On January 22, 2025, we welcomed back Dr. Nicole Plenty to answer fertility, hormones, pregnancy and how it can affect those with idiopathicThe term idiopathic is used when there is no detectable reason for something. intracranial hypertension (IIH).
Dr. Nicole Plenty is a double board-certified Obstetrician and Gynecologist and Maternal Fetal Medicine Physician. She is the Director of MFM at Wellstar in Atlanta, Georgia. She is a patient advocateTo self-advocate in your health is to communicate your needs and has a podcast and website called Pregnancy Pearls where people can access evidence-based information.
After our September Community Chat last year, we had an overwhelming number of questions related to fertility, hormones, and pregnancy and how it affects one with IIH.
Incase you missed her talk, here are a few key points from her lecture:
- Dr. Plenty states that if one is on diamox for the management of IIH and is well-controlled in the pre-pregnancy stage, your OB will likely let you stay on it throughout your pregnancy.
- If you are over 35, you are more at risk of having a baby with chromosomal abnormalities, preeclampsiaA condition that develops in pregnant women, it is marked by high blood pressure and presence of proteins in urine., and other pregnancy complications regardless if you have IIH or not.
- The risk of being overweight during pregnancy is not limited to: gestational diabetes, preeclampsia, macrosomia, and diabetes in the baby.
- Increased circulating hormones occur in ones who have a high adipose tissue, such as higher androgen levels, which affects the menstrual cycle and fertility.
- In her experience and in the literature, one with a BMIA value derived from the mass (weight) and height of a person. A healthy range is between 18.5-24.9, overweight is defined as 25-29.9 and obese… over 35 can have improvement in their fertility and a normal menstrual cycle and ovulatory phase when they loose as little as 10 pounds.
- Weight loss including the use of GLP-1 agonists are encouraged in the pre-conception stage. There is caution that after one’s weight loss goal is achieved, a window of waiting should occur of 8-10 weeks, then attempt pregnancy. There are no studies of women who are pregnant on GLP-1 and its effect on the mother and baby or during breastfeeding, thus should be discontinued during this stage.
- GLP-1 usage can decrease ICPincreased intracranial pressure about 5 points but that affect only last 10-12 weeks.
- One with IIH who is looking to go through the IVF process will undergo a comprehensive work up including checking hormone levels.
- If a woman becomes pregnant immediately after a venous sinus stent, most patients have to convert to lovenox and heparin, if on plavix, can go on after 1st trimester. Low dose aspirin is okay.
- For those looking to use a reproductive endocrinology and infertility (REI) specialist to get pregnant, if you are on a diureticSomething that increases the production of urine such as diamox, it will likely be held during a few points during the IVF process but REÍ will guide you.
We think Dr. Plenty for sharing her time and knowledge with us on this very important topic. The lecture will be available on our YouTube channel.
We hope to announce our next webinar next month.
