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Pregnancy Bliss | Reproductive Health Hub

Reversal of female sterilisation

Question:  if a woman has undergone an operation of family planning (means she will not conceive), is there any possibility  to conceive again? S.K. (India)


Answer: Reversal of female sterilisation is possible. The chances of success after the reversal of sterilisation depend on how it was performed. Overall, successful conception after reversal of female sterilisation ranges from 50 to 75%. Where sterilisation was performed by clamping the tubes via keyhole surgery, chances of a successful reversal are highest. You also need to be aware that there is a risk of ectopic pregnancy after reversal of sterilisation. Another issue to consider is the cost implication. This will differ from country to country.

Where facilities allow and if affordable, assisted conception is arguably a better option for a sterilised woman who wants to conceive again.




Cystic fibrosis sufferer trying to conceive

Question:  I have cystic fibrosis. I was looking for tips on how to become pregnant. Any ideas? M. (USA)


Answer: As we have mentioned on the section on this subject, there is no standard advice. However, there are important things that you need to consider and assess before you embark upon this quest:

I am mindful of the fact that your question was ‘how to become pregnant’. The answer to that is simple: Just the normal way. The fertility potential of women with cystic fibrosis in reasonably good health is not reduced in any way. The thick mucous they produce on the cervix is not a hindrance. Ovulation is usually regular.  Can I also say that, if there are issues mentioned above in your case but you are keen to have a child who is genetically your own, there is the alternative of surrogacy, a subject discussed in detail here. There are cost implications in this but it is always worth looking at all the options. You should also remember to have your partner tested for carrier status. 5% of Caucasians (whites) do carry the CF gene mutation. The rate is less than 1% among those of black African origin and an even lower 0.2% among Asians and those of asian origin, which is 25 times lower compared to Caucasians.



Flying at 27 weeks pregnant

Question:  I will be 27 weeks pregnant when I would like to fly to Spain from England. What risks are involved in flying. I have had early bleeding in pregnancy and I have pains in my lower abdomen from time to time. I also had a miscarriage at 12 weeks the last time I was pregnant. I have 2 children 12 and 8 who went to full term. J.B. (UK)


Answer: Regarding the risks of flying in pregnancy, I would like to refer you back to the appropriate section where this subject is discussed in detail. I can only comment here that, in general, flying during pregnancy is safe. I doubt very much that the bleed you had earlier in pregnancy would be an important consideration in this situation. On the other hand, if you have had vaginal bleeding since going past the half-way mark (20 weeks), you should avoid flying. Your previous first trimester miscarriage is not an important factor as far as this issue is concerned.



Using warfarin in pregnancy

Question:  I have been on warfarin for 2 years and I am now 6 weeks pregnant. Is it safe to take this. E.S. (Ghana)


Answer: You need to arrange to see your doctor without delay. Warfarin use during pregnancy carries unacceptable levels of risk for your baby. You will need to be switched to an injectable anticoagulant. I hope you have available in your area one of the so-called low-molecular weight heparins (LMWH). These are the type recommended for use in pregnancy. They are effective in preventing clot formation or thrombosis and are safe. Normally you need one injection daily. You have not said why you are on Warfarin but presumably you still need to have an anticoagulant medication and that is why you have been kept on this. You need to switch but don’t stop taking warfarin until that has been done.



Amniocentesis for gender identification

Question:  Can i check fetus's sex in amniotic fluid? If yes,how early? I mean how many weeks? R.P. (UK)


Answer: Yes, this is easily done. The taking of amniotic fluid (amniocentesis) can be done from around 15 weeks. The issue of availability of the service is another matter. In the UK, you cannot have an amniocentesis just to check fetal sex. That is, unless there was a risk of a serious sex-linked medical condition. Such conditions include Fragile X or Duchenne muscular dystrophy which affect boys and not girls.



Married to close relative and risk of abnormalities

Question:  I am married to my first cousin and 25 weeks preg. We don’t have any abnormalities in any of the family trees, except that our common first cousin is an albino.  I want to know if there are any test or sonography by which we can know if there are any abnormalities in the child. A. (India)


Answer: There are no special test for this sort of situation. As you pointed out, there aren’t any reference abnormalities by which you can do targeted tests. Marriage between close relatives, in this case, first cousins carries an inherent increased risk of abnormalities regardless of whether there are no known abnormalities within the family. There are many genetic mutations which are recessive in nature. That means, when only one gene (in a pair) is affected, the disease will not be expressed. Many members of an extended family can carry such a gene mutation without any of them showing disease. However, if there is consanguinity (marriage between blood relatives), the chances of having a child with two genes affected is increased dramatically. In fact, albinism is a case in point. The defective gene needs to be inherited from both parents for the condition to occur. It is quite plausible that many members of your extended family carry this gene defect but there has been only one person affected. If both you and your partner carry this gene defect, your child will have a 25% chance of being albino. Of-course this cannot be diagnosed before birth but many other conditions can be suspected or diagnosed in the womb. The best possible measure you can take is just to have a detailed ultrasound scan which should be able to pick up most major anomalies. That is, if the child is affected by any of those.


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