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Sunday, January 15, 2006

Computers in pregnancy

Hi Dr. Amy,

I've just found out I'm pregnant (probably 4/5 weeks) and use a computer at work all day and a laptop at home (on my lap as I don't have a table as such - yet) for 2/3 per night. Please can you let me know if this is safe?.

Thanks,
Julie

Dear Julie,

As far as I can determine, there is no evidence that computer use has any effect on pregnancy.

Sincerely,
Amy

Pregnancy after Thermachoice

A year ago I had a Thermachoice procedure. I just took an ept and I'm pregnant. Will I be able to have this baby?

Kelly

Dear Kelly,

Thermachoice is a treatment for heavy menstrual bleeding. It is only supposed to be used by women who have no desire to become pregnant in the future because it can affect fertility. You need to talk to the doctor who performed the Thermachoice procedure and have a blood pregnancy test and additional evaluation to make sure that this is not an ectopic (tubal) pregnancy. Call the doctor (or your regular doctor) tomorrow and get this checked out.

Sincerely,
Amy

Should polyp be removed?

Dear Dr Amy,

I am 39 and trying to get pregnant for the first time. I recently had an HSG which found a small polyp in my uterus. The tubes looked good, but the testwas inconclusive as to spillage. Because of my age my doctor recommended removing the polyp by hysteroscopy and also a laparoscopy done at the same time. She would also put more dye in to see the spillage. I'm just wondering if a small polyp, 4mm, would really prevent me from getting pregnant?

Carol

Dear Carol,

The polyp can't be considered in isolation. If you have been trying to get pregnant for more than 4 months, and all infertility testing is complete, and no other cause has been found, it may make sense to have the hysteroscopy and laparoscopy. In general, however, you should not embark upon treatment until the evaluation is finished. If it turns out that the problem is a low sperm count, for example, hysteroscopy and laparoscopy will not be helpful.

Sincerely,
Amy

Could I get pregnant at 48

Dr. Amy,

I am 48 years old. My periods are every 29 day. Iam seeing a man same age who claims he has had a vastecomy 16 yrs ago. I am pass my 29 day cycle going on 33. I realize at my age I could be going into menopause. I just need to know could he still get me pregnant?

L

Dear L,

The chances of being pregnant are low, but they are not zero. You should check a pregnancy test to be sure.

Sincerely,
Amy

Friday, January 13, 2006

Pregnancies close together

Dear Dr. Amy,

I'am a young mother of four beautiful children. My oldest is 6 years old and my youngest is 5 months old. On January 3rd. I found out that once again I was expecting. I was woundering if their are any risks of complications for me and my unborn baby due to getting pregnant so close to giving birth?

Michelle

Dear Michelle,

There are no significant risks to either you or the baby, except that you may become nutritionally depleted from so many pregnancies in a relatively short space of time. You can lower this risk by taking your prenatal vitamins, eating a healthy diet, drinking milk and taking additional supplements (like iron) if your doctor recommends them.

Sincerely,
Amy

Trauma and periods

Dear Dr. Amy,

In December I suffered a head concussion, and ten days later slipped on my steps resulting in a nasty fall and the worst bruises I have had in my life. This all has happened since my last menstral cycle, and now I am on day 38. Last year's bloodwork showed beginnings of menopause, but the past 6 months have been regular periods until now. I'm not sexually active. Could the trauma of the fall and bruising change my cycle, or would these be unrelated?

Thanks much,
M

Dear M,

Any illness or trauma can affect your menstrual cycle. However, if there is any chance that you are pregnant, you should check a pregnancy test.

Sincerely,
Amy

Wednesday, January 11, 2006

Sperm count

Hi Dr. Amy,

My doctor told me that I had a sperm count of 40. I am getting conflicting numbers in my research about what a bad and good sperm count is. Also, my motility is 46. Could you please clarify what these numbers mean about my fertility?

Thank you,
Henry

Dear Henry,

A semen analysis measure 6 or more factors about the amount of sperm and the health of the sperm. A doctor needs to have the entire report to interpret it properly. Talk to your doctor about how your results compare with the normal values in a complete semen analysis.

Sincerely,
Amy

Getting pregnant after Depo Provera

Dr. Amy,

I've been on depo-provera for 5 years now, but I stopped Oct., '05 because my husband & I want to have a baby, I'm 34 so I'm not getting any younger (ha!). My doctor told me it can take awhile to get my menstrual cycle back, but it may end up where he needs to "jump start" it. Now that I've been off the shot for awhile, I've noticed changes with my body as far as cravings, exhaustion and the past two days my nipples have been extremely sore. Is this my body getting back to "normal", it's almost like I'm having symptoms of a menstrual cycle, but w/out the bleeding. I also wondered if it was possible to get pregnant even though I'm not ovulating or having my period? Since I wasn't sure, I went ahead and took a pregnancy test about 3 or 4 weeks ago just to be safe and it was negative. My doctor told me that if I was to get pregnant right now or after my first period, I would have a greater chance of having a miscarriage since I haven't ovulated in so long. I'd like to know your thoughts on all of this. Thanks so much!!

Robin

Dear Robin,

It can take from 6 months to a year for your periods to return to normal after stopping Depo Provera.

You cannot get pregnant if you are not ovulating, but you will ovulate for the first time 2 weeks before you get your first period. Therefore, it is possible to get pregnant before your period returns (but only if you have sex approximately 2 weeks before your period would have returned).

I am not aware of any increased risk of miscarriage if you get pregnant before getting your first period or in the cycle thereafter. The risk should be exactly the same as if you get pregnant at any other time.

Sincerely,
Amy

Lupron for endometriosis

Dear Dr. Amy,

I am 27 yrs. old and my gynecologist has suggested that I take Lupron to treat endometriosis. I also have a uterine fibroid and wanted to know what affect this drug will have on my fibroid. From what my doctor states it will possible shrink it but the fibroid will most likely return in six months. I want to be sure that if the fibroid does return it returns to its regular size. My fibroid is currently the size of a globe grape and it's been that size for the last 3 yrs. with no problems. I am concerned if I take the Lupron it will cause my fibroid to double in size once treatment is over for the endometriosis.

Thanks much,
D

Dear D,

Fibroids are dependent on estrogen for their growth, so when you take Lupron and your estrogen level decreases, your fibroid will shrink. When you stop Lupron, your estrogen level will eventually return to normal, and the fibroid will return to its previous size. After that, it may continue to increase in size, but that's because almost all fibroids grow larger as a woman gets older (until menopause, that is).

Sincerely,
Amy

Guillaine-Barre and pregnancy

I had guillaine-Barre nearly 5 years ago. Now I am 29 weeks pregnant. How will this effect me as I still get alot of weakness?

Y

Dear Y,

As you know, Guillaine-Barre is a nerve disorder that often occurs after a viral illness. As far as I can determine from the medical literature, it should not have an impact on your pregnancy.

Sincerely,
Amy

Tuesday, January 10, 2006

Smoking and sperm count

Dr. Amy,

Is it true that smoking and drinking alot can lower a man's sperm count? My husband and I have been trying to have a baby for the past year and we have yet to be successful. My husband smokes and drinks pretty much on a regular basis and he's been doing this for about 10 years. Is it possible that the reason we have not conceived is because all that smoking and drinking has lowered his sperm count or caused it to be not as strong as its supposed to be. I would really appreciate a response as this is very important to me.

Thank You!
Tiffany

Dear Tiffany,

While it is true that smoking can lower a man's sperm count, that is not a common cause of difficulty in getting pregnant. There are many other factors that could be responsible. If you are not pregnant by the end of a year of trying, you should see a gynecologist or infertility doctor for a complete evaluation of you and your husband. In the meantime, avoid blaming anyone or any specific thing for the difficulty. A complete evaluation will reveal the problem (if there is one) and it could be something that you have not even considered.

Sincerely,
Amy

Anxious after two miscarriages

Dear Dr Amy,

I have had two miscarriages. I am pregnant again and was so distressed that my doctor sent me to an early pregnancy unit. I had a vaginal scan yesterday and they said it looked very good and there was a strong heartbeat and everything was in the right place. I have had slight stomach cramps throughout but today have a tummy bug and light cramps again. Is it normal to experience light cramps throughout the first 12 weeks? Do you thinkI will be ok this time?

Thanks,
C

Dear C,

Mild cramping is not a sign of miscarriage, so you do not need to be anxious about that.

Once the heartbeat is seen on ultrasound, the risk of miscarriage is cut in half. Once you pass 12 weeks, the risk of miscarriage drops even further. There is no way to know what will happen, but the odds are high that this pregnancy will be successful.

Sincerely,
Amy

Conceiving after methotrexate

Hi,

I had an ectopic pregnancy treated on 20 October 2005 by one dose of methotextrate. How long do I have to wait before I can start trying to get pregnant again. I would rather be safe than sorry and lose another baby.

Many thanks,
Ros

Dear Ros,

Most doctors recommend waiting at least 3 months before trying again (because of theoretical side effects of methotrexate). Be sure to start on prenatal vitamins before you begin trying.

Sincerely,
Amy

Sunday, January 08, 2006

Irregular periods, negative pregnancy test

Hello Dr Amy,

I have very irregular periods. In June, July no period or a positive HPT. In August went and seen my gyno. I was given Provera then Clomid. September, No period or baby. I went back to my gyno again. I was given Provera and Clomid again. After that I had a period a week later. 38 days later I had a period. So my LMP was on 11-27-05, I took Clomid too. Now it has been 43 days later and still no period or a positive HPT. Recent HPT was on Jan 6. negative. Throughout December to now I have been having bad nausea, tiredness, sleepy and a bit of breaking out. Should I take another HPT or I am just not pregnant!

Thank you,
Sammie

Dear Sammie,

I does not sound like you are pregnant, and it sounds like the problem is that you are not ovulating (releasing an egg), so you can't get pregnant.

Clomid is a fertility medication. It is given to women who are not ovulating, to stimulate ovulation. When Clomid works, you either get pregnant or have a regular period. Since neither is happening, you may need a higher dose of medication, or additional fertility tests. Talk to your doctor to understand just what the problem is, and how the doctor plans to treat it.

Sincerely,
Amy

Breast implants and breastfeeding

Hi,

I have had breast implants for 3 years this August. Will becoming pregnant cause problems with my implants and will I be able to breast feed?

Thanks,
GM

Dear GM,

Most breast implants are placed behind the actual breast tissue and usually do not cause any problems in pregnancy or with breastfeeding, so you should be able to breastfeed. Check with the surgeon who did your operation, just to be sure.

Sincerely,
Amy

Prenatal vitamins

My doctor did a pregnancy test on me and it was negative, but she prescribed prenatal vitamins. My friend said that she probably prescribed them because I show signs of pregnancy. Is she right?

L

Dear L,

You should start prenatal vitamins before you are pregnant, when you are just trying, because prenatal vitamins are most important in the earliest weeks of pregnancy. The doctor should recommend prenatal vitamins to anyone who is thinking about getting pregnant.

Sincerely,
Amy

Which dates are correct?

I am pregnant. I think I am about 9 weeks. The doctor did my ultrasound and says I am only 6weeks. I think that is wrong because I tested postive the first week of December, so if they are right it would of been too early to get a positive result. This is important to me because I have to have a cerclage. Now I am afraid they will move it to a later date and if the doctor is wrong that could be a very bad thing.

Billie

Dear Billie,

It depends on what, precisely, the doctor saw. At nine weeks, you should be able to see the baby and the heartbeat very easily. It is possible that the doctor only saw a sac without a baby. If the doctor did not see a baby, there are two possibilities: you could be not as far along as you thought, or you could be in the process of having a miscarriage (eventually leading to the actual miscarriage).

Talk to your doctor to clarify why he thinks you are only 6 weeks along. It he saw only the sac, you need to have another ultrasound to see if a baby is present.

Sincerely,
Amy

Ativan

Hi Dr Amy,

I recently went to the ER because I had a severe headache that was persistant for 3 days. They treated me by giving me a pain medication called Dilaudid IV. Upon discharge the ER doctor prescribed me Ativan for muscle spasms.

My mother told me that Ativan was more for depression and anxiety. I have no history of either of those. The medication is a pregnancy class D. What does that mean? My husband and I are TTC and I am scared that taking this medicine (for a short period of time) may affect our TTC. I have since discontined use of this medication until I speak to my primary physican but what are you thoughts on Ativan. Thanks in advance.

F

Dear F,

Ativan is related to valium. It can be used as an anti-anxiety medication and as a muscle relaxant. It is not an antidepressant.

Category D drugs are known to be harmful in pregnancy, so you should not take it if you are trying to conceive. Ask your doctor if there is a better alternative for you.

Sincerely,
Amy

Friday, January 06, 2006

Is Zyrtec safe in pregnancy?

Hi,

My husband and I would like to have another child. However, Iwas diagnosed about 7 months ago with chronic uticaria (hives) and angioedema (severe swelling). I am currently on zyrtec, an allergy medication. Would this medicine and disease harm a fetus? Is there an alternative medication that is safer?

Thank you so much,
Michelle

Dear Michelle,

There is currently no evidence that Zyrtec is harmful in pregnancy, but we have very little experience with it. The American College of Obstetricians and Gynecologists recommends using other antihistamines instead.

Before getting pregnant, you should talk with your allergy doctor and with an obstetrician about which antihistamine is safest for you and your baby. You can then switch to the new antihistamine before getting pregnant.

Sincerely,
Amy

Will provera harm an early pregnancy?

Hello Dr. Amy,

It has been 8 weeks since I had surgery for an ectopic pregnancy and I still have not had a cycle. My doctor prescribed Provera to take to jump start my cycles. I was wondering if I am pregnant but very early it the drug would harm the fetus?

Tiffany

Dear Tiffany,

There is no evidence that taking Provera in early pregnancy is harmful. You don't have to take Provera, though, unless you want to do so. Your periods will probably return on their own within a few weeks.

Sincerely,
Amy

Itching in pregnancy

I was told some itching is ok in pregnancy, because that's just you growing, but for the past few weeks my itching started at my feet and now all over my body. I itch all the time. I do not have a rash or bumps but its getting quite annoying. Is there a condition that causes this? I'm 19 weeks pregnant and my next appt. is on the 20th.

Thanks,
S

Dear S,

There are two pregnancy related conditions that can cause itching. One is a bumpy rash called PUPPS. This commonly occurs toward the end of pregnancy. The second condition is cholestasis of pregnancy. This is a liver problem that appears to be caused by pregnancy hormones and goes away after the baby is born. The most prominent symptom is itching, particularly on the hands and feet. It is not harmful, but it can be very uncomfortable. You should call your doctor to talk this over.

Sincerely,
Amy

6 positive tests, but doctor's test is negative.

My period is nearly 2 weeks late and I have had 6 positive home pregnancy tests but when i did a urine test at the doctors, it was negative. Im very confused, am I pregnant or not?
Please help,

Kelly

Dear Kelly,

It sounds like you are probably pregnant, but there is an easy way to find out for sure. A blood pregnancy test is far more accurate than any urine test. Talk to your doctor about getting a blood pregnancy test to find out what is going on.

Sincerely,
Amy

Was this a miscarriage?

Hi,

My last period was on 15.11.05 and I am now over three weeks late. We are trying for a baby and found out when I am ovulating etc. Normally my periods are regular. I am having night sickness, sore breasts, mood swings, etc. Also on 14.12.05 I have a light brown stain with no cramping. But despite all this no positive tests, yet I feel pregnant!I went to the doctors and they said it is a missed miscarriage and told me to go home and wait to bleed. Is this normal and correct?

Thanks,
Jade

Dear Jade,

In order to label this a miscarriage, there must be some medical evidence that you were pregnant. There is no way the doctor could know that it is a miscarriage without either a positive blood pregnancy test or an ultrasound. That does not mean that you are necessarily pregnant, since you could simply have missed a period. You should ask your doctor for a blood pregnancy test to find out what is going on.

Sincerely,
Amy

Wednesday, January 04, 2006

Placenta previa in early pregnancy

Dear Dr. Amy,

Im almost 10 weeks pregnant and have had an almost perfect pregnancy. I've had two c-sections in the past 3 years and 1 miscarriage a few months ago.

I started to spot a brown and cramp yesterday and it has continued today. I went to my doctor and she did an ultrasound and said the baby looked great but that my placenta was over my cervix. She didn't sound to concerned about it though, and never really told me why I'm spotting or cramping. I'm very worried.

My mom had 3 placenta previas. Could this spotting and cramping be because of the low lying placenta or is it something else? I have also had my two children early (33 and 35 weeks) because of severe preeclampsia and pre-term labor. I was hoping that maybe you could give me some insight on this.

Thank you,
Tiffany

Dear Tiffany,

If the placenta is lying on top of the cervix, you have a placenta previa, too. This could be the cause of the spotting, but there is no way to know for sure at this point.

Your doctor is probably not concerned now because the placenta tends to move away from the cervix as pregnancy progresses. Therefore, the odds are high that the you will not have a placenta previa in late pregnancy. On the other hand, woman who have had a previous C-section and now have a placenta previa are more likely to end up with a placenta previa at the time of delivery and it can cause bleeding problems. Talk it over with your doctor in more detail.

Sincerely,
Amy

Fertility after gonorrhea

Dr. Amy,

I was told that you can't get pregnant if you have had gonorrhea. Is that true?

L

Dear L,

Most women who have had gonorrhea will have no trouble getting pregnant. However, somen women will have scarring in their fallopian tubes which may make it difficult to get pregnant or lead to an ectopic (tubal) pregnancy.

Sincerely,
Amy

Pregnant after miscarriage

Hi,

I am 4 weeks pregnant and feel like I am pregnant. However, I am worried as I had a missed miscarriage 5 months agao and I had precancerous cells removed 6 weeks ago.

A

Dear A,

A history of one miscarriage in the past has no effect on the current pregnancy. You are no more likely to have a miscarriage in this pregnancy than a woman who has never had a miscarriage.

The impact of the removal of the abnormal cells depends on the way in which they were removed. Most methods do not cause any permanent scarring or damage. Talk to your doctor about whether he or she thinks there will be any problem.

Sincerely,
Amy

Semen analysis

Dr. Amy,

My fiance recently had a sperm analysis done. His test came back that 65 percent of the sperm were dead. The second test revealed that 70 percent were dead. Can this mean that he can NEVER have children or that it might be next to impossible?

Thank you,
SA

Dear SA,

This is definitely an abnormal value. In a normal sample, less than 25% are dead. It is difficult to know what this means in the absence of other parts of the analysis. For example, if there are signs of infection, treating the infection could improve the quality of the sperm. You need to talk to your doctor about the meaning of the results.

Sincerely,
Amy

Monday, January 02, 2006

Vitamins and periods

Hello Dr. Amy,

I've been trying to get pregnant now for about eight months and so far no luck, but I know the importance of taking vitamins before you conceive along with a healthy diet. My periods are very irregular, my cycles are anywhere from 40-60 days. When I started taking the vitamins (Oct. 15) I started getting a brownish red discharge and then a couple days later i started to get some light bleeding. It didn't last a long time, only for 4 days and then exactly one month later (Nov.15) I started my period. I never started my period so soon, except when i was on the pill. Is it possible for the vitamins to regulate your periods?

Thank you,
Carmen

Dear Carmen,

No, the prenatal vitamins have no effect on your periods. Your irregular periods suggest that you may have a hormonal problem. If you do not get pregnant in the next 4 months or so, you should make an appointment with a gynecologist for a complete evaluation. It is possible that you may need fertility medication to help you get pregnant.

Sincerely,
Amy

No periods for over a year, now pregnant

Dear Dr. Amy,

I have not had a period since March 2004. I do check to see if I am pregnant with home pregnancy tests and when I visit the doctor. In early December I was not pregnant. Recently, I noticed I felt different. My breasts felt different and I kind of thought I may be pregnant. So I took a home pregnancy test and I am.

Is it possible for someone to get pregnant when you are not having a cycle? I am very worried about this and a bit confused so any advice will be very much appreciated.

Thank you for your time,
LV

Dear LV,

It is very likely that you have a hormone problem of some kind, probably polycystic ovary syndrome or perhaps related to your weight (if you are extremely overweight). You should have been treated with Provera (progesterone) or birth control pills, since going for months at a time without a period can increase your risk of developing uterine cancer in the future. That will be something to address after your pregnancy.

Even women who have hormonal problems can ovulate on their own now and then. Since you ovulate 2 weeks before you get your period, it is possible to ovulate and get pregnant without getting a period. This does not mean that there is any increased risk to the pregnancy. An ultrasound will be able to estimate when you got pregnant and when your baby is due.

Sincerely,
Amy

Fertility after endometriosis surgery

Hi,

I am a 36 and having some infertility problems.

Six years ago I had endoscopic surgery done for a mild case of endometriosis and to have a chocolate cyst removed from my right ovary. On November the 28th of 2005, I was admitted to the hospital with severe abdominal pain & on the 29th had surgery to remove a chronic case of endometriosis, acorpus luteum cyst or adnexal mass about the size of an apple removed from the right ovary, my right ovary & fallopian tube removed and my left ovary and fallopian tube had to be cut away from my intestines. I was advised to start trying to get pregnant in three months after the surgery in fear of the endometriosis coming back.

What are my chances of being able to become pregnant after having the right ovary removed. I currently have two children, but have also had two miscarriages. I want to hurry up and get pregnant due to my age and the endo. Should we try anything else to increase our chances of getting pregnant?

Melissa

Dear Melissa,

It sounds from your description like you have significant endometriosis and scarring, and that could definitely affect your fertility. The chance of getting pregnant is highest in the 6 months after surgery so it makes sense to get try to get pregnant on your own. If you are not pregnant within 6 months, you should make an appointment with an infertility evaluation. An infertility specialist will be able to give you more information about the chances of getting pregnant, and recommend treatment if necessary. There is nothing that you can do on your own (beyond having intercourse around the time of ovulation) that will impact your chances of getting pregnant in the next 6 months.

Sincerely,
Amy

Bowel distension in pregnancy

Everything I read just says that bowel distention is common in pregnancy, but I have yet to discover what exactly it is.

A

Dear A,

Bowel distention is just the medical term for bloating and gas, both of which are very common in pregnancy.

Sincerely,
Amy

Sunday, January 01, 2006

Breast infection

Dr. Amy,

I have had three children whom I have breastfed. I am now pregnant again. The problem is that I have cystic breast and one of them is chronically infected. I have been on antibiotics, had a mammogram and even a biopsy of the area to rule out cancer. There is still an abnormal discharge which clears up sometimes but then is right back. I would really like to nurse this baby also but am a little worried about the discharge. Would it clear itself up and if not I more than likely shouldn't nurse ( not off of that breast anyhow)?

Thanks alot,
SKA's mom

Dear SKA's mom,

I have been researching your question and I cannot find a definite answer. I suspect that nursing would be fine, since you can nurse when you have mastitis (a breast infection), but you should consult your own doctor for additional information.

Sincerely,
Amy
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