removal

I had the coil removed 3 weeks ago. Could this make my period late?

Thank you,
Debbie

Dear Debbie,

Removing an IUD usually has no effect on the timing of your periods. Now that you are not using birth control, it is possible that you are pregnant.

Sincerely,
Amy

Pregnancy after miscarriage

Is it possible to ovulate/get pregnant within a week or two after miscarriage even though you are still bleeding? Does the 'week or two' time frame after a miscarriage refer to when the bleeding started, or when it is determined the fetus stopped growing (as in the case of a missed abortion) or when the bleeding stops?

I have heard different opinions about not only when it its recommended to start trying again (any where from after 1 complete cycle to 6 months) and I have also heard stories that the woman's body is actually extremely fertile right after a miscarriage, something about it being more receptive to conception. Is there any medical documentation or statistics that deals with specifically that very short window of time after miscarriage?

Thank you for any information you may be able to provide.

S

Dear S,

A woman is not more fertile after a miscarriage.

Most women will ovulate 2-4 weeks after all the pregnancy tissue has been removed from the uterus, whether this happens spontaneously during a miscarriage or whether a D&C is needed. Most doctors recommend waiting for at least one normal period before trying again. That is because you cannot tell when you are ovulating after a miscarriage and it makes it very difficult to accurately predict a due date. It is much easier (and more accurate) to have a menstrual period to refer to.

Sincerely,
Amy

Metformin and birth control pills in PCOS

Dr. Amy,

Yesterday I went to see my internist for my yearly physical. I have not seen him since I was diagnosed by my OBGYN at the same clinic with PCOS. He told me he works with a lot of woman with this condition and has a high success rate with treating symptoms and achieving pregnancy if that's what they want.

I am getting married in 11 days and already have a child, so pregnancy is not my goal until next year. He wants me to take metformin 500mg twice a day and birth control pills. He wants the metformin to treat my symptoms of PCOS and the BC to help me not get pregnant. He wants the Metformin started now and birth control once I get my period. That scares me because on my wedding night I don't want to worry about pregnancy and I know Metformin is used to help you ovulate and I would be at risk since I can't start the pill yet. Is this combination safe and have you heard of these two pills together before? Would it hurt to wait taking any of the pills until after my wedding? I don't want my period on my wedding or to get pregnant.

Thank you in advance,
Future Bride

Dear Future Bride,

You should talk it over with your doctor, but I suspect that postponing the start of the medication until after your honeymoon should not make any difference.

PCOS can cause problems in addition to irregular periods. PCOS can lead to excess weight gain, excess body hair and various hormonal imbalances. Birth control pills can treat the irregular periods of PCOS, but they have little effect on other symptoms of PCOS. Metformin appears to treat some of the additional hormonal abnormalities. That's why it is reasonable to combine Metformin with birth control pills.

Talk with your doctor about what benefits he or she anticipates for you if you take Metformin in addition to birth control pills.

Sincerely,
Amy

Quitting smoking before pregnancy

I am a heavy smoker. My husband and I are planning on having a baby soon. How long should a woman be clean from cigarettes before trying to conceive? I have friends who are smokers who have smoked during pregnancy and they say it is okay. I don't want to take any chances. My husband and I suggested 6 months of being cigaretteless before conceiving. I want to have a babysoon.

Aasha

Dear Aasha,

The sooner you quit, the better. That's because smoking can also reduce your fertility. So if you quit now, it may be easier to get pregnant.

I was unable to find any information about whether it makes a difference to quit for a specific amount of time before trying to conceive.

Sincerely,
Amy

Tuesday, December 06, 2005

Progesterone only birth control pills

Hi,

I changed from the combined pill to the POP (Cazarette) on my doctors orders in the beginning of October. I haven't had a period since I have been on the POP. Is this normal??

Thanks,
Vikki

Dear Vikki,

About 1% of women taking progesterone only pills (POP) will miss periods. However it is important to keep in mind that missing even one pill can lead to pregnancy, so you should take a pregnancy test to be sure that you are not pregnant. You should talk this situation over with your doctor.

Sincerely,
Amy

Period after having a baby

Dear Dr. Amy,

I am a mom of a new 11 week old baby girl. How long does it take for my period. I haven't had any bleeding since she was 4 weeks old. I am not currently using birth control. We are trying natural family planning and withdrawal.

D

Dear D,

Women who are breastfeeding might not have a period until after they stop breastfeeding. Women who are not breastfeeding will usually have a period within 6-8 weeks after delivery.

Both natural family planning and withdrawal are unreliable methods of birth control. You should check a pregnancy test because there is always a possibility that you are pregnant.

Sincerely,
Amy

Ulcerative colitis and fertility

Dear Dr. Amy,

I had ulcerative colitis when I was 12 years old. I am now 20 years old. I had 3 surgeries and they rerouted my intestinal area. I was just wondering if by having ulcerative colitis when I was younger would possibly make it impossible or hard for me to become pregnant in the future?

Thanks,

R

Dear R,

Ulcerative colitis does not usually affect fertility. However, the surgeries could have left some scarring in your abdomen and this could affect your ability to become pregnant. The chance that you will have a problem depends on the specific types of surgery, the findings during the surgery and whether or not you had post-operative infections. Your surgeon should be able to tell you about these factors.

Sincerely,

Amy

Failure rate of the IUD

Hi Dr. Amy,

I had my first child in july (04) and then in may (05) I got an IUD. What are the chances of becoming pregnant with the IUD?

Thank you,
Mrs. Costa

Dear Mrs. Costa,

The most common type of IUD in use today is the Mirena IUD. The failure rate for the Mirena IUD is less than 1% which means that it is a very effective form of birth control.

Sincerely,
Amy

Clomid and periods

My husband and I have been trying to conceive for 4 years. I have had a HSG and a sonohysterogram. Everything was o.k. to proceed with the next step.

I have been on clomid for the past 8 months. Before starting clomid I would have a light/short 3-4 day period. Since taking the pills I have had 7-8 day periods with heavy bleeding. Last month my period was so heavy that I could not leave the house for a day and a half. I had a lot of large blood clots and was changing every hour or so. This month I had a light 4 day period. Is it a possibility that I had a miscarriage?

Anita

Dear Anita,

The differences in your period from month to month may reflect whether or not you ovulated in that cycle. When you ovulate, your period is heavy and when you don't ovulate, your period is light. You should discuss this with your doctor.

Sincerely,
Amy

Can I still get pregnant?

I am 40 with one child. Recently I had a paratubal cyst and my left fallopian tube removed. My periods were ok for 3 months after the operation, but 2 months ago they stopped. Will they come back to normal or am I going to start menopause. I've done a pregnancy test but it was negative. My husband and i had been trying for a baby for the last 5 years. Is there any hope for me?

M

Dear M,

If you have been trying for 5 years without success, there is likely to be a problem of some kind. The best thing to do would be to see an infertility specialist for infertility testing. An infertility specialist could tell you your chances of getting pregnant at this point.

Sincerely,
Amy

Angus catus

Can angus catus help you get pregnant after depo provera? I only had 1 shot in august 2004 and my cycle not back to normal yet.

M

Dear M,

There is nothing that you can buy without a prescription that will improve your chances of pregnancy.

If your periods do not return to normal (that is, what is normal for you) by the end of the year, you should make an appointment with a gynecologist to find out what is going on.

Sincerely,
Amy

Sex during the first trimester

Dear Dr Amy,

Is it safe to have sex with my partner when i am only 6 weeks pregnant and I already had one miscarriage.

Thanks,
Hepz

Dear Hepz,

Sex in the first trimester is considered safe as long as you have not had any bleeding and as long as your doctor has not told you otherwise.

Sincerely,
Amy

Immunizations in pregnancy

Dear Dr. Amy,

I am in the military, and I am going overseas soon, so I am scheduled to have
immunizations this Wed (including smallpox, anthrax, etc.). My last period was Nov. 19, and I am pretty sure that i ovulated somewhere around the 23 or 24. While I know that may sound strange, I usually ovulate on the last day of my cycle or soon afterwards.

My husband, who is also military, came to visit me for Thanksgiving, and we had sex from
thurs(24) through sund(27). I am not on any birth control,

Yesterday and today my breasts have been very sore, and I lost count of the times i went to the
bathroom. Soooo, I decided to go to the doctor and get a blood test(since they can detect pregnancy the earliest). I just wanted to know before I get the shots because I dont want them to harm the baby if i am in fact pregnant. The test was negative, and I know that really doesnt mean anything, I was just wondering if you had any advise/input to give me on
this situation.

Thanks for your help,
Tiffany

Dear Tiffany,

You need to be sure that you are not pregnant before you have any immunizations that may be harmful in pregnancy.

As you have already realized, the chances of being pregnant are significant. If the first day of your last period was Nov. 19, it is likely that you ovulated around Dec. 3. Almost all women ovulate 14 days before their next period and most women have a 28 day cycle. You cannot ovulate on the last day of your cycle. Since you had sex as late as Nov. 27, it is possible that sperm survived to fertilize an egg.

A blood pregnancy test can turn positive as early as 6-8 days after conception, so it is too soon for a blood test to be positive yet.

You should discuss the possibility of pregnancy with your health care provider to be sure that there is absolutely no chance of pregnancy before getting the immunizations.

Sincerely,
Amy

Monday, December 05, 2005

Positive pregnancy test after tubal ligation

I had a tubal ligation done 10 years ago. My period is very late, and I had a positive pregnancy test today. Could this happen?

P

Dear P,

It is unusual, but it can happen.

It is important that you see a doctor about this right away. If you cannot get an immediate appointment, you may need to go to the emergency room. That's because women who get pregnant after a tubal ligation have a very high risk of ectopic (tubal) pregnancy. Since this is a potentially life threatening condition, you need to have an ultrasound to find out whether the pregnancy is in your uterus or in your fallopian tube. If it is in the fallopian tube, you will need to have either medication or surgery to treat it.

Sincerely,
Amy

No periods after IUD insertion

Dear Dr. Amy,

I have a 18 month old child and after his birth had an IUD inserted. I have not had a period since then unless you count the occasional brown spotting. This worries me because before my son I bled heavily. The last six months I have also had breast tenderness and mild cramping with occasional nausea. I have gone to the doctor once before and had a pelvic examine they found nothing and basically told me they had no idea why I no longer had an actual period. Your thoughts on this matter would be very helpful because I don't want something serious to be overlooked.

T

Dear T,

Just to be sure, you should check a pregnancy test if you have not done so yet. There is always a possibility that you are pregnant.

A Mirena IUD could cause you to have very light periods because it contains progesterone. Over 20% of women using Mirena will stop having periods after awhile. An IUD that does not contain hormones would not do this, so if you do not have a Mirena IUD, you should see a gynecologist to figure out what is going on.

Sincerely,
Amy

Cocaine in pregnancy

My question is : How long after using cocaine(Crack) does the drug stay in the baby's sytem before the baby is clean? You see I have an addiction to crack/cocaine, but I went into detox (5 days) and rehab (28 days) and I am in the final trimester of pregnancy. I am clean now but I just finished the inpatient programs and I have an active acs case and I would like to know if I have a chance of having a clean baby. I'm scared and need some type of info to either prepare me for the worst or leave me some hope for mine and my baby's future.

Thank you,
K

Dear K,

If you don't use any more cocaine or marijuana, your baby will be born clean. If you do use, the chances are high that it will be in the baby's system when she is born. That's especially true because cocaine can cause premature labor, so although you may not be due for awhile, you may deliver shortly after using cocaine at any point in pregnancy.

It sounds like you you may be asking because you want to figure out how to use cocaine over the next few weeks without having your baby taken away at birth. Afterall, Child Services already knows you have used cocaine up to this point; they will only be checking to find out if you continue to use. If that's the case, there are two things to keep in mind. First, you will probably get caught. Second, if you continue to use, you are not fit to take care of a baby. If you love your baby, you will give her up at least temporarily to someone who can care for her. If you take her home while continuing to use, you risk neglecting her and hurting her very badly because of your addiction.

Sincerely,
Amy

No periods on Topamax

I am on Topamax for migraine headaches. I know one of the side effects is painful periods, but can it cause your period to stop? I haven't had my period in 3 months, and I have been assuming that is what it is.

S

Dear S,

Missing a period can be a side effect of Topamax, but it is an uncommon side effect. The most common reason for missing a period is pregnancy, so you should check a pregnancy test to be sure that you are not pregnant.

Sincerely,
Amy

What kind of doctor takes care of pregnant women?

Hi,

I am 20 years old and applying for Medicaid here in NJ and they ask for the HMO plan and about my doctor. I do not understand what type of doctor to use while being pregnant? I do not have a doctor now so I would like to see what is out there. Also, does a doctor I choose take care of the baby to or is that a different type altogether? And does the doctor do an ultrasound or would I have to ask the hospital to?

Thank you,
Krystal

Dear Krystal,

During pregnancy, you should see an obstetrician. An obstetrician is a doctor who takes care of pregnant women and delivers babies.

When the baby is born, he or she should be cared for by a pediatrician. A pediatrician cares for only babies and children.

Some obstetricians have ultrasound machines in their offices. However, radiologists are the experts in ultrasound. Radiologists work in private offices and in hospitals. You can only have an ultrasound if your obstetrician orders one. You cannot arrange one on your own.

Sincerely,
Amy

Sunday, December 04, 2005

HPV in pregnancy

I have the hpv virus and i'm 9 weeks pregnant. Does that mean I will have a miscarrage?

N

Dear N,

No, HPV (human papilloma virus) does not cause miscarriages.

HPV is a sexually transmitted virus that can cause genital warts, precancerous cells on the cervix or cervical cancer. HPV can be transmitted to a baby at the time of delivery, whether you have a vaginal delivery or a C-section. Most babies are not affected by HPV. The few who do catch HPV could develop warts on the vocal cords, but this can be treated.

Sincerely,
Amy

HCG level and dates

My wife had her initial blood test done by our local, small office, family doctor. The lab results said that her level was at 36,000. The doctor couldn't tell us how far along she is because the lab didn't send a chart. Her first appointment with her ob/gyn isn't for another 11 days and we're trying to figure out how far along she is. Can you help?

Thank you,
J

Dear J,

You cannot tell how far along a pregnancy is by the level of HCG.

There are two ways to tell how far along a pregnancy is. The most accurate way is to calculate from the first day of the last menstrual period. The Pregnancy Calculator on our site can give you that information.

If you don't know the date of the last menstrual period, an ultrasound can tell how far along you are.

Sincerely,
Amy

Causing a miscarriage

Could I have a miscarriage from being pushed down hard to the ground? Will a lot of stress cause me to miscarry?

Thank You lots,
Danielle

Dear Danielle,

Neither stress, nor being pushed down hard to the ground will cause a miscarriage.

If you are asking whether you can cause a miscarriage on purpose, the answer is no.

Sincerely,
Amy

How long does Depo Provera stay in your system?

Dear Dr. Amy,

I had my first child at the age of 20 and my husband and I decided that I should be on birth control until we were ready to have another child. I was on the Depo for about 3 years and came off so that we could start TTC. It has been about 2/12 years since we started trying and we are still not pregnant. I have gone to the doctors where they drew some blood and did some preliminary hormone testing which all came back fine. We also bought a home fertility test for my husband which came back fine.

I was wondering if maybe the amount of time I was on the Depo could be the cause of this? I have heard that it takes a long time to flush out of your system completely but wasn't sure if this was true or not?

Thanks,
Jenn

Dear Jenn,

Depo Provera can affect your chances of getting pregnant for up to a year after you stop taking it. After that, it will have no effect.

If you have been trying to get pregnant for 2 1/2 years without success, there is likely to be some other problem. You need to see a gynecologist, or an infertility specialist to figure out what is wrong, and start the appropriate treatment. The chances of pregnancy after appropriate treatment are very high at your age.

Sincerely,
Amy

Chamydia and fertility

About a year ago I was treated for chlamydia and now we are trying to get pregnant. I went to the doctot in June and was told that I had an irregular pap and needed more testing. I can't afford it right now so I have not had it done.

Could having chlamydia reduce my chances of getting pregnant? Will I be able to get pregnant even though I had an abnormal pap? My periods are not regular at all.

Thanks,
K

Dear K,

An abnormal Pap smear can be a sign of precancer or cancer of the cervix. It is very important to have the tests that your doctor recommends. If you do not have the appropriate tests, and any treatment that might be necessary, you risk developing cervical cancer. An abnormal Pap smear does not affect the chances of getting pregnant, but you should really get this taken care of before you get pregnant, since it is much more difficult to treat during pregnancy.

Chlamydia is a sexually transmitted disease that can damage your fallopian tubes. This could affect your chances of getting pregnant, but there is no way to know unless you try. If you have difficulty getting pregnant (no pregnancy after a year of trying), you should see a gynecologist. He or she may recommend a hysterosalpingogram, a test that can show whether or not your fallopian tubes are damaged.

Sincerely,
Amy

Thursday, December 01, 2005

Shortness of breath in pregnancy

Dr. Amy,

I will be 12 weeks pregnant on Saturday and I was wondering if it is common to have shortness of breath this early in the pregnancy? This is my second pregnancy and I never had this problem before.

I also have a rash (hives). I get it about 3 or 4 times a year and the doctor just said to take some Benadryl till it clears up, but now that I am pregnant I am not sure if the Benadryl is considered safe during pregnancy.

Thanks,
Lisa

Dear Lisa,

No, shortness of breath is not common in early pregnancy. You should talk it over with your doctor just to be sure that it is not a sign of a serious medical problem.

Benadryl is considered safe in pregnancy.

Sincerely,

Amy

Is my girlfriend lying?

I had sex with a girl for the first time the day before her regular period. Now she says she took a pregnancy test 4 days after and it read positive. I also never ejaculated in her but it was unprotected. Is she lying because she has a previous history of doing this?

D

Dear D,

You cannot have a positive home pregnancy test 4 days after conception, so it sounds like she is not telling the truth this time.

However, if you don't want a baby, it is YOUR responsibility to make sure you don't have one by using condoms, whether you plan to ejaculate or not.

Sincerely,
Amy

Is this a new pregnancy?

On Oct 7th I had a D&C performed due to a blighted ovum. It is now Nov 30th and no period. My husband and I had unprotected sex on Nov 4th. I took a EPT test today and it was a very faint line. My question is could I still have the hormone (HCG) in my body from my last pregnancy and that may be the reason why I got a + pregnancy test today? I can't see myself having enough HCG in my system within 3 weeks (Nov 4th until now, that's not even 28 days).
W

Dear W,

It sounds like this is a new pregnancy. You probably ovulated around November 4th and would have gotten a period on November 18th, but you got pregnant instead. A pregnancy test will become positive approximately 14 days after conception (that's 28 days after your last period, if you had had one). Talk it over with your doctor if you are concerned.

Sincerely,
Amy

Could the doctor have done more?

Hi Dr. Amy,

I recently suspected I was pregnant and confirmed it through a hpt. I started bleeding lightly yesterday morning so called my general practitioner who does do obstetrics. He ordered a blood test and confirmed the pregnancy. He also ordered a serial HCG titre for yesterday, tomorrow and Saturday. I also had an ultrasound (done by the doctor himself, not a technician) and he detected a gestational sac that was the appropriate size for the stage of my pregnancy. He didn't detect a heartbeat but felt since I am at 61/2 weeks it wasn't abnormal.

I was sent home to rest and wait for the HCG levels to be complete and for a follow up ultrasound on Wednesday of next week. While all of this was happening, I started bleeding heavily but there was no cramping or pain. As soon as I got home the bleeding became spotting and stopped overnight.

Given this information, my doctor felt there was over a 50% chance the pregnancy was still viable. Is there anything else an OB/GYN could/would have done versus my general practitioner.

Thank you,
T

Dear T,

There is nothing that can be done to prevent a miscarriage, so you don't need to worry that another doctor would have done more. The most common reason for a miscarriage is a one time non-repeating genetic defect, so the miscarriage is inevitable from the moment of conception.

Sincerely,
Amy

Adderall and Concerta in pregnancy

Dear Amy,

Can a very low dose of adderall 25 mg. and then switched to concerta18mg effect a baby in the first month?

S

Dear S,

Both Adderall and Concerta are category C drugs, which means that there is no information yet about birth defects after taking these medications in early pregnancy.

Sincerely,
Amy

Progesterone supplements and miscarriages

Hi Dr. Amy,

A recent ultrasound confirmed that I am 3 weeks pregnant. Subsequent blood tests showed a lack of progesterone, for which my doctor prescribed supplements. However, from what I understand, low progesterone levels usually precede a miscarriage- and supplements will not bring the pregnancy "back to life". Are these supplements a waste of time?

By the way, I've had 3 miscarriages in a row in the past year (after 2 healthy babies). I noticed during the miscarriages that my breasts were much less swollen and painful than I remember compared with my healthy pregnancies. Is there a connection?

Thanks in advance,
Suzy

Dear Suzy,

Progesterone supplements can be helpful if the cause of miscarriage is progesterone deficiency. However, it will not be helpful if a pregnancy is destined to miscarry because of a genetic defect (the most common cause of miscarriages).

If you've had three miscarriages in a row, it raises the possibility of a medical problem. You should consider consulting an infertility specialist. He or she may be able to figure out why this is happening and prescribe the appropriate treatment.

Sincerely,
Amy
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