Trying to Conceive: High Risk Conditions

WebMD Live Events Transcript

Do you have diabetes, PCOS, thyroid problems, or another chronic condition? How will it affect your fertility and your future pregnancy? Amos Grunebaum, MD, director of the WebMD Fertility Center, joined us on July 19, 2004, to talk about the options you have for getting pregnant and managing a high-risk pregnancy.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MEMBER QUESTION:
I'm 33 and my DH is 32. I am suffering from secondary infertility. DH has no children. I had an hsg (all clear) and laparoscopy (removed three cysts). DH has had an SA and SCSA with results as "good." With no luck resulting after lap we moved straight on to IVF. Our first IVF helped us learn that we must use ICSI. IVF No. 3 added assisted hatching, which resulted in a pregnancy, only to miscarriage at seven weeks. My RE did an implantation failure panel. Two panels were positive (bio essay and ETF comp.). Since both of these are cardiolipids he is treating this with prednisone only. If this pregnancy results in a miscarriage, is there any other testing I should speak with my RE about? Any other treatment options? Any help would be greatly appreciated!

DR. AMOS:
You seem to have a very complicated issue going on here. As I am not an IVF specialist, it's going to be difficult to address. But may I suggest that you see another RE for a second opinion? Sometimes getting different information about an issue may help you getting pregnant. I have seen several couples that were not able to get pregnant with one IVF center, and when they tried a different center they were able to have a healthy baby. Good luck.

MEMBER QUESTION:
How hard is it to get pregnant with PCOS? I was diagnosed with PCOS and have been trying to get pregnant for four months now. How can I tell if I am ovulating if I don't get regular periods?

DR. AMOS:
PCOS is the No. 1 reason for infertility. Not having regular periods usually means that you don't ovulate, and you can confirm this by keeping a BBT chart. If you don't ovulate, then you may want to see a specialist. If you are overweight then losing weight to better BMI levels often helps you ovulate. In addition, your doctor can provide you with the right medicine to improve your chances. Good luck.

MEMBER QUESTION:
Have doctors known that PCOS is the No. 1 leading cause for infertility for a long time or is this new research. I am frustrated that my doctor has told me for the last five years that it doesn't mean I will have a hard time getting pregnant, and said a specialist won't see me until I have been trying to get pregnant for a year.

DR. AMOS:
It's well known for many years now that PCOS is the No. 1 cause for ovulation and infertility problems in women. If you don't ovulate, then seeing a specialist right away will help you gain time and improve your chances getting pregnant faster.

"I have seen several couples that were not able to get pregnant with one IVF center, and when they tried a different center they were able to have a healthy baby."

MEMBER QUESTION:
I am diagnosed with hypothyroidism and am monitored approximately every three months. I am taking .088 micrograms of Synthroid. If I am on Synthroid and my thyroid is regulated, can I exclude thyroid dysfunction as a reason for anovulation?

DR. AMOS:
You first should make sure that your thyroid is really well regulated. This is usually confirmed by doing several blood tests that show your hormones to be normal. Women with hypothyroidism usually ovulate once they are well controlled. So if you are now well controlled then your doctor should look for other causes. Seeing a reproductive endocrinologist usually helps you find the problem and get pregnant faster.

MEMBER QUESTION:
I will be having a thyroidectomy in October. How will this affect the possibility of getting pregnant in the future? I've been diagnosed with fibromyalgia and reactive hypoglycemia. The nodules on my thyroid, reason for removal, are due to Hashitmoto's thyroidism.

DR. AMOS:
Women after a thyroidectomy are usually placed on thyroid medication, and if your thyroid hormones are improved then your chances of ovulating and getting pregnant are significantly improved. You may want to continue to be under close observation of an endocrinologist.

DR. AMOS:
My mother had gestational diabetes with me. Am I at risk high for developing the same?

MEMBER QUESTION:
Yes you are. Getting tested before and during pregnancy will help you quickly find out whether you have diabetes or not. Before and during pregnancy this is usually done by doing a GCT, a glucose challenge test. You ingest a certain amount of glucose and the blood glucose level is tested an hour later.




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