Monday, May 28, 2007

The results of the visit to the Gynae

Dr Fatima listened to all my list below:

33 years old
TTC for 1 year and 2 mth *last year March.
My cycle used to be 28 days but this year has tapered out to 31 days
Last period came on the 19th May
We normally give it a go alternate days from day 10 to day 18.
A miscarriage in April last year- 1st time trying. Detected pregnant one week after missing period but fetus self aborted a few days later. No D+C as passed out fetal matter.
A blood test last year by a gynae for dunno what reason and am perfectly fine.
A pap smear and a HPV virus check in April 2007 and the results are good
Previous gynae said that my uterus is beautiful??

Husband is 41, not gone for sperm count.

Tried Ovulation kits but only tested once positive (3 months testing)

From the above, she concluded that, due to the change of days of menstruation cycle from 28 to 31, I may not be ovulating during some months. After some discussion, she recommended CLOMID. However, she cautioned that clomid may 'cause' ovarian cancer if one prolonged usage. Also, she checked my ovaries to ensure that there is no cysts otherwise this drug is not suitable for me as it aggravates the cysts.

I feel a bit strange about consuming clomid. Ovarian cancer!! A quick read on the internet revealed:

# Mikkelson et al. (1986) suggested that with repeated treatment cycles, clomid and its metabolites might build up, resulting in considerable exposure for the fetus.
# Furthermore, multiple gestations occur in 8-13% of pregnancies after use of clomid (Adashi et al., 1979; MacGregor et al., 1968; Harlap, 1976; Hack et al., 1972; Karrow et al., 1968).
# Several reports suggest a possible association between pre-ovulatory clomid use and increased frequency of pregnancy loss. Toshinobu et al. (1979) found a 24% SAB (spontaneous abortion) rate post-clomid use compared to a control group rate of 8.9%. Garcia et al. (1977) found a 25% SAB rate for pregnancies conceived after previous clomid use but which had been discontinued before conception.
# Perhaps the most controversial issue is the possible association between NTDs (neurall tubes defects) and clomid use. Between 1972 and 1990, 368 birth defects arising after clomid use by the mother were reported to the FDA. This number included 35 reports of NTDs (Rosa, 1990).
# The lifetime risk for ovarian cancer in the general population is 1.8%. Whittemore (1994) cites a 4-5% risk for women treated with clomid. Rossing (1994) evaluated this risk and the lengths of time women were on clomid and found that the relative risk for less than 1 year of treatment was 2.3. However, this risk increased to 11.1 for women treated for 1 year or longer (12 cycles).

After reading this, I think I better reevaluate my decision to use clomid. Hhmm.. I will give myself another month to think about this. In the meantime, I welcome any discussions and thoughts about this.

Monday, May 21, 2007

Am I infertile?

This seems such a weird topic to be writing about. I wrote a piece much earlier.. maybe 2 years earlier that "perhaps the decision then to have children is not from the fact that I SHOULD or WANT to but because I CAN".... and funnily... now I can't.

So in the quest of getting a child, I spent the first month having a miscarriage, the next three months feeling weird, the subsequent 6 months wondering if my husband will be around for us to try to have a kid and in the following 4 months watching in dismay as the trickle of fresh blood appears faithfully after each month.

I wonder what is wrong? Ok..ok..maybe I am getting paranoid... it's normal to have a kid in one year... but er.. it has been one month after the normal one year... or seriously.. am I too impatient? 2 good friends assured me that I should be a little worried and should start finding out why I can't seem to conceive.

There are a few questions that I have yet to answer... and I think that it is important to do so.
1. Ovulation problems: Do I ovulate regularly? – I dunno
2. Sperm problems: Is his sperm count OK? - I dunno either
3. Fallopian tube problems: Are my tubes open? – Was this even on my radar?

The strange thing is that my gynaecologist (Dr G - a famous one in Damansara Specialist Centre) is not even worried. He just ask me to do a pap smear and a HPV test to check for cervical cancer causing virus .. and the results were fine!! He just told me to come back again next year... what a doc????

This Friday, I will go for a second opinion with Dr Fatima, a gynae in Kelana Jaya Medical Centre. Hopefully she will be able to give me some idea as to the questions above.

Well,... at least I am taking some more action.