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what are the pros and cons of late pregnancy?

Mar 2013
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Practicing since : 1998
Answered : 5971 Questions
I had a missed miscarriage 8 months back. From starting I have cycle issues. but from past 2 months it has been regular. I also had PCOS earlier. Now I dont wish to concieve at least for the next 2 years for various issues. What are the pros & cons for late pregnency & how can I prepare myself for the same
Posted Mon, 10 Feb 2014 in Pregnancy
Answered by Dr. Aarti Abraham 16 minutes later
Brief Answer: DETAILED BELOW Detailed Answer: Hello Thanks for writing to us with your health concern. Now, there are two issues in your case, let me discuss them separately. A. The missed miscarriage - was a chromosomal analysis done for the products of conception ? It should have been done, as it is the commonest reason for a miscarriage. 2. Hormonal tests should be done - complete blood count, HIV, HBsAg, HCV, VDRL, FSH, LH, TSH, Prolactin, OGTT, DHEAS, Free testosterone, Lipid Profile. 3. Baseline pelvic ultrasound on day 2 of cycle. 4. Screening for APLA - antiphospholipid antibody syndrome. 5. Semen analysis. If this workup is normal, you can then defer pregnancy for atleast 6 months. Meanwhile take daily folic acid 5 mg per day tablets . Now the second issue. That is , B. PCOS It is a condition of hormonal imbalance, THe ovaries are studded with numerous cysts but none mature to form an egg. Thus ovulation suffers and cycles are irregular. With PCOS, conception also is a problem due to erratic ovulation, so you were lucky if you got pregnant easily. With PCOS and your age ( 31 ) , I would not recommend waiting for 2 years for a second pregnancy. The pros of a late pregnancy are none in your case. The cons - 1. Your age. Beyond 30, the fertility potential of every woman decreases. At 33, it would be significantly lesser. 2. Worsening of PCOS. 3. Increase in chances of a miscarriage, abortion, genetic abnormalities in babies with increased maternal age. 4. Increased chances of complications during pregnancy such as hypertension, diabetes, etc. 5. Difficulties with normal delivery with increasing maternal age. As you can see, all aspects of childbirth get more difficult with increasing age. If it is inevitable, and you have to delay it, you can take the following steps - 1. Exercise regularly and eat healthy. Maintain an ideal BMI. 2. Get the investigations for PCOS done, if any gross abnormal result is observed, then get that corrected with treatment. 3. Prepare yourself for some difficulties in conception when you attempt a pregnancy after 2 years. 4. You can use oral contraceptive pills, as they will bring about improvement in PCOS also. From my side, I would ask you to start planning a pregnancy as it has already been 8 months since your miscarriage Take daily folic acid supplements without fail. All the best. Please feel free to discuss further.
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Follow-up: what are the pros and cons of late pregnancy? 6 minutes later
Thank you for the answer doctor. Non of the tests were done at that point of time. i want to know how can can I check if I have PCOS now. and what could be the other reson for irreregula periods. Also, during my pregency one of my ultrasound sugeested that I do not have corpus leutel cyst. what does that mean.
Answered by Dr. Aarti Abraham 5 hours later
Brief Answer: EXPLAINED BELOW Detailed Answer: Hello Please get the tests done before planning your next pregnancy. For PCOS, please get the hormonal tests I have named in addition to the pelvic ultrasound scan. That will tell you if you still have PCOS. Also, hypothyroidism , stress, weight gain, late nights, erratic eating habits - all these can cause irregular cylces. Once the pregnancy is developing, the corpus luteum is the structure in the ovary which supports the embryo It is not necessary to have a corpus luteal cyst everytime during pregnancy - however presence of a corpus luteum indicates adequate hormonal support. Absence of it indicates deficiency of progesterone and HCG , both are pregnancy supportive hormones, and women with PCOS often have hormonal imbalance - this might be the reason.
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