Allon Message Board

Dr. Allon? - Chemical Pregnancy

emptyvessel — Fri, 22 Aug 2008 16:53:06 GMT

Hello Dr.,

I am 30 years old with 2 failed fresh transfers and 1 failed frozen transfer. We transferred a total of 10 embryos over these 3 cycles. The final 2 cycles included 7 (3 then 4) high quality blastocysts transferred with each ending in a chemical pregnancy at 5 weeks. I am diagnosed with stage 3 endo and had my second lap 8 weeks ago - after the lap we immediately did the FET, it just ended in a chemical pregnancy. We immediately did the lap b/c we wanted to ensure we beat the endo which presumably returns in 6 months or less. Each time my lining was >9mm.

Before we embark upon our 4th IVF (3rd fresh) do you suggest we do a RPL blood screening? There is a history of strokes in my family + my uterus should have been free from endo after this recent lap, thus, inducing pregancy. Do you have any other suggestions? I appreciate any feedback as it might be time to pay you a visit.

Thank You

Forum: IVF

ivf

cpena — Sun, 27 Jul 2008 16:29:26 GMT

Is it normal in some cases to have a cycle 9 days after ivf procedure?

Forum: IVF

i need help

aliciadavina — Wed, 23 Jul 2008 18:45:11 GMT

Dr. Allon,

About 7 years ago, I had a tubal ligation by you. I also had surgery by you about 3yrs ago for some other minor things, but my concern is that the pain that i had at that time is still the same now. I had lots of lower abdomen pains and I still wonder if it's from the tubal ligation. You had told me that could not be, but the pain did not start until that procedure was done. I was wondering what are the health risks of a reversal and the costs. My full name is Alicia D Velasquez and DOB is 9-19-78. If you can look at that and let me know. I hope you remember me. I had so many health problems and i'm just afraid to just trust anyone. I also lost a little girl, she had turner syndrome. I was being treated by Dr. Ortega at Spring Branch Hospital. I hope this helps you a little bit.

Forum: Infertility

2 hour insulin-pcos

mandimoore — Mon, 30 Jun 2008 03:05:23 GMT

I was diagnosed with pcos about 2 years ago. (cysts on ultrasound, total testosterone = 74, fasting insulin = 13, 2 hour insulin = 65) I am curious to know what the doctor thinks is an "optimal 2 hour insulin" level if my fasting is now at 9. (My last 2 hour insulin was 53. I take 500 mg. of metformin 1 time a day and spironolactone 100 mg 1 time a day.) My fasting glucose is always normal in the mid-70's and 2 hour is usually right around the mid-70s to no higher than mid 80's.

My acne is much improved, but I still have lots of scalp hair loss (going on 3 years now) and hirituism. I'm wondering if I need to increase my metformin to bring my insulin down even more, to get a better response for my existing symptoms.

Forum: PCOS

intestinal endometriosis

anamarsal — Tue, 24 Jun 2008 04:43:56 GMT

I am 31 years old. I had been married for 7 years with no children yet. I guess I have a lot of medical conditions that lessen my chances of having a baby. I had my thyroid gland removed when I was 16 y.o. Had an ectopic pregnancy on 2003 where one of my tubes was removed. Had a miscarriage on 2004. Last summer of 2007 I had a laparascopy where I was diagnosed with intestinal endometriosis stage IV. I was told that my only option was undergoing a 3 month lupron treatment and then have a surgery to remove endo. The doctor also found out that a small part of my intestine was stucked to my uterus. I have heard of the lupron symptoms and this is what is stopping me from proceeding with treatment. What would you suggest me to do? Are there any other options without using the lupron. I am very desperate on trying to find any other options. I would appreciate any advice or info you provide me. Thank you.

Forum: Endometriosis

pregnant of twins

oscarm — Wed, 04 Jun 2008 02:14:49 GMT

me and my wife whant to get twins i whant more information, about how do you help us

Forum: Endometriosis

Retrograde Ejaculation

amirini — Fri, 30 May 2008 03:39:32 GMT

My husband suffers from Type 1 Diabetes and as a result he has developed Retograde Ejaculation. We are consitereing ART and would like to know what avenue to go first. A couple of rounds of IUIs or straight to IVF. WHat would you recommend.

Forum: Male Infertility

Recurrent chemical pregnancies

Aggiegal3 — Sun, 04 May 2008 18:20:09 GMT

Dr. Allon,
I am a 27, my husband is 28. We are both healthy without any known medical conditions and no h/o STD's. We have been trying to conceive(TTC) our first child for 2 months. Prior to TTC, I charted my cycles for 4 months and noted that I had 28-32 day regular cycles and ovulation, based on ovulation predictor kits (24-48 hrs after surge detected), estimated my ovulation falling on day 19-20 of my cycle. This places my luteal phase lasting 11-12 days.

Here is where our problem begins, the first month of trying we had a chemical pregnancy. Positive HPT on CD 32 and 33 (4 tests in total, 2 different brands), but I subsequently started my period anyway on CD 35. Gestation according to LMP would have been about 4 weeks along. I had an OB eval the morning that my miscarriage started and it showed a negative urine PT, blood HCG of only 3 and a progesterone of 1.2. A transvaginal US was also performed which showed a uterine stripe of 12mm, no sac.

THe OB recommended that we did not need to wait a cycle and so we tried again the very next cycle. Again same problem, another chemical pg, 5.5 weeks by LMP. This time I had a postive HPT on CD 33 and because I was worried continued to test every other day. The lines were darkening up until CD 40. On CD 40 I had a blood HCG of 41 and progesterone of 2.6. Two days later my follow up Beta was 66 and progesterone 6.0. The active bleeding began on CD 42. No U/s performed.

My OB ran blood work to rule out clotting disorders, anti cardiolipin IGM IGG, protein c and s, ANA, anti DS DNA, lupus anticoagulant, factor 5, APL, PT, PTT, INR, homocysteine, and performed a Prenatal screen. All of which were normal, blood type A +.
She suggested that we empirically treat with prenatal vitamins, 81 mg ASA, and then once I get a positve HPT: adding progesterone and lovenox.

I wasnt totally comfortable with this plan, because I have read that progesterone is not effective in LPD unless it is started immediately after ovulation, and the other tx (asa and lovenox) are supposed to be for clotting abberations which I have tested negative for.

I sought the advice of an RE, who is a researcher but only sees patients one half day a week. (I didnt realize this at the time) He took my history, performed a transvaginal US, and took blood for a TSH and a chromosomal analysis of both me and my husband, recommended for me to undergo HSG during next cycle. The transvaginal U/S revealed no abnormalites in either ovary or uterus. The TSH and chromosome results are still pending. He didnt seem to have any answers, but felt I should start Clomid 50mg next cycle from CD 5-9. He said he wanted to do this (even though I am ovulating regularly) to attempt to improve my luteal phase and also to try to induce ovulation sooner. He said the asa, lovenox plan was not recommended because I dont have evidence of a clotting d/o.
I have researched the medical literature about the clomid for my particular problem and have not found any reassuring evidence that it helps someone in my position. In fact I think it might introduce more problems with cervical mucous and with implantation from the information I have read. Why shouldnt I just do the progesterone support post ovulation instead?

SOme additional info....I do not have any of the "typical" phenotypic features of PCOS, I do not smoke or drink, and during the TTC period drank very very minimal caffeine. I do not exercise heavily and I have a BMI of 23. Family hx for me does include RA in MGM, and Crohn's Disease in MA, TPO antibodies (without overt hypothyroidism) in my Mom. No one in the family has had recurrent m/c on either mine or my husbands side. No known genetic problems in the family either.

I am so frightened of having another M/C and am worried that my RE and OB have only partially worked me up for this. I just would like another opinion on tx options and your general thoughts on my case and possible likely causes. What do you think of the clomid stuff, my luteal phase length, and possible reasons for the recurrent chemical pg? How worried should I be about not being able to carry a baby to term in the future?
Thanks in advance,
Laura

Forum: Infertility

Intention of the Day

briel — Thur, 01 May 2008 05:28:02 GMT

Not sure if you've seen this, but there is an Inspiration of the Day mailing available to help people overcome fertility issues. The daily mailing approaches the issue from a holistic (positive thinking) standpoint, and is intended to be supplemental to medical treatment. Can be found here. I receive this every weekday morning and it is a joy to read :)

Forum: Infertility

Second opinion?!?

praying4baby — Wed, 16 Apr 2008 18:09:23 GMT

Hi Dr. Allon,

First, let me say thank you for your commitment to women/men/families by hosting this forum! I was directed to your website by my general MD, who happens to be a patient of yours. I was diagnosed with PCOS in Sept 07 and put on 1500 mg of Metformin by another fertility doctor here in Houston. I have a uterine abnormality and endometriosis, not to mention the fact that I am 37 years old. My husband and I desperately want to have a child of our own, but I want to make sure I am being given the best choices possible. My husband and I had the first round of tests done last fall. I took the Clomid challenge test and was told that all was well, EXCEPT the PCOS.... There has been no aftercare since that appointment. We were told to make our appointment to sign the IVF contracts to start on our journey. Before I ramble too much I will just ask the question...... Is it possible to have a second opinion based on the original test results or does this mean starting all over? We have invested $3000 out of pocket already and would like to keep the expenses as minimal (HA!) as possible since we have no assistance from our health insurance plan. Thank you in advance for you help! You will be hearing from us very soon - my husband is out of the country at the present time, but we would like to schedule an appointment SOON! Thank you, thank you, thank you!!

Forum: PCOS

diet changes (SICK)

live4fitness — Mon, 14 Apr 2008 14:42:52 GMT

Any one get sick (colds), yeast infections, coldsores when they have changed their diet to a low carb diet with the pcos, IR? I did several years ago and I am going through it again. I am not happy. Any suggestions. I take a product called 3 lac that has helped in the past and I hoping will help now.

Forum: PCOS

HCG

live4fitness — Tue, 08 Apr 2008 17:41:10 GMT

I have a few friends who have been successful with the hcg drug and diet and some who take hcg and vit B12 shots to loose weight. Anyone know if this would help with weightloss and PCOS. (I am currently on Metformin @1500mg on my way to 2000mg)

Thanks

Forum: PCOS

TWINS?

txgirl — Mon, 31 Mar 2008 19:25:34 GMT

Dr. Allon, I am 36 with 3 children.... my husband & i are interested in having twins or triplets. Would a fertility drug help with our wish? If so, what is the cost? Thank you.

Forum: Infertility

need suggestions on conceiving please

cromero_pix — Mon, 31 Mar 2008 17:24:49 GMT

I was young and dumb when i first tied to conceive, it never worked i tried for 3 years, i thought maybe i was too young. Fortunately i didn't get pregnant by that one guy . Now, that I'm mature, i found somebody and I'm now engaged to my best friend. We've been trying for about 8 months now and he previously conceived with an ex, so i know its not his sperm that's not right, ITS ME. . this is the first time admitting it and it hurts, cuz i would do anything before i give up. I want to make sure he marries someone who can give him the baby boy hes always wanted. I need help and now I'm researching as i am in a drastic measure.
I'm hoping i receive tips before i have to take medication... but if it leads down to it, i'll do it because i want a child to be the best mother to.
Thanks, please write and suggest

Forum: Infertility

abnormal sperms

waleed — Wed, 26 Mar 2008 22:21:05 GMT

Dear Dr. Allon:

I have been in a good shape all my life, dont somke, drink or do drugs , and never worked in any bad working conditions. I did a sperm test and the abnormal number of sperms is 98%..!!!!!!

My question is , is there any cure for abnormal sperms?

Thank you ,

waleed

Forum: Age & Infertility