Answer: When a miscarriage happens, we are forced to bear witness to the complexity of human life. Miscarriage is often kept private, and its frequency of occurrence (15 to 25 percent) is in sharp contrast to the view that "pregnancy = healthy birth."

Most miscarriages happen during the first trimester, within the first 13 weeks. They can occur up to the 20th week of gestation. Even though common, miscarriage results in parents looking for the "why."

One factor may be simply the mother's age: Over 35, a mother's risk of deadly chromosomal defects rises significantly. For example, the risk of any chromosomal defect's occurring at age 26 is estimated at 1 in 476. The risk of any chromosomal defect's occurring at age 40 is 1 in 66. About 7 percent of all miscarriages or stillborn deaths are due to a chromosomal abnormality.

The mother may have a disease or infection that contributes to an unfavorable environment for a developing baby to grow. Examples include severe kidney disease; uncontrolled diabetes; an underactive thyroid; auto-immune disorders like rheumatoid arthritis or lupus; or uterine infection from sexually transmitted disease like chlamydia, gonorrhea, or herpes simplex virus.

If it was a first pregnancy, one cause of a miscarriage could be "antiphospholipid antibody syndrome." With this disorder, a mother is at increased risk of blood clots. For such women, aspirin is taken to decrease the risk of clots and miscarriage.

Anatomical factors may also increase risk of miscarriage. If the uterus is abnormally shaped, or the cervix is short and weak, the mother may be unable to successfully carry a baby to term.

If the pregnancy was longer than six weeks, there are developmental hormones, such as progesterone, that need to return to pre-pregnant levels. I'd recommend a resting period of at least 60 to 90 days before trying to conceive again. In most women, the emotional healing time may take a lot longer than that.

He had testicular cancer, now needs testosterone

A: Yes, I do. Testosterone patches, gel, and shots should be avoided if there's a history of prostate cancer or a history of breast cancer (men rarely can develop breast cancer), but not with a history of testicular cancer. Viagra won't help restore your sex drive and stamina; it will only help you achieve an erection. Testosterone replacement therapy is the only way for you to restore your virility.

Typically, when my patients complain about erectile dysfunction but have a good sex drive, they usually have adequate testosterone levels. On the other hand, men with a low testosterone level may report a very low sex drive, low stamina, and a dissatisfied sexual partner.

Bear in mind that when starting testosterone replacement therapy, the testosterone and PSA (prostate specific antigen) levels should be checked following six weeks of treatment and periodically thereafter. While testosterone supplementation won't directly cause prostate cancer, it may stimulate the growth of an existing but silent prostate cancer. It also may cause symptomatic but benign prostate tissue enlargement.