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Re: Ob: IVF candidate From: art fougner, md (evsono@pipeline.com) Tue Sep 30 07:38:13 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: Ob: IVF candidate" Previous message: R. Daniel Braun: "Re: Ob: IVF candidate" In reply to: Garry E. Siegel, M.D.: "Ob: IVF candidate" Next in thread: JD Stewart,MD: "Re: Ob: IVF candidate" Reply: JD Stewart,MD: "Re: Ob: IVF candidate" The customer is not always right. Art At Mon, 29 Sep 2008, Garry E. Siegel, M.D. wrote: > >Here's a case for discussion: > >41 YO P1414 with no medical problems or issues. I have cared for her >only in her last pregnancy, and the history is from the reliable >patients, as opposed to records. > >Ob #1 32 week Monoamniotic twins, IUFD, C/Section > >Myomectomy > >Ob #2 36 week C/Section (PTL) >Ob #3 Term C/Section >Ob #4 35 week C/Section (PTL) >Ob #5 First trimester missed Ab, D and C >Ob #6 36 week C/Section, PTL, Classical due to densely adherent bladder > >Subsequently, she had an apparent ventral hernia of some type, and >underwent an abdominoplasty and the general surgeon did not find a >hernia. While in the OR I did a Pomeroy TL via the laparotomy. > >She now has sought IVF and is planning to do so. She ideally would want >a twin pregnancy, as she wants two more children. > >Obviously, she is at risk for surgical complications at laparotomy, AND >increased risk of uterine rupture, premature labor, hysterectomy, and >abnormal placentation. > >She asked (paraphrased): > >If we could predict this, and I had enough embryos, should I "shoot for" >a twin pregnancy, versus two separate singletons to have two more >children? > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > -- art fougner, md "May The Wings of Liberty Never Lose a Feather." - Jack Burton Next message: Garry E. Siegel, M.D.: "Re: Ob: IVF candidate" Previous message: R. Daniel Braun: "Re: Ob: IVF candidate" In reply to: Garry E. Siegel, M.D.: "Ob: IVF candidate" Next in thread: JD Stewart,MD: "Re: Ob: IVF candidate" Reply: JD Stewart,MD: "Re: Ob: IVF candidate"

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