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Pregnancy Bliss | Reproductive Health Hub

Pursuing IVF at 41

Question:  I am 41 years old and would like information on ivf, the success rates and costs T.L. (UK)

Answer: Inevitably this question will have to be couched in general terms as I could not be specific to you without the necessary details. The cost of IVF, even in the same country tends to vary widely. At 41 years of age, in the UK, you would almost certainly be outside the eligible age range for NHS fertility services. The age limit is determined by those holding the purse-strings in any particular area, currently the Primary Care Trusts (PCTs). The most generous have an age limit of 40 but most quote around 37-38. Private straight-forward IVF will range anything from £3000 to over £7000 in places like London for one IVF cycle.The cost will also be influenced by whether you are using your own eggs or using a donor egg. In general, the success rate, as measured by what is termed as ‘take baby home rate’ (rather than simply conception) is around 1 in 5 or 20%. For any individual, this is influenced by a number of factors including age, presence of medical conditions such as diabetes, obesity, endometriosis etc; as well as the quality of eggs produced.

Anti-D in pregnancy

Question: When do you give anti-D  serum in pregnancy? J. (Tanzania)

Answer: Anti-D is currently administered as a single dose at 28 weeks gestation in the UK and many other countries. It is also administered after delivery if the baby is Rhesus Positive. In places where immediate checking of the baby’s Rhesus status is not available, the recommendation is to give anti-D to all rhesus negative mothers soon as they deliver. Another time when anti-D is administered is in case of antepartum haemorrhage unless this occurs a few days after the routine 28 week administration.

Drugs used in each trimester

Question:  I would like to know the drugs that are recommended in each trimester of pregnancy. B.

Answer: In strict terms of the word, there are no drugs ‘recommended’ at any stage of pregnancy. If you mean safety of drugs at each stage or trimester, it is taken as a general safety rule that, if a drug is likely to cause harm at any stage of fetal development, it should ideally be avoided throughout pregnancy. Likewise, those drugs that are safe in pregnancy like Penicillin group of antibiotics or the common pain-killer Paracetamol can be used in any trimester. We have discussed commonly used drugs and their safety (or otherwise) in pregnancy in this section.

Blood colour in a miscarriage

Question:  What colour would the blood be in a miscarriage? E. (UK)

Answer: Blood in a miscarriage is quite similar to blood in a normal menstrual period. There may be a difference in the quantity and presence of clots (heavier and more clotty with miscarriage) but even in these areas there is a big overlap. A heavy period can be easily confused for a miscarriage especially if periods tend to be irregular. Likewise, an early miscarriage can pass unnoticed as it is thought to be a period.

Trying to conceive

Question:  my periods are absolutely right... Two and half months passed but i m not getting pregnant.  Why? A.K.

Answer: I cannot pretend to know why you have not conceived despite (presumably) 2½ months of trying. There are many variables that come into play when it comes to successful conception and any of those could be a factor in your case. However, I have to say two and a half months are really a very short time for you to start worrying. For most couples having regular unprotected sex, it takes between 6 and 12 months for successful conception to take place. By regular sex we really mean at least 3 or 4 times a week, every week. You may have seen quite recent study reports showing that a woman, on average, needs to have sex over a 100 times for conception to take place. Of course the operative word there is ‘average’. There are many women who conceive after one sex act. The other end of that spectrum are those who try for years without success. In my view, you are getting yourself worked up when there may not be a problem at all. 2½ months is far too short a duration to make any judgement on this issue. Just keep trying and my best wishes.

Type 4 Ehlers Danlos Syndrome and pregnancy

Question:  Hi, i have EDS type 4 and i am trying for a baby. I have been told the risks and the doctors did ask me not to get pregnant. Me and my partner of 7 years are desperate for a baby.

We have put in an application for adoption but been refused because of my EDS and we have had long talks about having a baby and we are going to take the risk. Do u think i have made the wrong decision and also is it ok to take pregnacare conception ? A.B. (UK)

Answer: This is an incredibly difficult situation you find yourself in. It is clear from the details you have given that you are very keen to have a child. It is also obvious that you are in a stable loving relationship. However, the quest you have set yourself does pose massive risks for you. It will be shirking professional responsibility on the part of your doctor not to give you the very advice you have been given. Pregnancy  in your case is truly a life threatening endeavour. With Type 4 EDS, also known as ‘vascular EDS’ approximately 1 in 4 women will die as a direct result of pregnancy. This is the reality of the situation.

Even for the 75% who will escape with their lives, there are formidable potential complications including catastrophic rupture of the womb, almost always with loss of the baby and life threatening blood loss for the mother, very poor healing of caesarean or vaginal tear wounds, sometimes taking months to heal and a host of other problems. It is no exaggeration to say that no woman with Type 4 EDS escapes scot-free. There is also the very difficult reality which needs to be addressed which is your risk of shortened life-expectancy. I do not know how old you are at present but with most affected individuals rarely living beyond their late 30s or at most early 40s, it is something that you need to think quite carefully about. I am sure this would have been the main reason for the heart-breaking decision by the authorities to turn down your application for an adoption. On top of that, there is the 50% or 1 in 2 risk that, if you were to conceive, the child will inherit the condition. An incredibly difficult situation which must be heart-breaking but, with a heavy heart but a clear conscience, I have to say I agree fully with the advice you have been given not to try for a baby. It is not in your interest, your partner’s interest or the potential child’s.