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Dr. Pfeiffer
Dr. Pfeiffer, Doctor
Category: OB GYN
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Experience:  Ob/Gyn Doctor
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I am 38 years old and trying to get pregnant. Have tried for

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I am 38 years old and trying to get pregnant. Have tried for @6 months. Got pregnant 1x (for 7 weeks) then back to trying. I have had an endometrial cyst on my ovary that my doctor removed when I was 37. No problems since then. My doctor is recommending an HSG at this time. I sort of feel like even though I am older - 6 months isn't a long time to try - and since I did get pregnant 1x in the time period (but it failed) - I shouldn't escalate yet. I am in good shape (lift or run at least 5x a week), no medications, no smoking, no alcohol ever - the only thing I am missing is a vacation from a very stressful job (transactional attorney) where I have to travel a lot for work. Insurance kicks in in my state for infertility at 6 months of trying - so is this just getting escalated because of that. Am I way off on my estimation of percentages, etc.
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. Pfeiffer replied 1 year ago.
hello,
When it comes to infertility the threshold really drops at the age of 35 as far as escalating to more aggressive testing and treatment.
This is not based on one's health or insurance, rather, we see a decline in fertility beginning at age 35 that drops fairly rapidly beyond age 37. Now, this does not mean natural pregnancy at 38 or beyond is impossible at all..that's not what I'm saying. We have to remember that a woman has her entire amount of eggs in her ovaries when she is still in her mother's womb...and, over the years, the genetic material in these eggs can become damaged due to environmental factors. So, this is the main reason women beyond 35 years old have a bit more difficulty beccoming pregnant and also why their risk of birth defects and miscarriages is higher.
So, while you sound like you are in great health and have taken very good care of yourself there are things that happen and you are exposed to that are out of your contro that may affect one's fertility (ie. radiation from flying in a plane for example)..I believe your doctor is doing the correct thing to help maximize your potential for having a baby.
Dr. Pfeiffer Ob/Gyn
Customer: replied 1 year ago.
Thanks - I think it sounds like it is a matter of percentages. So my Dr. is testing for the first possible failure by doing an HSG - and then wants to rapidly go to the next phase which is IVF - since I have asked to bypass months of hormones if she does believe that we should move me to the next level (going from natural to medically assisted pregnancy). We only want one child and it is late but I don't have a great sense of whether I have a 15% chance of getting pregnant naturally or whether I have a 50% chance - and should just try a couple more months naturally before elevating it. I was very encouraged that on the second try I did get pregnant (even if only for 7 weeks) -so maybe I am being bolstered by that thought.
Expert:  Dr. Pfeiffer replied 1 year ago.
ok..
The rough percentages drop from about 20% per month in a woman younger than 35 to about 2% per month at age 38 naturally.
So that gives you an idea.
Another thing you might ask your doctor is to do a test called AMH (antimullarian hormone) which will provide a number that correlates with your ovarian reserve...meaning how many immature follicles you have left. If the test result returns low enough suggesting you have several left, waiting another couple of month might be an option.
Conversely, if the number is ***** suggesting few follicle remaining...that would also give you a realistic idea on how likely IVF is to be successful.
Now, when you talk about fertility treatments you also have no real way to guarantee just one baby...chances of multiples increases with infertility treatments.
Dr. Pfeiffer
Customer: replied 1 year ago.
Thank you for this information. That really helps. Going in for the HSG on Thursday so just wanted to run through the parameters with another expert. You are right - fertility treatments can yield multiples - but they are all covered in Massachusetts and my doctor is willing to implant one at a time if I wish...so that should control better for that. Thank you again - I don't have any additional questions at this time. 2% a month is low. Puts it in perspective.
Expert:  Dr. Pfeiffer replied 1 year ago.
ok..you're welcome.
good luck and take care.
please take the time to rate my service.
thank you
Dr. Pfeiffer
Dr. Pfeiffer, Doctor
Category: OB GYN
Satisfied Customers: 5986
Experience: Ob/Gyn Doctor
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