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Jeffrey Ecker, M.D. is an Associate Professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics and Gynecology at Massachusetts General Hospital, where he practices maternal-fetal medicine.
Question:
I have been under the care of my doctor for the past five years for chronic anemia. Every so often, I receive iron infusions because my blood count is low. Can my condition make it hard for me to conceive?
Answer:
Anemia itself is unlikely to prevent conception, although any underlying disease that causes the anemia may have an effect. You should talk with your doctor about how the cause of your anemia may affect pregnancy.
Oxygen is carried to the all the tissues in the body by hemoglobin inside red blood cells. In pregnant women, additional blood with oxygen needs to get to the placenta and the developing baby.
A low level of red blood cells or hemoglobin is called anemia. Anemia may result from nutritional problems (low iron or vitamin B12), inherited abnormalities (sickle cell anemia, thalassemia), chronic disease (lupus, cancer), problems of the bone marrow and the cells that make red blood cells (aplastic anemia), or loss of blood.
In pregnancy some degree of anemia is normal as a result of dilution (increased fluids in the body's circulation) and increased iron demands to provide for the baby's needs. Women with pre-existing anemia may find that as their anemia worsens in pregnancy, symptoms such as fatigue, shortness of breath or dizziness become more of a problem. Many of these symptoms, of course, are common to all pregnancies, so having them is not necessarily a sign of anemia.
For those with iron deficiency, iron supplementation can be continued or started during pregnancy. Usually this comes from iron pills. It is unusual to need IV iron infusions, but this can be done during pregnancy if deemed necessary.