Question:
Hello Dr Edelstein,

I hope this email finds Dr well.
I really hope dr can assist as I am desperate for some advice on what to do next.

A very short history…
We don’t struggle to fall pregnant, but have miscarriages…

First pregnancy, got pregnant on first try (drank Clomid as cycles was a bit irregular (29-32 days). Saw heartbeat at 8 weeks, missed miscarriage at 12 weeks. – Did not do any tests. (baby stopped growing at 9 weeks)

Second pregnancy, fell pregnant 2nd cycle trying. At 12 weeks, NT measured 6.4mm. Did CVS and little girl was diagnosed with Trisomy 18. Had a missed miscarriage at 16 weeks. (baby stopped growing at 14 weeks).

Third pregnancy, tried to avoid and still fell pregnant… No complications during pregnancy, healthy girl born at 40.1 weeks.

Fourth pregnancy, did not try / avoid. First cycle after birth fell pregnant. Saw heartbeat at 7 weeks. Missed miscarriage at 9 weeks, baby stopped growing at 7 weeks.

My Gynae did a few tests, and all came back normal. (intra phospho lipids, TSH, Glucose, Toxoplasmosis, Cytomegalovirus, Liver, and 2 other, cant remember the names). We’ve also had karyotyping done on my husband and myself, all normal.

Is it time to go to a FS?? And also I have stumbled across a new study about hyperfertility, are you aware of this “condition” and do you know of any studies / treatment for this in SA?

Looking forward to your reply.

Question:

Please can you assist.

I am trying to fall pregnant. However we have hit a bump after my husband’s test results.
Please can you advise :
-is there any medication that will definitely get his sperm count up?

Question:

Last year I had a TOP just before I got married. Four months later I paid a visit to a fertility clinic and the doctor I had the consultation with was very supportive and gave me great advice. The problem I had was that I had some pelvic pains and he suggested I should have a laparoscopy. I went to 2Military hospital for funding or to do the surgery and they blew me off and I never had medical aid to turn to. Just after my consultation with the fertility specialist I conceived right away two days after my visit with him. At my 2nd prenatal visit (13 February 2014) I was told I had a missed miscarriage. I was devastated as I really want a little one. Until today still no such luck and I even had a d&c (evacuation of uterus) at 2Military hospital. My question would be, did they somehow do something wrong with the d&c and that’s why I didn’t conceive again? Can I have the laparoscopy now or should I do consultation again because I have pelvic pains again, gained weight, back pain and heavy headaches. I joined Discovery recently and think I have the funding now. Will I ever conceive naturally again?

Question:

Dear Dr Edelstein,

Hubby and I have decided that I will stop using Visanne. We want to start trying to conceive again after my next cycle.

Any advice on what I can take to improve my chances? Just a bit of history. I was diagnosed with endometriosis in 1998 and the diagnosis was confirmed in 2001 via laparoscopy. Since then I have had 7 laparoscopies and my most recent operation was a laparotomy (25th June). I have stage 4 endo. With the last op the Dr did excision surgery and removed all endo as well as endo on my bowel. Hubby and I have been ttc’ing for 5 years now. Took a 6 month break while I was on Visanne. We have done 6 cycles with Clomid and Estrofem, as  well as 2 cycles IUI.

I have seen on Fairhaven that they sell Fertilaid, I have bought some this month, and hoping that it will make a difference.
Hubby’s last sperm test was last year October, when we did the IUI’s, and the dr at that stage said that everything was normal.
The Dr did however say, that he would suggest that we still rather try with help.
Was just hoping that maybe you have some advice for me please.

Question:

Good day dr. We have been trying to conceive for 3 months. I started feeling my cervix for up and down movement and soft and hard to figure out when I’m ovulating. I think I have figured out when that happens. But now with all this feeling, I have noticed little hard bumps on the edge of my cervix, not painful, just freaked out when I felt that. What could be the cause?

When me and hubby have sex, we kinda go to sleep afterwards, so the semen stays there the whole night, could that maybe be a cause?

Question:

What makes fertility treatment procedures so expensive?

Question:

With such a big variety of diagnoses out there, how is a clinic’s success rate measured? Are the “difficult” and “unexplained” cases measured right along the “easier” ones?

Question:

I have heard you can prevent OHSS with a Lupron trigger. Please tell me how this works and if you agree?

Question:

Is there a statistic available for patients with unexplained infertility who actually fall pregnant using IUI? Is there an average amount of IUI cycles it took to achieve pregnancy?

Should a patient with unexplained infertility rather move on to IVF sooner? How soon?

Question:

Can being pregnant and giving birth change your AMH and FSH results or are they always as bad as your most recent test? My last test was performed roughly 12 months ago (I have since given birth) and my AMH was 0.7 and FSH 14.

I recently gave birth to a donor egg conceived baby, and have a very low AMH and high FSH. What are the chances of falling pregnant naturally with my own eggs or are we likely to face further IVF using donor eggs again in order to achieve a second pregnancy?

Question:
I know the recommended waiting period before seeing a specialist is 1 year if I am under 35. Yet a year feels so wasted if I do then get to a specialist only to learn I have needed ART all along. Have you ever wished patients would have gotten to you sooner than that? Are there any other criteria/ warning signs which would send a patient to you sooner?
If the year gets too long, is there a “basic” set of tests which can be done just to see if the year is worth waiting out?