QuestionHello Dr. Ramirez. My name is Whitney, I'm 27 and have been married for five years. I have had two miscarriages. The first one was after I had been on Methotrexate for Lupus. I got pregnant with twins the month after stopping it, but it wasn't enough time for my body to recover itself. I had no clue how evasive the medicine would be until I got off of it. I didn't even miscarry, the babies stopped growing at 7 and 8 weeks. The second miscarriage was in Sept of 08 and there was no rhyme or reason. I did have an actual miscarriage that time. After this, I saw a fertility specialist in Memphis, TN. This is where I live.
She told me there was no reason why I shouldn't be able to have a child, but then during an ultrasound mentioned something about me having PCOS. She didn't even discuss it with me and I only found out more after seeing an article about it online. Also, I was diagnosed with APS and I read that this could be something that causes miscarriages. I'm currently on Methotrexate and Plaquenil. I will stop the MTX in December and I wanted to start trying to have a baby again a few months after that. Do these two conditions play a big role in infertility? My husband and I tried for a year after our second miscarriage to get pregnant with no luck. I appreciate any advice that you could give me. Thanks in advance for your time and your help.
AnswerHello Whitney from the U.S.,
PCOS can definitely affect fertility if it is affecting your ovarian function. PCO is defined by ovarian function, and not necessarily, by the ovarian appearance (on ultrasound). PCO patients tend to have very irregular menstrual cycles because their ovaries are dysfunctioning and so ovulation does not occur. In that case the hormones are "out of whack", so pregnancy is difficult to achieve. If you are having regular menstrual cycles, then you don't have PCO, and this should not affect your chances of pregnancy or increase your risks for a miscarriage. Miscarriages are usually random and can occur in up to 40% of pregnancies.
AS to the "APS", I cannot comment on that because I am not sure what you are referring to. There are many problems/diseases that this acronym could fit. Are you referring to "anti-phospholipid antibody syndrome"?
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
