Contact Answers In the News Hot Topics
© 2007-2015. All rights reserved
Share on Facebook
Share on Twitter
Share on Digg
Share on Google Bookmarks
Share on Reddit
Share via e-mail

Pregnancy Bliss | Reproductive Health Hub

Anembryonic pregnancy and blood groups

Question: My partner and I are going to try for a baby next year, but a couple of years ago i had an anembryonic pregnancy. I had a D&C at the hospital, and they gave me an injection as they said the baby chose a different blood type to me and this is why i had an anembryonic pregnancy. Is this likely to happen again and will i need to have injections when we try for a baby again. Many thanks.  S. (UK)

Answer: There was either a communication mishap or, I am sorry to say, you might have been misled. A difference in blood group between the mother and the baby in the womb NEVER causes an anembryonic pregnancy or a miscarriage of any kind for that matter. It is clear from your details that you are blood type Rhesus Negative hence the injection that you were given after your pregnancy loss. This would have been done purely as a precaution in case the baby that never formed was of the Rhesus Positive blood type. As I say, this was purely precautionary as it would not have been possible to know what blood type the baby would have been. The reason why any pregnancy fails in this way (anembryonic pregnancy) is exceedingly difficult to establish. In fact, no attempt is ever made to do so because such efforts are virtually guaranteed to be fruitless. Anembryonic pregnancies can recur but this is unusual. An anembryonic pregnancy  is also known  by the older term of a ‘blighted ovum’.

The issue of your blood type (Rhesus Negative)and the significance of this in any pregnancy is discussed in more detail in this section. Let me reiterate, however, that this played no part in the pregnancy loss you had as it never does in this type of loss.

Choragon injections whilst trying to conceive

Question:   What are the side effects of choragon injection on a woman trying to conceive? O. (Nigeria)

Answer: The active ingredient of Choragon is human chorionic gonadotrophin, better known by its short acronym ‘hCG’. Human chorionic gonadotrophin is  a natural hormone which is safe if and when trying to conceive. It is typically used to treat women with fertility problems  if the identified underlying problem is poor ovulation. Once eggs have been stimulated to develop, usually using a series of FSH injections, a Choragon (hCG) injection will be administered to facilitate the release of the egg. The couple are then supposed to have sex on that day and the next to maximise chances of successful conception. Whilst overall, Choragon is safe; its use does lead to increased possibility of multiple pregnancy (twins or more) resulting from release of more than one egg.

In vitro fertilization (IVF) after the menopause

Question:  What is the current medical advice regarding trying ivf if you have already gone through menopause? P.D.(UK)

Answer: The general medical opinion on pursuit of pregnancy has not changed over the years. It is clearly the case that a pregnancy after menoMrs Bousada de Larapause can only be successfully achieved via a donated egg. This is because the woman’s ovaries are no longer able to produce eggs. It is not only that there is no medication that can stimulate the ovaries to produce eggs, it is more a case of exhaustion of the egg store. Having said that, the uterus, under appropriate hormone stimulus retains the ability to successfully carry a pregnancy into advanced age. Mrs Bousada de Lara (pictured) is a case in point. She carried her twin pregnancy successfully at the age of 66. Many similar cases have been recorded in various parts of the world, some involving even older women. That is the positive side. The negative side is the fact that the older the woman, the more likely the IVF attempt is to fail. There is also more likelihood of many of the known pregnancy complications including miscarriage, pre-eclampsia, gestational diabetes, fetal growth restriction, pre-term delivery, operative delivery etc.

We cannot ignore the fact that when the mother is of advanced age, her chances of orphaning the child while the child is still young is high. This was tragically the case with Mrs Bousada who passed away when the twins were only three years old. Women planning to embark upon such a quest need to consider all these issues and doctors should always strive to give them the professional honest support required. The subject of assisted conception for women over 40 is discussed here:

From conception to implantation

Question:  How long after intercourse does implantation take place? O. (Nigeria)

Answer: As long as the egg is already released, fertilization will take place within seconds of ejaculation into the vagina. The process of the fertilised egg undergoing multiple divisions starts within about 24-30 hours after the fertilization.

This fast dividing ball of cells travels along the fallopian tube towards the womb cavity. Implantation starts taking place within approximately seven days of fertilization and will take about another week to complete.

Endometriosis, fertility and cancer

Question:  I have been found to have endometriosis and doctor says I need to have this treated before trying for a baby. What’s your opinion? Is it true that endometriosis can cause cancer? Thanks. E. (UK)

Answer: The doctor’s advice is sound. However, this cannot be generalised. You have not said how the diagnosis of endometriosis was reached. Whilst you can suspect endometriosis on the basis of the signs and symptoms, the only way you can confirm the diagnosis is by having a laparoscopy and actually visualising the endometriotic lesions. Scans are helpful but not confirmatory. When endometriosis is severe (as seen at laparoscopy), that can negatively impact on the ability to conceive and carry a pregnancy successfully. In such a case, surgical treatment will help improve fertility. Medication used to treat endometriosis is very good in alleviating associated symptoms but, significantly, does not improve fertility. It is therefore important to be very clear about what you want and the type of treatment offered. This is particularly important because a course of medical treatment takes an average of 6-9 months. The benefit from surgical treatment is instant.

Regarding the second part of your question, it is arguably a bit of a stretch to say ‘endometriosis causes cancer’. It is, however, true that there is a slight increase in the lifetime risk of some forms of ovarian cancer. This increase has been observed when endometriosis is severe and directly affecting the ovaries. The overall absolute risk remains small and, it is important to make it clear here that there is no firm evidence of a direct cause-effect relationship between endometriosis and cancer.