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

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

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

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

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

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

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

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

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

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

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

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

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