Infertility and placental insufficiency?

[Rahjah]

Hi... I posted this somewhere else but realised it should have been in here!

Does anyone know why Obstetricians are wary about couples who have had infertility issues, in letting them past their due date? Our Ob wants to induce straight away for the risk of placental insufficiency...just because it took us years to conceive. He's been flexible with us the whole way until now, he's not really willing to negotiate on this one, he thinks its too risky for us.
But the bub was conceived naturally in the end so I'm not sure what the concern is?

I've been looking for some literature on this but can't find any either.

Thanks...

[sushee]

I have to admit I've never having heard of an ob giving infertility as a reason to expect a decline in placental function. Did he have any evidence to believe that might be the case?

Infertility can be caused by a myriad of factors, so I can't possibly understand the correlation between it and placental function. It's too sweeping a generalisation! I don't know if you ever had your fertility issue identified, but even then, no, I can't say I've heard of anything that says that one has to do with the other. Perhaps it's unique to your situation? I don't know. But if I were you, and didn't want to be induced, I'd expect the ob to convince me with facts and proof as to why an induction was really necessary.

[onthefly]

Hi
I don't actually know the reason either, but noticed it in my 'book' for antenatal classes in the list of reasons doctors may not want patients to go 'over'. I plan to ask why.
I agree with Sushee - you should definitely ask why.

[sushee]

Decline of placental function is possible in any pregnancy, not just in those of women who struggled to concieve. And there are ways to monitor you to ensure that it isn't happening, or if it is happening, to then make the decision to induce. But to say that it's a risk because you took a long time to concieve, before you're even due for that matter, makes no sense at all.

I'm going to see if I can find out any more about this. Will report back soon.

[Rahjah]

Thanks for your replies...

ahh this is so frustrating! I asked directly why re the infertility and his reply was that people who have had infertility have a higher risk/rate of placental insufficiency.

We never had a diagnosis. Oh, I was diagnosed once with endo but then had what was there burnt off. I haven't seen that it's a problem anymore.

It's SO hard to keep questioning. I have always trusted our Ob, he's a lovely person, but I guess he gets irritated by people questioning him when we pay him to keep our baby alive. He's not real communicative in his explanations. Still...I deserve answers. I wonder how to get them.

He wants to induce day 1 past our due date.
grrrrrrrrrrrrrrrrrrrr

[{sarah}]

I'm not sure about this one either.... It took us just over 2 years to conceive Zander & I was booked for induction at 41wk 4 days (so 11 days over) and there was no question about placental function at all. I'm not really sure I understand why there would be a link to time TTC & placental function, it's not like the placenta is there for the entire time you're TTC, it's only there during pregnancy the same as any other woman.....

[Tanya]

Does your Dr have any other reason to suspect placental insufficiency? From my knowledge you would have to be measuring small and have had a scan for this to be diagnosed.

Maybe ask your Dr for a scan before agreeing to an induction.

[Rahjah]

At our 35 week scan bubs was between 40-50th percentile.
He hasn't mentioned size as an issue?

Geeessshhhh it's hard to get communication flowing with the medical world sometimes.

[sushee]

Rahjah,

I too had the kind of Dr who didn't seem to be open and approachable initially about me questioning his treatment suggestions, and I think it's that sort of 'I know better than you' atttitude than makes it hard for us to question anything they say. Personally over time, I certainly learnt to stand my ground with him, and TBH in the long run (despite the fact that I'm sure he thinks I'm a pushy cow) we got on better. Yes he is my ob, yes I trust him to an extent to do his best for me and my baby, but responsibility for my well-being also rested in my own hands. And when the time came, I knew my choices were my own, not his, and in that respect at least, he could not be blamed for a birth I was dissatisfied with, IYKWIM.

I honestly think you're entitled to at least ask him for evidence that infertility and placental function is linked. I TTCed for 4.5 years, concieved after 8 Assisted Conception cycles and my son is an IVF baby, but at no time did anyone ever bring up the possibility that my infertility could impact on placental function. And in fact my Dr was happy to let me go over by 10 days (and even then we'd discuss it if baby hadn't come by then)

[Tanya]

Great advise Sush

Rah, it sounds like bub is growing normally from the sound of your scan results.

Do you think you will follow your Dr's advice? Or will you be pushing for labour to establish in it's own time?

If you need some advice as to why you would like to avoid induction let us know, there are plenty of reasons to avoid it

[SamanthaP]

Cut and paste from the other thread.

Ask him for his evidence to support induction. He may well have some but you have every right to see it. Saying 'just because I said so' is not a good enough reason, iykwim? What exactly are the risks and why does he think it's his call on not risky/too risky, and not yours?

[Tanya]

How did you go Rah??

[Rahjah]

Thanks

Still working on natural induction atm! Had acupuncture today and got it again on Wed...failing that looks like we'll be doing the gel thing on Thursday...

but we see the Ob again tomorrow and we're a bit better prepared with questions this time so fingers crossed we get some good answers!

My acupuncturist today said he thought placental insufficiency IS a risk with me as I've been laying down for 3 months with low BP - so that has calmed me a little. Not the Ob's reasons, but still, if an Eastern medicine man can tell me that I am a risky case then I'll listen....

see what happens tomorrow.

Thanks.