QuestionQUESTION: hi, i have been trying to fall pregnant for along time now with very less success. last December i took a htp and it showed positive, i then did a blood test which also confirmed that i was pregnant. we were over the moon, But when i went to the doc he did an ultra sound that showed that there was no pregnancy. we were devasted. last Tuesday i fell a little sick so i went to the doctor who did a pregnancy test which showed positive as my lmp was 6/04/09. i went on Saturday to do a scan and we could see nothing so the doctor did another test which showed negative. how is this possible that my body was feeling all this symptoms but there is no signs of pregnancy.
Dr. Ramirez
ANSWER: Hello Sandra from South Africa,
It sounds like both pregnancies were "chemical" pregnancies. That is when you get pregnant, i.e. you had implantation, the pregnancy started to develop then stopped. So there was insufficient growth to confirm by ultrasound. However, the bHCG has to be above 2500 in order to see a pregnancy in the uterus. If it is not above that level, you won't see anything. In that case, the doctor should follow the bHCG levels until it reaches 2500 or above then repeat the ultrasound.
I hope this answers your question.
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 join me on twitter at @monteeybayivf.com
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QUESTION: hi, i forgot to mention that in the first incident i did not bleed and after 1 month i had to take medication to get my periods. is it normal to bleed after a miss . my problem is that i was never regular with my periods so it could have happened prior to this and i was not aware of it. im worried of my age as well as i am 37 years old.
AnswerHello Again,
Yes, if you have a miscarriage, you should have bleeding after. If the pregnancy did not progress very long, then the bleeding would be minimal and like a period. Usually that is the case if the miscarriage is before 8 weeks gestational age.
Your age is a significant factor in terms of your fertility and miscarriage risk. Infertility and miscarriage increase with age. At 37 years old, your natural fertility rate would be 15% per year of trying, and you would have an up to 40% chance of miscarriage per pregnancy. This is because a woman is born with all the eggs that she will have in your lifetime and the eggs age with her. Unfortunately, the viability of eggs is only until about 42 years (there are exceptions of course). As the eggs deteriorate in quality (inside), the risk of chromosomal breakage occurs upon division and so an abnormal embryo is formed. Nature (your body) recognizes most abnormal embryos and stops the process (miscarriage). There is not treatment for poor quality eggs. The best treatment is to increase the number of eggs that are fertilized and implanted to increase the statistical chances that there is a good egg/embryo. This is done with In Vitro Fertilization. That would be the treatment of choice in your age group. Of course, since you have been pregnant naturally before, you could continue to try on your own. You just need to be prepared to fail more times, have more miscarriages and take more time.
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 and twitter with me at @montereybayivf.
