QuestionHi, my name is Marie Wienholz. I am a type two diabetic who is being treated with 1000 mg of Metformin twice daily combined with regular insulin once a day and NPH insulin twice a day. Three years ago i got pregnant for the first time in 11 years and miscarried in the first 8 weeks; 8 months later i got pregnant again and miscarried in the first 8 weeks. The second miscarriage was in September of 2007. Now, three years later i have had a papsmear/pelvic exam that came out normal, my blood sugars are under good control, but the doctors did a progesterone level test on me and said that i am not ovulating; so, now the doctor wants to do 2-3 cycles of fertility drugs and if i still dont get pregnant wants to do laparoscopic surgery. So, my question is, is that the procedure that you would recommend or should i have the surgery done first????
AnswerHello Marie from the U.S.,
I do not recommend the laparoscopy at this time for any reason, and I would recommend that you go see a fertility specialist, not your general Ob/Gyn doc. You were able to get pregnant spontaneously twice. That indicates that the entire process your body has to go through worked. I am surprised at the diagnosis of PCO at this time. Besides, if that were the diagnosis, PCO is an ovarian ovulatory dysfunction. The treatment is to use fertility medication to induce ovulation and correct your cycle (if you are not ovulating on a regular basis), if you have irregular cycles. If you have regular cycles, then you are ovulating and don't need the fertility drugs.
The miscarriages were more than likelly the result of diabetes. Diabetics that require insulin are at much higher risk of miscarriages. The key is for you to have your glucose levels under control and maintain this control during pregnancy.
My recommendation is to go see a fertility specialist. He/She will serve you the best.
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
