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About Edward Joseph Ramirez, MD, FACOG
Expertise
I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience
I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 15 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

You are here: Experts > Health/Fitness > Women's Health > Infertility/Fertility > Pregnancy problem

Infertility/Fertility - Pregnancy problem

Expert: Edward Joseph Ramirez, MD, FACOG - 11/3/2009

Question
I am 33 years old and I get miscarriage in week 4 last month and my doctor told me I can try anytime after the period ends. This month my cycle is longer than expected, 32 days and it has an abnormal pain in the first two days (I usually feel painful in the first day of period but not two days in a row). I went to see the doctor he suggested me to take some pills to make my period becomes regular and said I should wait for at least 3 mths before I try to get pregnant again. I was puzzled because last time he told me I do not need to wait. I did not ask him back because he seems impatient when I said I don't want to wait and take the pills. Later on, I did an ultra sound and the doctor said I have an intra uterine mass - fibroid. He suggested me to do another ultra sound after my next period ends. My question is:

Do you suggest me to take the pill to regular my period?
If my period is irregular that means it is difficult for me to count my ovulation time. Other than that, any shortcoming for pregnancy?
Can I use the ovulation test instead?
Will intra uterine mass makes me difficult to get pregnant?

I will see another doctor tonight and seek for a second advice. Thanks for your time. Any suggestion will help.

Answer
Hello Wendy from Hong Kong,

Boy you certainly have been getting some confusing information.

After a miscarriage, you will need to wait some time for your body rhythms to get back to normal. This can take 6-8 weeks. Basically, your ovary will not begin to function normally (ovulate) immediately after a pregnancy. It needs time to re-set then resumes its normal function. So because of this, you should wait until you have a normal cycle before you begin trying for pregnancy again. There is no need for you to take the pill to do this. Your body will do it normally. Once your body gets back to normal, you can begin trying for pregnancy again.

You can certainly use an ovulation kit after that to help you time your intercourse if you want.

Whatever this is in the uterus can certainly have an impact on your ability to become pregnant. I recommend that you undergo an evaluation for this, which will probably involve a diagnostic hysteroscopy (passing a scope into the uterine cavity to see inside). This will then need to be treated because leaving it behind can lead to the prevention of implantation or miscarriage.

I hope this helps,

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

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