Download Infertility for Dummies (ISBN - 0470115181) PDF

TitleInfertility for Dummies (ISBN - 0470115181)
TagsFor Dummies
LanguageEnglish
File Size3.3 MB
Total Pages386
Table of Contents
                            Infertility FOR DUMMIES®
	Contents at a Glance
	Table of Contents
Introduction
	About This Book
	Conventions Used in This Book
	What You’re Not to Read
	Foolish Assumptions
	How This Book is Organized
	Icons Used in This Book
	Where to Go from Here
Part I Are We There Yet? Wondering Why You’re Not Pregnant
	Chapter 1 Where, Oh Where, Can My Baby Be?
		Defining Infertility
		Infertility in America —Looking at the Statistics
		Shaking Down the Family Tree
		What Causes Infertility?
		Diagnosing Infertility
		Getting Pregnant: More Difficult Today than Yesterday?
		Calculating the Cost of Infertility
	Chapter 2 Understanding Your Anatomy
		Biology 101: Reviewing Male and Female Anatomy
		Putting All Your Reproductive Parts Together: Your Menstrual Cycle
		Hanging Out with the Guys
		Putting Male and Female Parts Together: Having Sex (At the Right Time)
		Conceiving a Baby: How Sex Should Work
		Figuring Out How Often to Have Sex
		Getting Into Your Genes
	Chapter 3 Practicing Positive Behaviors — Before Conception
		Making Healthy Lifestyle Changes
		Eating Well When Trying to Conceive
		Complicating Things through Common Infections
		Looking at Everyday Lifestyle Issues
		Getting Checked Out From Top to Bottom
	Chapter 4 Struggling with Secondary Infertility
		Defining Secondary Infertility
		Facing Secondary Infertility
		Looking for What’s Different This Time Around
		Hurting Just As Much: The Emotional Pain
		Wanting an Heir and a Spare?
Part II Stepping Up Your Efforts
	Chapter 5 Trying Simple Techniques in Not-So-Simple Situations
		Reading Your Body’s Signals and Signs
		Keeping a Fertility Chart
		Predicting Ovulation: Kits, Sticks, and Software
		Hoping for a Boy or Girl: Will Timing Help?
		Getting through the Two-Week Wait
		Looking for a Positive —Home Pregnancy Tests
		Dealing With Buttinskis (Also Known As Friends and Relatives)
	Chapter 6 Considering Special Circumstances
		Are You an “Older Mom?” Calculating Your Fertility Odds at Different Ages
		Living with Diseases That Affect Fertility
		Cancer and Fertility: The News Is Cautiously Optimistic
		Turning Around a Tubal Ligation
	Chapter 7 Seeing a Doctor — and Keeping Your Cool
		Deciding When You Should Make an Appointment with Dr. Basic
		Understanding What Your Doctor Says
		Keeping Your Own (Hit) Records
		Moving Up to Dr. Specialist
		Facing the Stranger in Your Sex Life —Treatment and Your Privacy
		Knowing When to Switch Doctors
	Chapter 8 Taking Supplemental Stepson the Road to Baby
		Eating for Two? Sampling a Fertility Diet
		The Controversy over Estrogen
		Looking at Supplements — Vitamins, Minerals, Herbs, and More
		Visiting a Traditional Chinese Medicine Practitioner
		The Eyes Have It: Visualizing Your Baby
		Saying Om: Meditation and Yoga
		Massaging Away What Ails You
		Seeking Help from On High
		Exercising without Overdoing It
		Evaluating the Good and the Bad of Antidepressants
		Taking a Break from Your Fertility “Job” — You Deserve It
	Chapter 9 Are We Having Fun Yet? Trying to Conceive and Your Relationship
		Navigating the Relationship Pitfalls of Infertility
		Fun and Games for Two – Remembering How to Enjoy Each Other Again
		Getting Some Professional Guidance
Part III Asking for Directions: Finding the Problem
	Chapter 10 Finding the Problem: Testing 1, 2, 3
		Understanding Female Structural Problems
		Common Tests to Diagnose Structural Problems
		Taking Your Blood
		Considering the Possibility of Endometriosis
		Ovulation Issues
	Chapter 11 All About the Boys
		Analyzing a Semen Specimen
		Interpreting Your Partner’s Test Results
		Correcting Varicoceles
		Lifestyle Changes to Improve Sperm Production
		Considering Erectile Dysfunction Issues: A Sensitive Topic
		Undoing a Vasectomy:Is It Worth the Pain?
	Chapter 12 When the Beginning Is the End:Early Pregnancy Loss
		Being “a Little Bit” Pregnant —It’s Possible
		Suffering a Miscarriage
		Ectopic Pregnancy: When the EmbryoIs Developing in the Wrong Place
		Recurring Miscarriage: Why It Happens
		Picking Yourself Up after a Loss
Part IV Moving Up to High-Tech Conception
	Chapter 13 A Little Help from Dr. Specialist: Intrauterine Insemination and Fertility Injections
		Deciding How Much Treatment You Need
		“Artificial” Insemination? No, It’s Real!
		Moving Up to Controlled Ovarian Hyperstimulation
		Treating Luteal Phase Defects
		Boosting Progesterone
		Getting Your Medications for Less
		Deciding How Long to Keep Trying COH and IUI
	Chapter 14 Welcome to the Big Time: In Vitro Fertilization
		Reaching the Top of the Mountain: What In Vitro Fertilization Means for You
		Deciding Whether to Stay with Your Current Doctor
		Moving On: Finding Dr. Magic’s Clinic
		Why IVF Costs So Much — Especially Without a Free Toaster
		Touring the States That Mandate Fertility Coverage
		Fighting City Hall: Insurance Appeals
		When Having Insurance Doesn’t Help
		Getting Creative When You’re Out of Other Options
	Chapter 15 Let the IVF Cycle Begin!
		Starting an IVF Cycle: A Roller Coaster Ride of Emotions
		Taking a Shot in the Dark: Time for hCG
		Going for the Gold: The Egg Retrieval
		Doing His Duty: Your Partner Is Busy, Too
		Answering Common Post-IVF Questions
	Chapter 16 The Care and Feeding of an Embryo: Amazing Teamwork in the Lab
		Recognizing a Good Egg When You See One
		Checking Chromosomes with Pre-Implantation Genetic Diagnosis (PGD)
		Answering the Call from Embryology
		Looking at Your Uterine Lining
		Hatching Embryos — Come on Out, You Guys
		Deciding How Many Embryos to Transfer
		Blasting Off! Considering a Blastocyst Transfer
		Taking Post-retrieval Pills and Potions
		Transferring Your Embryo
		Keeping Your Feet and Your Spirits Up After the Transfer
	Chapter 17 Waiting, Waiting:Surviving the Two-Week Wait after an IVF Cycle
		Technically, You’re Pregnant —Waiting for the Proof
		Sensing Every Little Twinge: The Truth about Pregnancy Symptoms
		Saying No to Home Pregnancy Tests
		Waiting for the Phone to Ring
		Responding to Positive News
		Considering the Next Step If IVF Doesn’t Work
		Keeping Embryos Frozen — What’s Their Expiration Date?
		Giving Up on Fertility Treatments? Considering When to Let Go
Part V The Road Less Traveled . . .So Far!
	Chapter 18 Challenges of Third-Party Reproduction
		Deciding to Use Donor Eggs, Sperm, or Embryos
		Protecting Yourselves — the Least You Should Do If You’re Using a Donor
		Borrowing from the Bank — the Sperm Bank, That Is
		Using Donor Eggs
		Borrowing a Uterus for the Next Nine Months
		Traditional Surrogacy — the Road Less Traveled
		Adopting at the Cellular Level — Embryo Donation
		Telling the Family or Keeping It to Yourself
		Utilizing a Registry
		Getting Pregnant When You’re Single or Gay
	Chapter 19 Moving On
		Deciding to Let Go of the Dream
		Opting to Adopt
		Deciding to Live Child Free
	Chapter 20 Hello, Dolly! New Advances, New Concerns in Fertility
		Looking Down the Road: Long-Term Health Effects of Fertility Medication
		Sex Selection: When You Absolutely, Positively, Want a Boy (Or a Girl)
		The Promises — and Pitfalls — of Preimplantation Genetic Diagnosis (PGD)
		Freezing Eggs: The Next Big Technology?
		Posthumous Conception: Legal and Ethical Issues
		Dividing Up the Leftover Embryos
		Saving Stem Cells for Research: Raising Ethical Concerns
		Cloning and Human Concerns
		Forcing Clinics to Decide Who’s Fit to Parent
		Making Mistakes in the Lab: When Saying You’re Sorry Isn’t Enough
		Injecting Immune Therapy
Part VI The Part of Tens
	Chapter 21 The Ten-Plus Most Annoying Things to Hear When You’re Trying to Get Pregnant
		Helpful Hints
		“I Know How You Feel”
		Comments You Can’t Believe You Heard
		Straight from Your Doctor’s Mouth
		Leaving You Speechless
	Chapter 22 Ten (Okay, Seven) Groups of Fertility Medications and Where to Find Them
		Sorting the Medications
		Mail-Order Pharmacies
Index
                        
Document Text Contents
Page 1

by Sharon Perkins, RN and
Jackie Meyers-Thompson

Infertility
FOR

DUMmIES


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Page 2

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� Morphology: More than a certain percentage of the sperm should be
normally shaped, as determined by the lab technician. If the lab is using
the WHO criteria, the normal cutoff is 30 percent. If the lab is using
Kruger criteria, which are more strict, the normal cutoff is 14%, with a
value of 4 percent to 13 percent considered “borderline.” Less than 4
percent is considered poor prognosis.

� Forward progression: On a scale of 1 to 4, at least 2+ means a good
number of sperm moving forward.

� White blood cells: Should be no more than 0 to 5 per high-power field.
More could indicate infection.

� Hyperviscosity: Should gel promptly but liquefy within 30 minutes
after ejaculation.

� Ph: Should be alkaline, to protect sperm from the acidic environment
of the vagina.

There are some other tests that the doctor may order, although these are not
normally performed during the initial evaluation:

� HOS, or hypo-osmotic swelling, test: Greater than 50 percent of the
sperm tails should swell when exposed to a hypo-osmotic solution;
this swelling is a sign of normal functioning.

� Antisperm antibodies: A normal semen sample contains no antisperm
antibodies. Antibodies cause problems if they’re attached to the sperm
tail, because they interfere with movement, or to the head, where they
may make it difficult for the sperm to penetrate the egg.

� Zona-free hamster-egg penetrating test: Human sperm cannot penetrate
the egg of another species. This is because there are specific binding
sites on the zona pellucida, the outer layer or “shell” of the human egg.
However, a normal human sperm can penetrate a hamster egg after the
zona, or outside layer of the egg, is removed. The ability to penetrate
the hamster egg has predictive value for the sperm because sperm
that can penetrate the hamster egg can generally also penetrate intact
human eggs. The Kruger morphology assessment is so good that many
fertility programs use it in place of the hamster test.

� Acrosome reaction test: The head of the sperm is covered with two
layers of membranes, called the acrosome. It contains enzymes that
allow the sperm to penetrate the egg. In order for the enzymes to be
released, the sperm needs to undergo an “acrosome reaction.”. The
proportion of sperm that have undergone the acrosome reaction can
be assessed in the laboratory and this result is thought to be predictive
of fertility in the male.

171Chapter 11: All About the Boys

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Page 194

It takes three months for sperm to properly develop, so if your partner was
sick, taking medication, or had anything else unusual going on three months
ago, his specimen may be abnormal. Check a second specimen in a few weeks
to see whether anything has changed.

Interpreting Your Partner’s Test Results
With some of the test results back, you may be even more confused than you
were before. If your partner’s semen analysis comes back with some results
askew, he may be too embarrassed to ask what the results mean. Sometimes
it’s easier to look up the problems in a book, so here you are!

Semen samples can vary from month to month, or even day to day. That’s
because it takes about 72 days for sperm to develop. Unlike eggs, which are
present from your embryonic days, sperm are replenished all the time.

Sperm are produced in the testicle, then collect in an area called the epididymis,
and from there they must be transported via the vas deferens to the ejaculatory
duct. The prostate adds the seminal plasma, the thick liquid which then carries
the sperm via ejaculation into the outer world. There are lots of things that have
to happen to make sperm come out, and therefore, there are lots of factors that
can cause variability from ejaculate to ejaculate.

Head

Tail

Midpiece

Figure 11-1:
A normal

sperm.

172 Part III: Asking for Directions: Finding the Problem

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