Infertility/Fertility/Lupron

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QUESTION: Dear Doctor,

I am 39. I had two missed abortions at 37 both in the ninth week after heart beat was felt. Both the conceptions were natural and I conceived after four to five months of trying.

Subsequently I have been trying to conceive for one year but could not conceive. I had two rounds of IUI.   It did not yield result. My doctor has advised to me go for IVF and is putting me on Lupron from day 21 of the present cycle.

My question is in case I happen to conceive in this cycle which I may not know by day 21 (when I will be starting Lupron), what will happen to the pregnancy.

I will be very grateful for your kind reply.

Best Regards,

Renu

ANSWER: Hello Renu from India,

I can't tell you what will happen if you get pregnant, because I don't have that type of ability.  However, you need to keep in mind that most miscarriages are due to genetic abnormalities caused by weak and old eggs.  This miscarriage rate increases dramatically after 35 years old.  That is probably the reason for your previous miscarriages.  So, although you certainly have the chance to get pregnant, there is almost a 40% chance of miscarriage with each pregnancy you have.  However, eventually you will be successful if you keep trying.

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: Dear Doctor,

I could not fully understand your answer.

My question is if a person who starts Lupron on day 21 finds herself pregnant say on day 29 of the same cycle, what are the chances of birth defects or miscarriage. How Lupron exposure affect fetus.

I will be grateful for your reply.

Renu

Answer
Hello Again,

I misunderstood your question to be about the chances of a miscarriage.  

The IVF protocol you are using is the classic "long protocol".  In that case, you take the lupron only until you get to the trigger day, which is the day that your follicles reach the appropriate size for mature eggs and your receive the HCG injection.  You do not continue it beyond that point.  So if done correctly, you will NOT be taking Lupron at the 29th day of the cycle or at the time that you get pregnant (implantation).  If stopped by then, it will not cause any birth defects.  If continued into the pregnancy, however, there is a risk that it could.

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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