Feb 06, 06 | 11:46 pm

Planned Pregnancy

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Q: Should I see my OB-Gyn before I am pregnant?

It’s a great idea to see your OB before trying to conceive so that you can be tested for STDs, make sure you have all your immunizations and to make sure you are not anemic. It’s also important to have a pap smear and to go over which prenatal vitamins you should start taking. Additionally, your doctor may look over your daily medications to make sure they are safe to take while you are pregnant.

Q. My husband and I have been trying for over a year to get pregnant, when should I see a Fertility Doctor? What will the process be like for me?

Generally women under 35 should see a Reproductive (RE) after 1 year of trying to conceive (TTC) and women over 35 should see an RE after 6 months. Reproductive Endocrinologists are gynecologists who specialize in infertility. We had trouble conceiving our second child and after talking with an acquaintance that had been through infertility treatment, we made an appointment with an RE.

The first few appointments, the RE will discuss both of your medical histories and do a full work up on both of you. The common questions an RE may ask:

Do you have a history of Endometriosis? Pelvic Inflammatory Disease? Thyroid Problems? Fibroids? Irregular Periods?
Are you ovulating?
Have you ever had an STD?
How often to you have sex?
Have you ever been pregnant?
The RE will most likely ask to see a few months of Basal Body Temperature Charting to see if you are ovulating.

They will most likely also take some blood tests including TSH (Thyroid Stimulating Hormone), FSH (Follicle Stimulating Hormone), LH (luteinizing hormone), Testosterone, Estrogen, Liver Function Studies, CBC (Complete Blood Count), Prolactin, an HIV test, RPR (Rapid Plasma Re-agent), Androgen and Progesterone. The RE may also perform the following tests:
*Endometrial Biopsy: a short procedure to evaluate the quality of your uterine lining.

* HSG (Hysterosalpingogram): During this procedure, a dye is injected through your cervix and its movement is traced through your uterus and fallopian tubes through X-ray. This procedure can determine whether your Fallopian tubes areand if you have any scar tissue or abnormalities that may prevent an egg from implanting in your uterus.

* Laparoscopy : a surgical procedure to examine your pelvic organs.

*Pelvic Ultrasound: An ultrasound performed during key points in your menstrual cycle to detect ovulation and is often performed in conjunction with fertility medications (e.g. Clomid).

* Post-coital test: This test is performed within 24 hours of sexual intercourse with your partner to determine how your cervical mucous tolerates your partner’s sperm.

Your partner will also go through a workup that includes blood tests and a spermanalysis that will examine his total sperm count and motility.

Q. What is a Basal Body Temperature? How do I chart?

A Basal Body Temperature (BBT) is your “at rest” temperature. It is taken every morning right when you wake up with a special thermometer that can be found at any drugstore. The BBT Thermometer measures in tenths of a degree, making it possible to detect even small changes in body temperature. The charting should begin the 1st day of your period and should be done before your get out of bed in the morning.

During a woman’s menstrual cycle, hormone changes cause a woman’s BBT to dip slightly when she ovulates than increase after ovulation. When the temp rises by .4 -1.5 degrees for a few days in a row, this usually indicates that ovulation has occurred.

Article by Elana Rubin and Ron Rubin M.D. Elana is the designer and owner of FutureFashionista.com and mom of two. Dr. Ron Rubin is the father of two young daughters, ages 3 and 5 years, and husband of jewelry designer, Elana Rubin. He has practiced medicine and psychiatry for over 20 years and is Board Certified by the American Board of Psychiatry and Neurology.

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