Ask your question!
Kurt Barnhart, MD, MSCE, Christos
Coutifaris, MD, PhD, Steven
Sondheimer, MD, and Richard
Tureck, MD, answered your questions this
month on egg donation.
Mary asks:
Since the onset of menstruation at age 13, I have always had irregular
cycles (sometimes as long as 60 days). When I went on the pill in 1998,
my cycles became regular 28 day cycles, until I went off the pill in
2003 so we could try to conceive. At this point, I went back to having
irregular cycles (ranging from 28 to 44 days with no pattern from cycle
to cycle).
I have had two "missed miscarriages" in
the past four months (fetal demise at seven
weeks with the first pregnancy,
the other at six weeks), although I am otherwise a healthy person.
With the second pregnancy, my OB put me on 200 mg of oral progesterone
(prometrium) because my progesterone level (drawn very early in the
pregnancy) was "normal, but on the low side."
I am wondering
if there is some kind of hormonal imbalance that is causing both
the irregular cycles and miscarriages, and what, if anything can
be done
about it. |
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Kurt
Barnhart MD, MSCE responds:
I am sorry to hear about your losses and your difficulty with your cycles.
There may be a hormonal explanation for your difficulties. Some women with
irregular cycles suffer from polycystic ovarian syndrome. This is also
associated with a higher than normal rate of miscarriage.
To best determine
your issue, you will need a full work up (evaluation) by a fertility
specialist. Progesterone, while not a bad
idea, does little to help you. We at Penn
Fertility Care would be happy to take the time to talk to you, and to
hopefully
help you. If you would like to schedule an appointment, please contact
1-800-789-PENN (7366) or schedule
an appointment online. |
Frustrated
Me asks:
I have been seeing a fertility specialist for several months. Prior to
that, I spent over two years seeing my OB/GYN and taking clomid mothly.
I had an hysterosalpinogram (HSG) that showed that my uterus was completely
blocked, so I underwent a DNC the next week. The next month, I was pregnant.
Unfortunately,
we lost that baby. I have since had another HSG and it indicated everthing
was fine. However, that was in July 2003. I am now being scheduled
for laporoscopy and I want to know what we may be looking for and what
the consequences of the surgery may be. |
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Steven
Sondheimer, MD responds:
You have had a rough few years. Your questions deserve an answer from your
doctors and I would suggest that you write them down and ask your gynecologist
or infertility specialist. Your doctor is best able to answer these questions
because she/he knows your whole history. If you have the questions written
down at the time of your visit it is easier.
In general a laparoscopy is a surgical
procedure to look for evidence of endometriosis
or scarring. Often if these problems are
found at surgery they can be helped during
the surgery. I hope you talk to your doctors
about why this surgery was recommended
and what alternatives if any are available
for treating your infertility. Best of
luck. |
Kurt
Barnhart, MD, MSCE, is the associate Director
of Penn Fertility Care, the director of the Donor
Egg Program at Penn Fertility Care and an associate
professor of obstetrics and gynecology at the
Hospital of the University of Pennsylvania. He
received his medical degree from the Mt. Sinai
School of Medicine and completed his residency
and fellowship at the Hospital of the University
of Pennsylvania. Dr. Barnhart is a member of
the following organizations: American Society
for Reproductive Medicine, American College of
Obstetricians and Gynecologists, Society for
Reproductive Endocrinology and Infertility, Philadelphia
Obstetrical Society, and the World Academy of
Art and Science.
Christos
Coutifaris, MD, PhD, is the director of
Penn Fertility Care, the director of Penn's
Division of Reproductive
Endocrinology and Infertility
and a professor of obstetrics and gynecology
at the Hospital of the University of Pennsylvania.
He received his medical degree from the University
of Pennsylvania School of Medicine and completed
his residency and fellowship at the Hospital
of the University of Pennsylvania. Dr. Coutifaris
is a member of the following organizations:
American Society for Reproductive Medicine, Society
for Gynecological Investigation, Society for
the Study of Reproduction, Society for Reproductive
Endocrinology and Infertility, and the Endocrine
Society.
Steven
Sondheimer, MD, is
a reproductive endocrinologist at Penn Fertility
Care and a professor of obstetrics and gynecology
at the Hospital of the University of Pennsylvania.
He received his medical degree from the University
of Pennsylvania School of Medicine
and completed his residency and fellowship at
the Hospital of the University of Pennsylvania.
Dr. Sondheimer is a member of the following
organizations: Society of Reproductive Endocrinologists,
Association of Reproductive Health Professionals,
Obstetric Society of Philadelphia, Philadelphia
Endocrine Society, and the Family Planning
Council of Southeastern Pennsylvania.
Richard
Tureck, MD, is a
reproductive endocrinologist at Penn Fertility
Care and a professor of obstetrics and gynecology
at the Hospital of the University of Pennsylvania.
He received his medical degree from Cornell University
Medical College and completed his residency at
Cornell University/NYC. Dr. Tureck completed
his fellowship at the Hospital of the University
of Pennsylvania. He is a member of the following
organizations: American Fertility Society, Endocrine
Society, American Association for the Advancement
of Science, Society of Reproductive Surgeons
and the Society of Gynecological Surgeons.
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