Postpartum Notes: The First Three Months

The first three months after a baby’s birth can be overwhelming for some first-time parents. These months can also be full of joy and excitement as each new milestone is reached and the baby gradually turns into an individual, who might not yet be articulate and mobile but surely knows who her parents are and often rewards them with a wide, gummy smile.

Labor Induction

Sometimes it is necessary to give your unborn baby a little nudge and kick-start the labor. Typical reasons include complications (such as diabetes or decreased levels of amniotic fluid), medical emergencies (such as water breaking before the onset of contractions), or pregnancy duration in excess of 40 weeks. Rarely, it is also a matter of scheduling convenience, especially around major holidays or in cases when getting to the hospital in a timely manner might be a problem.

Counting Baby Kicks

Over the last couple of months, my OB-GYN began each visit with the question “Is the baby moving okay?” At first, I wasn’t sure what she meant and how to answer. I thought the baby was moving from time to time, but I was not sure. Plus, I didn’t know what was considered normal. Was I supposed to feel him kick at any particular time of the day? How many times were considered sufficient? How strong should the kicks be in order to count?

Fetal Heart Rate

I learned to worry about fetal heart rate with my first pregnancy, when I hurried to the computer after each visit with my reproductive endocrinologist, anxious to see if my pregnancy was progressing normally. We were able to hear a heartbeat as early as at the end of week 5, which was a milestone we were happy to reach, but once we were able to measure the heart rate, I began to feel apprehensive.

Placenta Previa

I am generally healthy, but I am now 40 years old, have had three failed pregnancies, and have now conceived via in vitro fertilization (IVF). All of these factors qualify my pregnancy as high risk, so when I graduated from the fertility clinic, my reproductive endocrinologist urged me to find an OB-GYN who specialized in high-risk pregnancies. I had no idea how difficult my quest would be.

Intralipid Infusion: A Possible Solution to Failed Implantations and Early Miscarriages

After my last miscarriage, my doctor tested me for blood clotting problems. The tests came out negative. That was not necessarily good news because we still had no explanation for the failed pregnancy. Implanting a perfect, genetically tested embryo in a healthy uterus did give me the best possible chance of getting pregnant, but it did not help me stay pregnant. I had officially joined the list of women with multiple unexplained miscarriages.

Natural Miscarriage

When my reproductive endocrinologist discovered no fetal heartbeat at one of our regular appointments, he gave me the option to either have a dilation and curettage (D&C) or wait for the miscarriage to happen naturally. Though the decision was up to me, he did recommend the latter approach. I was too preoccupied with the sad news to ask why.

Cramps and Bleeding: A Miscarriage? (Updated Post)

On Thursday afternoon, while I was at work, I started feeling some abdominal discomfort. My first thought was that my lunch was causing me the problem. But we had had a company lunch, and no one else seemed to be affected. So I continued working, not really worried--that is, not until the bleeding started.

hCG Levels: What Do They Tell Us, and Why Should We Care

If you are doing infertility treatments, chances are your doctor will have you test your human chorionic gonadotropin (hCG) hormone levels about 12 days after your procedure to determine if you are pregnant. hCG can be detected in one’s urine or blood, but a home pregnancy test will not show you the amount of this hormone, only whether you have enough of it to be considered pregnant. Knowing the actual level on a given date, however, is important if you want to be sure that the pregnancy is going well in its early stages.

Endometrial Scratching

Your in vitro fertilization (IVF) cycle has failed, and you do not know why. You had diligently followed your IVF protocol, had several eggs successfully retrieved and fertilized, then screened the embryos for chromosomal abnormalities and had at least one normal embryo. You also have no anatomical anomalies, your uterine lining was triple-layered and thick enough, and the embryo transfer procedure had gone smoothly. Still, your pregnancy test came out negative. What do you do? Repeat the same steps and hope for better luck? If the answer is yes, you might also want to consider endometrial scratching. It could help tilt the scales in the other direction.

My Preimplantation Genetic Screening (PGS) Results

As a follow-up to my post called “Preimplantation Genetic Screening (PGS): Why You Should Do It,” I decided to publish the results of my two PGS tests. I hope the information is useful to anyone who wishes to compare her results or get a better idea of how maternal age may affect the quality of embryos.

IVF Milestone: Egg Retrieval

Egg retrieval is one of the key phases of in vitro fertilization (IVF). After multiple follicles in the ovaries have matured sufficiently (i.e., have reached at least 15 mm in diameter), your doctor will instruct you on when to have the ovulation trigger shot. (The timing needs to be precise.) The egg retrieval takes place about 35 hours after this shot.

How to Eliminate Stretch Marks

Permanent or not, stretch marks are an unpleasant yet inevitable side effect of pregnancy. While almost all expecting mothers get them, some are luckier than others and lose theirs faster, with little or no intervention. The rest of us, the genetically not-so-lucky lot, must do some extra work to minimize the appearance of stretch marks.

Trisomy 13 (Patau Syndrome)

A trisomy is a type of aneuploidy (chromosomal abnormality) in which the cells of the body contain an extra copy of a chromosome. While most aneuploidies result in miscarriage, fetal development can progress to live birth in the case of trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome), trisomy 13 (Patau syndrome), and a few other, less common chromosomal abnormalities. Of the three most common trisomies, Patau syndrome is the rarest; it also has the most severe clinical presentation.

Male Infertility No Longer a Taboo

Many of you had probably heard that June is the national male heath month, but did you know that male infertility is a leading cause in about one-third of infertility cases?

How Many Embryos Should One Transfer: The IVF Dilemma

It is common knowledge that assisted reproduction methods, such as intrauterine insemination (IUI) and in vitro fertilization (IVF), when successful, often result in multiple pregnancy. Some wonna-be-moms, in fact, want to have twins or triplets, especially those who have tried to conceive for a long time—after all, having more than one baby at the same time seems to compensate for the many months or years lost in waiting. Doctors, however, frown at such possibilities. The optimal outcome of an assisted reproduction, they say, is a singleton pregnancy.

Preimplantation Genetic Screening (PGS):

Why You Should Do It

Many factors can sabotage the success of infertility treatments, such as in vitro fertilization (IVF). A woman might respond poorly to ovarian stimulation, develop eggs that fail to fertilize, or produce embryos that are chromosomally abnormal. Her uterine lining might not be thick enough to support implantation, or there might be some other cause of failed implantation, such as damage to oocyte/embryo during unfreezing or transfer. The egg retrieval and embryo transfer procedure too can fail—sometimes due to the doctor’s lack of experience but more often due to uterine contractility. Of all of these factors, however, chromosomal abnormality is the one that controls the success of the majority of cases.

Can Stress Contribute to Infertility?

Stress has become an everyday constant for many individuals. Work, personal life, and other responsibilities keep us awake at night, force us to develop unhealthy habits, and disturb our moods. Add to these the anxieties of trying to get pregnant, and you will see a fair portrayal of many women today. Could this stress affect one’s ability to conceive? In my experience, the answer is: quite possibly so. Many researchers, however, disagree.

What Doctors Don't Tell You About Fertility Medications

Before you started your first intrauterine insemination (IUI) or in vitro fertilization (IVF) cycle, did you know that you would most likely end up injecting yourself with hormones several times a day for as many as three months? I didn’t. Possibly so as not to discourage potential patients, reproductive endocrinologists do not go into detail regarding your medication schedule until you are already emotionally involved and committed to complete the treatment.

Prenatal Multivitamins

Most pregnant women strive for healthy diet and lifestyle, but sometimes nutritional gaps still exist, and supplements need to be added. Rich on folic acid, iron, and calcium, prenatal multivitamins can be key for supporting fetal development and a healthy pregnancy. Many brands are marketed to this effect, but are they all equal in their purported benefits? What prenatal multivitamin do you use? Could you tell us why?