OBGYNDoc
Minneapolis, MN
Female, 36
I am a practicing Obstetrician and Gynecologist, providing care for women in all stages of life. Approximately half of my practice consists of pregnancy-related care, including routine prenatal care, high risk obstetrics, and delivering babies at all hours of the day. The other half consists of gynecologic care, which ranges from routine annual check-ups to contraception and menopause. I perform many surgeries, including laparoscopies and hysterectomies.
An uncomplicated removal of an IUD is actually quite painless and fast, especially in comparison to insertion. Most patients are pleasantly surprised at how easy it is. Very infrequently, the IUD strings are not visible or the IUD is not in the proper position, which may make the removal more difficult and uncomfortable.
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I'm not sure where you live, but I would start by talking to your infectious disease specialists for any good referrals. You should also check the website of any major local university hospital systems, as they may have gynecologists who specialize in patients with HIV. Another good source is the American College of OBGYN website physician finder: http://www.acog.org/About_ACOG/Find_an_Ob-Gyn
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So, as I said, in order to graduate from medical school, you have to complete 4 years of college followed by 4 years of medical school. At that point, you choose your specialty. ObGYN happens to require 4 years of training. Once you have completed residency, if you wanted to change specialties, you would have to repeat a residency in whatever field you have chosen. General surgery requires 5 years, cardiology can require up to 6-7 years, neurosurgery 7 years, etc. It is generally an unattractive prospect to have to go back and retrain for anywhere from 3-7 years when you are already in your mid-30's, so most people aren't willing to do this. But, again, if you are unhappy with your job, you have to find the job that brings you fulfillment.
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A baby's gender cannot be identified by HCG and AFP results. The only tests that can identify a baby's gender at this time are ultrasound, amniocentesis, CVS, or a test for fetal free DNA. Unfortunately, I am not able to interpret a baby's gender based on the information you have given me.
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The cost of an IUD removal will vary between different offices, but costs approximately $200. It should only take a few minutes and is much less painful than an IUD insertion. Very rarely, the IUD strings are not visible, and the procedure may be more uncomfortable or invasive.
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I recommend you discuss any medication concerns with your physican.
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This is a difficult question to answer, because it depends on many variables. A high A1C may be indicative of either diabetes, or even a "pre-diabetes" state. If you are able to control this through diet or medications, your chance of successfully conceiving will be much higher. With a slightly high testosterone and A1C, it is likely that you have polycystic ovarian syndrome, which can put you at risk for many other medical problems such as diabetes and heart disease. It is important that you try to make lifestyle changes to improve your numbers- healthy diet, exercise and weight loss (if you are overweight) will be important. In the end, the biggest determining factor as to whether you will be able to conceive is whether or not you are ovulating. You can determine this by tracking your cycles carefully, paying attention to certain subtle signs, taking your basal body temperatures daily or by using an ovulation predictor kit. If you are ovulating regularly, then there is a good chance that you will be able to conceive without assistance. If you are not ovulating, then you will likely need assistance with either a medication that will induce ovulation (clomid), or a medication that will help control "pre-diabetes" (metformin).
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