QuestionI am 35 years old and have a four year old son. I got pregnant while I was on birth control in 2004. I was taking it as directed and was taking it for six years. I took the birth control for the first four weeks of my pregnancy and didn't find out I was pregnant until I was at least six weeks along. Due to a family history of blood clots, a genetic screening was done and I was diagnosed with MTHFR and treated with Lovenox. I gained over 100 lbs while I was pregnant. Since having my son in 2005, I have had two miscarriages. One in August 2007 and another one in February 2008. The first one occurred in Santa Cruz while I was on vacation. When I found out I was pregnant the second time I immediately contacted the doctor and they completed a hormone blood test. The second one was diagnosed as a blighted ovum when they did a ultrasound when I was six weeks along. The hormone levels were identified as normal and a karyotype was completed and no genetic anomalies were found. I have not been able to get pregnant since. Would me staying on birth control my first four weeks of pregnancy have anything to do with the pregnancy going full term. My annual examination with my OBGYN is in a few weeks and I am curious about Clomid although it has taken me several years and lots of cash to lose all that weight, therefore I do not want to take any hormones. Do you have any advice for me? I am taking 81mg Aspirin and Folic acid daily.
Answer
Dr. Ramirez
Hello Stephanie from the U.S.
Thanks for your question. The birth control pill would have no affect on your pregnancy. It would have been out of your system by the time that you became pregnant. I think that you are at the point that you should see a reproductive specialist for further evaluation and treatment. It is possible that something has changed since your last pregnancy that is preventing you from becoming spontaneously pregnant, or it is just the "age" factor that has reduced your chances of pregnancy. I would not recommend proceeding to treatment without an evaluation first, however. You could be just wasting your time. Clomid is a form of fertility treatment, and in a woman that ovulates normally, its purpose is to increase the number of eggs that you ovulate thereby increasing the chance that one egg will get to the tube and get fertilized. This may be the treatment of choice for you, but you can't know that without doing an evaluation.
I think that low dose aspirin is appropriate in patients trying to become pregnant. You probably will need to go back on the Lovenox or Heparin prior to pregnancy as well because of your miscarriage history.
I hope this helps,
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 and twitter with me at @montereybayivf.
