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Re: Ob:  IVF candidate From: Garry E. Siegel, M.D. (garrys@mindspring.com) Tue Sep 30 15:13:26 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Charlie Chambers: "Re: OB: Sleep study" Previous message: Glen Elrod: "OB: Sleep study" This has been a fun thread. Ron, Joe, Louanna make nice points. Of course, she's heard of all of the risks she'll undertake should she proceed, and ultimately it is her decision whether to proceed or not. I am a bit surprised that the REI (and he is a premier REI in our area) would proceed, but I know that he deferred the Ob risk discussion to me. That said, she is 41 so she may not have the best eggs for IVF, of course. I told her that I was going to post this case, and talk to one of my MFM friends, too. My advice (at this point)is to proceed at your own risk, but don't shoot for a twin pregnancy in any event. I don't see a need to refer her away, as I feel that I can give the care that she needs, and I am comfortable giving that care. If she conceives, we'll be looking hard at the uterus, placentation, and cervix, of course, and will have the gang there for her section. Garry At Tue, 30 Sep 2008, Ronald Ainsworth MD wrote: > >This is a multipart message in MIME format. > >I agree with Joe. She should only be given the option of a singleton >pregnancy and needs to understand that she could end up with a ruptured >uterus, placenta acreta, etc. She needs to know that she could end up with >no baby and a hysterectomy and that her living children could end up with no >mother. Saying all that as non-biased as possible, the decision is >ultimately hers. > >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of >DoctorJoe@aol.com >Sent: Monday, September 29, 2008 9:30 PM >To: Multiple recipients of list OB-GYN-L >Subject: Re: Ob: IVF candidate > >In a message dated 9/29/08 10:36:44 PM, islesannie@gmail.com writes: > >I am interested in seeing what those doing OB say - and that may include >telling me I am off base here! > >Well, I don't do OB now. But I think you're HALF way off base. > >There are two questions here: > >1) wanting another baby -- who is to say how many is too many? If you want >to argue ZPG, go right ahead. But I don't think OBs (or witches) are >supposed to strong-arm patients into having "only" 2 kids, or 3 kids, or 1 >kid. Does RED CHINA mean anything to you? > >2) purposefully trying for twins, especially with a scarred uterus -- now >THAT is something a responsible OB can go balistic on. Primum non nocere is >something that should be partially operative here. Don't go making things >more difficult (twins!!!) that you have to. Don't go asking for trouble. > >There you go. You asked. > >Joe P. > >(http://www.walletpop.com/?NCID=emlcntuswall00000001) > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Charlie Chambers: "Re: OB: Sleep study" Previous message: Glen Elrod: "OB: Sleep study"

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