Treatment after multiple ectopic pregnancies

I recently had a miscarriage 3 months ago after going through IVF. The reason I went through IVF is becauseI have had 4 ectopic pregnancies. My left tube is completely blocked and my right has very minimal scars. My OBGYN says that my husband and I should try again naturally. She also told me to do acupuncture. I have gone through acupuncture and they also gave me some fertile type pills. Is there any way that this could help with my infertility?

T

Dear T,

Based on your description of the problem it does not sound like acupuncture or medication is likely to lead to a pregnancy. You may want to get a second opinion from an infertility specialist.

Sincerely,
Amy

Bicornuate uterus

Can I get pregnant if I have a bicornuate uterus?

J

Dear J,

Many women with bicornuate uterus can get pregnant, but they have an increased risk of miscarriages and premature delivery. The best thing to do would be to talk this over with a gynecologist before getting pregnant. He or she can order tests to find out the extent problem (the uterus could be completely or only partially double). This will allow the doctor to make better predictions about the odds in your particular case.

Sincerely,

Amy

Can you feel the baby move at 12 weeks?

My daughter is only 17 and 12 weeks pregnant. We felt the baby for sure last week. I know as a mother of three this is not normally possible. Could you give any explanation why we felt the baby?

LD

Dear LD,

The most likely explanation is that your daughter is farther along than 12 weeks. The doctor should be able to tell you if that is the case.

Another possibility is that you didn't feel the baby, you just felt activity in your daughter's intestines.

Sincerely,
Amy

Persistent positive pregnancy test

Dear Dr Amy,

As you recommend I pressed my doctor for a scan as I havent had a period for three months and had four faint positives now. I saw a different doctor who listended for a heart beat and said he may be able to hear something and felt my tummy and said he could feel what felt like my womb and called the hospital for a scan.

I had a scan done Monday and they didnt find any sign of a baby or any sign of any complications. I didn't have a full bladder. In fact, I was told to empty my bladder since they were going to perform a transvaginal scan, but they read the notes and it said abdominal ultrasound and proceeded with an abdominal ultrasound.

Would an empty bladder stopped them seeing anything if I was 14 weeks pregnant? Surely they could see something with or without a full bladder.

Really appreciate your reply as all this messing around is driving me crazy!

Stephanie

Dear Stephanie,

This is a serious situation and should have been sorted out long ago. You need to see a gynecologist (or a more competent one, if you've seen one already). You may have an ectopic (tubal) pregnancy, and that is a potentially life threatening problem.

You need to have HCG levels checked twice at least 24 hours apart and you need a transvaginal ultrasound. Both of these things should be done as soon as possible.

It is extremely unlikely that this is a normal pregnancy. A baby would be clearly visible on an abdominal ultrasound by 14 weeks.

In a normal pregnancy, the HCG levels will double approximately every 48 hours. By 14 weeks, the HCG level should be in the tens of thousands. If it is low and not rising appropriately, there is a very high chance that this is an ectopic pregnancy. An transvaginal ultrasound may show pregnancy tissue in the fallopian tube, but if it does not, it is still possible to have an ectopic pregnancy.

If you have an ectopic pregnancy, you need to be treated with medication or, less commonly, with surgery.

If you cannot get an appointment with a doctor, you may need to go to your local emergency room.

Sincerely,

Amy

Only one period per year

I want to get pregnant but i dont have a normal period. I go a year or so without a period. Can I still get pregnant without a period?

Thank you so much,
Dianna

Dear Dianna,

Having only one period per year is very abnormal and you need to see a gynecologist about this. It is also makes it very difficult, to get pregnant.

You may have polycystic ovary syndrome (PCOS), a hormonal imbalance. It is very likely that you need medication to regulate your periods, and you may need fertility medication in order to get pregnant.

Sincerely,
Amy

Pregnancy test positive again

Last month I was 4 days late, so I took a hpt and it was +. I called my doctor who ordered a blood test. It came back with a weak +. They tested again in a couple days, and it to came back with a weak +, so they ordered an hcg level. The count came back at 16, so they said come back in a week to retest. In the mean time I spotted for about 4 days.

After the second test the nurse called and said my hcg level was at 2. She could not explain why and just said that I was not pregnant, even though I had 4 + tests. The doctor never did any exam. From what I read I thought maybe it could be a chemical pregnancy.

Now here I am a month later and late again. I did a hpt this weekend and it came back +. I am very worried. Is it possible that I have been pregnant this whole time and maybe the second blood test was not accurate?

Thank you,
D

Dear D,

The most likely scenario is that you were pregnant, had a very early miscarriage (chemical pregnancy), were no longer pregnant when the second HCG level was done, and are now pregnant again.

You need to have an HCG level to see if your HCG level indicates a new pregnancy, and another level in 48 hours or more to make sure that the HCG level is rising appropriately (doubling every 48 hours). Talk this over with your doctor.

You did not mention whether you ever had a period in the last cycle (after the HCG level of 2). If you did not have a period, it is possible that you have an ectopic (tubal) pregnancy that has persisted over these past few weeks. In an ectopic pregnancy, it is possible for the levels to rise and fall and rise again. If you did not have a period, you should talk to your doctor about making sure that you don't have an ectopic pregnancy.

Sincerely,
Amy

Light periods after D&C

I had a D&C early May for MAB at 11 weeks. My period flow is light compared with before the pregnancy/D&C. Does this light flow have any bearing on uterine ability to accept and nourish a fertilized egg? I am 41 and am anxious about fertility.

Thanks,

S

Dear S,

I do not know if the lighter periods have an impact on your ability to conceive. Your fertility does diminish after age 35. The recommendation for women age 35 and over is to consult a fertility specialist if you have tried for 6 months without success. Since it has been approximately 6 months since your miscarriage, you should consider making an appointment. An infertility specialist will be able to advise you about the light periods, as well.

Sincerely,
Amy

Paxil in pregnancy

I just started on paxil two days ago and I know I am ovulating. Should I stop the paxil and could it harm my unconceived child?

S

Dear S,

There is some question about the safety of Paxil in pregnancy. The best thing to do is to take precautions to prevent pregnancy: use birth control or avoid intercourse for the next few days. You should avoid getting pregnant until you talk with your doctor about whether you should use a different medication.

Sincerely,
Amy

IUD and positive pregnancy test

Dear Dr. Amy,

I have had an iud in for two yrs now and just recently i hve started with the pregancy feeling.
I took three home pregnancy tests. Two came back inconclusive and the other one said positive. If i am pregnant will the iud hurt this pregnancy?

Thank you,
Lesley

Dear Lesley,

You need to talk this over with your doctor as soon as possible. A positive pregnancy test means that you are pregnant. Women who get pregnant with an IUD in place have an increased risk of an ectopic (tubal) pregnancy. This is a serious medical condition that needs to be treated. If you develop abdominal pain, you need to see a doctor right away, day or night.

In addition, the IUD could be harmful to a nomal pregnancy. In some cases, though, the IUD can be removed safely. Your doctor will probably order an ultrasound test to check on the status of the pregnancy.

Sincerely,
Amy

Egg white to conceive

I read on one site that you can use real egg whites to help with fertilization. It said many women over 35 don't have enough natural egg white during ovulation and this is a sperm friendly alternative and allowed the same consistency and protection towards fertilization.It sounds strange to me, but women were swearing they used it and it worked for them.I was hoping you knew if this is true.

Linda

Dear Linda,

Some people recommend egg white as a form of lubrication during sexual intercourse. This only applies to women who need artificial lubricants such as KY Jelly or Astroglide during intercourse. The theory is that KY Jelly and Astroglide could be harmful to sperm. In actual practice, artificial lubricants have little impact on pregnancy rates. They may have an increased impact in the case of men with a low sperm count.

Egg white does not promote fertilization.

Sincerely,

Amy

Enalapril in pregnancy

Is it safe to take enalapril if you are pregnant?

N

Dear N,

No, enalapril is not considered safe in pregnancy. If you think you are pregnant you should talk to your doctor as soon as possible. There are other, safer, blood pressure medications that can be used in pregnancy.

Sincerely,
Amy

Birth defects

Hi Dr. Amy,

I had to have a termination on the 4th of march this year as my child was severely ill. My specialist told me that the baby's heart was growing on the outside of his chest, there was alot of fluid on his brain and his spine was all twisted. My sister also was born with spina bifida and I am scared that this will happen again. The doctor told me he couldn't see it happening again as it was only the 2nd case he'd seen in 10 years. I'm just worried about it happening again as I'm 2 weeks late for my period.

Thank you,
Nicola

Dear Nicola,

Certain birth defects can be inherited, so your concern is very appropriate. First, you need to check a pregnancy test to see if you are pregnant.

Regardless of the outcome of the pregnancy test, you need a consultation with a genetic counselor. A genetic counselor can review your family history and the history of your recent pregnancy to see if there is a possibility that these birth defects are genetic. In addition, the counselor can recommend tests that may show exactly the genetic defect that is responsible. This information will allow the counselor to calculate the chances that this could happen again.

In addition, women who have a family history of spina bifida as you do should take an increased dose of folic acid before pregnancy and during pregnancy (a larger dose than that recommended for the average woman).

Sincerely,
Amy

Endometriosis and menopause

Dear Dr. Amy,

Does Endometriosis bring on menopause early? In other words, does endometriosis affect menopause in any way? My wife started her last period Sept. 5th 2005 and hasn't had one since (it is now Nov. 25th). She is 37 y.o. and has endometriosis bad.

Sincerely,
Concerned Hubby

Dear Concerned Hubby,

No, endometriosis has no effect on menopause, or menstrual cycles generally. Your wife should check a pregnancy test to be sure that she is not pregnant.

Sincerely,
Amy

Elevated blood pressure

Dr Amy,

My due date is December 15, 2005. When should I really worry about my blood pressure? My normal pressure stays at 120+/60+. At my appointment on Wednesday, my blood pressure was something/90, so I checked it again later that day at Wal-Mart. I tested at 136/87. I called my doctor, it was the day before Thanksgiving, he said to go home and rest and check again later. He said that if it didn't seem to go down to call again. Their office is closed until Monday.

My blood pressures have ranged from 105/66 to 133/91.

L

Dear L,

Even though the office is closed, there is always a doctor available to see you. You can reach the doctor on call through the answering service at the office or the hospital.

The diagnosis of pre-eclampsia is based on more than just blood pressure. It depends on swelling, reflexes, and protein in the urine, among other things. At a minimum, your doctor should talk with you this weekend about your blood pressures, and if there is any question about what is going on, he should examine you at the hospital.

Pre-eclampsia is a potentially dangerous condition. If your doctor is confident that you don't have pre-eclampsia, you can wait until your next appointment. If there is any question about whether or not you have pre-eclampsia, you should be seen today. Holidays are irrelevant when it comes to providing medical care.

Sincerely,
Amy

Is this a reason to have an abortion?

I found out I was pregnant just about 2 weeks ago. From the day that I found out I stopped drinking and smoking all together, started taking pre-natal vitamins and also eating well and getting good amounts of sleep.

This past Wednesday afternoon I decided that it wasn't the right time for me to go through with it. Thinking that I was going to end the pregnancy, I went out that night and drank quite a bit and smoked about a half a pack of cigarettes. I don't know if I have a choice any longer because of the large amounts of alcohol and cigarettes I consumed on Wednesday night, but I think I may want to go through with my original decision to have the baby. My boyfriend, who was upset with my decision to have an abortion, thinks that although he wanted to keep it we no longer have that option because of my night out on Wednesday.

Do I have a choice if I want a healthy baby or did I ruin those chances with that one night out of binge drinking and smoking? Thank you!

Nervous in New York

Dear Nervous,

There is no medical reason for you to have an abortion. Neither smoking, nor one night of binge drinking is likely to have any impact on the baby.

An abortion is a purely personal choice. There is almost never a medical reason to have an abortion except in the very rare case that your life is in endangered by pregnancy.

Sincerely,

Amy

Flu shot in pregnancy

I have to get the flu shot yearly because of my employment. I just received it yesterday. Now I am not sure I should have received it. I have been trying to get pregnant but I am not sure if I am. If I am pregnant it is only a few weeks along. Is it o.k.? I have learned that is packed with mercury.

J

Dear J,

The flu shot is considered safe in pregnancy.

Flu shots don't have mercury. Some vaccines used to have thimerosol (a chemical that contains mercury) in them as a preservative. Under pressure from autism groups, thimerosol was removed from all vaccines. It is important to know, though, that there is no scientific evidence that autism (or any other disorder) is linked in any way to thimerosol.

Sincerely,
Amy

Sincerely,
Amy

Getting pregnant

Hi Dr Amy,

My husband and I have been trying to conceive for 10 months now. I am 34 yrs of age we both smoke and I have a stressful job. Does the above limit my chances of getting pregnant? We only have sex once a week does that make a difference (the amount of times)?

Thank you,
Louise

Dear Louise,

Smoking can interfere with fertility. It is not clear if stress has a significant impact.

The frequency of sex does not matter, but having sex near the time of ovulation is extremely important. You can only get pregnant at the time that you ovulate (release an egg). For most women, ovulation occurs 14 days before the next period. For women who have a 28 day cycle, that means that they would ovulate on day 14 (counting from the first day of the previous period). You don't have to have sex on the day of ovulation since sperm can live inside you for several days and wait for the egg to be released. However, it is very important to have sex at least once and preferably twice in the days leading up to ovulation.

Most couples will get pregnant within the first 12 months of trying. If you do not get pregnant in the next 2 months, you should make an appointment with your gynecologist or an infertility specialist to make sure that nothing is wrong.

Sincerely,

Amy

Feta cheese in pregnancy

Hi,

I am 8 weeks pregnant and love Greek food. Can I continue to eat feta cheese and tarasomalarter (contains fish roe)?

Thanks,
Helen

Dear Helen,

Pregnant women are advised to avoid soft and semi-soft cheeses made from unpasteurized milk. Cheese made in the United States must be made from pasteurized milk, but imported cheeses are not under the same requirement. Therefore, you should avoid feta, brie, camembert and other cheeses made from unpasteurized milk.

Unpasteurized milk can carry listeria. Listeria usually causes only a minor illness, but in pregnant women it is more serious and can cause a miscarriage or late pregnancy loss.

I could find no research that indicated any problems with fish roe.

Sincerely,
Amy

Chest pain

I had a c-section on 8-4-05 and ever since then, if I sleep on my sides I have severe pain in my chest in betweeen my breasts. What could this be ? I have no insurance now so I can't go to the doctor.

SH

Dear Sheena,

Sometimes you just have to go to the doctor. Chest pain is one of those times. It could be something minor like an inflammation of the sternum (breast bone), but it could also be something very serious like a lung or heart problem, so you have to get it checked out as soon as possible.

Sincerely,
Amy

Testing for birth defects

I'm 13 weeks pregnant. If there are no known defects on my side or my bf's side of the family, is it still worth testing for this?

My friend who just had a healthy baby girl in October had a triple screen test done and it came back positive for Down's symdrome. She went back for another test and it was fine. Would you advise against the triple screen testing? Thanks.

Stephanie

Dear Stephanie,

I definitely recommend the triple screen test.

It is important to understand what these tests can and cannot do. For example, you mention that your friend had a triple screen test that was positive for Down's Syndrome. That's a common misunderstanding. The triple screen test is a screening test. That means that it identifies babies who are at risk of Down's Syndrome. It cannot tell which babies actually have Down's Syndrome. So a positive result does not mean that the baby has Down's Syndrome.

There are many more babies who are at risk than babies who actually have Down's. Another test is necessary to find out the diagnosis. This test is amniocentesis. In amniocentesis, a needle is used to take out some amniotic fluid. There are cells from the baby in the fluid. Looking at these cells under a microscope can identify which babies have Down's.

If you have a family history of birth defects, you are at increased risk for having a baby with birth defects. However, most babies who have birth defects are born into families that have no family history. That is why the triple test is recommended for everyone.

Sincerely,
Amy

Irregular periods

Hi!

I'm 19 and I still don't get my period every month..... What's wrong with me? What do you suggest? --

ldyny

Dear ldyny,

You may have PCOS (polycystic ovary syndrome). This is a hormonal problem that can lead to irregular periods. The best thing to do would be to talk it over with your doctor. He or she may recommend tests to find out what is going on.

Many women with PCOS take birth control pills to regulate their periods. Some women with PCOS may need medication to help them get pregnant.

Sincerely,
Amy

Questions about birth control

Dr. Amy,

I recently started dating a guy who had had sex before, however, I have not. My mother wants me to go on birth control just in case. I don't plan on having sex for a while. I want to go on birth control to be safe but I get uncomfortable easily. I was just wondering what questions to expect from the OB/GYN if I do ddecide to go through with it. Also, I was wondering if birth control would hurt my chances of getting pregnant in the future. I am only 18 and would like to have children of my own someday. What kind of birth control is the healthiest for you?

Thank you for listening,
H

Dear H,

It is an excellent idea to think about birth control even before you become sexually active.

Birth control does not interfere with fertility. The only exception to this is the IUD. If you get an infection while using an IUD, it could cause damage to your fallopian tubes. That's why an IUD should only be used by women who have completed their families, and should not be used by women who have not yet had children.

Of course, permanent birth control, like getting your tubes tied, is meant to be permanent.

Most methods of birth control fall into one of three categories:

1. barrier methods like condoms or the diaphragm that prevent the sperm from reaching the egg.
2. hormonal methods like the Pill or Depo Provera (the shot) that prevent ovulation (releasing an egg).
3. the IUD and the morning after pill which prevent conception or implantation of the fertilized egg in the uterus.

Each method has different benefits and risks.

Hormonal methods are the most effective. The Pill is 99% effective when taken faithfully. Depo Provera is even more effective. These methods are extremely popular because of effectiveness and ease of use. However, hormones can cause side effects for some women, and other women may not be able to use hormonal birth control because of other medical conditions.

Barrier methods can be very effective when used faithfully. Condoms, especially when used with foam, can be over 90% effective. In addition, condoms protect against most sexually transmitted diseases.

The IUD is only for women who have completed their families and the morning after pill is only for emergency contraception. The morning after pill is taken after you have unprotected intercourse and is only 75% effective.

The choice of birth control method depends on a lot of personal factors. There is no "best" method for everyone. Talk to your doctor about all methods and think carefully about what method you would be able to stick to. No method of birth control will work unless you use it faithfully.

Sincerely,
Amy

SoBe energy drinks in pregnancy

Dear Dr. Amy,

I am 8 weeks pregnant and I was wondering if it is all right to drink SoBe energy drinks. I have heard many different answers and I thought I would get the opinion from a doctor. Thank you very much.

Melissa

Dear Melissa,

I would avoid these drinks. They are filled with caffeine and sugar. The amino acids and herbs do not enhance health in any way and could turn out to be harmful, especially to a developing baby.

Sincerely,
Amy

Vaginal infections and fertility

If you have a yeast infection or any type of vaginal infection, can that stop you from ovulating or becoming pregnant?

CC

Dear CC,

No, vaginal infections, including yeast infections, have no effect on ovulation or conception.

Sincerely,
Amy

No period on Seasonale

Dear Dr. Amy,

I'm 17 years old and I have Von Willebrands disease (a bleeding disorder). I have heavy periods that last for sometimes two weeks. I've also been very stressed out lately. I had sex the first day I was put on birth control my last period start day was October 12 I took a home pregnancy test and it came up negative. I was wondering if I could be pregnant? I am currently on Seasonale 0.15 mg/0.03 mg.

S

Dear S,

Seasonale causes you to have only 4 periods a year, one every 3 months. If you started Seasonale in mid-October, you should not expect a period until January.

Sincerely,
Amy

Second trimester bleeding

Hello Dr. Amy,

I am 15 weeks pregnant, & after having sex with my husband I sometimes bleed. This has only happened 2 times so far. After the 1st time I bled after sex I had my OB appt & saw my baby was still healthy on the ultrasound, so I never mentioned it to my doctor. But now it happened again over the weekend. The bleeding usualy lasts about 2-3 hrs then stops. It's not real heavy bleeding, but is evident enough to KNOW it is blood. & this last time, there was not only blood but there were small amounts of what looked like tissue matter (not sure how to explain it).

The bleeding has stopped now, but could you please let me know if this normal, or could something be wrong? Does alot of women bleed after intercourse when pregnant?

Thank you so much for your help Dr. Amy.

Sincerely,
Belinda

Dear Belinda,

Bleeding in the second trimester is not normal and you need to talk it over with your doctor. The cervix is very sensitive during pregnancy, and sometimes the bleeding is just due to irritation of the cervix. This is not harmful to the baby or to you. However, it is also possible that the bleeding is coming from inside your uterus. It is important for your doctor to check this.

Sincerely,
Amy

Diabetes and pregnancy

Dear Dr. Amy,

My boyfriend and I have been trying to get pregnant for the last 6 months and no luck. I have diabetes and I'm taking insuling twice a day. Can that have something to do with getting pregnant?

Isabell

Dear Isabell,

Diabetes can have a big impact on getting pregnant and having a healthy baby. You should talk to your diabetes doctor BEFORE you even try to get pregnant. It is very, very important that your diabetes be under tight control before getting pregnant or you may have difficulty conceiving, an increased chance of miscarriage and an increased chance of birth defects.

Sincerely,
Amy

Can you get pregnant while you have an STD?

My partner and I have an STD (chlamydia). We have a prescription to treat the STD, but we did not have protected sex and we wanted to know if there is a possibility of getting pregnant while having this STD?

My partner has had this STD for a while and was not aware of it. I have not had this for long, maybe 2 months He is afraid that he may have gone sterile by now, since he believes he has had it for a year and a half.

D

Dear D,

Yes, you can get pregnant when you have an STD. It is true that some STDs can result in damage to the fallopian tubes, leading to infertility, but that is not what happens most of the time.

Chlamydia does not cause men to become sterile. In fact, it often causes no problems at all for men.

Sincerely,
Amy

Mirena IUD

Hello Dr Amy,

I had the mirena coil fitted about 6 weeks ago. I feel like I am pregnant again. I have 2 girls one at 18 months the other 4 months. Recently my appetite has been getting bigger, I have been having mood swings and my boobs are sore. I am feeling sick a little in the mornings. Do you think it could be the coil that is making me feel like this or am I pregnant?

Claire

Dear Claire,

The Mirena IUD (coil) contains progesterone. That could be the cause of your symptoms. Talk it over with your doctor and check a pregnancy test to be sure that you are not pregnant.

Sincerely,
Amy

Can medication intefere with a pregnancy test?

Up until 4 weeks ago, I was taking Lexapro for anxiety. I feel I may be pregnant, but have taken a hpt and the result is negative. I am actually due today, and I am ALWAYS on schedule. My concern is that something in the drug could interfere with a correct reading. Is this possible? Thanks.

Dear L,

I could find no evidence that Lexapro can cause a false positive pregnancy test. Only certain anti-seizure or anti-Parkinson's medications and some tranquilizers can cause false positives.

Sincerely,
Amy

PCOS and metformin

I have PCOS and I have recently started taking Metformin for treatment. I have a 10 year old. Since starting Metformin, I have had a period, so it must be doing something. I worry that I will never be able to get pregnant again. Is this the right medication to take for this syndrome? Are my chances of pregnancy the same as other women who do not have PCOS, since I am being treated? It means the world to me to have another child. I hope you can give me an answer to help put my mind at ease.

Thank you,
Tonya

Dear Tonya,

Only a doctor who has read your medical records could tell you if Metformin is the best treatment for you. However, Metformin is helpful to many women who have PCOS. It increases the chance of pregnancy, but does not raise it to the level of women who do not have PCOS. Your doctor can give you a better idea of the chances of conceiving in your particular case.

Sincerely,
Amy

Cervicitis

Dr. Amy

I have been diagnosed with cervicitis and am taking antibiotics (which cause nausea), and I am having constant left lower side pain. Can cervicits cause a delay in my period? I have all the symptoms of being on my period except for the bleeding. It also hurts during sex, very badly. I am only 19 and very scared, what do i do? Am I pregnant?

Very scared,
Michelle

Dear Michelle,

My first concern is that your infection is more severe than cervicitis. The lower abdominal pain and pain during intercourse suggest that the infection has spread into your uterus and fallopian tubes. You may need a stronger antibiotic or IV antibiotics. You should return to the doctor for another exam as soon as possible.

The doctor should have taken cultures during the last exam to find out if you have gonorrhea or chlamydia (common causes of pelvic infections). Ask about the culture results.

Any illness can delay your period, but so can pregnancy. Check a pregnancy test as soon as possible.

Sincerely,
Amy

Do it yourself morning after pill?

I'm 20 years old, and I've been on Seasonale bc pills for almost two years now. I'd just gotten out of a 3 year committed relationship, and in an attempt to save money went off the pill for a full month as I didn't expect to be having regular intercourse. Alas, I had unprotected sex exactly 2 weeks after my last period started. (Not smart, I know).

The day after, my brain kicked in and I filled the Seasonale prescription. I took 3 pills the first day and have been taking it ever since. This was one week ago today. One more week until a test will be accurate.

By taking those three pills did I reduce the odds of pregnancy? Is my fertility at all reduced after only 1 month off Seasonale after years of use?

A college student

Dear College Student,

The appropriate method to prevent pregnancy after unplanned intercourse is to use the morning after pill. Taking 3 Seasonale pills is not equivalent. It might reduce the chance of pregnancy, but the chance of pregnancy would still be significant, so be sure to check a pregnancy test next week.

Sincerely,
Amy

Baby's weight is not increasing

Dear Doctor,

I'm 30 weeks, 5 days pregnant. I went to the doctor last week & she told me that my weight is increasing but my baby's weight is not. Please tell me what should be the actual weight of baby at this time & why this problem is occuring. How can I overcome by this problem.

VS

Dear VS,

How did the doctor determine that the baby's weight is not increasing? Simply measuring the size of your uterus is not accurate enough to tell what the baby weighs. Only an ultrasound is accurate enough to tell you if the baby weighs less than expected. If you have not had an ultrasound yet, that would be next step.

If the ultrasound shows that the baby is not growing, it raises the possibility that the placenta is not providing the baby with enough oxygen and nutrients. If that situation continues over the next few weeks, the baby might need to be delivered early. At 30+ weeks of pregnancy, the baby should weigh about 3 pounds or so.

There is nothing that you can do to increase the baby's weight or to improve the function of the placenta except in the case of high blood pressure when blood pressure medication may improve placental function.

Sincerely,
Amy

Oral sex in pregnancy

Is it ok to have oral sex or do oral sex while pregnant?

C

Dear C,

Oral sex is considered safe in pregnancy with one exception; it is not safe to blow air into the vagina.

Sincerely,
Amy

HCG levels not rising appropriately

I am 10 weeks pregnant and started spotting a little on Tuesday. I went to the doctor and they drew some blood to test my hormone level they said it should double in two days. I went back on Thursday for the second test and so when I called this morning they said my numbers did not double but they were a little higher. My doctor said he thought everything was okay but I am still worried. I have not bled anymore since Wednesday do you have any advice?

GA,

Dear GA,

The HCG levels should double approximately every 48 hours. The fact that they did not raises the possibility of a miscarriage. Ask the doctor for an ultrasound test to find out what is going on. A miscarriage is not preventable, so you need not worry about having an ultrasound immediately on an emergency basis, but it should be done soon to spare you further anxiety.

Sincerely,
Amy

Why does my daughter need another test?

My daughter was on the bc patch recently and stopped using it because it irritated her skin horribly so she took it off. She had a period on 10-5 and another one on 10-24 which was very not heavy. She is on a 21 day cycle which if my calculations are correct she is late. I took her to the clinic to put her on the birth control pill and they did a pregnancy test and it was negative but they also said that since she had two last month that if she didn’t start by this weekend she needed to take another test early next week. I am a little confused as to why she would need to take another one.

Thank you,
Lisa

Dear Lisa,

It sounds like they were concerned that the first test could have been done too early. They want to be absolutely sure she is not pregnant before starting her on the Pill.

Sincerely,
Amy

Ovulex and Amberoz

Hi Dr. Amy,

A year ago I was diagnosed with PCOS. A couple months ago we (my husband and I) ordered and started taking Ovulex and Amberoz. I thought we'd give it a try since we are ttc.. I was wondering if you know anything about Ovulex and Amberoz. I've heard from a couple of people that it doesn't work, but I don't want to get my hopes down. We bought the six month supply and according to them (Selmedica Healthcare) there is a 100% money back guarantee if we don't see results.

I'm a little confused now. The first month when I started taking it I got my period which was on Sept 22nd and I haven't gotten it since then. Last month on Oct 30th I took a HPT and I got a faint + result, on Nov. 1st I tested again I got a - result. I made an appt on Nov. 3rd to see my OB/GYN I took both a urine and blood PG test and I had a negative result for both. Is it possible for me to be PG?, and for some reason my body is not producing enough hCG.
Please Dr. Amy, any comments, advice, or suggestions that you have for me I would really appreciate it.

Thanks,
E.B

Dear EB,

There is nothing that you can buy over the counter (without a prescription) that will increase your chances of getting pregnant.

It is not very risky for these companies to offer a money back guarantee when you consider the statistics for pregnancy. Of all couples having unprotected intercourse, 50% will be pregnant in 4 months and 75% will be pregnant in 8 months. These companies know that the majority of women who order their products are going to get pregnant in the next 6 months no matter what.

When you consider the reasons why you don't get pregnant each and every month you try, you can see why there is no product that is going to change the odds. The chances of getting pregnant in any given cycle are 20%. The most common reason for not getting pregnant in a particular month in that either the egg, or the sperm, or the combination is abnormal in some way and cannot develop further. These abnormalities are random genetic problems, and are not affected by any medication or vitamins.

In fact, it sounds like this has already happened to you. The positive pregnancy test that you had was probably the result of a chemical pregnancy (a very early miscarriage). You did conceive, but the pregnancy stopped growing within days of implantation. This is extremely common and does not mean that you will have problems in the future. In fact, the odds are very high that you will get pregnant in the next 6 months.

If, however, you ovulate very irregularly, it will take you longer than most women to get pregnant. That problem can be treated with a fertility medication like Clomid that stimulates ovulation.


Sincerely,
Amy

Am I ovulating?

Hi Dr. Amy,

My husband I have been trying to get pregnant for about 10 months. I went off the pill last December. My periods have not been normal since. (Normal for me on the pill is a 28 day cycle) Now my cycles range from 35 to 42 days. This past month I purchased a home ovulation kit to determine the best day to try and conceive. The problem is I never received a positive test. Does this mean I'm not ovulating? Is it necessary to ovulate in order to get pregnant? This terrifies me.

A friend of mine stated that she had an issue similar to this and her doctor prescribed her Letrozole. She said after about 2 months of taking it she got pregnant. Is this something I should consider? Does it have any dangerous side effects that I should be concerned about? Any advice you can give me I will greatly appreciate. I desperately want to get pregnant and I'm starting to get worried that this dream will never come true. Thanks for all your help.

Desperately wanting to be a mommy

Dear Desperate,

It is indeed possible that you are not ovulating, and you must ovulate (release an egg) in order to get pregnant. There are many possible causes and each cause has a specific treatment. What worked for a friend is not necessarily going to work for you because it may not be the appropriate treatment for your situation.

The best thing to do would be to see a gynecologist or an infertility specialist for an exam and tests to find out whether or not you are ovulating and what treatment, if any, you may need.

Sincerely,
Amy

Recurrent miscarriages

I have a question for a friend of mine who is having trouble staying pregnant. She has been pregnant 4 times and 3 times she has had a miscarriage, and the last time she had to get the pregnancy terminated due to there was no baby in the sac. She has been for tests and they can't seem to find out that they is anything wrong with her. Do you have any suggestions for her?

Thank you,
JC

Dear JC,

Four miscarriages in a row means that there is definitely something wrong. Your friend needs to see an infertility specialists, preferably one who has experience in repeated miscarriages. There are specialized tests that can be done to figure out what is going on and what can be done to treat it.

Sincerely,
Amy

Do you ovulate after a tubal ligation?

Dr Amy,

I was wndering if a women ovulates with her tubes being tied?And if so where do the egg(s) go if they can't pass through the tubes?

Thanks,
Shelly

Dear Shelly,

You continue to ovulate after your tubes are tied. When the egg is not fertilized, it disintegrates within a few days.

Sincerely,
Amy

Heavy discharge in pregnancy

Hi,

I have just found out that I am 6 weeks pregnant and the other day when I went to the toilet a thick blob of white discharge came out of me, I haven't had any bleeding yet so I hope that I haven't miscarried! Could you please tell me why this has happened?

Thanks,
April

Dear April,

An increased amount of discharge is very common in pregnancy. The amount tends to increase as pregnancy progresses.

Sincerely,
Amy

Pregnancy after tubal ligation

I am 30 years old and I've had a tubal ligation and a uterine thermal ablation. I have had regular periods for the past year and a half and the past two months my periods have been late or longer than usual and my breasts became tender. A few weeks ago I noticed colostrum coming from my nipples and I've been very nauseated and "feel" like I'm pregnant. I took a home urine test and that came back positive but then I had a blood test and that came back neg. Is it possible that one of the tests are wrong or is there something else that can cause the symptoms of preg but not be pregnant. I'd appreciate any input