Dr. Diane Klivington, DO, MS

Have a healthy diet!! Also, taking a prenatal vitamin as many do not have enough folic acid in our diets. Stay away from processed foods and fast foods. Cook meals from scratch there are lots of great recipes that can make healthy meals in less than 10 minutes. I personally like the Noom app as it helps teach you about foods low in saturated fats and how to increase complex carbohydrates.
2. Being at a BMI of less than 25 optimally will help your chances. This of course will entail an exercise program.

Make sure you are ovulating (releasing an egg). You can do this by taking an LH test over 5 days in the luteal phase (usually days 10-15 of your cycle). Using this will alert you to your fertile times. It is important to note that if you have not achieved pregnancy within 1 year (age less than 35 yo), see your OBGYN for an infertility evaluation bloodwork to test your egg reserve, thyroid, and screen for diabetes. In addition, a structural investigation may be done to make sure the uterus has no defects, your Fallopian tubes are open, you are ovulating and your OB-GYN may also order a semen analysis.

Sleeping 7-8 hours a day reduces stress and helps maintain normal body weight. Use an LH kit you can buy this at a drug store I personally like Clear Blue Easy. Read the instructions carefully as you need first morning urine. You should test for 1-3 cycles to determine if you are ovulating if the test is negative see your OB-GYN. If it is positive and after 6 cycles of trying to get pregnant you are unsuccessful you will need an infertility evaluation as described above.

This is a great question. The egg is released after ovulation and remains in the Fallopian tube for a few days. If sperm are present the egg is fertilized and normally implants in the uterus. Semen can be present for up to 5 days. So one could theoretically get pregnant if they had intercourse 3-5 days ago and then ovulated.

I would see a OBGYN for an infertility work up. The patency of your Fallopian tubes ( making sure the tubes are open) as well as a semen analysis seems warranted. Timing coitus to LH surge is important.

Calcifications can be benign. I would want to know if there were any other concerns on the ultrasound concerning for a complex mass. One would be reassured by size less 10 cm, smooth borders and no internal septations or masses within the cyst. Second your OBGYN May order a follow up ultrasound as well as a CA125 or Tumor panel to look for ovarian cancer. Third I would want to know your personal history of cancer as well as a family history. Having a family member with BRCA1/2 or Lynch syndrome increases your risk of ovarian cancer. Please see your provider and give them this additional information.

I would recommend being seen by your family doctor or OBGYN to rule out a UTI or an infection such as yeast, bacterial vaginitis trichomoniasis, chlamydia, urge incontinence or interstitial cystitis. Sometimes patient presents with symptoms similar to yours when they have interstitial cystitis. There is a PUF questionnaire that you can Google online that may be helpful. I would keep a voiding dairy ie when you urinate how much and what area your symptoms and see your physician.

Yes. Carefully lift one end of the strip and gently pull off. To remove adhesive not within the incision line, you can use a small amount of lotion or rubbing alcohol. You should have a annual exam done by your provider 3 months after delivery. As annual exams are important to address any concern regarding contraception, get preventative health etc.

Prenatal vitamins are important because they give you folic acid that helps prevent open neural tube defects. Prevention of miscarriage can be accomplished by early visits to your OBGYN to rule out diseases such as diabetes, thyroid disease, or others which can affect miscarriage. If you have had prior losses it is very important to get testing and see your OBGYN.

Lastly, stay away from tobacco and alcohol which have been shown to cause miscarriage.

I would suggest a LH kit most ovulate between days 10-15 of the cycle. The LH kit such as Clear Blue Easy can be used to help predict your exact day. It also helps you time when you need to have coitus to improve success of pregnancy.

It’s not pain free. But you will have a spinal and pain medication afterwards. The first week is the hardest. By 6 weeks you should be back to normal activities although for some it takes longer. Having a good family support for the first month will help.

Make sure you stay hydrated drink water and avoid sugar sweetened beverages. I recommend a diet rich in fresh fruits and vegetables. If you are breastfeeding try and avoid foods that can cause extra gas such as excessive broccoli and salads. There are many great apps on diet for the breastfeeding Noom. Noom is a great app that helps you follow a healthy diet. Sleep is very important as well make sure you have extra family support.

There are many reasons why people spot pregnancy. But no it’s not normal. Sometimes it can be from cervicitis or vaginitis, for example, a yeast infection. In addition, if you are Rh-negative you may need RhoGAM. Spotting can occur in pregnancy. And most of the time this can be treated but you need to rule out other causes such as a placenta previa (low placenta), subchronic bleed (partial placenta separation), infection such as UTI, cervix incompetence ( cervix opens early)… etc. Please see your provider.

Yes I recommend you take 1g if Folic Acid before pregnancy daily.

Folic acid is easily eliminated through the urine. There are some people that are on 4 g of Folic acid to prevent neural tube defects. The recommendation is 1 g daily.

Diet is really important eat fresh vegetables and fruits stay away from sugar sweetened beverages. Make sure you have a healthy diet. Watch your weight gain, I recommend 25 pounds for those with a normal weight. 10-15 pounds for those overweight.

The research on this is divided but I usually encourage omega three and six along with a good prenatal with 1g of Folic acid.

Folic acid. 1 g daily.

Definitely anything with hormones such as testosterone in it! In addition some herbal medications can increase uterine contractions and should be avoided. I would stick to a prenatal vitamin you can get one with omega3 and 6. This is definitely a topic I would ask your OBGYN.

You should have a planned parenthood in your town. They offer low fee services. They will offer testing at little or no cost and treatment. They also can offer the HPV vaccine. As it protects against cervix cancer and genital warts. It will not eradicate current HPV. However, Without a biopsy it is hard to know the exact cause.

If one had genital warts they can be removed by TCA or a cream or by laser. Your health is important I would be seen as soon as possible.

First, I would take a pregnancy test. Yes even if you had Depo Provera as failures can occur. Second, I would see your OBGYN to get a vaginitis panel to look for yeast, bacterial vaginitis, trichomoniasis, gonorrhea and chlamydia. Third, if you are breast feeding you can have breakthrough bleeding. Fourth, depo provera can cause break through bleeding.

I would take a pregnancy test. I would suggest you see your OBGYN.