Healthy Weight
Don't you just hate to get weighed at the doctor's office It can be a humiliating and embarrassing experience for many women, me included. The truth is that most doctors don't really care about your exact weight. No one expects you to look like a skinny super model or movie star. However, your health care provider does want you to be at a reasonable and healthy weight. Before you become pregnant, you should try to be at a healthy weight. Being at a healthy weight makes it easier for you to...
How To Select Your Fertility Counselor
It's very important that your counselor be trained and well versed in the issues of fertility, both the causes and the treatment options. That way the counselor can truly understand the range of physical issues and emotions that you are facing. Start by talking with your own fertility specialist and medical staff at your fertility clinic. Fertility clinics may have counselors who are associated with the clinic and ready to help you, and if not, they likely have already compiled a list of good...
Bromocriptine Parlodel
Parlodel is a medication that slows or stops the production of the hormone prolactin in the brain's pituitary gland. It is very useful in treating women with abnormally high prolactin levels. Very high levels of prolactin may be due to polycystic ovary syndrome (PCOS), hormonal imbalance, or a benign tumor in the pituitary gland called a pituitary adenoma. Unfortunately, high prolactin levels interfere with the body's normal production of LH and FSH and thus hinder the ovulation process....
Youve Chosen Your Specialist Now What
If you are part of a couple, your partner should be with you during your first visit with the new doctor. In fact, it's best if your partner can accompany you to all of your appointments. That's because fertility is often a couple topic and both of you are involved in this experience. If you are able, it's best to bring your medical records, test results, and report summaries with you for your new doctor's review. One of the doctor's first priorities will be to evaluate whether you have a...
Fertility Testing for Women
Most women will undergo several basic tests and procedures during a fertility evaluation. Depending on your particular medical history and situation, some of these examinations may play a more important role for you than others. In most cases, the fertility tests can be completed within a few menstrual cycles. Certain tests must be done during a specific time of your monthly cycle. Your fertility doctor will most likely ask you to prepare for a few of these tests beforehand. So beware, you may...
Body Weight
Being overweight by even 10 to 15 percent above normal can overload your body with estrogen. This extra estrogen is produced within the fatty tissue and can dramatically change your hormone balance. In many cases, obese women ovulate irregularly, if at all. Lack of body fat may also result in irregular periods and infertility. A woman who is underweight by 10 to 15 percent has less fat storage and therefore less estrogen. Although it may vary from woman to woman, most medical experts agree that...
How Will I Be Monitored When Im Taking Parlodel
Your doctor will draw your blood and check your prolactin level before you begin treatment with Parlodel. If your prolactin level is elevated, you will probably undergo a magnetic resonance imaging (MRI) of your head. The purpose of that radiological study is to evaluate your brain's pituitary gland. Once you begin Parlodel, your doctor will order blood work to evaluate your response to the medication. When you are going to have your blood prolactin level checked, remember these few important...
Ovarian Tissue Donation And Transplant
It may soon be possible to transplant ovarian tissue from one woman to another. This would allow one woman to donate a piece of her ovary and have it transplanted into another woman. The recipient would use the donor ovarian tissue to ovulate and become pregnant using natural sexual intercourse. The eggs would have the genetic material from the donor, but the pregnancy would be fertilized and grown within the body of the recipient. Ovarian tissue transplant is generally acceptable even for...
Advancing
The current social trend seems to be for women to wait longer before starting a family. Advantages to waiting to start a family include established career, financial security, and overall maturity. However, there may also be a price to pay for delayed childbearing. Many women find it more difficult to become pregnant than they expected. That's because, from a hormonal standpoint, most women reach their reproductive peak between the ages of 20 and 25. As you age, various changes within the...
How The Egg Donation Procedure Works
The procedure for egg donation is considerably more complicated than for sperm donation. Part of this is because eggs cannot yet be effectively frozen. Therefore, the donor and the recipient must have their hormonal cycles adjusted so they coincide with one another. That way, eggs can be removed from the donor and implanted into the intended mother within a few days of each other. Egg donation is also more complicated than sperm donation because eggs are considerably more difficult to obtain....
Thirdparty Reproduction
Third-party reproduction means that you would use sperm, eggs, or embryos donated by a third person to have a baby. It also encompasses surrogacy and adoption, because an outside party is used to conceive or carry the baby. Many emotional and ethical complexities are associated with third-party reproduction. Have a candid discussion with your partner about the types of medical assistance that you are both willing to accept. Your partner may feel differently from you when it comes to sperm...
Conclusion
If you are about to embark on an ART procedure, it's a big deal. Not only does it require a big financial commitment, but it also can take a lot out of you both mentally and physically. That's why this chapter aims to educate you about the various ART procedures that you may encounter. By understanding your options and what's happening to your body, you'll be better equipped to handle the uncertainties that may come your way. You'll be armed with the knowledge and be able to a have a more...
Timing Is Everything
Of course, you already know that you should have sexual intercourse during your most fertile time of the month that is, around the time of your ovulation. But did you also know that some holistic practitioners suggest that a couple's most fertile time of day is between 3 p.m. and 7 p.m. Medical research shows that the number and quality of sperm seem to peak in the late afternoon. In fact, some studies indicate that a man's sperm count may be up to 35 percent higher in the late afternoon when...
Basal Body Temperature Bbt Method
The BBT method is based on the knowledge that most women have a slight increase in their normal body temperature just after ovulation. That's because your progesterone hormone levels increase with ovulation. This increasing progesterone level causes your temperature to rise, a least a little bit. Here's how the BBT technique works. Every morning, first thing before you even get out of bed, you take your temperature and record it on a sheet of paper. Purchase a special thermometer (a BBT...
Internal Female Reproductive Organs
The internal female reproductive organs consist of the cervix and uterus, two fallopian tubes, and two ovaries. (See Figure 3.3.) The cervix is a small rounded structure that is about an inch and a half across. It separates the vagina from the uterus. It juts out like a bottleneck into the upper part of the vagina. The cervix, which is actually the lower part of the uterus, opens into the uterus via a narrow cervical canal. The cervical canal is lined with glands that produce cervical mucus....
Hormones
Hormones are produced by the body to transmit instruction from one area to another. The same hormones are produced in both men and women, but in different amounts. It helps to understand how the reproductive hormones react within the body. They play an important role in fertility. A small area located within the midportion of the brain is known as the hypothalamus nearby lies a grape-sized gland called the pituitary gland. Together these two structures control the production and release of the...
Selecting Your Embryos
Unfortunately, most recipients don't have much of a choice when it comes to embryo donations. That's because there usually aren't many embryos available for donation. Couples who have undergone their own fertility procedures and have leftover frozen embryos do not always feel comfortable donating them to another couple. Fortunately, some fertility clinics do arrange for embryo donations. These programs do their best to match donors and recipients based upon ethnicity and physical traits.
Cytoplasmic Transfer
To understand this procedure, you should know a little about cytoplasm. Cytoplasm is the liquid portion of the egg that surrounds the central nucleus. (Is this bringing back thoughts of high school biology ) It may help to think of a regular chicken egg. For example, the yellow yolk would be the nucleus, and the white liquid part that surrounds it is the cytoplasm. In human eggs, the nucleus is also the center part of the egg and contains the genetic material, DNA. The surrounding cytoplasm...
Raising A Child Conceived With Donor Material
The challenge of raising an ART child has been discussed previously. Raising a child that has been conceived with donor material forces you to tackle even more ethical considerations. Of course, you must decide if you will explain your child's conception to him or her. And you'll also want to discuss your wishes with close family members and friends so that they will abide by your wishes. In the case of donor sperm, eggs, or embryos, you'll also need to decide if you want to explain this to...
How Do GnRh Antagonists Work
GnRH antagonists work directly on your pituitary gland to block the release of FSH and LH. This direct blockage works almost immediately. Compare this to the tradi tional GnRHa, which suppresses FSH and LH in the bloodstream and takes several days to stop ovulation. In contrast, the GnRH antagonist is effective at shutting down ovulation within an hour or two. Remember that the purpose of traditional GnRHa and GnRH antagonists is the same. They are both used to suppress your body's hormones and...
Ovulation
Each month, under the influence of your reproductive hormones, one of your ovaries selects between 10 and 20 eggs to become possible candidates for release. The number of eggs decreases with age until menopause, when ovulation stops completely. The chosen eggs begin to mature within their own sacs, called follicles. In most cases, only one follicle matures and one egg is released each month. Some women feel a cramp on one side of their pelvic region during this time. Next, the egg moves into...
Rhythm Method
This technique is also sometimes called the calendar method. To perform this method, you keep a calendar and record every day of your menstrual cycle for at least six months. From that information, you can calculate when you are ovulating and thus when you are most fertile. As discussed in Chapter 3, your menstrual cycle is counted from the first day of bleeding (this is considered day 1 of your cycle) to the first day of the next menstrual cycle. For most women, this is typically about 28...
Emotional Issues
Few things in life rival the emotional and hormonal roller coaster that the fertility patient must endure. It's difficult enough to come to terms with the shocking diagnosis of infertility. Most women see infertility as a major life crisis and experience significant feelings of loss. Add to that the numerous doctor visits, various medications, multiple unpleasant tests and procedures, and perhaps also surgeries. The financial burden of paying for this medical care, most of which is not covered...
Endometrial Biopsy
If your doctor recommends an endometrial biopsy, that means that he or she wants to obtain a small sample of lining (endometrium) inside your uterus. During a fertility evaluation, the purpose of this test is to determine if and when ovulation has occurred. Typically, the endometrial biopsy is performed just a few days prior to the start of your next menstrual period. It is assumed that at that time, ovulation has already occurred and progesterone levels should be adequate within the uterus....
Avoid Artificial Lubricants
To boost your fertility, avoid the use of artificial lubricants. These lubricants often contain chemicals that can damage or kill sperm. Clinical studies show that sperm mobility is reduced by 60 to 100 percent after one hour of contact with commercial lubricants. This applies to regular over-the-counter lubricants, petroleum jelly, plain glycerin, and even saliva. Instead of using a lubricant, try to lengthen the amount of time you and your partner spend on sexual foreplay. For most women,...
Nuclear Transfer
The nucleus is the central part of the egg that contains the genetic material, DNA. Nuclear transfer is an experimental laboratory technique that removes the nucleus of one egg and replaces it with the nucleus from another egg. Because the nucleus contains the DNA, the baby that is formed will have the newly transplanted DNA. This procedure could be beneficial for women who are not able to produce their own viable eggs. In such a case, a donor egg would be obtained and the nucleus removed. Then...
Urine Analysis
A urine sample and analysis can provide the fertility specialist with additional information. The urine is checked for the presence of bacteria and also for the presence of white blood cells. White blood cells may indicate an infection either within the urinary tract or the prostate gland. If infection is suspected, more tests will be performed and treatment given. The urine is also checked for the presence of sperm. A high concentration of sperm in the urine may indicate retrograde...
Embryo Assisted Hatching
Assisted hatching is a special technique to help the embryo implant into your uterus. The technique is typically used in conjunction with IVF or ICSI. The thought is that thinning or making a small hole in the embryo's outer shell (called the zona pellucida) may help the embryo to progress and successfully implant in your uterine lining. Some fertility specialists and clinics choose to use assisted hatching with all of their IVF patients because they believe that it increases pregnancy success...
Certain Prescription Medications
Before you try to conceive, have a complete physical examination and medical checkup. One reason is to detect any new medical conditions that may require treatment. Another reason is to review your medications and make sure it is safe to continue taking them as you try to become pregnant. Your doctor will want to review your list of current prescription medications. Although many medications can be safely taken during pregnancy, some may increase your chance of miscarriage or cause potential...
Previous Vasectomy
A vasectomy is a voluntary surgery to block the sperm ducts for the purpose of contraception. Sometimes, for various personal reasons, the man wishes to have his vasectomy reversed. In fact, approximately 10 percent of vasectomized men eventually request vasectomy reversal in the United States. While it is usually possible to surgically reconnect the tubes after vasectomy, some men remain infertile because their body has developed an immune reaction against their own sperm. That means they...
Varicocele
A varicocele is a collection of dilated veins within the scrotum that look like varicose veins. It lessens a man's fertility by producing a slightly higher temperature in the testicles. A varicocele occurs in about 15 percent of all men and accounts for as much as 40 percent of male infertility problems. Varicoceles are treated surgically. The most common type of procedure is microsurgery, which is done on an outpatient basis under spinal anesthesia. The enlarged veins are repaired surgically,...
Assisted Reproductive Technologies ARTs
Assisted reproductive technologies (ARTs) involves the sophisticated treatment and processing of human eggs and sperm to help you become pregnant. The treatments that you receive will depend on a variety of issues, including your health and that of your partner, your concerns and desires, and your particular fertility situation. Examples of ART include intrauterine insemination (IUI), which is commonly referred to as artificial insemination, and in vitro fertilization (IVF), which results in...
The Causes of Infertility
Many couples who want to become pregnant often find that it's more difficult than they originally believed. Sadly, this problem is common. According to the American College of Obstetricians and Gynecologists, approximately 15 percent of couples in the United States may be infertile. This means that of the more than 40 million couples of childbearing age living together in the United States today, about 6 million of them may be affected by infertility issues. So if you are reading this book and...
Herbal Remedies
Herbs have been used for thousands of years in various parts of the world as treatment for medical ailments. Certain herbal remedies have been used to promote and boost fertility in both men and women. Herbs are not regulated by a governmental agency, as the Food and Drug Administration does for prescription and some over-the-counter medication. Consequently, herbs that you may use could be contaminated or not contain the exact ingredients that are listed on the label. Because herbal medicine...
Lcarnitine
Like L-arginine, L-carnitine is an amino acid. It also is required for the normal functioning of sperm cells. The Office of Dietary Supplements at the National Institutes of Health reports that the higher the L-carnitine level within the sperm cells, the better the sperm count and sperm quality. The ODS further states that larger and more carefully designed studies are needed to evaluate L-carnitine's potential value as an infertility treatment therapy. The following list summarizes the...
Gestational Carrier Surrogacy
Remember Phoebe on the TV show Friends She was a gestational surrogate for her brother and his wife. She carried triplets for them Those babies were the creation of her brother's sperm and his wife's eggs and therefore not directly genetically linked to her. That's how gestational surrogacy works. The surrogate is only used to carry the pregnancy and the baby is not genetically connected to the surro gate. The baby is the combination of genetic material from you and your male partner. In...
Internal Male Reproductive Organs
The internal male reproductive organs consist of the epididymis, vas deferens, seminal vesicles, prostate gland, ejaculatory ducts, and urethra. (See Figure 3.1.) The epididymis is a long, thin, hollow coiled tubular system within the scrotum. A man has two epididymides each one sits on top of its corresponding testicle. Sperm that are still maturing leave the testicle, enter one end of the epididymis, and loop and coil along the path. The sperm's journey takes about 10 days, and by the end of...
Gonadotropin Releasing Hormone Agonists GnRHa Lupron Synarel Nafarelin Buserelin
GnRHa is not really a fertility medication however, it is often used as part of your IVF protocol. When used in this practice, GnRHa is given first to restrain your own body's hormones. Once your natural hormones have been suppressed, another medication (usually the gonadotropins discussed previously) will be given to induce ovulation. Using this protocol, the fertility specialist is able to precisely control the reproductive hormones and ovulation, thereby making conception more likely. GnRHa...
Objections To Technology
Some couples have a moral dilemma or religious objection to using any type of ART. Certainly, couples should come to terms with these concerns and apprehensions before embarking on any type of advanced fertility treatment. It helps to establish what you and your partner are willing and unwilling to do. You may find that it's easier to come to a decision when you are educated and well informed about your options. Talk openly with your fertility specialist. Many couples also benefit from talking...
Hysteroscopy
Your doctor may recommend a hysteroscopy procedure to evaluate if you could have an abnormality within your uterus. The hysteroscope is a thin telescope-like instrument that is inserted through your vagina and cervix and then into your uterus. This procedure provides the doctor with a way to view inside of your uterus and make a certain diagnosis. Sometimes, hysteroscopy is done in conjunction with a laparoscopy procedure (see below for discussion of laparoscopy). The hysteroscopy procedure has...
Why Does Icsi Work Better Than Natural Intercourse
ICSI is more effective than natural intercourse because Fertility medications are used to produce more eggs than would develop naturally. Instead of your having to wait for the eggs to ovulate naturally, with IVF the eggs are retrieved manually by your doctor. IVF bypasses the fallopian tubes because the eggs are retrieved directly from the ovaries and transferred directly into the uterus. Your eggs are treated in the laboratory, and their outside protective layer is removed to make them more...
Hysterosalpingogram
The purpose of the HSG is to check for obstructions or growths within your uterus and fallopian tubes. Conditions such as blocked fallopian tubes, fibroids, and adhesions may be diagnosed during the HSG procedure. Your doctor may recommend that you undergo an HSG if he or she suspects that you have an abnormality within your uterus or fallopian tubes. The HSG is performed shortly after you have completed your monthly period bleeding. The procedure is usually carried out in a hospital or an...
Potential Causes Of Recurrent Miscarriage
Recurrent miscarriage can happen because of any of many possible reasons. Lifestyle Factors We've all heard about the dangers of tobacco, alcohol, and street drugs. They just aren't part of a healthy lifestyle. This is especially true as you try to conceive and also during your pregnancy. If you smoke during pregnancy, you are more likely to experience vaginal bleeding and miscarriage. Women who drink excessive alcohol or engage in illicit drug use have a definite increased risk of miscarriage....
How Do Aspirin And Heparin Work
If you have had prior miscarriages, they possibly were caused by a blood-clotting problem. Aspirin and heparin are both able to thin your blood and help to prevent the formation of blood clots. Women with antiphospholipid syndrome (see Chapter 2) possess an increased tendency to form clots within their blood vessels. This is especially troublesome during pregnancy when clotting problems occur within the placenta. This places the baby at risk and increases the chance of miscarriage and or...
Selective Reduction in Multiple Pregnancies
Most women who undergo an ART procedure are thrilled and can successfully carry a twin pregnancy. However, pregnancies with triplets and especially a higher number of fetuses carry increased risks of birth defects and premature delivery. Risks for the mother include greater chance of high blood pressure, gestational diabetes, uterine bleeding, and complications associated with a C-section delivery. For these reasons, most fertility clinics limit the number of embryos transferred into the...
Does Icsi Hurt And What Are The Risks
The man experiences essentially no risk or discomfort when sperm is collected, usually through masturbation or sexual intercourse with a special collection condom. However, as previously stated, in the case of severe male fertility problems, a testicular biopsy may be required to obtain sperm. Risks are infrequent with ICSI, but you need to be aware that they could occur. Risks include Ovarian hyperstimulation syndrome (OHSS) Some fertility experts speculate that a link exists between ICSI and...
Endometriosis
Endometriosis is a medical condition where the tissue that lines the inside of your uterus (also called the endometrium) spreads to other areas of your body, usually to your pelvic organs. Endometrial tissue found on your fallopian tubes or ovaries can lead to scarring, adhesions, and blockages within your pelvis. (See Figure 1.2.) Illustration copyright Nucleus Medical Art, all rights reserved, nucleusinc.com. Illustration copyright Nucleus Medical Art, all rights reserved, nucleusinc.com....
Semen Analysis
Performing a complete analysis of the semen is a major part of the male fertility assessment. This test checks for both the quality and quantity of sperm. The semen sample is obtained by the male partner performing masturbation. In some cases, the sample may be obtained at home. In other situations, the semen sample must be obtained at the clinic or laboratory. Many fertility specialists recommend that the male partner refrain from sexual activity for at least three days prior to this test....
