Dear Heea,
I can certainly understand your desire to do everything you can to
keep your pregnancy going. I myself have just entered my second
trimester and am breathing a huge sigh of relief.
However, upping your HCG levels is probably not the way to go. For
one thing, an excess of HCG can cause lots of problems (like certain
"female" cancers). For another, the drugs that can elevate HCG are
most likely very dangerous for your fetus. Since it is the fetus
itself that produces HCG, not your body, it is my understanding that
decreases in the HCG levels are because of a problem with the fetus
itself, not with your ability to carry it to term.
You are clearly very concerned about keeping this pregnancy going. My
strongest suggestion to you is to talk to your doctor. You are
already taking a number of medications that are designed to make your
body as receptive as possible to this pregnancy (including the
progesterone), and adding another one could throw the whole system out
of whack. Given that you are an IVF patient, I am confident that you
have a fertility specialist who is tracking your progress. That
person is the best person to talk to about your concerns and about
additional ways of securing the pregnancy.
Your health provider may also schedule an early ultrasound to check
that all is well - this will show whether the fetus is developing
"normally" and where it has implanted. You will NOT see a heartbeat
until later, though, so if you have one on Thursday it will look
something like an avocado - with your uterus as the "meat" of the
fruit and the embryo as the "pit". However, not all insurance
companies will pay for multiple ultrasounds, and not all physicians
want to do one so early, so talk it over with your doctor.
I looked in MEDLINEplus, the online consumer health product from the
National Library of Medicine/National Institutes of Health for
information on HCG levels and drugs that affect HCG. Here are some
links to what I found:
ADAM Health Encyclopedia: First Trimester Pregnancy
http://www.nlm.nih.gov/medlineplus/ency/article/000887.htm
This is a nice overview of the first three months of pregnancy,
including signs & symptoms, precautions, and so on. In particular,
note the caution about drugs and herbal remedies:
"Pregnant women are advised to avoid all medications, unless the
medications are necessary and recommended by a prenatal health care
provider. Women should discuss all medication use with their
providers.
"Pregnant women should avoid all alcohol and drug use. They should not
smoke. They should avoid herbal preparations and common
over-the-counter medications that may interfere with normal
development of the fetus."
ADAM Health Encyclopedia: HCG - quantitative
http://www.nlm.nih.gov/medlineplus/ency/article/003510.htm
A nice overview of the hormone, what it does, and so on. The article
suggests that anticonvulsants, antiparkinson's drugs, phenothiazine,
and promethazine can increase HCG levels.
USPDI - Progestins For Noncontraceptive Use (Systemic)
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202758.html
Both the Prometrium and the progesterone suppositories are progestins,
which you doctor most likely prescribed to you for the explicit
purpose of supporting your pregnancy. For example:
"Progestins are prescribed for several reasons: .... To help a
pregnancy occur during egg donor or infertility procedures in women
who do not produce enough progesterone. Also, progesterone is given to
help maintain a pregnancy when not enough of it is made by the body."
USPDI - Phenothiazines (Systemic)
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202457.html
Here are the precautions for pregnancy (emphasis mine):
"Pregnancy—Although studies have not been done in pregnant women, some
side effects, such as jaundice and movement disorders, have occurred
in a few newborns whose mothers received phenothiazines during
pregnancy. Studies in animals have shown that, when given to the
mother during pregnancy, THESE MEDICINES CAN DECREASE THE NUMBER OF
SUCCESSFUL PREGNANCIES AND CAUSE PROBLEMS WITH BONE DEVELOPMENT IN THE
OFFSPRING. Before taking this medicine, make sure your doctor knows if
you are pregnant or if you may become pregnant."
USPDI - Antihistamines, Phenothiazine-derivative (Systemic)
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202063.html
This is the general entry for promethazine.
Here are the precautions for pregnancy:
"Pregnancy—Methdilazine, promethazine, and trimeprazine have not been
studied in pregnant women. In animal studies, promethazine has not
been shown to cause birth defects. However, other phenothiazine
medicines caused jaundice and muscle tremors in a few newborn babies
whose mothers received these medicines during pregnancy. Also, the
newborn baby may have blood clotting problems if promethazine is taken
by the mother within 2 weeks before delivery."
You may also find the links contained in the following MEDLINEplus
health topics useful:
Prenatal Care: http://www.nlm.nih.gov/medlineplus/prenatalcare.html
Infertility: http://www.nlm.nih.gov/medlineplus/infertility.html
Pregnancy Loss: http://www.nlm.nih.gov/medlineplus/pregnancyloss.html
I would strongly suggest you start taking a prenatal vitamin, if
you're not already, especially one that includes folic acid or folate.
A study by the National Institute of Child Health and Human
Development found that decreased levels of folate in the mother's
bloodstream may be linked with a higher likelihood of miscarriage:
Folate Deficiency Associated with Higher Early Miscarriage Risk
http://www.nih.gov/news/pr/oct2002/nichd-15.htm
Finally, if you get sick of looking at the medical literature and
suchlike, a website that I have found particularly helpful for
preconception and pregnancy information (it includes not only articles
and guides but also some great community bulletin boards) is
BabyCenter.com. (www.babycenter.com). The women on the bulletin
boards are particularly supportive and may be able to share personal
experiences that helped them. The article on miscarriage is nice, for
example: http://www.babycenter.com/refcap/pregnancy/pregcomplications/252.html.
You may also find the articles and boards at iVillage helpful. Here's
the link to the pregnancy topics there:
http://www.ivillage.com/topics/pregbaby/a-z. They have similar
information as BabyCenter, but I also found an article that suggests
that certain kinds of exercise help maintain a pregnancy (confer with
your doctor before starting a new exercise program).
In addition, you might try some of the books that are out there to
help you with your early pregnancy. Here are some recommendations,
all of which are available at Amazon.com:
Preventing Miscarriage: The Good News, by Jonathan Scher
Getting Pregnant and Staying Pregnant: Overcoming Infertility and
Managing Your High-Risk Pregnancy, by Diana Raab
So, to sum up, here's what I found online:
HCG levels mainly depend on the output of your embryo, so anything you
do to up them will directly impact the baby. While there are drugs
out there that affect HCG levels, most of them have warnings against
using them while pregnant.
There is some evidence that not having enough folate in your blood can
influence your risk of miscarriage. You can get folic acid from a
vitamin pill (get the kind prescribed by your doctor, they aren't too
expensive), or from some foods.
You're already on progestins to help maintain the pregnancy (this is
the most common drug for maintaining pregnancy, and does not seem to
have the side effects that, for example, thalidomide had in the 1960s
&70s). Anything additional you try should first be discussed with
your doctor.
There are groups out there to help you both by offering advice (which
I cannot do) and by offering support.
Finally, the absolute best thing you can do is to talk to your doctor.
I know that this can be very hard - I hate to admit to my doctor that
I'm scared out of my wits - so if you don't feel that you can admit
yor concerns to your doc, try one of the OB/GYN nurses in his/her
office. I have one who is wonderful and has really helped. The
information I have provided is mainly based on my research at
MEDLINEplus, BabyCenter, and iVillage. I want to caution you that the
statements I have made cannot and should not be taken as medical
advice - I'm a librarian, not a doctor - and the only people qualified
to give you medical advice are health professionals who are familiar
with you and the specifics of your case.
That said, I hope the above information is helpful to you. Good luck
with your pregnancy - millions of women around the world are right
there with you! - and with your appointment on Thursday. Let me know
if you need additional clarifications -
- librariankt |
