Case of the month Aug/Sep '08: Episode #9
Click here for episode 1
When patients make it to 12 or 13 weeks gestation, they graduate. We have a small ceremony and give them gifts. They celebrate freedom from taking their progesterone shots. We make a DVD of their baby doing back flips in their final first trimester ultrasound so they can watch it over and over. They say goodbye to us as they transition to their OB, relieved to be out of the first trimester, usually the most common period of pregnancy loss.
For Irene, she was not entirely free. She had to stay on her heparin and aspirin. Over the past two months, we had seen her every week and the pattern was consistent. We would show her the baby’s heartbeat on the ultrasound and she would be so relieved and happy. And then, at home, over the course of the week, the fear and anxiety would gradually gnaw at her insides so that by the time she came back for her next ultrasound, she was a complete nervous wreck.
Now on her last visit, she seemed panicked about saying goodbye to us. I knew it was because she realized that with her OB, she would be only getting visits every 3-4 weeks, which meant to her 3-4 weeks of not knowing how the baby was. I promised her she could drop by any day for a quick heartbeat check ultrasound all the way until 20 weeks when she would start feeling the baby move. At that time, she would have her own way of reassuring herself that the baby was fine.
We kept in touch with her less and less, until one day, we got the call from her husband that she had delivered a beautiful 7 pound 6 ounce baby girl, thanks to the benefits of heparin!


October 4th, 2008 at 9:34 am
Hi Doctor,
Your website is very nice and it helped me to learn more about these treatments….success stories really gives me hope…
I took clomid for 5 cycles but ovulated only once and didnt get pregnant. I had an ultrasound after the 3rd cycle and found a cyst on the right ovary. As the cyst was small they continued with the clomid for two more rounds. But I didnt ovulate. So my RE changed my treatment plan.
I took prometrium for 10 days and got periods after stopping it. I had my baseline ultrasound on cycle day three. Again they found a cyst on my right ovary and they put me on BCP for 11 days. On 12th day I had another ultrasound but the cyst was still there of the same size. So my RE said it might be the same cyst that I had 4 months back .RE said either it might be cyst hanging out on the ovary or on fallopian tube. I had an HSG earlier and my tubes are clear.
RE said this cyst won’t get affected by the stimulation. So she told me to start on the follistim.
I am confused now , because I stopped BCP and RE didn’t wait for the periods to come. She asked me to start on the follistim on the third day after I stopped the BCP.
Is this correct? Should I wait for the periods to come before starting the follistim? If I don’t wait will I get periods while I am on follistim?
It would be a great help if you could answer my question. Thanks in advance.
Annie
October 5th, 2008 at 11:36 pm
Here’s my response. Thank you for the question.
http://fertilityfile.com/2008/10/05/cysts-and-ovarian-stimulation/