QuestionQUESTION: Hello there! My name is Kara and I'm from Seattle, WA.
I have a history is 3 m/c since 2007 all around 6w, and 2 year window of infertility before that... (Well, I guess it's all infertility if I still don't have my bundle of joy after 4 years.) I was referred to an RE last year, which found and removed a golf ball sized fibroid in July. I have been on LDA and Progesterone supplements for 3 of the 4 pregnancies, and am currently taking LDA (low dose aspirin.)
I am currently pregnant around 6w w/ mild brown spotting - which has happened with each pregnancy around this same week. I can only assume the spotting is coinciding with the fetus' ceasing to grow past 6w size. I have worked at an industrial manufacturing plant that makes commercial aquariums for all pregnancies. Industrial glues and silicone (off gassing ammonia) are used quite often in an approx. 2000 sq. ft. shop with 2 floor-ceiling bay doors open. My office is next to this area separated by a wall and door.
My question is do you think the glues/chemicals are effecting my pregnancies negatively? Or would a golf ball sized fibroid located at the top middle of the uterus be more of a problem.
Thank you any help you can offer me. If you need more information, please ask.
ANSWER: Hello Kara from the U.S.,
I am less convinced of the fibroid being the problem than the chemicals. Studies have shown that fibroids that are located away from the endometrial cavity probably do not affect the ability to get pregnant or maintain the pregnancy. However, exogenous chemicals, radiation or medications can certainly affect a pregnancy. If you are known to be pregnant, I would recommend that you take time off away from the chemicals for now, especially with your history.
Sincerely,
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 facebook and twitter with me at @montereybayivf
---------- FOLLOW-UP ----------
QUESTION: Thank you for your answer!
However, now I'm a bit more confused. I had to wait until 3 m/c to even be referred to this Reproductive Endocrinologist, who insisted this fibroid was the issue. In fact, on our first appt. during our u/s she even said, "Ahh, there's your problem" stating that the location and size was the problem.
As ideal as it would be to be able to just "take time off" from my job, I also have have mortgage, car payments, etc. I need to pay which doesn't facilitate leaving. Can you offer me workable options?
Also, can you tell me if the spotting at 6w means something? Should I be checking my progesterone? Is there some sort of implantation issue that would be indicated by this time? Sure something that has happened 4 times, should indicate something.
Thank you.
AnswerHello Again,
The impact of the fibroid depends mostly on its location. I'll have to leave that to your RE to decide this since I cannot examine you.
The only option I could suggest in regards to your work are either (1# have your work purchase a portable HEPA filter, which are available in many stores now-a-days, and run it in your office and/or #2# wear a filtered mask #like the ones that painters use).
In terms of the spotting, it seems to occur frequently when progesterone supplements are used vaginally, and with early pregnancy. Yes, it can herald a miscarriage, but not necessarily. The only bleeding I worry about is bright red bleeding like a period. With other types of bleeding, you just have to wait and see how things go because they are not specific indicators of anything.
As an afterthought, in addition to low dose aspirin and progesterone, I place my patients on Heparin 2000 U subcutaneous injections twice per day. I usually start this at the beginning of the cycle, but in patients referred to me at the beginning of their pregnancy, with a history of recurrent miscarriage, I will start it right away. There are many studies showing the benefit of this regimen.
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 facebook and twitter with me at @montereybayivf
