Ask a Fertility Specialist: Dr Sumithra Devi Valiapan from Sunfert International Malaysia

dr. Sumithra Devi Valiapan replied 2 years ago

Hi there, thank you for the question. Congratulations on your pregnancy! Nausea and some vomiting are very common in pregnancy. This is easily controlled in most cases by slight dietary changes. Avoid oily, spicy and strong tasting food for the time being. Cut down on coffee, tea and milk. Eat smaller portions but more frequently. Drink small amounts a a time but remain well hydrated, drink more frequently.

Ginger based drinks and food can help relieve some nausea and vomiting. You might need to see your obstetrician who can prescribe some medications for the vomiting. Nausea and vomiting is also easily controlled by medications. Take the medicine at least half an hour to an hour before meals.

The nausea and vomiting will usually resolve after the 1st trimester. It occurs due to pregnancy hormonal changes in your body. If you're still unable to keep down your food, then your doctor will give you drips and injections to control the vomiting.

Hope you have a safe pregnancy.

dr. Sumithra Devi Valiapan replied 2 years ago

Hi there Madam Kartika,

Thank you for your question. The number of embryos that are replaced can determine the number of pregnancies. However, not all embryos will implant all the time. For example, if 2 embryos are replaced, there are 3 possibilities:

1.no pregnancy at all
2. twin pregnancy
3. single baby

This is because not all embryos formed will be normal. There are other factors that determine quality of the embryos and implantation success. For example mother's health,womb quality and sperm quality.

Good luck with your IVF treatment.

dr. Sumithra Devi Valiapan replied 2 years ago

Thank you for the interesting question. Yes dates are safe in pregnancy. So, enjoy your dates.

dr. Sumithra Devi Valiapan replied 2 years ago

Generally it takes a few months for women to be fertile after the monthly birth control injections. However, some women do ovulate immediately after the end of their monthly dose, therefore women not keen for pregnancy are encouraged to use alternative contraceptives if stopping the monthly injections.

dr. Sumithra Devi Valiapan replied 2 years ago

I'm sorry to hear of your failed IVF cycles. There are many reasons why IVF might fail. I need complete information on you, your husband, both your IVF cycles, the quality of your embryos and the condition of your womb before I can give you an appropriate answer. The reasons IVF fail are different for each couple. However, your Fertility Specialist should be able to go through each of these with you. There are also tests that can be done to determine possible causes.

Briefly though, IVF success depends on the health of both partners, the sperm and eggs' quality, the age of the woman, the quality and genetics of the embryos, the appearance of the womb and, the quality and receptivity of the womb's lining. Success also depends on the ability of the scientists in the laboratory.

Good luck next time, don't give up.

dr. Sumithra Devi Valiapan replied 2 years ago

If you're planning for natural pregnancy with the same partner whom you had sex with before, then there is no need for a HIV test at all.

If you had sex with a different partner, then a negative HIV test 3 months after the last encounter and no subsequent unprotected intercourse with the same person after that, should cover the window period for HIV.

dr. Sumithra Devi Valiapan replied 2 years ago

I'm sorry to hear of your molar pregnancy. Molar pregnancies are usually not dangerous unless you ignore proper medical care and surveillance that your doctor will advise you to follow.

Recovering from molar pregnancy will not reduce your baseline chances of conception. However, you need to avoid pregnancy until your doctor says the molar pregnancy has resolved and it is safe to get pregnant again. I suggest you see a fertility specialist for your infertility. You are young and have a good chance of successful fertility treatment. The success rates of fertility treatment decline significantly with advancing female age.

Good luck and best wishes.

dr. Sumithra Devi Valiapan replied 2 years ago

Fertility assessment must always involve both partners. 30% of the time, there's combined male and female factors causing the infertility. Therefore, yes it's prudent to go together for a fertility screen and support each other throughout the process while never assigning blame to either partner.

Good luck trying.

dr. Sumithra Devi Valiapan replied 2 years ago

I'm not sure what your gestational age is currently, however you might be experiencing braxton hicks contractions, they're quite harmless. On the other hand, if your contractions are regular and getting stronger, you need to see your obstetrician to rule out premature labour or some form of infection. If you've had any abdominal surgeries before, the pain might also be related to the previous surgery.

It is quite common to have appetite changes in pregnancy. It is more important to weigh you regularly to ensure appropriate weight gain. Regular scans of your baby is also necessary to plot its growth.

I hope you have a safe pregnancy and delivery.

dr. Sumithra Devi Valiapan replied 2 years ago

Firstly, we need to find the cause of your menstrual disorder. PCOS is one of the possible causes. Gynaecologists can easily diagnose pcos. You also need some blood tests and a scan to look for other causes of menstrual problems. Management also depends on your weight.

If it is PCOS, you can get pregnant easily with some lifestyle changes, dietary modification and simple medication.

Congratulations on your upcoming wedding.

dr. Sumithra Devi Valiapan replied 2 years ago

Ivf has the highest success rates compared to other treatments. Unfortunately, yes, ivf can fail. Many couples will need a few ivf cycles to achieve pregnancy.

Health of the couple, dietary pattern of the couple, exercise, sperm and egg quality, age of tbe couple, medications used, treatment protocol, laboratory quality, skill of the doctor all determine ivf success.

Please visit my Facebook page "Dr sumithra devi valiapan, fertility specialist" for detailed information in a few videos that's in Malay. There are videos on all your questions: how to improve success rates and why treatment fails, as well as dietary advice.

Good luck in your ivf cycle.

dr. Sumithra Devi Valiapan replied 2 years ago

Congratulations on having 3 boys. There isn't any specific food, time for intercourse or sexual position that offers guaranteed success in getting the gender you want.

Ivf and pgs can help, but you need to find a clinic that'll do sex selection.

Good luck trying for a girl.

dr. Sumithra Devi Valiapan replied 2 years ago

Have you consulted a fertility specialist? your chances of successful fertility treatment will depend on a few factors which a fertility specialist can discuss with you. your doctor will also suggest the most appropriate fertility treatment for you after examining you and your husband. you should not delay getting fertility treatment as the success rates drop significantly with your increasing age.

it is normal for semen to liquefy and flow out of you. that doesn't mean the sperm is coming out. sperm will swim upwards into your uterus, it's only the seminal fluid which flows out.

dr. Sumithra Devi Valiapan replied 2 years ago

When did you deliver? The most common causes of giddiness and cramps are a low blood hemoglobin (red blood cells that carry oxygen in our body) count or abnormal electrolytes eg. sodium, potassium, calcium. these are easily diagnosed. Please see your obstetrician or family doctor. Do not delay finding the cause of your ailment.

dr. Sumithra Devi Valiapan replied 2 years ago

You should see your obstetrician if your frequent headaches persist, to look for the cause. you must ensure whatever medication you consume in pregnancy is safe for your baby, and has no adverse effect on your pregnancy. read the labels that come with the medication or ask your pharmacist or doctor.