Brief Answer: No further tests needed Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about this miscarriage. The amount f tie you spent trying to get pregnant is just good enough. Trying for up to a year is acceptable before trying to investigate for infertility. You have no problem conceiving and should not go for any IVF. You can try to get pregnant again as soon as your menses return to normal. Adenomysosis and the location of this fibroid will not interfere with you getting pregnant. The difficulty you have maybe retaining pregnancies given this fibroid and adenomyosis. If the next pregnancy should suffer similar complications of miscarriage, I will strongly recommend that you consider surgery before going on to to get pregnant again. Talk to your OBGYN and hear what they have to propose about this. I hope this helps. I wish you success with futiue pregnancies. Feel free to request for more information if need be. Thanks. Dr. Ditah, MD.

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Brief Answer: See below Detailed Answer: If you are in a hurry to get pregnant, then getting aggressive and faster methods like IVF would be of help. However, the real difficulty would be to get this pregnancy stay in place and grow to full term. This is because, fibroid and adenomyosis would certainly lead to poor implantation and increased risk of loosing your pregnancy. If you could address these, then the chances of being able to hold onto future pregnancies would be increased. Though the problem is not with conception, I will advise that your husband should get treated for this condition because semen is normally sterile and he should get his infection treated before it becomes too late to address or leads to other complications. Folic acid and VItD are good. Did you by any chance get to be evaluated for other possible causes of this pregnancy loss like chromosome abnormalities, infections, etc. It may be very easy to stop at these anatomical problems and forget that it could still have been caused by other conditions. I hope this helps. I wish you well. Thank you so much and feel free to keep the discussion going on if need be. Dr. Ivo, MD.

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Brief Answer: Husband needs no treatment Detailed Answer: Hi and thank you so much for following up with me. I have taken a look at this seen analysis and there is no reason to get worried about it. He needs no further attention on this. There are a group of infections grouped as TORCH.(Toxoplasmosis, rubella, herpes, etc) that should be investigate. Also, analysis of the fetal tissue may be able t tell whether there was any other possible chromosome abnormality. There is no surgical treatment for adenomysosis except for hysterectomy which is not an option for a woman who desires to become pregnant. If the fibroid is not in the cavity, then you should allow it and do no immediate surgery. Try getting pregnant again and see what you get as a possible outcome. Should this occur again, then we may need to explore further options. There is no need for any specific procedure to ensure expulsion. If bleeding should fail to decrease and eventually stop, then there is no to get worried, However, if it all ends it means it was all expelled. A quick ultrasound can make the difference and guide about the need for D&C or not. I wish you well. Thanks. Dr. Ditah, MD

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