My Fertility Query

My doctor says I shouldn’t get pregnant

What does that mean?

At times, other than the reproductive system, other systems (like renal / digestive / hormonal) prevent the body from conceiving or carrying a pregnancy healthily.

In few conditions, the system may not even allow her to conceive or carry a pregnancy.

In many conditions, the child may be born prematurely or severely affected, or even risk the life of the mother, if the pregnancy continued.

Those are the conditions, where it is recommended that the woman herself should not get pregnant.


Few examples of systemic conditions are:

MRKH/RUDIMENTARY UTERUS

MRKH is a disorder that occurs in females and mainly affects the reproductive system. This condition causes the vagina and uterus to be underdeveloped or absent. Often, the first noticeable sign of MRKH syndrome is that menstruation does not begin by age 16. A unicornuate uterus is defined as a uterus that has a single horn which is banana shaped. This uterine anomaly is seen as the least common anomaly in women and represents 1 to 2% of uterine abnormalities. Women with a rudimentary or unicornuate uterus are at risk of reproductive complications. They may have problems taking in because only one of their fallopian tube seems to be functioning. Most times, these conditions are only discovered when women first opt for infertility investigation. Notwithstanding, women with a unicornuate uterus can still get pregnant but stand the risk of getting that pregnancy terminated via spontaneous abortion. Surrogacy becomes best treatment option in such cases.

GESTATIONAL DIABETES

Women with gestational diabetes are bound to experience problems during pregnancy. If these conditions are not effectively treated they could result in health problems for mother and child, other times, it could result in miscarriage. Gestational diabetes is common among women who have polycystic ovarian syndrome (PCOS). For cases of infertility or miscarriage that are caused by gestational diabetes, IVF treatment has proven very potent with many women getting pregnant and conceiving successfully. Studies have shown that Gestational diabetes in women after IVF is characterized by increased first trimester leading to a higher glucose level. In this case, early diagnostic in IVF pregnancies is quickly needed.

HYPERTENSION/PIH

Although IVF treatment can effectively make a woman pregnant, there are chances that women can suffer pre-eclampsia complication which is a form of pregnancy-induced hypertension. This condition is common, but in the event of a serious complication, it tends to affect first pregnancies. Pre-eclampsia is a condition that happens when there is a problem with the placenta which delivers nutrients to the fetus. When this occurs, it will result in high blood pressure in the woman, stunting the growth of the child. If untreated, it can lead to eclampsia – seizures. In this situation, the only treatment available may be to induce labor and deliver the child. This too has its own complications.


PULMONARY HYPERTENSION (PH)

PH is one of the leading causes of death in mixed connective tissue disease (MCTD) and absolutely remains a contraindication for getting pregnant. Given the risk of pregnancy in people having pulmonary hypertension or mixed connective tissue disease, IVF together with gestational surrogacy may be their option to have their own biological children.

RENAL DISEASE/TRANSPLANT

Although the complications and risk related to IVF are low, people should be aware that IVF can cause compression or damage to the uterus which may summarily lead to acute renal failure. To prevent permanent kidney damage including a safe development of pregnancy, this condition has to be diagnosed and treated immediately.

THYRIOD DYSFUCTION

Hypothyroidism is a condition that results from the inability of the thyroid gland to generate as much thyroid hormone as required. This can result in failure to ovulate regularly. In this case, there is no variation in the chances for IVF success especially when a woman has at one time had untreated subclinical hypothyroidism at the initial stage of IVF cycle.

HORMONAL IMBALANCE

Hormonal imbalance is yet another condition most women have to deal with as regards infertility. Generally, hormones are regarded as a chemical communication, used by the body to regulate reproduction, growth and other processes. Consequently, when too much or too little of a hormone is produced as a result of conditions like a glandular malfunction or a polycystic ovarian syndrome, problems may arise. In women, hormonal imbalance can lead to infertility by preventing the thickening of uterine lining, ovulation or in other cases prevent pregnancy from occurring. Luckily, once hormonal imbalance is detected, it can usually be corrected using medication, or intentionally making dietary changes.

CA OVARIES/CERVIX/UTERUS

Current results regarding fertility preservation options for women suffering gynecological cancer shows oncological safety and high potency of fertility-sparing surgery. For women with sub-fertility, they can undergo assisted reproductive procedures or treatment to achieve pregnancy. In recent publications of international guidelines for fertility preservation, there was the call for timely discussion on the impact of cancer treatment on future fertility and options for fertility preservation.

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COAGULATION DISORDER

Thrombophilia or Clotting Disorders are two conditions that can lead to recurrent miscarriage in women. However, it is imperative to know that although blood clotting disorders have been linked to miscarriages for eons, they are not seen as the primary cause of infertility. Hence a woman who has a medical history of clotting disorders or miscarriages but remains infertile need not be tested for these problems.

CROHNS/IBS

Inflammatory bowel disease (IBD) is another condition that is sure to overburden women during their reproductive days. Also, family planning issues can cause significant concern when women are nursing inflammatory bowel disease. Fertility is common among women with nonsurgical treated ulcerative colitis while it is reduced in women with Crohn’s disease. Furthermore, women who undergo ileal pouch anastomosis often have to deal with reduced fertility. Conversely, Fertility is likely exacerbated by disease activity but unaffected by drugs used to treat IBD. Notwithstanding, Infertile patients having IBD together with non-IBD patients respond very well to IVF treatments. Regardless of normal fertility, people with IBD have a fewer number of children due to concerns regarding disease inheritance, infertility, congenital abnormalities and generally, disease related sexual dysfunction.

MYOCARDITIS

Myocarditis is a rare cause of cardiovascular disease primarily manifest as sudden death, chest pain or heart failure. Patient will Myocarditis is best advised to not get pregnant. Surrogacy and even egg donation is what they should consider.

SLE (LUPUS)

The immune system normally fights off dangerous infections and bacteria to keep the body healthy. An autoimmune disease occurs when the immune system attacks the body because it confuses it for something foreign. There is a very high possibility that In-vitro fertilization will succeed for women with systemic lupus erythematosus and antiphospholipid syndrome. However, it may increase the risk of flares or blood clots if they are not committed to taking medications.