WOMENS-HEALTH Messages for April, 2009: PREGNANCY: conflicting opinions

PREGNANCY: conflicting opinions

From: Leah (anonymous@obgyn.net)
Fri, 24 Apr 2009 13:36:18 -0500 (CDT)

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My husband and I have actively been trying to conceive since October of 2007, in November 2007 I became pregnant but miscarried in January 2008. The fetus aborted naturally at 13 weeks but ultrasound showed that fetal growth stopped between 8 and 9 weeks. A d&c was preformed to clean out any remaining tissue but results were inconclusive because the majority of material was expelled at home. This was my second consecutive miscarriage, the first was unexpected pregnancy due to misuse of birth control pill. The first miscarriage occured at 9 weeks and fetal growth stopped at 6 weeks. The new doctor I started to see agreed to investigate any concern I may have. During the next year, from January 2008 until January 2009, I under went many reproductive tests including blood screens, hormone screens, a hysterosalpinogram, a uterine biopsy, and several ultrasounds. I was diagnosed with homozygeous MTHFR and PCOS. I agree with the finding of MTHFR because shortly after my sister was also diagnosed with it. On the other hand, the diagnosis of PCOS was based on slightly elivated androgen levels, my slightly overweight physique, and adult acne. I disagree with the diagnosis because the HSG showed that there were no blockages or defects in my tubes and ultrasound and blood tests confirmed ovulation on several occasions. In January 2009 I had a positive pregnancy test and am currently at 20 weeks gestation. I have had some complications during pregnancy. Because of the MTHFR I take an increased amount of folic acid along with my prenatal vitamin. I understand that some doctors recommend baby aspirin and others do not which is only the first disagreement between the two doctors I am seeing. My main concern comes from this: shortly after my first prenatal visit the doctor sent me for a progesterone level. She stated it was very low and I needed to be supplemented; she started me at 400CC twice weekly intermuscular injections. I received the injections for about 3 weeks, and during those 3 weeks I became very lethargic, and slept for about 18-20 hours a day, my skin broke out in boils, and I had a painful reaction at the injection site. I also started to spot which was diagnosed as a subchorianic hemmorage and was put on bedrest for 3 weeks. I spoke to the doctor and she lowered the injection to 200CC and added oral supplements of 400 mgs daily, although she disagreed that it was from the progesterone and blamed it on seasonal depression. The tiredness lightened but my skin did not clear. Eventually the subchorianic hemmorage absolved itself and the pregnancy progressed normally. Also, the former doctor on several occassions suggested my husband and I separate which I feel was very inappropriate.

I decided to get a second opinion. The new doctor has now informed me that the type of progestorone usage is outdated and that several varations of the treatment the first doctor used are unconventional or not used. I would like any opinion or information on the issues stated above. It will be greatly appreciated.

thank you, Leah

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