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Infertility/Fertility/7 weeks 2 days pregnant with ivf

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QUESTION: i am 7 weeks 2 days pregnant with ivf.I have two heartbeats,means pregnant with twins and each 113-112 beats.I have on and off brown color spotting.like a few drops in morning,then afternoon.my doc said increase cyclogest.now 3 per day.
My question is ,IS 1200MG PROGESTERONE per day is safe?am i suppose to go for bed rest?
i would appreciate your reply.

ANSWER: Hello Sana from the U.A.E,

Congratulations on the pregnancy.  Yes, that dose of Cyclogest is fine and has no side effects.  You should know, however, that there has been an increased incidence of spotting, like you've had, with vaginal progesterone, so the bleeding may not be anything to worry about.
You don't need to be a bedrest, as that will do nothing to prevent a miscarriage.  However, I would limit your activity to light activity only.

Good Luck,

Dr. 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 and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate


---------- FOLLOW-UP ----------

QUESTION: Thanks for your reply.It relieved my stress.I would like to ask that i don't have morning sickness and no breast soreness as such.does it means that i lack progesterone.One thing more,as you mentioned in the end that bed rest wont prevent a miscarriage.Am i opt to?
I would like to share my history that i had ivf as i have pcos and couldnt get preg,other than that no issue.I was pregnant with ivf twins two years back and had preterm labor at 25week.the reason being too much walk n other activities.
My third question is i am using metformine 1500mg per day.Am i suppose to stay on low carb diet.My wt is 45kg,ht:5.1 and age 27.
would be looking forward to ur reply.n thanks!

Answer
Hello Again,

These are all questions that should be directed to the doctor directing your care.  They are reasonable questions and you should get the answers to them.  My answers may not fit the plan that your doctor has, especially one in a different country.

Not all women have morning sickness or breast tenderness with their pregnancy so having or not having those symptoms does not indicate anything.

In your pregnancy with twins, it is considered a "high risk" pregnancy and we usually limit the activity of those patients because of the risk of premature labor and delivery, so you should have had your activities limited in that case.  However, we do not limit all pregnancies.

Metformin 1500 mg is the appropriate dose in PCOD, but we don't usually continue it once the patient becomes pregnant, if it is for PCOD.  If it's for diabetes, then we stop it and change to insulin.  I don't think you need to be on a low carb diet unless you are diabetic.

Good Luck,

Dr. 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 and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate

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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 19 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, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

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

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