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  • [-]I have rheumatoid arthritis. Do I need a high risk OB? Any suggestions for specialists in autoimmune disorders and pregnancy.

    11 replies [ Reply | Watch | Options ]
    11.19.09, 09:07 AM [ Flag ]
    • What does your rheumatologist think?

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      11.19.09, 09:16 AM [ Flag | link to this post ]
      • He doesn't think it's a foregone conclusion. My regular OB/GYN gave me a referral for an MFM specialist, though she's at Beth Israel and a friend had a really bad experience there. I'm looking elsewhere, and wondering if anyone out there has a subspecialty in autoimmune diseases. Anyone else out there w/ RA...what did you do?

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        11.19.09, 09:24 AM [ Flag | link to this post ]
    • I have RA- had two pregnancies- luckily in both I was great with no meds but fish oil. Went to high risk after reading study that suggested RA patients had higher rates of preeclampsia (though not that much higher) and pretty significantly higher rates of IUGR. Had more monitoring at the end because of the increased IUGR risk and also was not allowed, by my high risk doctor, to go more than 41 weeks because she said there was risk of placenta detrioration beyond the normal amount when you go past the due date. My rheum said high risk wasn't necessary, but another rheum I saw during pregnancy (that had privileges at the hospital I was delivering at) thought it was a wise move. Lupus pg's are obviously more high risk and I think anyone wi...

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      11.19.09, 09:46 AM [ Flag | link to this post ]
      • That's great you were in remission. I'm new here - what's IUGR? Are you in NYC? If so, do you recommend your high risk OB? Also, were you on any TNF meds prior to conception? How before trying did you go off? This is one thing that I can't seem to find anything resembling consensus on...For MTX it's 3 months, but that is a LONG time to go w/o anything...Thanks.

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        11.19.09, 02:12 PM [ Flag | link to this post ]
        • OR here- I was on Kineret, a biological but not a TNF inhibitor. I dropepd to only Kineret and fish oil, stopped NSAIDs and plaquenil and sulfaslazine. My rheum said the Kineret left my system so quickly that he said I coudl take up until a positive home pregnancy test. SO I always tested super early. Ended up needing IVF, so I actually stopepd the Kineret two days before egg retrieval.

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          11.20.09, 08:43 AM [ Flag | link to this post ]
          • With pg number 2, got pregnant naturally first month trying, tested super early and got the faintest positive about 9-10 days after ovulation, and stopped kineret then. My RE, OB, and Rheum never had a probalem with just staying on Kineret and stopping it super early in the pregnancy.

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            11.20.09, 08:46 AM [ Flag | link to this post ]
          • on my second pg, it happened naturally, I was on Kineret while trying and stopped it at 9-10 DPO when I got the faintest positive on a pg test. RE< OB< and rheum never had issues with me being on Kineret while trying.

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            11.20.09, 08:47 AM [ Flag | link to this post ]
        • As for IUGR - google it-

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          11.20.09, 08:50 AM [ Flag | link to this post ]
    • I have RA, and intentionally went off Remacaid to get pregnant. Tried a # of times earlier, but couldn't last off meds for 3 mos. Over 40, severe RA, did not need a high risk OB (even though I hit that category in 2 areas; age and disease). Textbook pregnancy, pain free for 9 months, and back needing meds nearly a week after I gave birth. She's beautiful, smart and worth every bit!!! GL!

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      11.19.09, 03:36 PM [ Flag | link to this post ]
      • Good to hear. Not the part about not being able to go w/o meds...but the remission part, and the beautiful baby part.

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        11.19.09, 08:40 PM [ Flag | link to this post ]
  • [-]Is Clomid 50mg usually the first thing doctors give you after you try for a few months? I am 39 and have been trying only for 2 months but doc said to try Clomid this cycle, given my age. WWYD?

    8 replies [ Reply | Watch | Options ]
    11.20.09, 05:52 AM [ Flag ]
    • After having taken Clomid for six cycles I read that more and more literature suggestst that Clomid fixes certain things -- e.g., if you are not ovulating or if have pcos -- but doesn't do much for unexplained infertility. Yet it has become standard 'first line of defense'. If I was you (and I was) I would waste no time, find out what the underlying problem is (if you can) and use the most direct means to address it.

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      11.20.09, 06:06 AM [ Flag | link to this post ]
    • Agreeing with the post above, though I'm not BTDT, it seems that more and more ob/gyns are leaping to try it before doing a real assessment of the fertility issues. Via friends who have gone that route, I'd encourage you to really read up on it because while it can fix certain specific problems it can also create other obstacles (lessen cervical fluid, etc.). I'm almost 39, so I know the sense of urgency, but two months of trying also really isn't that long. Are you doing all the "cycle tracking" you can (temp, OPKs, cervical fluid, etc.)?

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      11.20.09, 06:12 AM [ Flag | link to this post ]
    • I hope you are seeing a fertility doctor and not a regular ob/gyn. If you are seeing a RE (fertility) clomid and IUI would be the first step. If that doesn't work, they could introduce injectables to help you produce more eggs (with iui). If that doesn't work, given your age, I would go straight to IVF and not waste time. Good luck.

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      11.20.09, 06:12 AM [ Flag | link to this post ]
    • op: I have an appointment with an RE for next month but obgyn prescrbied Clomid and I am wondering I should use it this cycle while I am waiting to see RE. Thanks for all your responses.

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      11.20.09, 06:38 AM [ Flag | link to this post ]
    • I used Clomid 50mg only 1 time and became pregnant with my son. My OB suggested we try 3 cycles before being referred to fertility doctor. I also highly recommend using ovalation kit. Good luck

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      11.20.09, 06:52 AM [ Flag | link to this post ]
    • BTDT - also 39 when we started trying, after 6 mos, OB then RE tried us on 3 rounds of 100mg Clomid/IUI without success. First IVF cycle = 1 DC, 2nd IVF cycle = 2 DCs. I would agree with previous posters that I wouldn't waste a lot of time on Clomid, particularily if your infertility is unexplained but after only 2 mos, you probably don't even know if an issue exists. Glad you are going to an RE for a full work-up so you'll know how best to proceed. In the meantime tho, I don't see the harm in doing Clomid. Good luck!

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      11.20.09, 07:27 AM [ Flag | link to this post ]
    • After having unexplained infertility for FOUR years, I determined on my own that I had a short luteal phase. I had no idea Clomid would be helpful for this (because I was ovulating each month like clockwork), but after doing my own research on medical websites, I discovered that Clomid was known to help with this. I went to my OB, took 1 round of Clomid, and got pregnant. I have another friend who got pregnant after her second round, and then lots of others for whom Clomid was the "gateway drug" to IUI, IVF, etc. So you never know.

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      11.20.09, 07:42 AM [ Flag | link to this post ]
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