All About Getting Pregnant Fast

Pregnancy Miracle Book

Lisa Olson developed system for all those wives that want to conceive and want to give birth to beautiful child in natural way. The name of this system is called Pregnancy Miracle. If you are looking for the way to reverse your infertility and want to give birth to healthy baby then you must heard the name of Pregnancy Miracle. Before releasing this system to public, Lisa tested her techniques on 36 females with infertility problems and after only 2 months 26 females gets pregnant and successfully gives birth to healthy child. More importantly none of these 36 females reported any case of miscarriage. Anyone searching for the truth about pregnancy, infertility and holistic treatment optionsand who is willing to put in some work and make the lifestyle changes necessary to get pregnant and give birth to a healthy babywill find Pregnancy Miracle to be one of the best investments they ever made. Read more...

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Pregnancy and Infertility

There are many causes of infertility. Abnormal semen causes the infertility problems of about 30 percent of couples seeking treatment. Tubal disease and endometriosis in the female partner account for another 30 percent. A female partner's failure to ovulate accounts for 15 percent, and the inability of sperm to penetrate the woman's cervical mucus accounts for another 10 percent. The final 15 percent of couples seeking treatment are infertile for reasons that cannot be diagnosed. Many couples can be helped to overcome infertility through hormonal or surgical interventions. Women experiencing ovulation disorders may benefit from treatment with oral drugs such as clomiphene citrate, or through the injection of gonadotropins, such as follicle-stimulating hormone, which has about a 75 percent success rate. Women with tubal disease can be helped by various types of reconstructive surgery, but the success rate is only about 33 percent.

Intrauterine Insemination

Intrauterine insemination is used when a couple's inability to conceive a child is caused by the sperm's inability to reach the egg. Sperm must move through the uterus and enter the fallopian tube before they can fertilize the egg. Anything that prevents the sperm from making this trip will block conception. Coital or ejaculatory disorders can limit the sperm's travels, sperm antibodies in the female reproductive tract can kill the sperm, and sperm may be unable to penetrate the cervical mucus.

In Vitro Fertilization and Surrogacy

In vitro fertilization, even with anonymously donated ovum or sperm, is usually accepted as enabling a couple to experience gestation and create a fam In vitro fertilization also raises the possibility of employing a woman to be a surrogate mother, acting as the carrier of a child who is expected to be raised by another woman. Women have contracted to render this service in exchange for having all their medical costs covered and in exchange for a stipend to be paid when the baby is delivered. The ethical and legal problems posed by such arrangements have drawn much attention, and many states regulate the boundaries of such agreements.

Reproductive Endocrinologists Fertility Specialists

The reproductive endocrinologist has even more training than the OB GYN doctor. These doctors have completed all of the requirements of the OB GYN physician just discussed plus two to three additional years of fertility and reproductive procedure training. They are members of the Society for Reproductive Endocrinology and Infertility ( They may choose to become board certified by the American College of OB GYN in Reproductive Endocrinology & Infertility ( The primary role of the reproductive endocrinologist is to help you create your family. Most women use these doctors when they need additional assistance to become pregnant or avoid recurrent miscarriages. The reproductive endocrinologist is trained to diagnose and treat both female and male fertility issues. Of course, these doctors prescribe fertility medications and carry out advanced laparoscopy and hysteroscopic procedures. In addition, they can also boost your fertility with inseminations, in vitro...

Finding a Fertility Specialist

Depending on your needs and particular situation, you'll probably go to your regular OB GYN physician for your initial fertility workup. If you become pregnant, that's terrific If you do not become pregnant under the care of your OB GYN physician, ask him or her about a referral to a fertility specialist. You will probably want to interview several fertility specialists before making your final choice. Feel free to ask your OB GYN to give you several names and tell you a little about each one. Also, ask your friends and coworkers if they have experience with a particular physician. Try to find out what they liked or did not like about that doctor. If there is a medical school in your area, call and ask about recommendations for fertility specialists.

Fertility Testing for

Fertility specialists usually prefer to work with both partners. Therefore, no matter what your female fertility testing indicates, most men will also be evaluated for their own fertility. A key difference, however, is that if the male partner requires surgical treatment, he will probably be referred to a urologist (a doctor who specializes in the urinary tract). It's not surprising to discover that male fertility testing is typically much simpler and straightforward than a woman's. Part of that is because most of the male reproductive organs are located outside of the body. Another component is that male hormones are usually steadier and not subject to the monthly cyclic changes that women undergo. During your first appointment, the fertility specialist will ask you and your partner about your medical conditions, medications, lifestyle choices, and family history. Focus may be placed on identifying certain fertility risk factors, such as a history of mumps, undescended testicles, STD...

Natural Ways to Become Pregnant

If you are like most people reading this book, you really want to have a baby. And at some point, you feel like you might try almost anything to become pregnant and bring home a healthy baby. That's perfectly normal. But before embarking on lots of uncomfortable and expensive procedures, doesn't it make sense to first try to maximize your fertility naturally This situation doesn't apply to all women, for various personal reasons. However, most women prefer to try a natural approach to fertility, at least initially. This chapter discusses multiple ways to boost your fertility and maximize your chances to conceive naturally. This natural approach to fertility has been very successful. It is particularly useful among women and men who have been diagnosed with unexplained fertility concerns. A British study conducted by the University of Surrey examined a group of couples with a prior history of infertility. These men and women made healthful changes in lifestyle and diet and took...

Tips To Boost Your Fertilitynaturally

So by now you have an even better understanding of how your body is influenced by outside factors such as nutrition, exercise, stress, and lifestyle habits. You also know how to calculate your most fertile time of the month. Use this knowledge to boost your fertility. In addition, following are some more tips that you can try in hopes of becoming pregnant the old-fashioned way.

Assisted Reproduction

While in vitro fertilization has been available for over two decades, more recently it has become possible to test the resulting embryos for genetic disorders when the embryos are between eight and sixteen cells in size. In this procedure, one to two cells are removed, and the section of DNA containing the gene in question is replicated and tested. Only those embryos identified to be free of risk (based on the DNA results) for developing the genetic disorder are implanted in the uterus. This technique is not widely available, however, and it is both expensive and time consuming. Thus, it is used only infrequently.

If I Dont Become Pregnant Using Clomid Whats Next

Research shows that if you aren't pregnant after six cycles of Clomid, you are unlikely to become pregnant from this medication. In fact, about 80 percent of pregnancies that occur with Clomid are conceived during the first three months of use. In most situations, if you don't become pregnant after six months of taking Clo-mid, your doctor will recommend a different treatment. Many women go on to use other drug therapies, and some go directly to an assisted reproductive technology.

Why Does Ivf Work Better Than Natural Intercourse

IVF is more effective than natural intercourse because of the following 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. Most IVF programs transfer several fertilized eggs back into your uterus to improve the chances of a successful pregnancy outcome.

What About The Mans Role In

The sperm used during your IVF procedure may come from either your partner or a sperm donor. Most women prefer to use sperm from their partner. Unless your partner has a very low sperm count or extremely poor sperm quantity, his sperm can probably be used during the IVF process. That's because his sperm will be washed and concentrated and also specially treated in the laboratory to enhance their ability to fertilize your eggs. If he has very poor sperm function, he may need to produce several semen samples over a few days for the laboratory to have enough good-quality sperm for use on the day of fertilization.

Does Ivf Hurt And What Are The Risks

Risks are infrequent with the IVF procedure, but you need to be aware that they could occur. Risks include Infection with a bacteria or virus could occur during the IVF procedure from contaminated equipment or the sperm itself. Because you are using fertility medication to induce ovulation, you have an increased risk of multiple pregnancy. However, in the case of IVF, your doctor will determine how many embryos to transfer back to your uterus and thereby keep it to a reasonable number. Talk with your doctor about the number of embryos that you will have transferred back to your uterus. You'll also want to address, ahead of time, what to do with any leftover embryos that cannot be transferred back during that treatment cycle. If your doctor suspects OHSS, the IVF will be canceled for that treatment cycle. (For a more detailed discussion of OHSS, see Chapter 6.) There has been some speculation about the possibility of linking IVF to an increased incidence of birth defects. It is known...

How Successful Is

Overall, the success rate of IVF is between 25 and 50 percent per cycle. Rates vary based on a number of variables. In general, a higher success rate is more likely under these conditions You are willing and able to undergo the complete IVF procedure several times. Your IVF team is talented, skilled, and experienced.

How Is Icsi Performed

The ICSI procedure refers to the process of how the sperm fertilizes the egg and is typically performed in conjunction with another ART, such as IVF. The remainder of the steps are usually identical to IVF or another ART technique that your doctor may recommend. Because most of the time ICSI is performed in conjunction with IVF, the steps of these procedures are almost identical. Follow-up after ICSI Cryopreservation after ICSI Ovulation stimulation and egg retrieval follow the same steps as in the IVF procedure. The sperm used during your ICSI procedure almost always comes from your partner as opposed to a sperm donor. After all, the primary purpose of ICSI is to assist men with severe male fertility issues. So even if your partner has very poor sperm quality or quantity, his sperm are often still used successfully. The laboratory needs the semen specimen within a few hours after egg retrieval. The fresh semen is taken to the laboratory, where it is washed, concentrated, and...

How Successful Is Icsi

The success rate for ICSI is usually about 30 percent. This is essentially the same pregnancy rate as with IVF. However, this is a significant achievement because ICSI is primarily used in cases of severe male infertility. The success of the ICSI technique takes the anonymous sperm donor out of the picture, which eases much of the emotional difficulty that couples have when dealing with an outside third-party sperm donor. Of course, even more than with some of the other ART procedures, a high level of technical expertise is required to successfully perform ICSI, an exquisitely delicate and intricate technique.

Treatment of infertility

Table 45.14 Techniques used in assisted reproduction and their outcomes Table 45.14 Techniques used in assisted reproduction and their outcomes Intrauterine insemination (IUI) Unexplained infertility Mild male factor infertility In vitro fertilization or intracytoplasmic sperm injection (IVF or ICSI) Prolonged infertility (see below) In vitro fertilization (IVF) Intracytoplasmic sperm injection (ICSI) Severe oligozoospermia in the male Failed fertilization with IVF Absent or non-functioning ovaries Prevent transmission of genetic conditions Repeated poor response with IVF treatment Human Fertilization and Embryology Authority, 2005. Human Fertilization and Embryology Authority, 2005. women with weight-related amenorrhoea and anovulation to gain weight. Periconceptual dietary supplementation of folate has been shown to reduce the risk of neural tube defects (OR 0.28,95 CI 0.13-0.58) and a daily dose of 0.4 mg is recommended for all women (National Collaborating Centre for Women's and...

Management of male factor infertility

In the majority of cases no cause for abnormal semen parameters can be identified, and assisted reproduction offers the only option for men to have their own genetic offspring. INTRAUTERINE INSEMINATION Intrauterine insemination (IUI) using washed sperm may be considered in cases where semen parameters show mild or moderate abnormalities. A systematic review (Cohlen et al. 2000) found that compared with timed intercourse, IUI resulted in increased pregnancy rates, both in natural cycles (OR 2.5, 95 CI 1.6 3.9) and stimulated cycles (OR 2.2,95 CI 1.4-3.6). No difference was found between stimulated and unstimulated cycles (OR 1.8, 95 CI 0.983.3). As stimulated cycles are associated with a risk of multiple pregnancy, it may be prudent to consider IUI in a natural cycle in these cases. The evidence in favour of IUI has to be interpreted in the context of the overall prognosis for male infertility, which is poor, in the absence of assisted reproduction. Thus, although that IUI...

Conventional treatment for male infertility

Data on success rates after surgical procedures for post-infective block, including epididymovasotomy, are limited. Observational studies have described a post-surgical patency rate of 52 and a pregnancy rate of 38 . A systematic review based on seven RCTs found no evidence that surgical repair of varicoceles improved pregnancy rates in couples with male or unexplained infertility (RR 1.01 95 CI 0.73-1.40) (Evers, 2002). Sildenafil is an effective treatment in men with erectile dysfunction (Burls et al. 2001). Medical treatment of an ejaculation has included the use of alpha-agonists like imipramine and pseudoephedrine or parasympath-omimetic drugs such as neostigmine. The former are less successful than the latter (19 versus 51 ) (Kamischke and Nieschlag, 1999). Medical treatment of retrograde ejaculation has relied on measures to increase sympathetic stimulation of the bladder and decrease parasympathetic stimulation, but no clear difference in effectiveness has been found between...

Treatment of tubal factor infertility

The majority of women with moderate to severe tubal damage are unlikely to conceive spontaneously and IVF is generally accepted as the treatment of choice in these cases. In the absence of randomized trials, evidence to support this strategy is mainly derived from observational studies. A number of techniques for surgical reconstruction of damaged or occluded tubes have been described. Higher pregnancy rates have been reported in women who underwent tubal surgery than in those who did not (29 versus 12 ) over a period of 3 years (Wu and Gocial, 1988). The success of surgical treatment depends on the extent of tubal damage, age of the woman, experience and training of the operator and availability of suitable equipment. Surgery has been shown to be effective in minor or moderate tubal damage, but of no benefit to women with severe tubal disease (Akande et al. 2004). Data from a case series have suggested that pregnancy rates following surgical treatment of proximal occlusion, mild...

In Vitro Maturation Of Eggs

As a result, much research is being focused on in vitro maturation of eggs. What this means is that immature eggs are removed from your ovaries, taken to the laboratory, and treated with special techniques to cause them to further develop and mature. The mature eggs could subsequently be used with various assisted reproductive technologies. This saves you from the discomfort of fertility medications and the physical demands of many tests and procedures and you gain substantial financial savings. Premature ovarian failure Fertility issues that require IVF Once the technique of in vitro maturation of eggs becomes refined and available, it will likely revolutionize IVF.

Premature ovarian failure

Premature ovarian failure is said to have occurred when menstruation ceases before the age of 40 years and early menopause before the age of 45 years. Although there are many causes of early ovarian failure, the main cause is spontaneous or idiopathic. The main identified genetic causes are Turner's syndrome and Fragile X. Recently, forkhead genes (FOX03A defect) have been discovered which lead to early follicular activation and thus premature depletion of the follicle pool. Other causes include FSH receptor polymorphisms, where follicles are present but unable to respond due to the loss of the FSH receptor. The proportion of women with iatrogenic premature ovarian failure is growing as increasing numbers of women survive leukaemias, lymphomas and gynaecological cancers due to improved surgical techniques, radiotherapy and chemotherapeutic regimens.

Further investigations of female infertility

Male Groin Hernia Examination

Female Fertility Duration of infertility Nature of infertility (primary or secondary) Previous investigations or treatment for infertility Sexually transmitted diseases Epidydimitis Mumps orchiditis Testicular maldescent Chronic disease or medication Drug alcohol abuse Recurrent urinary tract infection (UTI) Surgical Miscarriage, termination of pregnancy, ectopic pregnancy Chronic illnesses (diabetes, hypertension, renal disease) Known endocrine disorders, e.g. hypothyroidism, PCOS Previous STD's, e.g. Chlamydia Known endometriosis Galactorrhoea Cervical smear history Current medication including folate Fig. 45.1 Investigation of infertility. Fig. 45.1 Investigation of infertility. studies comparing it with lap and dye or HSG have shown good concordance (Dijkman et al. 2000). Further research is needed to ascertain the value of endoscopic tests such as fertiloscopy and falloposcopy. Routine assessment of tubal status is debatable in situations where knowledge of tubal patency is...

Male factor infertility

The male partner is directly responsible for 25 of cases of infertility and is thought to play a contributory role in another 25 . Male factor infertility implies a lack of sufficient numbers of competent sperm, resulting in failure to fertilize the normal ovum. The World Health Organization (WHO) has proposed a set of criteria for normal semen parameters (Table 45.5). This is useful as a point of reference for results from different laboratories. A list of underlying factors responsible for male infertility compiled by the WHO is shown in Table 45.6. This classification needs to be updated in the light of recent scientific advances, especially in the genetic causes of defective sper-matogenesis. Some of the common causes are discussed below. In the majority of cases of male infertility the cause of impaired semen parameters is unknown. Azoospermia (absence of sperm) or significant oligozoospermia (sperm concentration

Intracytoplasmic sperm injection

Gynaecology Clinic

Intra-cytoplasmic sperm injection (ICSI) is where individual morphologically normal sperm are immobilized and injected into a mature oocyte that has had its surrounded cumulus and corona cells removed. An inverted Poor or total non-fertilization from previous IVF cycles. Most IVF units would have approximately 40 to 60 of their total IVF cycles using ICSI. Studies have been performed to see whether ICSI improves pregnancy rates with normal sperm parameters but there has not been any improvement shown by the routine use of ICSI 11 . Pregnancy rates of 36.5 per transfer are reported 12 with live birth rates of 30.4 per transfer based on over 28,800 cycles. ICSI has been in clinical use since 1991 and all the results of the follow-up studies are generally reassuring. The current recommendations are that any male who has sperm parameters that require ICSI should be offered screening for karyotype as well as cystic fibrosis screening. Some centres also advocate the use of Y chromosome...

In vitro fertilization

Cumulus Oocyte Cultures

IVF is where the mature oocyte is surgically removed from the ovary and then fertilized with sperm in the laboratory. The world's first successful IVF baby was delivered by Patrick Steptoe in 1978 after a number of years collaborating with Robert Edwards. Over the last 25 years the success rates and types of IVF have greatly improved and at present there are well over 2 million babies born throughout the world by this technique. Unexplained infertility Eggs are fertilized either by routine insemination with a concentration of approximately 100,000 normally motile sperm per ml or by ICSI (see p.467). They are incubated in a commercially prepared culture medium under strict laboratory conditions. Not only is the temperature carefully controlled within the incubators but also the gas content and pH. Although there is no chance that the embryos can 'fall out', many patients are not surprisingly very cautious at this stage and quite often are allowed to rest in a supine position for...

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 Some fertility experts speculate that a link exists between ICSI and an increased incidence of birth defects. However, extensive research has shown no increase in the rate of birth defects or other abnormalities due to the ICSI procedure. Some concern also exists that ICSI might increase the incidence of male infertility in male offspring. The thinking behind this theory is that in nature, the most viable and healthy sperm reaches and fertilizes the egg. However, with ICSI, the sperm are manually selected and injected and thereby bypass the natural selection process. Thus if rare sexual chromosomal...

Diagnostic categories in infertility

Adapted from Templeton et al. (2000) Management of infertility for the MRCOG and beyond. RCOG, Press London ISBN 1-900364-29-8. Absence of ovulation (anovulation) or infrequent ovulation (oligo-ovulation) is seen in a fifth of all women presenting with infertility. Types of anovulatory infertility can be further classified as shown in Table 45.3. Polycystic ovary syndrome (PCOS) accounts for over 75 of all women with anovulation (Adams et al. 1986). Clinical features are heterogeneous and can vary in the same individual over time. Women with PCOS may present with anovulatory infertility, menstrual irregularities (usually oligoamenorrhoea amenorrhoea), hirsutism and obesity. The currently accepted criteria for the diagnosis of PCOS are shown in Table 45.4 (see Chapter 39).

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. Medical experts believe that the majority of all miscarriages are caused by chromosomal problems within the fetus. Chromosomes are tiny structures within the cells of the body that contain genes. These genes are what determine a person's characteristics, such as sex, hair color, eye color, blood type, and so on. Both egg and sperm contain vast amounts of this genetic material. When the egg and sperm unite, a detailed series of intricate and complex steps must occur for them to form a fetus....

Fertility awareness methodsnatural family planning

Few couples in the UK use so-called natural methods of family planning (NFP) although in some parts of the world these methods are common. All involve the avoidance of intercourse during the fertile period of the cycle (periodic abstinence). Methods differ in the way in which they recognize the fertile period. The simplest is the calendar or rhythm method in which the woman calculates the fertile period according to the length of her normal menstrual cycle. The first day of the fertile period is calculated as being the length of the woman's shortest cycle minus 20 days, and the last day of the fertile period is the longest cycle minus 11 days. If therefore cycle length varies from 25-31 days the potential fertile period and days when intercourse should be avoided are days 5-20.

Why Does Icsi Work Better Than Natural Intercourse

ICSI is more effective than natural intercourse because 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. Most IVF programs transfer several fertilized eggs back into your uterus to improve the chances of a successful pregnancy outcome.

Homocysteine And Early Miscarriage

Clinical Background of Early Miscarriage The term miscarriage is used to emphasize the spontaneous interruption of pregnancy. For clinical and scientific reasons, it is important to avoid the international confusion on the duration of pregnancy when the term abortion is used because the range of pregnancy duration can be as wide as from 0 to 28 wk. Another reason for this distinction is that the causes for embryonic loss are quite different from those of fetal loss. We therefore tried to unravel literature reports in embryonic loss (up to 10 wk of menstrual age, or 8 wk postconceptional age) and fetal loss (from 10-8 wk up to the 16-24-wk period). The prevalence of neural tube defects in miscarriages is 10-fold higher compared to the prevalence at birth (52,53). Despite all research efforts, not much can be offered to a couple that experiences repeated recurrent early pregnancy loss. In only 5 of cases are factors associated with miscarriage found. Among the maternal factors, uterine...

Tubal factor infertility

Tubal disease accounts for 15-20 of cases of primary infertility and approximately 40 of secondary infertility. It represents the aftermath of pelvic infection or surgery resulting in tissue damage, scarring and adhesion formation. This can affect tubal function and result in either partial or total tubal occlusion. As the distal portion of the tube is commonly affected, fluid can accumulate within the tubes causing a hydrosalpinx. Functional competence of the fallopian tubes implies not just patency but also the integrity of the mucosal lining or the endosalpinx. As any damage to the fallopian tubes tends to be irreversible correction can be difficult. Due to current limitations in investigating tubal function it is only possible to assess the macroscopic appearance and patency of the fallopian tubes. The principal cause of tubal disease is pelvic inflammatory disease (PID) which may occur spontaneously or as a complication of miscarriage, puerperium, intrauterine instrumentation and...

Management of unexplained recurrent miscarriage

A significant number of couples investigated for recurrent miscarriage will have no cause identified to account for their pregnancy losses. While this is a frustrating situation for both patient and clinician, the prospective live-birth rate of women who are aPL negative is good 32 . The main determinants of future pregnancy outcome are the maternal age and the number of previous miscarriages she has had (Figs 13.4 and 13.5). A woman less than 38 years of age who has had less than five consecutive first trimester miscarriages and who is aPL negative has a 65 chance of her next pregnancy being successful with supportive care alone. While the scientific basis for the benefit of supportive care in early pregnancy remains to be elucidated, it is possible that elevated stress hormones (e.g. cathecholamines and cortisol) may be able to reduce fetal vascularization and oxygen supply and thereby induce miscarriage.

Further investigations of male infertility

And Doppler, radionucleotide angiography and thermog-raphy. Scrotal ultrasound scans are helpful if testicular tumours are suspected. In obstructive lesions of the male genital tract, vasography can be used to detect the site of obstruction. This is of limited clinical use with the advent of surgical sperm extraction and intracytoplasmic sperm injection. Introduction of assisted reproduction techniques such as IVF and ICSI has reduced the significance and clinical relevance of in vitro tests of sperm function including tests of acrosomereaction, zona binding and thezona freehamster egg penetration test (Table 45.14).

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 have concerns about becoming pregnant, please know that you are not alone and that you have reason to feel optimistic and hopeful. Medical research has shown that if you are a healthy young couple and have sexual intercourse a couple of times each week, your chances are about one in five (that is 20 percent) of becoming pregnant during any one menstrual cycle. This figure starts to decline in a woman's late 20s and early 30s and decreases even more after age 35. A man's fertility also declines...

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 have to do a little preparation and homework Following are descriptions of a variety of tests and procedures that you may encounter during your fertility evaluation.

How To Select Your Fertility Counselor

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 fertility counselors for your consideration. Some clinics also offer special relaxation and stress reduction programs to help you manage your overwhelming feelings. If these choices don't work, try the ASRM website They have a list of mental health professionals who specialize in fertility issues. Another alternative would be to contact a national support group such as RESOLVE ( or the American Fertility Association ( When narrowing down your search for a fertility counselor, feel free to interview several and see who best fits with your needs and values. Make sure you choose a counselor who is familiar with the emotional experience of infertility. It is also recommended that they have Experience in the...

Unexplained infertility

In the absence of a specific diagnosis, any form of treatment for unexplained infertility is speculative. While planning treatment, the likelihood of a spontaneous pregnancy must be taken into account, as even relatively invasive assisted reproduction techniques offer fairly modest pregnancy rates. A period of 3 years of unexplained infertility is generally accepted as a minimum duration before active intervention is considered. The decision to initiate treatment also needs to take the woman's age into consideration. Successful communication with the couple is vital at this point and the importance of detailed discussion, supported, where necessary, by written information sheets, cannot be overstated. Many couples feel frustrated by the apparent refusal to accede to their request for early treatment and need careful counselling. Clomifene citrate has been shown to increase the number of follicles produced per cycle, thus increasing the odds of a fertilized embryo reaching the uterine...


Human Uterus And Polyps

Ultrasound has made significantimprovementin the modern management of infertility. It has a role in the initial assessment of the infertile woman, in monitoring of treatment cycles and the performance of ultrasound guided procedures. Ultrasound has a significant role in the monitoring of women undergoing infertility treatment especially those patients undergoing superovulation there are details in the chapter on IVF.


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 many uses. When it comes to fertility evaluation, this procedure is often performed to evaluate a defect in the shape or size of the uterus. For example, if the patient has a septate uterus, the hysteroscopy may be able to diagnose this condition and also remove the membrane at the same time. The procedure may also be used to diagnose the presence of fibroids, polyps, or adhesions. These lesions might be missed during the HSG procedure (discussed previously) thus the hysteroscopy provides...

How Is Ivf Performed

Your fertility specialist will perform your IVF in either the doctor's office or an outpatient surgery facility. To increase your chances of success, the IVF procedure must be very well organized and perfectly timed. Most IVF programs follow these important steps. Each of these stages is discussed in more detail immediately following the list. Follow-up after IVF Cryopreservation after IVF You should be as comfortable as possible during the embryo transfer. Many doctors offer a relaxing medication or sedative for this stage of IVF. Fortunately, the procedure is not uncomfortable and it only takes a few minutes to perform. Although embryo transfer is the shortest step in the IVF procedure, it is a very important and critical element of the entire process. Follow-Up After IVF Your doctor will give you instructions about what activities you should and should not do after your IVF. Many women prefer to take it easy and rest for the remainder of the day. Depending on your medical history...

Prescription Medications

Certain prescription medications can have a negative impact on your fertility. For example, steroids (such as cortisone or prednisone) taken in high doses can prevent your pituitary gland from producing proper amounts of hormones. The resulting hormonal imbalance may interfere with your ovulation. It may also interrupt your normal menstrual cycle.

Recent Or Past Use Of Contraception

Many women are concerned about how past use of contraception might affect their future fertility. In almost all cases, your fertility is returned to normal within a short time of discontinuing the contraception. Birth control pills prevent pregnancy by stopping the ovulation process. Almost always, birth control pills do not affect your future fertility. That's especially true if your menstrual periods were normal prior to beginning the pill. However, a few women who stop taking birth control pills experience some difficulty getting pregnant. A medical investigation may be a good idea if you have gone off birth control pills and still don't have normal menstrual periods within six months. Another type of contraception is the Depo-Provera hormone injection, which works by stopping ovulation. One shot is supposed to prevent pregnancy for three months. Unfortunately, many women who want to become pregnant often find that it takes between 6 and 16 months for their menstrual cycle and...

Environmental And Occupational Factors

Prolonged exposure to emotional stress, high temperatures, chemicals, radiation, or electromagnetic or microwave emissions may reduce your fertility. Various occupational hazards also exist within certain work environments. For example, the rubber, leather, and dry-cleaning industries use the solvent benzene, which may adversely affect your fertility. Flight attendants are exposed to radiation and high altitudes, which may reduce fertility. Doctors, nurses, and other hospital employees may be exposed to anesthesia, chemicals, and radiation, all of which can have a harmful effect. Even people who work nights or irregular shifts may be adversely affected in their fertility because of changes in their internal clock and natural biorhythms.

Pituitary Gland Abnormalities

Pituitary gland abnormalities are a rare cause for male infertility. In such circumstances, the pituitary gland fails to release hormones necessary to promote sperm production. The pituitary gland in the man produces two important hormones for sexual reproduction luteinizing hormone (LH) and follicle-stimulating hormone (FSH). The primary function of LH is to act on specialized cells within the testicles to manufacture the male hormone testosterone. FSH has the main purpose of stimulating the production of sperm. In most cases of pituitary gland abnormalities, either LH or FSH or both are greatly reduced. This drop in hormones results in lowered testosterone levels and also reduced sperm production. Specific Causes of Infertility for Men Men may experience fertility problems because of a variety of abnormal physical conditions.

Positive Actions You Can Take to Reduce the Chance of Early Pregnancy Loss

If you have experienced recurrent miscarriage or other pregnancy loss, you can still feel hopeful for your upcoming pregnancies. You may be able to improve your chances of having a successful pregnancy by taking certain positive actions, such as these Undergo a complete medical workup before you try to get pregnant again. Work with your doctor to evaluate risk factors and causes of your past pregnancy loss.

Obstetriciansgynecologists Obgyns

These health care providers are the ones that most women go to for basic female needs, such as Pap smears, birth control, female infections, and routine pregnancy and delivery. As far as fertility evaluation, the OB GYN is capable of beginning some initial testing and treatment. For example, your OB GYN doctor may order blood tests, perform a laparoscopy, or prescribe a trial of a low-dose fertility medication. The amount of fertility evaluation and treatment that your OB GYN can provide is likely the result of the doctor's own training, interest, and comfort in the field of fertility. However, at some point, if you do not become pregnant from these preliminary methods, you will likely want to see a fertility specialist, the reproductive endocrinologist.

Good Vibrations Making Sure The Specialist Meets Your Emotional Needs

It is vitally important that you have a good feeling about the fertility specialist, the office staff, and the clinic itself. The process of fertility evaluation and treatment is stressful enough. That's why it's especially critical that you sense a good connection and feel comfortable around your fertility specialist.

Pelvic Ultrasound Examination

A pelvic ultrasound exam will most likely be performed at some time during your fertility evaluation and treatment. This is an important procedure that uses ultrasonic sound waves to view your internal pelvic organs. It can provide a wealth of information about your uterus, tubes, and ovaries. The ultrasound exam is performed in your doctor's office or in a nearby hospital. The procedure is conducted either by your doctor or a specially trained ultrasound technician. Ultrasound often plays an important role in both the diagnosis and treatment of infertility issues. For example, ultrasound can diagnose certain potential problems within your pelvis by identifying a mass or cyst. Ultrasound is also used in the treatment of infertility, such as retrieving eggs for in vitro fertilization (a process in which an egg is fertilized in a dish in a laboratory and then placed inside the woman to achieve pregnancy). You will experience no pain or discomfort during the vaginal approach pelvic...

Infection Tests On Semen

Certain viruses and bacteria can lead to infertility. Therefore, doctors will check for their presence in both partners. Some of the infection testing is done by evaluating a blood sample (see preceding). Other testing involves evaluating a semen sample. The semen will be checked for the presence of white blood cells. If a large number of white blood cells are present, this may indicate an infection. The semen may also be tested for specific bacteria and viruses. Following are the key infections typically checked during a basic fertility evaluation of semen

Other Tests For Sperm

In recent years, medical research has shown that certain abnormalities found within the sperm's DNA can lead to infertility. In such cases, even a man with completely normal standard semen analysis may not be able to bring about pregnancy. That's because the sperm with the abnormal DNA is not able to fertilize the egg. The computerized assisted analysis of sperm motion helps the fertility specialist show a relationship between sperm motility and fertility. This method of measuring sperm movement and speed is more precise than the basic evaluation done during a semen analysis. The hamster test is a test of the sperm's ability to penetrate hamster eggs. This test may be recommended when the male partner has a normal semen analysis and the woman has no obvious fertility problem, but pregnancy is still not occurring. etrate a certain percentage of eggs may indicate male infertility and require other testing. This test may be performed prior to IVF to see if that technology will be...

Testicular Sperm Extraction Tese And Testicular Sperm Aspiration Tesa

Sometimes your fertility specialist may recommend a special type of testicular biopsy. This procedure may be advised when the male partner has a completely normal physical examination but is not producing sperm. TESE TESA can be used to provide viable sperm for use during IVF. Sperm from men who have suffered past injury or sperm duct blockage can be obtained and used to father a child through IVF. Viable sperm can also be obtained from men who have undergone prior vasectomies, without reversing the vasectomy itself.

Vitamins and Nutrients

Just about everyone knows about the importance of taking a daily prenatal vitamin. But did you know it's best to begin taking them even before you become pregnant A good prenatal vitamin can supply you with important nutrients and increase your chance of conceiving. Even the best and most well-balanced diet in the world cannot contain all of the essential nutrients. That's why you should take a good prenatal vitamin, even when you are just starting to consider becoming pregnant. For those of you who have difficulty swallowing pills, chewable and liquid forms of prenatal vitamins are available. Talk with your pharmacist or doctor. Nutritionists have concluded that even slight vitamin and mineral deficiencies may interfere with egg and sperm production or lead to miscarriage. Therefore, both women and men should supplement their diets with these important nutrients. It may take several months of vitamin supplementation before you notice a change in your general health or boost in your...

Chemical Toxins And Radiation

Some substances found at home or in your workplace could potentially reduce your fertility and harm your fetus once you become pregnant. These environmental toxins can prevent normal growth of the fetus and even cause physical or mental defects. If you or your partner might be exposed to a potentially harmful substance, take steps to avoid it. Think about your home and workplace. Jobs involving heavy metals such as lead or mercury, chemicals in pesticides, or chemicals used in certain manufacturing (such as painting or printing) processes may be harmful to your fertility. Some of these toxins have been shown to damage sperm. These environmental toxins may also cause problems with the development of your unborn baby's central nervous system. Jobs that involve a high level of radiation can adversely affect the fertility of men and women. It can also hurt the developing fetus. Try to avoid contact with radiation as you try to conceive and once you become pregnant. The American College of...

Natural Ways to Monitor Your Own Fertility

One of the best ways of naturally boosting your fertility is to pinpoint exactly when you are ovulating. That's the time period when you are the most fertile. You maximize your chances of becoming pregnant if you have sexual intercourse just before your egg is released. Several natural family-planning methods can help you figure out when you are ovulating. The most popular techniques are the rhythm (calendar) method, the basal body temperature method, and the cervical mucus method. Each of these techniques is discussed in detail next. Many women perform all three systems because when combined together, these methods will increase your chances of conceiving. That's because they are a very effective way to track your menstrual cycle and let you determine exactly when you are ovulating.

Ovulation Predictor Test

If you check your urine with the test dipstick each morning, the test will likely be negative until the day of your LH surge. When your LH surge occurs, the test will be positive. This indicates that you should ovulate within the next 24 to 36 hours. Once you learn to pinpoint the day before ovulation, you can use this knowledge to boost your fertility.

Alternative Medicine Exploring Nonconventional Treatments

As a patient, you will help yourself the most by becoming educated about all of your treatment options. Choose a competent, well-trained health care provider, no matter what form of treatment you choose. Also, understand the limitations of the various treatments. You may find that alternative medicine practices may benefit you and boost your fertility.

Fertility Drug Therapies

Most women who find their way into a fertility specialist's office will eventually end up taking some sort of fertility medication. This chapter explains some of the more common medications that you may encounter as you undergo your fertility treatments. Fertility medications usually refer to drugs that regulate your hormones and induce ovulation. In addition, you may come across other medications that are designed to treat specific fertility problems or enhance other fertility medications.

What Are The Success Rates And Outcomes Associated With Clomid

Data indicates that approximately 80 percent of women who take Clomid will ovulate. However, only about 30 to 40 percent of women who take Clomid will actually become pregnant. Clomid is sometimes combined with an intrauterine insemination procedure, which may increase the pregnancy rate by about 3 to 4 percent.

How Will I Be Monitored When Im Taking Gonadotropins

While you are taking gonadotropins, you will be closely monitored by your fertility specialist. Your fertility specialist will also perform regular vaginal ultrasounds on you. That's because it's important to keep a close eye on your ovaries. Frequent vaginal ultrasound can visualize the number of developing eggs, measure their size, determine their growth rate, and so on. Ultrasound can also discover an emerging ovarian cyst or another such problem that may require additional treatment.

What Are The Success Rates And Outcomes Associated With Gonadotropins

It is also known that somewhere between 15 and 50 percent of women who take gonadotropins will actually become pregnant. When gonadotropins are combined with intrauterine insemination, women with unexplained infertility who are age 36 or younger experience a pregnancy rate of between 5 and 15 percent per cycle. The pregnancy rate drops for older women, and in fact, by age 40, the pregnancy rates with this form of treatment are quite low. (In such a case, an assisted reproductive technology such as IVF may be considered.) As with all fertility medication, there exists an increased chance for multiple pregnancies, which occur in approximately 20 percent of those women taking gonadotropins. Of those multiple gestation pregnancies, about 75 percent are twins and the remaining 25 percent are triplets or higher-order multiples.

Gonadotropin Releasing Hormone GnRH Antagonists Cetrotide Ganirelix

This is a relatively new class of medications used as part of your IVF or other assisted reproductive program. The purpose of this medication is exactly the same as GnRHa, to suppress your own body's hormones. Also as in the case of GnRHa, once your natural hormones have been suppressed, another medication (gonadotro-pins) 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.

How Does Progesterone Work

During your regular monthly cycle, progesterone is made by the ovarian follicle (called the corpus luteum) just after ovulation. This progesterone circulates through your bloodstream and helps to stabilize and maintain your uterine lining (endome-trium) so that it will be ready for a fertilized egg. If pregnancy occurs, progesterone is required to maintain the pregnancy. If you don't become pregnant during that cycle, the progesterone levels decrease and eventually cause the lining of your uterus to shed, resulting in menstrual bleeding. Progesterone plays an important role in your menstrual cycle, hormonal balance, and ovulation. Supplemental progesterone can be helpful if you suffer from these fertility conditions.

How Do I Take Progesterone

Progesterone therapy usually begins two or three days after ovulation has occurred. Therapy continues until your menstrual period begins. If you become pregnant, progesterone therapy will continue, oftentimes until you have completed your first trimester of pregnancy. However, the length of time that you take progesterone will depend on your medical history, your specific fertility condition, and the recommendation of your specialist. Progesterone as a supplemental hormone is available in several forms

What About Gamete Intrafallopian Transfer GIFT and Zygote Intrafallopian Transfer ZIFT

GIFT is a procedure where the eggs and sperm are placed directly into the woman's fallopian tube during a laparoscopy procedure. The ovaries are stimulated with fertility medications, and the mature eggs are retrieved during an ultrasound guided procedure, much like IVF. However, with GIFT, the eggs are mixed with the washed, enhanced sperm and then placed directly into the fallopian tube during a laparos-copy. The eggs are (hopefully) fertilized within the woman's body, unlike IVF, which fertilizes the eggs in a laboratory. ZIFT is a combination of GIFT and IVF. For the ZIFT procedure, fertilized eggs are placed directly into the woman's fallopian tube during a laparoscopy procedure. As with the other techniques, the ovaries are stimulated with fertility medications, and the mature eggs are retrieved during an ultrasound guided procedure. Then, like IVF, the eggs are mixed with the washed, enhanced sperm in the laboratory and monitored for fertilization. The only difference is where...

What Ever Happened To Gift And Zift

Report very similar pregnancy success rates when compared to IVF. However, GIFT and ZIFT are rarely performed anymore. The major reason is that both GIFT and ZIFT require a laparoscopy surgical procedure and general anesthesia. This makes GIFT and ZIFT considerably more expensive and more physically demanding than IVF. Given the additional costs and potential physical risks of surgery and anesthesia, it's difficult to justify GIFT or ZIFT in preference to IVF. Talk with your doctor to determine if GIFT or ZIFT is a realistic fertility treatment choice for you. Some doctors believe that it may be useful in certain situations. However, for the most part, many doctors say that GIFT and ZIFT are about ready to be reassigned to the history books.

Moving On Alternatives for the Infertile Couple

Perhaps you've already endured the time, expense, and physical and emotional difficulties of fertility treatments and still did not become pregnant. Now you can have renewed hope for becoming a parent. When traditional technologies are no longer a viable option, third-party reproduction offers an exciting and promising way for you to welcome a baby into your home. Third-party reproduction means that you would use eggs, sperm, or embryos that have been donated by a third person. The third-party donor may be someone you know or may be anonymous. In this chapter, we'll take a look at various third-party options, including

Selecting Your Sperm Donor

Selecting your sperm donor is a pretty big step and can be very exciting, too. Most sperm banks offer a catalog of all their sperm donors. You can look through the listings and note the physical and intellectual characteristics of each potential donor. You may want to select someone who is very similar to you or your own male partner. Or you may want to focus on certain traits and talents that you hope your baby may inherit. Your doctor and fertility clinic will offer some guidelines about selecting the best sperm donor for you. In addition, here are some things for you to consider when selecting your sperm donor

Selecting Your Egg Donor

Other women prefer to use anonymous donors. Some fertility clinics have egg donation programs, where women donate their eggs in exchange for money. Also, many fertility clinics encourage patients undergoing IVF to donate their leftover eggs to be used by another woman. By donating their leftover eggs, these patients generally receive a price break for their own IVF services. In either case, the fertility clinic will have information about the woman so that you will be able to read about her physical and intellectual characteristics. Another option is for you to place an ad in the newspaper and find a donor on your own. Your doctor and fertility clinic will provide you with guidelines for selecting the best egg donor for you. In addition, here are some things for you to consider to understand the ramifications of egg donation. A maximum age of 34 is recommended because younger women typically respond better to ovulation induction by producing more high-quality embryos and consequently...

Is there a legal contract between the egg donor and the recipient Be

Sure you have a legally binding contract with the egg donor. Even if the fertility clinic provides you with a form, it's best to have a reproductive law attorney review it. The important point is that the agreement states that the donor gives up all rights to the eggs and any children conceived from them. Is psychological counseling offered or required Most health care professionals recommend professional counseling for the donor, the recipient, and their partners. Egg donation and the IVF process can be physically and emotionally difficult for both parties. There are also ethical and social issues to explore. It's best to understand all of these demands prior to embarking on this difficult process. What are your pregnancy success rates with the egg donation process Ask about the pregnancy success rates at your particular fertility clinic. According to ASRM, the average live birth rate per transfer is about 43 percent for all egg donor programs.

The Embryo Donation Program

In addition to trying to match donor and recipient's ethnic background and physical characteristics, the program also works to ensure that other important standards are met. Your doctor and fertility clinic will explain to you how the embryo donation programs works. In addition, here are some things for you to consider Is there a legal contract between the embryo donors and the recipient It's very important that you have a legally binding agreement between you and the embryo donors. Some fertility clinics will provide you with a form or suggested format for a contract. That is helpful Is psychological counseling offered or required Embryo donation and the IVF process can take a toll on everyone involved, both from What are your pregnancy success rates with the embryo donation process You'll need to ask your particular fertility clinic about their pregnancy success rates. No national statistics exist on the pregnancy success rates of embryo donation because of the small number of...

How The Embryo Donation Procedure Works

As the recipient, you must take fertility medicines to adjust your hormones and prepare your uterine lining for the upcoming embryo transfer. Your fertility specialist will discuss which fertility medications and protocols are necessary for your particular situation. Additionally, you will likely undergo various blood tests and pelvic ultrasound to make sure that your hormone levels and uterine lining are prepared and ready to receive the new embryos. transfer is the same as for IVF, where a special catheter and syringe is passed through the cervix and embryos inserted into the uterus. Hormones are given to help the embryos implant, grow, and develop. Pregnancy tests and ultrasound are performed within a couple of weeks to confirm pregnancy.

Dealing With Family And Friends

Starting a family is supposed to be a personal and enjoyable experience. However, for couples with infertility issues or unconventional situations, such as lesbian couples or single women, it can be a very difficult situation. You come face-to-face with family and friends who may not be sensitive to your situation. They may or may not have good intentions, but they seem to believe that you will benefit from their Because most people view their infertility as a personal issue, they are often hesitant to share their experiences openly with family and friends. To a couple that has been diagnosed with infertility, unknowing friends and family may ask

Assisted Reproductive Technology

The assisted reproductive technologies include such procedures as intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI), to name a few. When you reach a decision to undergo one of these ART procedures, you may feel the conflicting emotions of both excitement and dread. It's normal to be excited, because this scientific approach offers tremendous breakthroughs and success in the world of fertility. With such high pregnancy rates and

When To See A Fertility Counselor

If you are having difficulty deciding whether to talk with a counselor, consider that it almost assuredly won't hurt you and it very well might help you. Many women find it beneficial to seek professional help to manage their emotions and also when they feel that they have reached a decision-making crossroad and need guidance regarding taking the next step in treatment. You may exhibit certain signs that indicate you could benefit from talking with an infertility counselor. Here's a checklist that you may find helpful Complete immersion in and preoccupation with infertility Consider counseling when you are feeling stuck and need to sort out your fertility treatment options and alternatives. Here are some possible scenarios that you may be facing How can you cope with the losses and disappointments associated with infertility and still continue on with more treatments How can you and your partner resolve your differences when it comes to dealing with fertility treatments

Preimplantation Genetic Diagnosis PGD

Preimplantation genetic diagnosis (PGD), a technique used for the early diagnosis of genetic disorders in developing embryos, involves conducting a biopsy of the embryo to identify which cells may contain the disorder. Couples undergoing IVF procedure may have their embryos screened for an assortment of genetic disorders, and only genetically normal embryos will then be used for embryo transfer back into the woman's uterus. The purpose of PGD is to select only healthy embryos for transfer to the uterus with the goal of achieving more healthy pregnancies, fewer miscarriages, and fewer genetically abnormal offspring.

What Are The Risks Associated With

How PGD affects embryo implantation rates remains an area of controversy. A report from the Kentucky Center for Reproductive Medicine & IVF suggests that the implantation rate may be slightly lowered as a result of the embryo biopsy. This means that embryos that have been biopsied may not be as likely to properly implant within your uterus. Therefore, early miscarriage may be more likely. However, a Spanish study done in 2003 and published by Reproductive Biomedi-cine Online concluded that implantation rates may actually increase when PGD is used in IVF patients that have experienced implantation failures in the past. This improvement is thought to be caused by transferring only tested and proven genetically normal embryos into the IVF patient's uterus.

Using Pgd To Determine The Sex Of Your Baby

When PGD was first offered to the public, it was intended for couples whose offspring were at high risk of inheriting a genetic disorder. Today as more fertility clinics offer PGD, this technology has become more available to those desiring it. However, at the current time, the majority of fertility centers in the United States do not offer this as an elective service. If you are looking to use PGD technology to choose the gender of your child, find out ahead of time if this is an option at your fertility clinic. Couples may desire a child of a specific gender for a variety of reasons. The euphemistic term for this gender selection is family balancing. PGD for the purpose of sex selection is performed in the same way as for PGD when used for genetic screening. As part of the IVF cycle, the eggs are retrieved from your ovaries and fertilized with your partner's sperm. The embryos are observed until they reach the six- to eight- cell stage. At that time, one or two cells are removed and...

How Is Microsort Performed

Once the sperm have been sorted for gender selection, they can be used with assisted reproductive technology (ART) to bring about a pregnancy. Most women use the MicroSort technique in conjunction with intrauterine insemination (IUI). Women who will be conceiving using IUI must go to one of these two facilities. Patients who plan to conceive using IVF can elect to have their sperm sorted at one of the two MicroSort facilities and then frozen and shipped to a collaborating fertility clinic in or near their hometown.

Who Might Benefit From Microsort

Many couples would prefer to have a child of one gender or the other. Perhaps they already have one or more children of one gender and would like to have a child of the other gender. As fertility patients, they have already endured a great deal to have a baby. They realize that they may only be able to endure fertility treatments one or two more times, so they may desire to choose the sex of their planned upcoming pregnancy. In each of these situations, MicroSort can be used to shift the odds in favor of the parents' becoming pregnant with a child of their desired gender.

How Is Ovarian Tissue And Egg Freezing Performed

The original problem with freezing ovarian tissue and eggs was due to damage from ice crystal formation in the inner layers of these cells. Now with the new vitrification process, the inside of the cell is not frozen. The new procedure is based on the insight that all of the eggs in each ovary live in the outermost layer of tissue. Japanese scientists discovered a successful way to flash freeze only this thin outer layer results have been remarkably effective. Medical researchers in the United States are working with the Japanese scientists, and clinical research trials have begun. Dr. Sherman Silber of the Infertility Center of St. Louis has partnered with the Kato Ladies Clinic in Tokyo to bring some of these emerging technologies to the United States. To obtain the eggs that will be frozen, the procedure is the same as for IVF egg retrieval. Fertility medication is given to stimulate and induce ovulation, ultrasound and blood tests monitor when the eggs are mature, and then...

Separate Professional Teams For Surrogate And Intended Parents

Of course, the fertility specialist must deal with both the surrogate and the intended parents because that doctor will perform the ART as part of the surrogacy services. However, the surrogate should obtain obstetrical care from a physician who is not involved with the intended parents in any way. This allows the surrogate

Selective Reduction in Multiple Pregnancies

For these reasons, most fertility clinics limit the number of embryos transferred into the woman's uterus to two or three. Sometimes three or more babies implant and grow in this circumstance, the parents and the fertility specialist are faced with a heart-wrenching decision. Do they continue the pregnancy as is and accept the many increased risks to mother and babies Or do they decide to destroy one or more of the fetuses in an effort to save the others

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 stillbirth. Aspirin therapy reduces these risks by maintaining good placental blood flow between the mother and fetus.


Your doctor will discuss your HSG test results with you. If uterine fibroids are noted, they may or may not require treatment, depending on their size and position within your uterus. Blocked fallopian tubes are a fairly common finding among infertility patients. It has been estimated that almost 35 percent of infertility cases are due to blockage of one or both fallopian tubes. If this is your situation, your doctor will discuss treatment options. (See Chapter 1 for more information.) A shortcoming of the HSG procedure is that it may not detect small lesions such as small polyps or fibroids within the uterus. It also does not provide any information whatsoever regarding the ovaries. On the positive side, a 2002 New Zealand study conducted at the University of Auckland showed an increase in conception rate in the months following the HSG procedure. This is thought to be due to the fluid dye pumped through the uterus and fallopian tubes during the HSG. This flushing of fluid may open...

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 with a mental health counselor who specializes in fertility matters. You may also find comfort and answers by speaking with your minister, priest, or rabbi. By exploring all possible options, you can find an approach that best suits your particular needs and situation.

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 can also be used as treatment for painful endometriosis. Your reproductive hormones are shut down, your periods stop, and the pain associated with endo-metriosis is gone. When GnRHa is used in this way, your body is transformed into a temporary menopausal state and pregnancy cannot occur during this time. This use of GnRHa is mentioned here because many women with fertility issues suffer from endometriosis. Therefore, it is possible that this treatment may be presented to you as temporary relief...

Gestational Carrier Surrogacy

The procedure for gestational surrogacy is carried out using IVF techniques previously discussed. In fact, the only difference is that the transferred embryos are placed into the surrogate's uterus instead of your own. That means ovulation stimulation and egg retrieval for you and sperm collection and preparation for your partner. The surrogate's hormonal cycle must be synchronized with yours and her uterus must be prepared with hormones for it to be receptive to embryo implantation. The surrogate will carry the resulting pregnancy and turn the baby over to you once it has been delivered. Gestational surrogacy is considered more complicated than traditional surrogacy because it requires IVF to create the embryos. Despite this, gestational surrogacy is more commonly used in the United States because it is considered to be legally and psychologically more acceptable to all parties.

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 what some people call test tube babies. Depending on your circumstance, you may be offered various other specialized techniques, such as intracytoplasmic sperm injection (ICSI), embryo assisted hatching, and cryopreservation of sperm and embryos. Each of these ART procedures is discussed in detail in this chapter. If you are seriously considering assisted reproduction, you need to understand what medical conditions or circumstances you have and why natural conception has not worked for you. You'll...

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 harm to the fetus. Be sure to

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 rates. Others decide to use assisted hatching under certain conditions, such as Couples who have failed implantation in previous IVF or ICSI cycles Assisted hatching is done just prior to embryo transfer during your IVF or ICSI treatment cycle. The procedure is usually performed on day 3 of the embryo's development and usually when the embryo is at the eight-cell stage. The methods used to place the tiny hole in the outer shell vary and may include the use of acid, a micro needle, or laser. The...

Basal Body Temperature Bbt Method

After two or three months, you'll likely be able to detect a pattern in your recorded temperatures. Hopefully, you'll notice that your temperature rises slightly after ovulation. Many women find that their temperature is somewhat lower during the first part of their cycle. Then it will typically rise slightly (between 0.4 and 0.8 degrees F) on the day of ovulation. Your temperature may stay elevated until just before the start of your next period. If you become pregnant, the temperatures typically continue to be elevated.

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 donors, egg donors, embryo donors, surrogates, and adoption. Keep in mind that the way you feel now may change as you and your partner move through the assorted fertility treatments. If you do not experience good success with the standard fertility treatments, your earlier objections to third-party reproduction may very well change.

How The Egg Donation Procedure Works

Your fertility doctor will explain the exact medications, their timing, and the necessary protocol requirements. The goal is to hormonally prepare the donor for egg production and retrieval and to prepare your uterus to receive the embryos that will be transferred. Ultrasound and blood tests may be performed to ensure that both the donor and recipient are properly prepared and ready to proceed. Once the eggs are developed, the donor will undergo an egg retrieval procedure. The standard IVF technique with ultrasound and needle is used to extract the eggs through the donor's vagina. Once the eggs have been harvested, they are taken to the laboratory, where they are evaluated for maturity and quality. The healthiest eggs are then inseminated with the male partner's sperm using the same fertilization technique as in IVF. (For a detailed description of the IVF process, see Chapter 7.) The embryos are transferred into the recipient's uterus within a few days after...

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 women who are forbidden to receive egg donation for religious reasons because it is viewed as an organ transplant and not a human egg or embryo donation.

Youve Chosen Your Specialist Now What

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 problem. The specialist will go over your complete medical history. You will be asked many questions about your medical conditions, gynecological issues, and the nature of your sexual relations. There will be considerable focus on your menstrual cycle, past pregnancies, sexually transmitted disease history, and birth control. You will also be asked about medications that you take, your family medical history, and your personal and lifestyle habits. Your partner may be asked many of these same questions. Just do your best to answer the questions and try to provide as many details as possible.

Human Chorionic Gonadotropin hCG Novarel Pregnyl Profasi Ovidrel

When you become pregnant, your body produces a pregnancy hormone called human chorionic gonadotropin (hCG). It is produced by the placenta and is responsible for the rise in your progesterone level and the cause of many changes during pregnancy, including morning sickness. In fact, hCG is the hormone that home pregnancy tests detect to determine whether you are pregnant.

How Does A Gonadotropin Work

Gonadotropins work to stimulate ovulation in the same way that your body's hormones should. The injection of high levels of FSH (and sometimes also LH) into your bloodstream stimulates your ovaries to develop multiple follicles and eggs. By increasing the number of developing eggs, you maximize your chances of becoming pregnant. Depending on what form of fertility treatment you are doing, you will proceed from here. Your doctor may simply recommend that you and your partner have intercourse. In other situations, you will be scheduled for an insemination or egg retrieval.


Virtually all scientific studies conclude that smoking is detrimental to your fertility. The American Society for Reproductive Medicine states that the best available scientific data indicates cigarette smoking strongly contributes to infertility and should be discouraged for both male and female partners. Tobacco appears to impinge on your fertility by reducing your ovarian reserve and also to contribute to fetal chromosomal abnormalities. Furthermore, women who smoke have an increased risk of miscarriage or stillbirth.

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