Question:
Hello, Sorry for my poor English. I live in Israel, so English is not my mother-tongue :) I had a Mirena placed at late November 2011. Ultrasounds showed that it was placed well. To make thing short: I've got pregnant in February. My ginecologist didn't succeed to get Mirena out. After doing more ultrasound tests with two different specialists: no one is sure if it is in or out.
I was checked by professor (who has very high reputation and I know him for several years and trust his opinion). He says that it might happen that Mirena has gone out of womb but not completely. He suspects that it is half-out (all this is very surreal for me). No one can tell what end of Mirena is out (I mean no one knows if it still secrete Progesteron into the womb) . We planned to have more children, so I'm not against the idea of pregnancy. Hence no one wants to perform laporascopy test to discover what is going on.
Now, suppose the Mirena is still in (half or complete) and it secretes the Progesterone into the womb. I know there is a risk of miscarriage and there is nothing I can do about. The question is: can these dose of Progesteron harm the embryo? Are there statistics or researches on that?
And say the embryo will be boy, can Progesterone influence him and his hormone levels as to even change the "orientation"? Sorry for that last question, but I can't help thinking of that.
Please make some order in my situation. Of course I'm observed by ginecologists and he is checking relevant information for me right now. Thanks in advance. LT from Israel
Answer:
Hello LT from Israel,
I'm sure that your gynecologist is doing the same research that I had to do to answer this question. It is a good question, but I don't think there is any real clear answer. This is what I found out and it is from the following website: http://www.drugs.com/pro/mirena.html
Based on the information from the above site, if an IUD is in place when pregnancy occurs, you have the following risks:
1. There is a two fold increased risk of miscarriage.
2. There is a four fold increased risk of preterm labor, delivery and loss.
3. There is an increased risk of 2nd trimester infection (chorioamnionitis) and maternal death.
4. Few congenital anomalies have been noted (there is no statistic).
5. Regarding your last question: There has been some reports of and there could be an increased risk of masculinization of a female fetus.
In your case, it would be very important to know if the IUD is in place. If it can't be seen easily by ultrasound, then a pelvic x-ray would probably be indicated, not a laparoscopy. The IUD should be seen and the amount of radiation is very small and won't affect the fetus or pregnancy.
I hope all goes well and good luck,
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A
Comment: My question required some serious research and was answered very clearly Thank you very much!
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