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Suffering from sleeping disorder and taking metformin tablets for PCOS. Advised to take hysterscopy of the uterus. Is it the correct treatment?
Question: Hi Doctor, My name is XXXX and my date of birth is 29-09-1980 (AB- blood group) and my husnand's date of birth is 25-03-1978.(A + blood group) We were married on 22-11-1008. I Would like to just summarize my brief medical history related to pregnancy, would like to know your expert opinion and way forward related to my pregnancy. 1. First case of failed pregnancy LMP 9/10/10 Missed abortion 7/3/11 at 20 weeks - before pregnancy found 7.2 cm fundal posterior fibroid with cystic degeneration, later conceived naturally(25.10.10) with the help of follicular study. - 5/3/11 21 weeks pregant with 13 x 11 cm fundal subserosal fibroid with cystic degeneration. Cervical length 3.2 cm - 7/3/11 Pre-term delivery and later D&C curterage. - 17/4/11 again D& C done dur to non-stop bleeding with big clots - 19/5/11 Laproscopic Myomectomy . Posterior Intramural fibroid 9 cm with degeneration and subseosal fibroid along RT fundus also removed. 2 Units of blood transfusion done because haemoglobin level at 7.6 - during pregnancy from 3rd month onwards had 103 F temperature fever only in the evenings. This stopped after myomectomy was done. - during discharge doctor recommended you shall have to do cervical stiches when i get pregnant and informed the delivery shall be C-section - Have a sleeping disorder issue 2. Second case of failed pregnancy - LMP 23/5/12 Abortion 23/7/12, abortion done at 7 weeks - before pregnancy LH,FSH, Prolaction, AMH/MIS, TSH, T3, T4 test done - concieved naturally with follicular study - Informed about PCOS metformin tablets started - 7 weeks abortion was done as fetal pole was not seen 3. Third Pre-term case September 2012 BOH panel Torch test, acl, LA, DS, DNA/ANA, Kaaryotyping< HW done all parameter are normal January and Febraury 2013 IUI done but concieiving not achieved March 2013 HSG done LMP 11/4/12 Preterm delivey on 27/9/13 24 weeks - Naturally conceived with follicular study - Quadruple marker test done - After 16 weeks OS tightening done - Cervical length was 2.1 cm at 24 weeks - Anomaly scan done. everything normal at this stage - 27/09/13 labour pain started. this preceeded with feeling of passing stools, continuos pressure near the anus. shifted to hospital. - Cervical stich removed - delivered a still born baby 650 gms - cervial tear suturing done. The doctors have now asked us to take a break. The treatment advised ahead is doing a hysterscopy of the uterus along with 3D pelivic sonography. We both are confused on whether our line of treatment is correct, we would like to do everything possible before our nect pregnancy so that the things mentioned above are not repeated. We would appreciate if you could help us and guide if we should do anything more. Regards, XXXX
Brief Answer: Genetic screening of embryos Detailed Answer: Hi, Thanks for your query. I have read your query & I understand your concerns. Following is my reply: 1) Majority of your pregnancy losses are either abortions or preterm deliveries. Preterm delivery after cervial stitch removal was also ended in stillbirth. 2) These point to probability of some unknown translocation or chromosomal disorder which is repeating in each pregnancy and not letting babies survive. 3) I recommend you undergo ICSI along with chromosomal abnormality testing for embryos (PGD). These result in selection of healthy embryos to be transferred into uterus. I hope I answered your query. I will be available for any followup queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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