### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello I am 38 years old and in 2011 I had a positive pregeancy test we had a 3 year old that it took 10 years and 3 miscarriages to conceive my pregeancy in 2011 was horrible I stayed In the hospital from 16 weeks until I had a emergency c-section at 26 weeks due to blood flow they diagnosed me with scleroderma and crest syndrome they said we were not gonna make it i had my tubes clamped 2 days ago I had 2 home pregeancy test that was positive I was misdiagnose I have burgers diease I was sent to duke they did test that is what they found no scaladerma or crest is it possible for me to be pregeant with my tubes clamped ?? And if so if the baby is planted in the womb could i Carrie it I do have to have loveanox shots when I am pregeant I am stressed beyond please help ??? Thanks shelly Conley

### output:

Hi Shelly, How are you doing ? I understand your concern. Let me start by saying that you can definitely conceive with the tubes clamped, but not by natural method, only by IVF or you will have to laparoscopically recanalize the tube & then try(of course there is risk of tubal pregnancy then). The main risk factor I see here is your age. As you cross 35 yrs pregnancy chances reduce, but only after 40yrs it falls Chat Doctor.  But the main plus point is that you had pregnancies in the past, no matter how it ended, maybe it was these underlying conditions which were causing abortions & blood flow problems to baby. With Gods grace you can surely have baby through IVF/ CSI. First have a Serum AMH level, this will tell you how many eggs you have in ovaries. They only give the quantity, not quality. I bet the result will be normal. In IVF you will be stimulated with hormone injections, when they are of mature size, diagnosed by scan, they will be aspirated out & at SME time your partners' semen is collected. They are taken into embryology lab, each egg is injected with one sperm. Now this is ready to grow into a baby. This is left in incubator for a stipulated time. Embryos are formed. In your country, they transfer 1 embryo at a time straight into the uterus. Baby is in uterus & it grows. So you see tubes are not needed at all !! You have to take Lovenox Injections till the end of pregnancy. This will improve the blood flow to baby, preventing abortions & also any blood flow problems to baby. Lovenox doesn't cross placenta, so will not affect the baby. After IVF extra embryos will be frozen in your name in the lab. You can use them at later date, say after this baby is old enough. Embryos age will be frozen at 38yrs age(your present age), even when you are 40, 50, 60 or so, embryo will be 38yrs. So you can have babies till those frozen embryos get over. Pregnancy is God given, prey well, you will make it. Never lose hope & never get stressed, trust in God. Hope I have cleared your overall the best