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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Absent gestational sac on scan

Question: I am a one and half months pregnant. My last period was **/**/****. Mine is IUI pregnancy. IUI was  done on six weeks ago. 15 days back I got positive result. 4 days back when I went for transvaginal scan, doctor not finding the sac. One cyst is there in right ovary. To find the sac, should I need some more time, or this is correct time to scan? S. (India)

Answer: This is a rather worrying situation. If you had the intrauterine insemination (IUI) six weeks ago, it means it is now almost six weeks since conception was supposed to have taken place. This, technically, makes the pregnancy gestation close to eight weeks. At that stage, the pregnancy should be clearly seen on a scan. it may be worthwhile you repeating the pregnancy test. If it is still positive, your doctor should actively try to rule out an ectopic pregnancy (yes; this can follow an IUI). If that is conclusively ruled out, then you should have a repeat scan two weeks from the last one.

Maximizing the chances of conception

Question: How do you find out the days when you ovulate? Or when you are most fertile when you don’t have the money to get the kits?..I’m trying to get pregnant and my partner is 50 and I’m 29, I’m not sure if his age may play a rule to why I’m not getting pregnant?..Can men still pregnant a woman at that age? I think I’ve sent you a question last time...lol. T. (USA)

Answer: Thank you for your question. I wish I had a satisfactory answer to your question but the subject of when a woman ovulates has never been straight-forward. A general answer is this: If you have regular periods, your most fertile phase is mid-cycle. let's say your menstrual cycle was the standard 28 days with the first day of your period being Day 1 of the cycle. In such a case, you will be expected to ovulate on Day 14, give or take a day or so. you will then need to ensure you have sex daily from around Day 12 through to Day 16 to maximize your chances of conceiving. Now; I realize your cycle might not be 28 days and may not even be regular. That's why no simple advice can be given.

If you have been trying to conceive for several months without success and you are having regular sexual intercourse with your partner, I am afraid there is no substitute to getting a proper evaluation with your gynecologist. There could be so many factors that might be making it difficult and they all need to be evaluated. What is certainly not a factor is your partner's age. Men retain their fertility well into their eighties, even beyond. At 50, your partner's age is not a problem at all.

Mode of delivery with baby in transverse lie

Question: what is the best approach of delivering a baby at 41 weeks 5 days,lying in a transverse or oblique position? E.N. (Nigeria)

Answer: A transverse or oblique lie at the post-term stage, which is what you are referring to, almost certainly means a caesarean delivery. However, there is a small wriggle room: If the baby is in an oblique position and the head is the leading part, the doctor could look at the possibility of doing what is known as a 'stabilising induction'. This involves gently manoeuvring the baby's head into the pelvis then breaking your waters to falitate fixation of the head in the pelvis. This is followed by a syntocinon (Pitocin) infusion to stimulate uterine contractions to get you into labour proper. Before embarking upon a 'stabilising induction', it is important to make sure that the placenta is not low lying (placenta previa). A scan should be able to easily establish this.

4D scan and sex of the baby

Question: When u have a 3d or a 4d scan will it tell u what sex your baby is? Can you still have one without getting told what sex is your baby? Please let me no as i am thinking about having a scan, thank you. S. (UK)

Answer: The big difference between traditional 2D scans and the 4D scans is that the latter have images that are so detailed and life-like that you don't need medical training to make out what you are seeing. In other words, it allows the prospective parents to interact with the baby without actually needing to be guided or told as to what they are looking at.

If you want to have a 4D scan but don't want to know the sex of the baby, you will need to inform the person doing the scan so that he/she can avoid scanning the part of the baby that will show the baby's sex.  I am sure the person performing the scan will be able to accommodate you on this but, inevitably, this will be a restricted scan .

Vasa praevia as a dangerous pregnancy condition.

Comment: In your section on bleeding in later pregnancy, there is no mention of vasa praevia. Would you consider adding information on this avoidable and devastating complication of pregnancy? C. (UK)

Answer: Thank you for your comment. You will be pleased to know that this has already been added and can be reached here.

Calculating expected date of delivery

Question: How can I calculate estimated date of delivery given the exact date of conception? J.L.  (UK)

Answer: If the exact date of conception is known, expected date of delivery (EDD) is calculated by extrapolation: This is how:

If a woman knows she conceived on a specific date, she needs to subtract 14 days from that date before calculating the expected date of delivery (EDD). For instance, if she conceived on the 21st of January. Take 14 days from the 21st. That will give her a reference date of 7th of January. She will then add 7 days to that date and add 9 months to the month. Her EDD will work out as the 14th of October:

Here are a couple more examples:

Conception date: 15 June; Reference date: 1 June; EDD: 8 March

Conception date: 30 September; Reference date: 16 September; EDD: 23 June

I am sure you are aware that an expected date of delivery is mostly a guide point as only about 1% actually deliver on the day.

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