Conference moira::parenting

    Just wanted to let everyone know (who hasn't heard yet)
    that quintuplets were born last week to a Montreal couple. 
    
    Multiple births always leave me in awe. Although the couple
    are not well off, they will be getting some government assistance
    (Quebec has a baby bonus program under which this couple is 
    entitled to 24,000$ for starters) 
    Babies were between 2.5 and 3 pounds (that's terrific for 5!)
    and last I heard only 2 of them had to be put on a respirator
    despite being delivered at 30 weeks.
    Mom had been using fertility drugs and now has an instant family
    of 3 boys and 2 girls.
    
    Makes us single pregnancies look easy I think.....
    
     

>>   Although the couple are not well off, 
    
>>     Mom had been using fertility drugs and now has an instant family
>>     of 3 boys and 2 girls.
    
    
    Is it me, or is something wrong with this picture?
    
    Chris D.

    What are you implying? That people who do not have "sufficient" incomes
    (by whose standards anyway) should not be entitled to the use of
    fertility drugs? 

    	Do poor people have less of a desire to have children than rich
    people? Should poor people not be entitled to have children? (Sounds
    like an idea that David Duke would endorse)

    	To answer your question, no, there is nothing wrong with that
    picture.

    				Wendy

    
    Nope, that's not quite what I'm implying.  The use of fertility drugs
    implies (at least to me) a very good chance of multiple births.  If you
    are not "well off" and using fertility drugs, then it seems to me you
    are puting yourself at risk of getting even worse off.  NOBODY should
    be deprived of having a kid.  If that's what you thought I meant, then
    sorry.  Kids are the greatest gift we can give to the world!!
    
    Chris D.
    
    p.s. Now that I think of it, fertility drugs implies multiple births to
    me probably 'cause that's all we ever hear/read about.  What are the
    chances of multiple births with fertility drugs?

It depends on how well they're monitored.  These days, with careful monitoring,
there's maybe a 20% chance of multiples, the vast majority of them twins.
Maybe 1% triplets, beyond that it's vanishingly small.  All these numbers
are off-the-top-of-my-head ballpark figures.

If the drugs are not carefully monitored, there's a greater chance of
multiples.  There may indeed be something wrong with the picture, namely
inadequate monitoring.

    re .6
    
    I doubt that you mean the outcome can be altered by observation :-) so
    I wonder what you mean by "monitored"...  can they determine the
    number of ova released with a certain dosage, then cut back on the
    dosage for the next cycle?  Or what?
    
    Leslie

    Since we went through Pergonal...
    
    They do a blood test every day, which measures Estradiaol, the hormone
    that is released by the egg sacs that form on the ovaries.  This gives
    a rough indication of how many eggs there might be.  Then, toward the
    end of the Pergonal cycle, when the E2 count is getting pretty high,
    they start doing sonograms, to actually count the eggs (yep, you can
    actually see them on the surface of the ovaries).
    
    We were doing IVF, so we wanted as many eggs as possible.  But in  a
    case where conception is to occur normally, I imagine they'd just say
    "You have too many eggs this month, so use birth control and we'll try
    again next month with lower doses of Pergonal."
    
    Steve

    Steve's got it pretty much right.  That's the procedure I used for my
    twins when we had GIFT done.  With me, they put back 3 eggs and 2
    fertilized.  They would have put back as many as 6 if I had made them
    due to my particular set of problems in the hopes of just having 1
    fertilize.
    
    I don't think there's anything wrong with a not-so-wel-off couple
    having multiples.  The only reason she would have been on fertility
    drugs is due to infertility problems, and I don't think how well off
    someone is should determine if they should be helped with fertility. 
    And I would guess that when 5 babies were discovered, the doctor
    recommended selective termination to reduce the babies to perhaps twins
    or triplets at the max, but the couple may not have been in favor of
    abortion and chose to have all 5.  Can't fault them for making their
    own decision.  And I would also guess that so many babies were from an
    invasive procedure such as IVF or GIFT and not something like IUI
    (intrauterine insemination) since with IUI's they typically scrap a
    cycle if too many eggs have been made to avoid having so many eggs
    fertilize.
    
    

    Sorry for the rat hole I created!
    I strongly suggest moderators consider shoving these notes under 
    a "multiple birth" or "fertility drug" topic (so I don't feel so
    guilty for starting this!)
     
    Re: drugs: 
    I was under the impression that there are a number of types of 
    fertility drugs, some of which are more likely to cause multiple 
    ovulation.
    
    RE: couple in question.
    This particular couple (to stop these arguments about lifestyle) 
    immigrated from another country -- often your savings and earning 
    power are changed dramatically when you move to another country.
    The drugs were taken in their home country. I cannot guess the 
    circumstances of their moving to Montreal, however, I would think
    that in THIS case it had an effect on their financial situation.
    
    I personally did not mean to start a discussion on finances vs.
    having children here, I just wanted to share my awe and positive 
    feelings for a couple that beat the odds to have five children!
    (although I would not want to have quints myself, I find I am
    a little envious!)
    
    Monica
    

With IVF and GIFT, the goal is to produce as many eggs as possible within
the bounds of safety (too much Pergonal can cause problems).  With IUI,
the goal is to produce a moderate number of eggs.  They monitor estradiol
level with a blood test, and check egg formation with ultrasounds.  Doses
of Pergonal and HCG are determined by the results of the monitoring.

[Note to mods: how about moving this discussion to a more appropriate topic?]

Responses .2  -- .11 of this note have been moved here from note 12.

In a happy coincidence, the new note 21.2 is old note 12.2, so the references 
match.

Clay Satow
co-moderator  

About the drugs:  Pergonal can easily produce twins, etc, but Clomid (Serophene,
etc) rarely produces even twins, especially if used in low dosages.  
The figures should be included in the drug's documentation which comes with
the drug, or the doctor should be able to provide it.  I *think* Clomid has
about a 10% chance of twins and 1% of anything else, but I haven't looked
at the stats since I was on Clomid, some 5-6 years ago.

       Carol

This note is being entered for a member of our community who wishes to
remain anonymous at this time.  

       Carol duBois, PARENTING co-moderator

***********************************************************************

I have read many of the notes relating to infertility in the past couple of 
parenting notes files (Parenting_V3, #105). Since the new version of 
Parenting has been opened, I haven't seen any Infertility related questions,
so, I'm starting this one.   Here's my story:

I have been on an emotional rollercoaster for the past two years.  I was
so "happy" to become pregnant about 1 year and 10 months ago.  It was the
first time I tried without birth control and it was Successful! However, I 
miscarried in the first trimester (reason unknown).  I took it 'very' hard.
Ever since my miscarriage, I have been trying to get pregnant (almost 2 
years).  

I feel very very depressed the week that my period shows up.  Like clockwork
the darn thing always comes.  My mind goes crazy imagining that I am 
pregnant month after month, only to realize I'm not.  Some days I am
excited about my tests and hope that the infertility doctor will help
us.  Other days, I feel that I'll never be able to conceive again.  As
I write this note, I am very low...As a matter of fact, I hope no one
comes by my cube...because I have tears starting. It's all so emotional.

I will try and keep you posted on my progress.  It may be tough for me
to write again, as this is a very personal matter and it's hard for me
to share it. But, trust me, I am out there reading every note that gets
entered on this subject.  My husband and I have just started seeing an
infertility & endocrinology specialist. Here's our results so far: 

Semen Analysis:  Passed with flying colors (great count and motility!)
Blood Tests   :  tsh, proloactin,thyroid...all fall in normal range
Culture       :  I tested positive for a bacteria (not a disease) 
                  called ueraplasma.  This bacteria is NOT present
                  in approx. 90% of people who get pregnant. This bacteria
                  has also been 'implicated' in some miscarriages. So,
                  my husband and I just finished taking 3 weeks of
                  antibiotics and the bacteria is gone.  Now we can
                  continue our treatment plan.  
HSG Test      :  I get the HSG (a bit nervous about it) done on 5/22.
                 The Dr. will review the X-rays of my tubes immediately
                 following the HSG test.  (hope the test isn't too
                 painful)

Please, if anyone has success stories or ideas...Keep them flowing in
this note.  It is very encouraging and often times the only outlet for
some of us who don't have a happy ending, "YET". 

Thanks,
Forever Hopeful 

re: .13

I had three miscarriages over a course of 3 years.  Following the third 
miscarriage, my spouse and I underwent numerous tests, including the HSG.
I won't lie and say that the HSG is comfortable, but I wouldn't rank it anywhere 
near the top of the pain chart either.(It's a piece of cake compared to the 
pain involved in a D&C, for example.) I never like them using that clamp-like
device that holds my cervix in place, and I did feel a brief, strong cramp when 
they inserted the catheter. The pain is quite brief, though, and goes away as 
soon as they remove the catheter and take the clamp off.  I'd guess the entire 
test took about 2 minutes?  As with all procedures, I always ask the doctor
to explain what he's going to do before he does it. It's much easier for
me to deal with pain if I know what to expect.  It might help to concentrate
on the monitor that shows the "video" of the x-ray.  I found that fascinating.
(You can see the dye enter you, and the progressive outline of your organs!) 
I felt fine and went out to lunch immediately following the test.

RE: long-term hope. I am currently in my fifth month of pregnancy. 
I used hormone treatments in the first three months. So far, this 
pregnancy has not had any complications, so I'm hopeful everything will 
work out well.

Repeated miscarriages (or as the doctors' call them "habitual aborters")
are technically infertility.  Infertility can cause a great strain on you,
as well as on your spouse.  I strongly suggest seeking group support via an
organization such as RESOLVE.  Seeking individual support with a therapist
who has experience with infertility problems can also be VERY helpful.
(If you're in the Boston/Nashua area, I can give you an off-line referral.)
I know it's hard to talk with others about this, but please remember that
you do not have to endure this alone.  I did not seek outside support 'til
after the third miscarriage, but in retrospect wish I had far sooner.  It
would have made everything far easier to bear, and has certainly helped
me deal with my fears this fourth time around.

--Jennifer

    My heart goes out to you.  I know well the emotional rollercoaster ride
    you are on as my husband and I have been trying to start a family for
    several years.  I am currently taking clomid and have become pregnant
    twice in the past year, but unfortunately both were ectopic
    pregnancies which resulted in major surgery once, and a laparoscopy
    once.
    
    You have already taken one very important step, which is going to an
    infertility specialist.  Does the clinic have a therapist on its staff? 
    Many infertility clinics do.  I also second contacting RESOLVE.  They
    organize support groups and have lots of good literature.  Infertility
    is a extremely personal issue, but it really can be good to talk openly
    to people who are experiencing the same things.  There are more people
    with similar problems out there than you think.
    
    Don't worry too much about your HSG.  I have had two, and while I
    really would rather be sailing, they weren't too bad.  The cramping
    involved was over very quickly.
    
    Cathryn

This note is being entered for another member of our community who wishes
to remain anonymous.

     Carol duBois, PARENTING co-moderator

*******************************************************

re: .13

Boy, can I relate your note. I've also been on the same emotional rollercoaster
ride with infertility for the past three years. I just received the news 
yesterday that my GIFT procedure was unsuccessful. My IVF attempt in January 
was also unsuccessful. But I've read some many success stories in the last 
couple of parenting files that I know I'll be one of them soon. I think you
will too!

At first, I couldn't share my story with anyone either. I couldn't believe
this was happening to me. But I've found that sharing my stories with
friends has really helped me remain positive. Especially on those days
when I'm at my lowest. I think you might be able to benefit from support
of others too.. It's hard to open up and the tears will flow, but friends
will help you keep things in perspective. I'm thinking of contacting RESOLVE
myself to expand my support group.   

As far as HSG, it was somewhat painful but it was over very quickly. The pain
only lasted as long as the procedure and I was back at work within a hour.

Please keep us posted on your progress. I too search this file everyday in
hopes of reading another success story. 

Another Forever Hopeful

This note is being entered by a member of the PARENTING community who
prefers to remain anonymous at this time.   This note is by the
same author as note 21.13.


Carol Stolicny, co-moderator

---------------------------------------------------------------------------

re: .13-.16

Thanks to all for the replies to .13.  It is great to get feedback.
I'm feeling much better this week.  Guess I'm slipping into hopeful
mode again this month.

On 5/22 I had my HSG procedure.  It wasn't as bad as I had anticipated.
The hospital I go to uses a 'balloon' procedure instead of the much talked
about and dreaded 'clamp' procedure.  It felt as though I was cramping and
getting my period during the procedure.  It took about 10 minutes in all...
and my results were good.  My x-rays showed no blockage...so looks like I
have open tubes at this point.

Today I had an Ultrasound to measure my egg...it was the right size...so
I also received an HCG shot (to ensure that I ovulate in the next 36 hours).
Tomorrow morning I return to the Dr's office and I'll be having my
first attempt at IUI (Intra Uterine Insemination).  I have heard some
pretty low success rates with this procedure...but, I'm giving it a try.
Who knows what will happen...I am hopeful.  It's kind of a nice change of
pace - if nothing else - It at least feels scientific.  I know two friends
who had success with this procedure.

I'll keep you posted on my progress.

Thanks again for the ears..and feedback,

Forever Hopeful

I did 9 cycles of IUI, and without exception, I always got awful cramps on the
second day.  I am assuming that you will have 2 consecutive days of IUI, in
which case you may also experience some cramping on the second day.  The way
it was explained to me is that the combination of sperm concentration in the
uterus plus the larger than usual follicle(s) which result from fertility 
drugs (typically, Pergonal) can cause cramping.  I just wanted you to be 
prepared for this possibility in case it happens to you.  It's fairly normal,
so you shouldn't worry about it whether or not you get this reaction.

For the record, I did not have any success with IUI's, but that's because I
have sperm antibodies.  My twins were the result of GIFT. 

Best of luck to you.  
Cathy

Cramping with IUI seems to depend on how they wash the sperm and on technique.

    
This reply is being entered for the anonymous noter of 21.13 and 21.17.

Carol Stolicny, co-mod

--------------------------------------------------------------
re: 18

Well, so far - no cramping from my 1st IUI.  Thanks for the warning,
I'll see what happens tomorrow...

I will be taking a pregnancy blood test on Sunday, 6/7 to see whether
the procedure worked.  I'm going to try and keep my sanity from now
til then.  If the test is negative, I will have an endometrial biopsy
on 6/8.

How exciting that GIFT worked for you.  Can you give me a brief
description of how and when...etc... you moved from IUI to GIFT.  How
did your Dr determine that you had sperm antibodies...and what are they?
Also - how many GIFT attempts did you make before you were "blessed"
with your twins??  I crave success stories - so please fill me in!
(perhaps your GIFT success story would be better placed in Note 23...
I'll look in 23 if I don't see your reply here.)

Thanks ( & a belated contratulations!),

F.E. (Forever Hopeful)

    I would like to tell you about my story.  My husband and I tried
    unsuccessfully for a baby for six long years.  We tried everything on
    offer at the time - including IVF.  All proved unsuccessful.  
    I had been diagnosed as having adhesions (following an appendicites
    operation at the age of 18), I had an overarian cyst removed whilst
    undergoing repair surgery at the age of 27, all this was said to have
    caused my infertility.  
    
    As you can imagine, after 6 years of total disappointments, we took a
    look at our lives and said "we can't handle this any more".  We had to
    try and be positive and start living again - so we did just that and
    gave up five years ago.    A couple of years after that my
    specialist advised me to have a hystarectamy (not sure of my spelling
    here), as I was suffering badly from cramps - I totally refused - I was
    only 34 then.
    
    In April 1991 I missed a period and thought - nature is playing tricks
    on me again.  A friend persuaded me to do a pregnancy test - I did and
    it was positive!!!
    
    My husband and I could not believe it - it happened naturally and
    against the odds - 10 years after we had first started trying.  We are
    now the proud parents of a lovely 6 month old boy - our little miracle.
    
    Maggie
    
    
    

Re .20

Here's my story.  We did the usual infertility workup with the standard tests
(12 pk's over 8 months because of poor timing, 2 endometrial biopsies, 1 hsg
test, sperm count and motility, and a laparoscopy) and found I had lots 
of problems.  I am prone to infection, I have a luteal phase defect which 
means I couldn't support a pregnancy if I managed to get pregnant, I do not 
ovulate regularly, I have scant cervical mucus and what I have never changes 
to non-hostile to allow the sperm to pass through.  My husband had no problems
and was considered 'stud material'.  We did AIH's 9 times with no success.  
All that took about 2 years before I was referred to another infertility 
specialist for GIFT since my HMO couldn't handle that procedure.

The first thing he did (Dr. Thompson, Boston Fertility/Boston IVF -- highly
recommend these folks!) was to check for sperm antibodies which hadn't been
done before.  That turned out to be positive.  Sperm antibodies means that my
body thinks sperm is an infection, and produces antibodies that are quite 
effective at killing it.  There is a very small percentage of the population 
that has this (5%??), and they can also show up in the man sometimes.  There
is no way to fix this problem, so they have to do things to go around it.

With a mild case, IUI's could be successful, and I was dead-set against doing
GIFT because I didn't want to go through another laparoscopy since the first
one was so much fun, so we tried IUI's.  We did 6 months of IUI's with Pergonal,
HCG, and progesterone with no success.  Then we decided to quit.  Or, more
accurately, I said I'd had enough and was done with people poking, prodding,
stabbing etc.  We took 6 months off, and my husband talked me into trying GIFT
but we agreed 1 attempt would be it.  If that didn't work, we would live
child-free.  The first 2 attempted GIFT cycles were cancelled at the last 
minute because I didn't produce enough follicles (there has to be at least 3),
so we did 2 more months of IUI's.  On the 3rd cycle,  I told the doctors I just
wanted to get it over with, so they decided they would do it even if I only
made 2 follicles.  It turned out that I made 3, all of which were healthy and
implanted.  2 of those fertilized giving me my beautiful twins that I have now.

It was a long road, and took 5 years from when we started trying to when I
finally conceived.  In all that, I found it much easier to deal with once they
started identifying problems as I knew what was being treated, why, and what
the chances for success were.  Without intervention, I would never have 
conceived given my identified problems.

I wish you the best of luck on this tough road, and if I can answer any other
questions, please feel free to send mail (anonymously, through the moderator,
if you wish) or put in another note here.

Cathy

My sister had problems with infertility too.  I don't know all the details
because she felt it was too private to share even with me.  From what I have
heard, I think it was her second attempt at GIFT.  They implanted 4 of which
3 were fertilized.  She successfully delivered triplets after a very normal
pregnacy.  She carried to full term, or as full as they will let you go
with triplets, and all of the babies were breathing on their own immediately!
There were 2 girls and 1 boy and they are now 2 months old.  Everyone is doing
wonderfully, and they are so happy.  

I hope another happy story helps.

Jill

This note is being entered for a member of the PARENTING notesfile
community who prefers to remain anonymous at this time.  

Carol Stolicny, PARENTING co-mod
--------------------------------------------------------------
re:23

Wow, what a family your sister now has.  What great news.  Yes,
another success story does help.  I hear a lot of good things
about the outcome of GIFT and your sisiters story is wonderful.
Thank you for sharing it!!

Update on my progress:
On Thursday I go in to get my progesterine level checked.  If it's
too low, I will receive some type of medication to increase it over
the next few days.  Then, this Sunday I will take a pregnancy blood
test (to check on the results of my IUI procedure).

I have been trying to keep very busy in my spare time so that I don't
continually evaluate every feeling I have in my body.  I keep imaging
that maybe the egg is moving from my tube to my uterus and implanting
(can you believe it...?)  It's as though I think that by visualizing it
that it'll happen.  But, actually, I don't feel any different (no breast
tenderness, etc...???)  So, as usual I must wait.....

(By the way, my 2 sisters just gave birth.  In addition my sister-in-law
called this weekend to say she got pregnant last month on her first try!!
I acted excited but it is very hard.  Of course, I haven't shared my
infertility frustrations with my sister-in-law so she had no idea what
was going through my heart when she said 'on-the-first-try'.  How lucky
she is!)

Thanks for listening to my continued ramblings...

F.E.

                                                         

    
    Just to give you another side of the infertility issue, I was also
    infertile for several years, but the docters couldn't find any problem
    which could have caused the infertility...very frustrating.  I kept
    hoping they would find a problem, so we could work around it.  We went
    thru all of the usual tests...sperm count, biopsy, hsp, laparoscopy....
    and still no conception.  The month before we were scheduled to start
    in the GIFT program...I got a positive result!!  We had been off birth
    control for about 5 years and I had been taking my temperature for
    every day for almost 2 years....what a drag!!
    
    We had a beautiful baby daughter and because of Murphy's law, we
    started birth control immediately after her birth (not the pill, since
    I was breastfeeding)!  Low and behold...when Shannon was 6 months, I
    conceived my second daughter.  I now have a 17 mos. old and a 2 1/2
    year old...LOTS of work, but I consider myself very lucky to have them!
    
    I was very surprised to find out that 1 out of 4 couples is infertile
    today!  When you are having fertility problems, it seems like you are
    all alone and that everyone around you is having babies!  Everywhere
    you look...you see babies!  
    
    I found the ovulation kits to be very helpful.  They can be very
    expensive, but well worth the sanity.  My docter recommended a brand
    which had to be obtained from the pharmacist (not an over the counter
    brand) but did not need a prescription.  It cost about $50/month, but
    since I was very regular I found I could spread it out over 2 months.
    
    Just try to stay positive and keep your hopes up!  I found the most
    frustrating comment during that time to be..."maybe you are trying to
    hard"!  People who make this comment have obviously never had
    infertility problems!!
    
    Good Luck!
    Carol

Ive also been going through infertility testing.  Its been 17  months for us now.
Ive had all the tests, been treated for ureaplasma (sp?) bacteria, was found to 
have a blocked tube through the hsp, have had 3 endo biopsies (the worst for me),
and just had a laparoscopy done in which they found nothing except some fibroids
on my uterus which my doctor does not feel causes infertility problems.  I have
been found to have a late luteal phase and am now on Chlomid.  I was wondering
if anyone out there could give me some input as to their experiences with
this drug.  Was it successful? after how long? Did you experience any of the
side effects?  etc.  Today is my first day to take this and I havent experienced
any side effects yet....

Maureen

    I was on Clomid for 6 mont for a luteal phase defect (short cycle), but
    did not have success with it.  I did experience side effects, though. 
    It would turn me into the bride of Frankenstein.  I became moody,
    emotional, would cry at the drop of a hat, and got upset for no reason. 
    This was definitely not me, and drove me and my husband nuts.  I knew
    that I was reacting from the Clomid, but it didn't make any difference
    as I still acted crazy.  I also got incredible hot flashes.  It was
    really strange because the side effects were very mild on day 5, but by
    day 9 when I would stop taking the Clomid, I was a regular witch!  Same
    thing with the hot flashes where they would be mild and infrequent in
    the beginning, but would build up in regularity and intensity by the
    last day of Clomid.  Fortunately, as soon as I stopped taking it each
    month, I would return to normal, but it didn't make me look forward to
    the next cycle.

    I also took Clomid off and on for about 6-8 months...with no
    success...don't get too discouraged alot of people do have
    succuss with it.  I has mild side effects, mostly bad headaches
    and hot flashes like the previous noter Cathy had.
    
    Good Luck to you,
    Deb
    
    P.S. Hi Cath...I'm still here hanging in on the infertility
         ride.  I have had 2 successes (on Pergonal/IUI) but
         both ended in early miscarraiges.  Now I'm moving on
         to IVF in the fall.
    

    I have had good success on clomid - I ovulated on 50mg's of clomid and
    became pregnant twice - the first time on the second cycle. 
    Unfortunately, both pregnancies were ectopics, but that had nothing to
    do with clomid.  I have had some mild mood swings, but never the hot
    flashes and more extreme mood swings.
    
    I know that it has been mentioned before, but RESOLVE, a non-profit
    association for infertile couples, has alot of good publications on
    different infertility treatments, as well as support groups and monthly
    lectures on different aspects of infertility.  I am in D.C., so I don't
    have the number of your local chapter, but they are usually listed in
    the phone book.
    
    Good luck with clomid!
    
    Cathryn

    I had success six years ago on clomid.  I was on 100mg's and on the
    6th month I got pregnant.  When we were trying for #2, I was on it
    for almost 4 years and no luck.  Come to find out, the longer your
    on clomid, the more it adds to your infertility instead of helping it.
    
    I had some hot flashes and mild mood swings, but nothing to drastic.
    
    Best of Luck.
    Cheryl
    

    I was on Clomid (sergin??) several times. Each time I became pregnant
    after several months ( 2 were miscarriages due to a genetic problem,
    not clomid), the third time Michael, my 1 year old, was conceived.
    I found taking the pill at night was much better for me. It reduced
    some of the symptoms I experienced.  I felt "out-of-it" or dazed
    right after taking it. Also, I was very moody and "wired" almost
    like I was experiencing PMS.  By taking it just before I went to
    sleep most of the symptoms had worn off and I was much more myself.
    
    My cycle is very erratic, so clomid helped me a great deal. A great
    deal of stress in my life  and even with the clomid I won't ovulate.
    I almost stopped taking the last time the month prior to conceiving
    Michael but gave it one more month. 
    
    Your doctor should monitor you and check your ovaries before each
    session of taking clomid. It may take several months to find the
    correct dosage too. My doctor starts out a 50mg then slowly increases
    it after several months.
    
    My suggestion is taking it a night before going to sleep. This worked
    for me.
    
    Good Luck,
    
    Pat K.

My doctor also started me at 50mg of Clomid.  This is only my 2nd day taking it
but so far Im feeling fine.  I was told that I had to be checked if I started
my period for cysts.  Im keeping my fingers crossed.  I do ovulate but
unfortunately my uterine lining is not mature enough at the time of ovulation
for an egg to implant.  And Ive never had a problem with my cycle.  Only time 
will tell I guess....

I appreciate all of the info you've all sent on Clomid. My doctor talked in great
detail about the drug and gave me reading material as well.  Its just nice to 
know that it has been successful for some people although so far the it didnt
help the majority it seems.....

Maureen

I took Clomid for 4 or 5 cycles when trying to get pregnant the third time.
(This was for a luteal phase defect.)  I too started at 50 mg and worked
my way up to 150 mg.

I didn't experience *any* side effects.  No mood swings, nothing.

The Clomid did help the defect, but not enough by itself (I miscarried
at 10 weeks.)  My fourth pregnancy was unplanned, so I was too late for
the Clomid.  I started progesterone as soon as we knew I was pregnant,
though.  (That did make me very nauseous.) Am in my 6th month now, with 
no complications.  I attribute our success to the progesterone.

I plan to use both the Clomid and progesterone for any future pregnancies.

    Can you explain how clomid and progesterone work together?
    
    I have very irregular periods, and take 10 mgs of Progesterone for 10
    days every other month to shed the uterine lining and give me a period. 
    I am under the impression that the progesterone does not induce
    ovulation -- is this correct?
    
    Without the progesterone, I can go years without a period.  In the
    past, I have taken Clomid as a test drug to see if it would bring on a
    period and it did, so I will probably have to take it in order to
    become pregant.  However, where does the progesterone fit in at that
    point in time?
    

    re .34  I can't give you an explaination of why *your* doctor is
    treating you this way, but I was on the clomid and progesterone
    suppository treatment for both of my conceptions.  I like many others
    had a ludeal phase defect.
    
    I took clomid for is it5 days? then on day 18 of my cycle, or 3 days
    after ovulation if I was able to tell when it occured, I started the
    progesterone suppositories until my period began (if conception didn't
    occur that month).  Or until I had a positive pregancy test, then I
    continued the progesterone until I was something like 6 months
    pregnant.
    
    The best description I can offer, from my experience, is that due to
    the LPD my body doesn't manufacture enough progesterone and the
    suppositories is the most natural and direct way of getting it. 
    Without the progesterone the conception will not attach itself properly
    to the uterine lining, and if the right level of hormone isn't present
    at conception you could end up with a "blighted ovum".  This is a
    conception in the sense of there is a sac, but not baby within it. 
    This will eventually abort itself, as it has in my case three times
    (might be more because it happens just like a regular period).
    
    Without starting a rats hole, the whole basis (as I understand it) of
    the RU486 "abortion pill" is that it strips the body of its
    progesterone level, causing the abortion to occur naturally.  I guess
    my body sort of has a built in RU486 device.
    
    I sort of look back with amazement at the covering doctor who was
    removing my c-section stitches and sending me home after AJ was born. 
    Along with the usual discharge instructions she offered me advise on
    how NOT to conceive.  I looked at her and told her my problem was NOT
    CONtraception, but CONception thank you very much!!
    
    Lyn

This note is being entered for the anonymous noter "F.E."

Carol Stolicny, PARENTING co-mod
--------------------------------------------------------------
re: .26 & .32

Maureen,  keep us posted on your clomid progress.  Looks like you and
I are on similar paths.  I too was treated for ureaplasma.  And I am
starting on clomid in the next couple of days.  I know what you are
going through, it's rough on the 'ole' emotions. I wish you the very
best of luck!!!!

AN UPDATE:
I had a very tough weekend.  As I mentioned in my last notes(.13,.17,.24)
I went for my pregnancy blood test this past Sunday (after my first IUI
attempt).

Turns out that my test was positive (but just barely) on Sunday!
I was so excited I could hardly contain myself!  However, the Dr. said
that since my HCG reading was kind of low, she wanted to test me again
on Monday to make sure that my HCG was continuing to rise.  If it
continued to rise, that would be a better indication that I was pregnant.
My Dr. was also concerned that my progesterone level was lower than it
should be.  I barely slept a wink on Sunday night wondering whether I was
really pregnant.  On Monday I went in for my 2nd pregnancy blood
test and it showed that my HCG level had dropped way down.  It was
quite depressing for me and my husband.

On Tuesday, my Dr. performed an Endo. Biopsy because she believes that
I may have a problem with my luetal phase (low progesterone...and perhaps
not an adequate uterus lining).

Tomorrow I go in for an ultrasound to ensure I haven't developed any
cists since last month.  Then, the plan is for me to go on clomid starting
this week.  (Maureen, I'll let you know if I have any side affects.)

I was very down after I found that I wasn't pregant....I keep wondering if
I was really pregnant and the egg couldn't stay attached to my lining.
However right now I feel pretty good again.  I guess that's because my
period is here and I'm starting a new cycle...so for now I am looking
forward to trying again this month. I think the toughest part of this
rollercoaster is the disappointment right before your period arrives
when you realize that you're not pregnant 'again'.

Thanks for all the support,
F.E. (Forever Hopeful)

F.E.

Well Im on the 4th day of Clomid and absolutely no side effects so far.  Tomorrow
is may last day for this cycle.  Im still awaiting lab results on my blood 
tests for Progesterone and Thyroid.  In the meantime I have sent to Resolve for
more info on Clomid, Luteal Phase Defect, and Pergonal (might as well plan ahead)
I normally would start my period around June 30th so I guess we'll just wait and
see.

I also had a month where I thought I was pregnant and it turned out that I wasnt.
I had one cycle where I was 5 days late (and Im always on time - like clockwork),
my temp was very much elevated and a home test tested positive.  I got a blood
test done which tested negative and on my 7th 'late' day I had the worse period
of my life (well, my first was the worse - I was only 10 years old).  I was 
bleeding so badly that they had to put me on Anaprox to stop it and if that 
hadnt worked they were going to schedule me for a D&C.  Luckily the Anaprox 
worked and I havnt had a problem since.  It was really wierd.  I had gotten so
excited at first...

Now I try to keep my emotions in check but I still wonder every month....

Ill keep you posted and wish you well.  
Good Luck! You are not alone!

Maureen

I'm recently married at age 27. My  husband and I are discussing when to start
a family. We would like to wait a few years, but I am concerned that if we
were to have any infertility problems this could push us to being a bit older
then what we would like. My doctor says that you can't test for infertility
until you've tried to have a baby and haven't succeeded. She gave me a very
low statistic of the number of couples with infertility problems and said I
shouldn't concern myself. However, the *majority* of couples I know that have
had babies had difficulty getting pregnant. So my question is... (and please
excuse me if this is a naive question) do you think there is any way to tell 
(problem periods, heavy cramping, etc.) who will have problems getting pregnant?


Thanks!

Im 31 and always wanted to wait for the 'right time' to start a family. We
decided when I was 30 it was time to start trying.  Ive never had problems with
my period, was always right on time, always lasted 5 days and like I said, never
had problems with my cycles.  We've been trying for a year and a half now and
that's nothing compared to other people.  I was  on the pill for over 10 years 
though and Im wondering if that has anything to do with my luteal phase defect.
The pill also caused me to lose my gall bladder at the age of 27. I have one
sister (younger) who got pregnant while on the pill, and now has 2 children at
the age of 30.  I have an older sister who also had no problems getting pregnant
so the though of my having problems never entered my mind....

Maureen

I also found out that my mother took DES during the first few months of her
pregnancy with me. We're not altogether sure if this fact is causing any of my
problems but sometimes it is a factor.  If your mother was prone to miscarriage
she may have taken this drug.  Be very sensitive to her feelings though should
you ask her if she did take DES.  My mother was very defensive at first, when I 
asked her about this.  It took her a little while to understand that I was not
blaming her for my problems (she took DES because she was told it would help to
prevent her from losing ME!) but the knowledge was useful to my doctor...

Maureen

>                                            So my question is... (and please
>excuse me if this is a naive question) do you think there is any way to tell 
>(problem periods, heavy cramping, etc.) who will have problems getting pregnant?

Problem periods and heavy cramping may indicate that a woman will have
problems getting pregnant, but the lack thereof doesn't indicate that
she won't.

    What exactly is a luteal phase defect?
    
    The previous information has been very helpful.
    
    I am not trying to get pregnant right now; I like to pop in here and
    learn from other's experiences with infertility.  There's loads of
    great information!  Good luck to both Maureen and Anon and I truly hope
    things work out for you!!
    
    I have been on the progesterone pills every other month since last
    August.  In the months between, I never got a period on my own... until
    today.  I was going to begin the pills again this month on day 16, but
    my body beat me to it.  Does this mean I ovulated naturally, or can a
    woman have a period without ovulation?  (I feel so naive at times too!)
    

    Caveat - this description is to the best of my knowledge - it isn't the
    cause of my infertility problem, though, so I am not as well versed in
    it. 
    
    The lutal phase is the days following ovulation and before your period. 
    The body produces progesterone during this time.  A lutal phase defect
    is a shortened lutal phase (period shortly after ovulation) or when the
    body is not producing adequate progesterone.
    
    Both of those situations would not allow an embryo to be sustained in
    the uterus.
    
    To Maureen and Anon. who are taking clomid - Good Luck and wish me luck
    too!  I will be taking clomid for another six months - if I have
    another ectopic or am not successful, my doctor has recommended
    bypassing the tubes and doing IVF.
    
    Cathryn
    

    Does anybody know what the name for it is when you ovulate too
    early?  My luteal phase is normal to longer than normal, which is
    why I've managed to have three kids, but the first one was
    conceived on day 5 of my period. 
    
    --bonnie

Through my testing we have found that I do ovulate but am probably losing the
egg do to the fact that my uterine lining is not mature enough for an egg to 
implant.....according to my doctor my period starts about 9 days too early.

Im on my last day of Clomid today and I have to admit that last nite and today
I have had headaches. Also, today only I seem to be very irritable. Ive almost
bitten the heads off of 2 people here at work - this is not like me at all.
Cant wait to go home!

Thanks for the luck from all - I need all I can get!
Maureen

I ovulate too early - my doctor says its a late luteal phase

Maureen

This note is being entered for a member of the PARENTING notesfile
community who prefers to remain anonymous at this time.

Carol Stolicny, PARENTING co-mod

------------------------------------------------------------------------------

re. 36

Sorry to hear your first IUI attempt was unsuccessful.. I had a similiar
experience with my first IVF attempt... My HCG levels were rising for the
first 5 days then they started to drop.. I don't think I've ever been so
depressed... But, my doctor said although it was unsuccessful that it was
still a good sign... We can fertilizes and implant. So, we'll keep trying...


Next month in fact... This time my doctor is changing my lupron schedule from
the first day of my period to the 21st day of my previous cycle. Has anyone
else out there started lupron in the previous cycle?  Does it help make more
and healthy eggs? He also increased my pergonal from 2 amps to 3 amps until
my first ultrasound.

I'm really nervous that these changes will somehow cause my attempt to be
cancelled.  I can't wait to try again but at the same time I'm really scared...
I'm always wondering if my body just doesn't want to be pregnant although my
mind really does...

re. 37

Good luck this cycle... Glad to hear you had no side effects from the Clomid.
I used to take my clomid at night to help reduce my side effects. I'd wake alot
with hot flashed but never had them during the day so I thought it was worth it.


Thanks for listening!!!

    I was on Lupron with Pergonal, then Lurpon with Metradin and Pergonal,
    then just perongal.  It turned out that in my case, the Lupron (which
    is supposed to somehow suppress ovulation) was actually hving a
    negative effect on my ability to produce eggs.  in fact, the first 2
    cycles which were supposed to be GIFT were cancelled due to lack of egg
    production since I only made 1 follicle each cycle.  The third cycle
    was when my doctor decided to cut out the Lupron entirely and take the
    chance that I would ovulate on my own instead of by the trigger shot of
    HCG in the hopes that the Pergonal would work well enough for me to
    make more eggs.  It worked, and I managed to make 3 eggs, all of which
    were healthy and 2 of which went on to fertilize and give me twins.
    
    You might try asking your doctor what the effect would be on you of not
    taking the Lupron.

    
This note is being entered for a member of the PARENTING notesfile
community who prefers to remain anonymous at this time.

Carol Stolicny, PARENTING co-mod
----------------------------------------------------------------

It's me again (Anon/F.E.)....

I've noticed a lot of discussion around LPD (luetal phase defect)
in the last few notes.  I just finished reading two excellent books.

      o Motherhood after Miscarriage (Dr. Kathleen Diamond)
      o How to get Pregnant with the New Technology
              (Dr. Sherman Silber)

Motherhood after Miscarriage has the best description of LPD that
I've read yet.  It's also a great book for those of us who have had
a miscarriage.  How to get Pregnant with the New Technology is very good
as well.  It discusses infertility and most of the 'technology'
oriented methods for getting pregnant.  Reading these books has really
helped me understand my current situation from a technical perspective.
I'm still working on the emotional side of all this...

-----
.38
Like Maureen, I too have had regular periods and no real cramping problems
I also have 3 sisters who have each had 2-5 kids.  In addition, my Mom had
7 kids! One of my sisters even got pregnant while on the pill.  So, I never
saw any signs of infertility until my 1st miscarriage approx. 2 years
ago. However, if you haven't started trying yet...and you don't have
any ob/gyn problems....don't give infertility too much attention at this
point.  'Odds'are with you.  Good luck when you decide to start trying.

Thanks,
F.E.

    re: 48...
    
    That's very interesting. Did you have a diagnosed reason for low
    egg production in general? How much pergonal did you end up taking?
    I am very interested in this because I had problems creating more
    than 1 follicle with high doses of pergonal. We know that my egg
    supply is very low, but I was also doing the Lupron. I'm interested
    in talking with my doctor about skipping the Lupron. 
    
    Cyn

    re: 42
    
    Yes, a woman can have a period without ovulation. I have had many!
    Usually, though, your cycle will be very long. I've had 45, 50, 60 day
    cycles. But not necessarily. If you are wondering if you ovulate you
    can 1. do your temps each morning, 2. use an ovulation predictor kit
    3. get blood tests from your doctor at day 10, 12, 15, 20 ...
    
    Cyn
    

    That's interesting, Cyn, because I just counted the days since my last
    period (induced with progesterone) in April until now, and it was
    exactly 45 days!
    
    I took the progesterone 4/16 through 4/25, got a period on 4/28, and
    then a got a period on my own on 6/12.  Nothing in May.  So, perhaps I
    didn't ovulate after all.
    
    I think I'll take your advice and buy a kit to see what's happening.
    
    Thanks,
    Roberta
    

    Roberta,
    
    It might be worth your while to start taking your basal temperature
    first to get an idea if you ovulate or not.  The kits are expensive,
    and are usually taken over a 3-5 day period, so it would be more cost
    effective if you began to get a "feel" for your cycle first.  
    
    When you take your temperature, you should do it first thing in the
    morning, before you move around, and really should take it at the same
    time every day.  I have been known to fall asleep when I have the
    thermometer in my mouth.  Your temperature is plotted daily on graph
    paper.  The "classic" sign of ovulation is a temperature dip one
    morning followed by a rise in temperature for the remainder of the
    cycle.  My temps usually stay in the 87.2 range during the first part
    of my cycle, dip down to 96.9 and then go up to around 87.8 for the 
    remainder of my cycle -give or take a few 10ths of a degree.  You are
    also suppose to take note of any restless nights, late nights,
    illnesses, etc., that could affect your temperature.
    
    An ovulation test is more accurate, but you need to get a feel for your
    cycle to know when to start taking it.
    
    BTW - The above pattern only occurs when I am taking clomid.  Before I
    started with clomid my cycles averaged between 45-60 days long.  I took
    my temperature for a couple of the marathon cycles and my temperature
    just meandered around the place in no particular pattern.
    
    I sure that you would find a more comprehensive discription of taking
    morning temps in any book on infertility or on how to get pregnant.

In general, I had very low egg production.  Of the 8 cycles of IUI's and finally
1 cycle of GIFT, I never managed to produce more than 3 mature follicles, though
sometimes had several smaller ones that didn't make it to maturity.  In general,
I usually only had 2 follicles that were mature, and sometimes had only 1.  The
most Pergonal I ever took was around 3 or 4 amps, and that was in conjunction with
Metradin which does the same thing.  My regimen included Lupron and Metradin in
the morning with Pergonal at night.  Some doctors do a similar regimen with 2
shots of Pergonal a day depending how the patient reacts.  I also ovulate fairly
early, and have been inseminated as early as day 7.  In fact, my successful GIFT
attempt was on day 10 of my cycle. 

I have met women in the waiting room who made as many as 19-21 eggs each cycle,
and were trying IVF.  I can't even imagine making 5 or 6 (my doctor would have
put up to 6 eggs back if I had made them due to all my difficulties).

Cathy

    .53:
    
    Thanks for the info on taking temps, but are the 87. temps typos?
    They sound awfully low.
    
    Are there special thermometors one can purchase to do this?
    

    For some reason, aparently due to my Ludeal Phase Defect, my temp never
    rises and a falls with ovulation.  For that matter I never got a real
    reading with the ovulation kits.  In fact I remember telling my OB in
    frustration once, "that for $20+ per month I sound like I've got some
    kind of illegal habit or addiction!"  Fortunately he is sympathetic,
    and told me not to bother with the kits any longer.
    
    As for temp taking, I mentioned it to my sister inlaw who used the the
    temp method successfully twice.  She told me there was a special type
    of thermometer, and it take your vaginal temp.  Am I way off base here? 
    I always used a rectal temp.
    
    Lyn

Basal thermometers have a smaller temperature range than fever thermometers
so you can get more accurate readings.  They can be used orally.  If you
don't see them on the shelf, ask the pharmacist.  (BTW, if you read the reply
carefully, you'll see that the 87s are typos.)

    Whoops - sure were typos.  My mind isn't on my typing, obviously!  I should
    have said that my temps were around 97.2 until ovulation, then drop to
    96.9 and up to 97.8.  
    
    Cathryn

I'm glad to see people discussing infertility.  Sometime I think its not an
acceptable problem to have.

My husband and I have had all the tests (which have all been normal), done
four chlomid cycles, 3 Pergonal/IUI, and 1 IVF.  So far no luck.  I just got
my pregnancy test results from the IVF attempt today.  My husband is 
disappointed and now says he thinks it is more likely that we won't get pregnant
than we will.  (As a consequence, we are signing up with the adoption agency 
that did our homestudy tomorrow)

I have a 25 day cycle and ovulate on day 11 or 12.  My doctor doesn't seem to
think that is a problem.  Our results from IVF in terms of yield and sperm
penetration where good, but I only got about 50% fertilization.  Makes me
scared that my eggs are defective or something.  Does that happen?  Can they
tell if eggs are bad?  Also, it seem that my Estradiol level gets real high
for the maturity of my eggs - anyone have this experience?  

I'm going to one of the top three IVF clinics in the country, but I see all 
these women who have done 4 or 5 attempts with no success.  Of course, everyone
has a diagnosis but me.

Anyway, if anyone out there has unexplained infertility, I'd appreciate knowing
how you cope with it.

Thanks,
Bobbi

    I thought I should add our success story here, to give others currently
    undergoing treatment hope that things can work out. I can really
    understand all the frustrations and dissapointments that I read about
    on this topic, of the waiting till the next period, will it wont it,
    and then to think you've succeeded only to find out later its failed.
    Knowing that you can discuss it and that your not alone really helps.
    
    Our particular infertility situation was as follows.
    
    We conceived a few years ago without any problems, and had a very
    beautiful little girl. After her birth my wife never had a
    period/ovulated. We left it until last year, thinking it would right
    itself over time. It did not. We went to see a specialist last November
    and he identified non ovulation as the problem. He took some blood
    tests and could see that the estrogen level in my wife was too low.
    First my wife had to start taking her temp every morning to build up a
    record of average temp. In January she started taking a course of 50mg
    CLomid. No ovulation. The next month it went to 100 mg and around the
    time when ovulation was to take place she went for some scans. They
    showed the egg but it was not big enough. My wife felt very ill from
    this second clomid dose. After the second month they decided to put my
    wife on a "oestrogen pump". This automatically dropped 2 drops of
    oestrogen in her blood every ninety minutes via an IV in her arm. After
    2 days the temp went up and her first period in 3 years followed 3
    weeks after. What a relief. She felt very happy, we both did1!. Then
    the followinf month (the IV still inserted) she ovulated again and she
    is now in her ninth week of pregnancy. So far the scan looked normal
    and she is feeling TERIBLELY sick. But we love it. We have been rather
    afraid that it might not work out in the last few weeks but I really 
    hope everything works out OK as my wife has had a miscarriage before at
    around this time....so we are hanging on.
    
    So my strongest thoughts go out to the people here trying to have
    children, I wish you strength and the best of luck!!
    
    Andrew Dooley
    

    
This note is being entered for "F.E". - a member of the PARENTING notesfile
community who prefers to remain anonymous at this time.

Carol Stolicny, PARENTING co-mod

=======================================================================

.59
<I'm glad to see people discussing infertility.  Sometime I think its not an
acceptable problem to have.>
-----------------------------------
Yes,  I have to admit I feel the same way.  I'm sure you could guess that
because I don't even enter my notes as 'Me'....I have them entered
anonymously.  For now, that's all I feel comfortable with.

.59
<I'm going to one of the top three IVF clinics in the country, but I see all
these women who have done 4 or 5 attempts with no success.  Of course, everyone
has a diagnosis but me.>
----------------------------------

I have a book called: How to Get Pregnant with the New Technology by
Dr. Sherman Silber.  In it he quotes the following statistics from
the Journal of Fertility and Sterility.  The stats come from a test
done of 486 infertility patients.  They did IVF on each patient for
up to 7 cycles until they were pregnant.  What's recorded below is
the stat for how many of the patients got pregnant on each cycle and
what percent of patients had success after 7 attemps.

PREGNANCY RATE BY NUMBER OF IVF ATTEMPTS RESULTING IN SUCCESSFUL IMPLANT

IVF      PATIENTS       PREGNANCIES      CUMULATIVE PREGNANCY
ATTEMPS  (number of)    per Transfer             RATE

1            486          119 (25%)              25%
2            229           66 (29%)              47%
3            114           32 (28%)              62%
4             60           20 (33%)              75%
5             26            9 (35%)              83%
6             10            3 (30%)              88%
7              5            2 (40%)              93%
I am always careful of stats because they are only as good as the study
that they come from.  Please reference the actual book if you want to
truely understand the parameters of the study and how it was done.
Then you can decide for yourself whether these stats have any validity
or relationship to what you are going through. For me, they 'allow' me
to have a lot of hope.  As the author of the book said "Even if you don't
get pregnant in the first few cycles and you keep on coming back, the
chances are 93 percent that in one of those 'seven' cycles you will
get pregnant."

.59
<Anyway, if anyone out there has unexplained infertility, I'd appreciate knowing
how you cope with it.>
-----------------------------------

Wow, this is a tough one.  Certainly can't apply statistics to this area.
I have been trying to cope with infertility for the past 2 years.  I know
others have been dealing with it much longer than I have.  It is the
toughest thing I have had to work on in my life so far.  Usually, if I
want to do something I research it, or study it then learn it and do it.
But, it just doesn't work that way with babies.  It's like I want something
so so badly - but, I just can't have it (?...yet?).  Sometimes I pray at night
trying to make deals with God: ....if I do this....then maybe he'll give me
a baby, etc...  I know it's crazy but I still do it. At other times,
I try to totally block it out...forget about it.  That's almost impossible
when I'm constantly going to the Dr. for ultrasounds, IUI , tests....
The best thing for me is trying to be really open with my husband
(sometimes the poor guy must think I'm an obsessed woman!). I also tell
everything to a few very close friends. A lot of people in the notes
file recommend RESOLVE as an outlet and source of support.  I haven't
tried it yet, but you may want to look up your local chapter.

Whatever you decide to do as you go through all the decsions that come
up when considering infertility options as well as adoption, I wish you
the very very best.  I believe it takes a truely special person to want
a child so very badly and to be willing to pursue so many avenues.
Good luck, and feel free to use the notes file to share your feelings
and questions. I have only recently discovered it...and so far the support
and information I have received has been great. The individuals who write
in it are wonderful caring people!...you can feel it just by reading there
responses.

Take Care
F.E.

When I first realized that getting pregnant was not going to be easy - I felt so
guilty, that something was terribly wrong with me. I discussed our problems with
no one and read as much as I could.  And of course all during the testing,
reading, 'trying', everyone around us was getting pregnant (or so it seemed). At
one point we had 3 christenings to attend in a 3 month period - it was awful.

But through this notesfile and through meeting people here at work who have also 
had similar problems - I began to realize that I was not the only person going 
through this and that there were so many more out there who had been trying much
longer than I. I think that this knowledge/realization made me feel more 
comfortable and the more I talked about it, rather than holding it  in, the 
better I was able to handle it emotionally.  The other thing that helped me was
that both my husband and I had problems, not just one or the other, and so we
were able to grow stronger together and even find some humor in it (we went to
the cape for a getaway weekend and in the window of a Tshirt shop was a Tshirt
with a sperm on the front, "water" in the background and the caption "Swim,
spermie, swim!")

Now, I talk about things more comfortably, and my parents know about our 
situation but in strictest confidence.  I do not feel comfortable with anyone
else in the family knowing yet.  We haven't discussed it with my husband's side
at all because his family tend more to gossip and his family is VERY large. Every
one would know in 10 minutes!  I have also had a problem with his mother already
making comments because we havent had kids yet.  Recently I found out that she's
going around telling people that she didn't think I was capable of having 
children.  This kind of ignorance is painful, thus our decision not to share our
problems with her.  My husband and I have both undergone surgeries and we 
basically kept it to ourselves.

I still have not given up hope and so far my doctor has given me no indication 
that I should.  Until that day, Ill keep hoping....

Best wishes to all,
Maureen

re .61 (Dr. Silber's stats):

Those statistics seem very high.  There are a number of ways that clinics use
to improve their statistics.  One is to report clinical pregnancies rather
than live births.  Another is to refuse patients whose chances are low.
BTW, I have a great deal of respect for Dr. Silber -- I understand he is the
foremost urologist in the country when it comes to male infertility.

re Resolve:

Even if you're not a "support group type" of person, a Resolve membership
is definitely worthwhile.  You can a lot a valuable information from their
newsletters and publications, and they have a hotline for referrals and
medical questions.

    
This note is being entered for a member of the PARENTING notesfile community
who prefers to remain anonymous at this time.

Carol Stolicny, PARENTING co-mod

------------------------

.re 59

I too have unexplained infertility... I first tried IVF because we
had no explanation then GIFT. So far, no luck. We learned from
IVF that we can indeed make healthy eggs and fertilization does occur,
so I'm not giving up yet. All the books I've read say it may take
several attempts before one is successful.

I'm always wondering if it maybe just too much stress. Stress from
work and wanting a baby so badly... Infertility doesn't run in
my family. My sister got pregnant on their first attempt. My mom
says all she had to do is think about a baby and she was pregnant.
Not real comforting words when I'm having no luck.

I too would love to have a diagnosis. That way perhaps I could come
to terms with my situation. But, I'll never know why. I cope with it
by not giving up hope. Since I have no physical reason than perhaps
someday it will happen.. I just have to be patient (I've been patient
for 3 years now). I do admit I have my days where everytime I see a baby
the tears start to build and I say why me?

Hope it helps to know there are others with unexplained infertility
( I believe I read that 10% of the infertility cases are unexplained)
and Good luck!

    I don't know if this is really relevant here, but .64 mentioned
    stress, and it might be that there are some factors beyond
    individual control making it harder here.  
    
    Last winter I heard a talk by an animal psychologist who has
    specialized in wolves.  He wondered some infertility couldn't be
    explained by a biological reaction to population stress -- not
    personal stress but environmental stress.  [I think he and his
    wife had been unable to have children.]
    
    He pointed out that in nearly all animal populations, if something
    happens to pressure the population as a whole -- reduced range,
    overpopulation, drought or other unnatural weather, disease -- the
    birth rate goes down drastically and the rate of neonatal and
    child deaths goes way up.  Normally extremely family oriented
    animals like wolves will go two and three years without the female
    going into heat, and if they do have a litter, often they will
    neglect, injure, or even kill the pups.  
    
    So his professional training made him wonder if our heavy exposure
    to environmental toxins, bad air, commuting, and all the rest of
    modern life was creating a population-wide stress that was cutting
    the human fertility rate.  
    
    --bonnie

re .65:

Those stresses on wolves are probably more similar to the stresses on humans
in famine-stricken regions than they are to those in our affluent society.

If stress causes infertility, why are there so many teenage pregnancies?

    Gerald,
    
    Let me see if I can explain his argument better. 
    
    He wasn't talking about the kind of individual stress of jobs, 
    life situation, wondering if you're going to get laid off, and so
    on. (Though as an aside the teen pregnancy rate has been down
    slightly since 1982.)  He was talking about population stress -- I
    wish there was another term for it because I think it's liable to
    be misunderstood. 
    
    He also wasn't saying it *causes* infertility in any given
    individual, and I didn't mean to make it sound like it did.  A
    parallel example might be breastfeeding as a means of birth
    control -- in a population of nursing mothers, the pregnancy rate
    will be much lower than in nonnursing women, but it's not a method
    of preventing conception in any individual woman.  
    
    His research was dealing with semi-wild wolves in range-restricted
    areas -- on game preserves and such -- where the animals are
    apparently healthy, have enough to eat, and are not generally
    hunted.  But they can't roam the way packs normally do, often
    they're fed rather than being able to hunt, they interact
    regularly with people, they're near human noise.   The population
    in a previously healthy and stable pack in upper Michigan went way
    down when a big airport opened and the wolves were regularly
    exposed to jet noise, even though they had plenty of room and
    food. 
    
    When your body is coping with extra stress just to stay alive,
    there's more vulnerability to other problems.  He's afraid that as 
    we continue to destroy our environment and surround ourselves with
    noise, chemicals, irradiated food, bad air, and all the rest,
    we're going to see a whole rash of new diseases from organisms
    that have been around all along but that we've been resistant to
    before now.  
    
    I've been debating for a long time about bringing this up.  I know
    it's a sensitive issue.   I know it's very very difficult for
    people who want to have children and can't.  Sometimes I want to
    say, "Here, I'll have one for you," but I know that wouldn't be
    the same thing, either.  But when I see the number of healthy
    adults who can't conceive skyrocketing, I have to think there's
    something more going on than just a bunch of individual problems.  
    
    --bonnie

I'm not convinced that there's more infertility now than there was
50 years ago.  Couples are starting to try to have children later,
when fertility is normally lower.  People are more open about such issues.
There's apparently no good data on which to base a comparison.

I don't buy the environment argument except in special cases.

    
    I've asked my doctor about this...since it APPEARS there is more
    infertility now. He agrees with Gerald, that couples are waiting
    until their 30's and 40's to have babies and that is the main
    factor in the infertility picture. Most problems that he has seen
    are due in a large part to the aging of his patients...not that they
    are too old at all, but that they have a particular problem that has
    shown up because they waited to have children. Of course we hear 
    about it more now because there is something they can do about it
    in some cases. 
    
    Environmental and mental stress might be a factor in some rare cases,
    but not being wolves, we humans are capable of having babies in very
    stressful situations, i.e. refugee camps, under war conditions, 
    as teenagers (talk about stress!!)... ;-)
    
    Cyn

    I don't know whether the data is there or not -- quality studies
    certainly haven't been done.  
    
    However, it also seems to me that it's unlikely that everything
    is an individual problem, or a special case.  Age doesn't seem to
    be enough to explain rates estimated as high as 1 in 4 couples. 
    Maybe environmental factors don't enter into it, but it seems like
    we should at least be looking at more broad-based questions.  
    
    It gripes me the way this society constantly takes issues that
    affect a big chunk of the population and says we should all be
    dealing with them as individuals, if you don't fit society's
    expectations you should keep decently out of sight and not talk
    about your problem in public.  It polarizes people so that those
    who don't have the particular problem are presumed to be
    unsympathetic and those who do have it are ashamed -- we treat
    everything from literacy to AIDS and cancer the same way.  
    
    If indeed a full quarter of the couples in this country are having
    trouble conceiving the babies they want, and the rest of us are so
    unreceptive that the discussion has to go on anonymously for fear
    of hurt, it's not just a medical problem, it's a societal problem
    too. 
    
    --bonnie

I may just be blowing off steam here but I honestly believe that as long as
the medical community continues to invent more things for women to stick into
their bodies (to prevent pregnancy, now we have a condom for women!) the 
more infertility problems we'll see.  I also wonder often if the pill causes
some infertility.  I myself took the pill for over 10 years straight - and I 
often wonder if that fact has anything to do with my luteal phase defect.  If so
then I have to take certain responsibility for being on the pill in the first
place but I don't ever recall being told by my doctor that the pill can effect
a woman's fertility.  Maybe women should be warned that long term use of any
contraceptive drug/device is dangerous if that is so.  

On the other hand I might be able to become pregnant with the new medical
technology that is offered to us today.  My mother didnt know that DES could
be dangerous to me anymore than I know if any treatment I undergo today will be
dangerous to my own.  I obviously don't have answers and may seem naive but I
have alot of questions .....

Maureen 

    One of my favorate quotes from RESOLVE:
    
    "Stress does not cause infertility, infertility causes stress."
    
    Deb (who also has unexplaned infertility)
    

    "Stress does not cause infertility, infertility causes stress."
    
    Right.  Environmental "stress" is not the same thing as personal
    stress.  
    
    Being in a prison camp or a famine are things that cause personal,
    individual stress, emotional and psychological stress.  
    Environmental stress is the things that strain the physical
    capacity of the organism, and not just an individual organism but
    a population collectively.  It's a physical fact, not a personal
    responsibility.  
    
    The only example that comes to mind is with trees, when the
    climate gets warmer in a certain area, the evergreen trees are
    gradually replaced by deciduous trees, particularly oaks.  You can
    see this happening across central New England.  The oaks replace
    the pines because the slightly changed climate isn't as good for
    pines.  The climate doesn't kill any individual pine tree.  But
    because the pine trees are at a disadvantage, they die more easily
    from other causes.
    
    The same thing is apparently happening because of prolonged acid
    rain in the White and Green Mountains of New England -- the trees
    are more vulnerable to insect infestations and are dying from
    attacks that they would have thrown off twenty years ago.  
    
    Environmental stresses of various kinds affect all species --
    that's part of the science behind ecology.  We're part of the
    living world of plants and animals,  and I find it very nearly
    impossible to believe that the things we're doing that put so much
    pressure on the plants and animals around us aren't having an
    effect on us at the same time and in similar ways.  
    
    --bonnie

    Re. 73
    
    I must admit I find these kind of ambiguous, vague theories only act as
    "old wives tales" in the making. In the good old days, lets say 300
    years ago, there was minimal pollution or "environmental stress", yet
    people suffered infertility problems. In looking for reasons and cures
    etc they where recommended equally bizzare theories, for example
    swimming in certain "magical waters" etc. This was out of ignorance on
    the subject. As we learn more, new solutions come about, not all at
    once but over a period of time. Todays "unexplained infertility" could
    be tomorrows success story. 30 years ago my wife and I would have had
    unexplained infertility problems, but now she is pregnant....
    
    May the research continue....
    
    Andrew

    Maybe it would be constructive to continue the "environmental"
    discussion somewhere else? I find the dicussion interesting, but it
    might be moving the focus in this particular note away from a more
    help-oriented discussion of infertility problems. 
    
    Cyn

    I have a very simplistic question..What is the relationship
    between ovulation prediction kits and basal body temperature
    monitoring? It is my under standing that the ovulation predictor kit
    predict within a specified period when ovulation has will take place
    and basal body temp. rise is indicative of having ovulated?

    I have another question...How is LFD diagnosed and does it come and go?

    Would anyone be able to reccommend and infertility specialist or
    or where to obtain a list ? THis would be either in the boston area or
    centrl Mass...

    I'll try to answer your questions.  The BBT shows the drop in
    temperature accompanied, usually, by a quick rise which indicates
    ovulation taking place.  If I remember correctly, the temperature
    change is caused by the body's estrogen level rising leading finally to
    ovulation followed by temperature remaining elevated as estrogen-making
    stops and progesterone is released.  I think the ovulation kits measure
    the increase in estrogen, but I'm not sure.
    
    A luteal phase defect is diagnosed by having an endometrial biopsy
    done.  The methodology sort of reminded me of tree rings because they
    take a sample of your uterine lining and compare it to a known sample
    to see where in the cycle you're supposed to be relative to where you
    actually are.  In my case, my lining looked like it was a few days less
    in my cycle which showed a luteal phase defect defined as me not making
    a lush enough uterine lining to support a pregnancy, assuming that I
    could get pregnant.  They typically prescribe a long course of
    progesterone with the cycles you actively try to conceive to provide
    the extra hormones your body can't create.
    
    As far as a doctor recommendation, I highly recommend Dr. Thompson at
    Boston Fertility/Boston IVF located at 1 Brookline Place in Brookline
    (corner of Brookline Ave. and Rte. 9).  Actually, I would recommend Dr.
    Berger, Dr. Alper or Dr. Thompson there.  The only doctor I didn't have
    was Dr. Oskowicz, but I imagine he'd be OK too.
    
    Cathy

    As you may have seen in previous notes, there are a number of fertility
    specialists to choose from in the Boston area.  Most of them
    sub-specialize in a particular set of problems, or a particular set of
    treatment techniques.  The best specialist for you is the one who is
    interested in the problems YOU are having; otherwise, you may get left
    to languish in the corner. 
    
    If you have some idea where your problems are (or aren't), your best
    bet is to call Resolve in Arlington, MA. 
    
    Good luck!
    Beth

    As per our moderator guidelines, please do not explicity recommend
    doctors here.  Please use mail to send a memo with the information.
    
    L
    

I second Beth's suggestion that you ask Resolve for recommendations.
It takes several months to get an appointment with a top specialist,
so it's worth getting an expert opinion.

You may find it helpful to ask here about specific doctors so people
can send you mail about their experiences (good or bad).

    Yes you should call RESOLVE.  The HELPLINE for RESOLVE is
    (617)623-0744 they should be able to help you.  They have
    a Medical Expert (Diane Clapp) who they can connect you
    with to help you with a specialist, I found her very
    helpful in my persuit for a specialist.
    
    Have you already done some infertility test?  You could start some
    of the simple test with your OBGYN.  But my experience has been
    that its better to just get in with a specialist because they
    may have to repeat test that can be done incorrectly by an
    OBGYN.
    
    Deb

Question to those who have used Chlomid in the past.
Did you notice that while on this drug your cycle got longer or extended...

May sound like a dumb question but let me explain.  Im on my first cycle using
Chlomid which I took Day 5-9 this month.  I have a 26 day cycle and I usually
ovulate on day 20 or 21.  Im up to day 23 now and have been taking my temp
every morning and Ive been running very low this cycle.  I just hit 98.3 today.
Usually by now Ive already hit about 98.7.  Will the Clomid give me a longer
cycle?

Just wondering....

Maureen

    
    More on the ovulation kits...they measure the levels of Leutenizing
    (sp?) Hormones in your urine.  When the LH levels rise, this means you
    will be ovulating in 24 hours.  These kits were much more helpful to
    us, than simply taking basal body temperature.  They showed I was
    ovulating two days earlier than my temperature said I was (over a 1 1/2
    year period).

Yes, the Clomid will give you a longer cycle.  It basically regulates you and
is supposed to lengthen the cycle so that you have the appropriate number of
days for each phase.  As I recall, I went from a 25-day cycle to a 28-day 
cycle on Clomid which is what I needed so I'd have a longer luteal phase
and have a more lush uterine lining.  

Ok thank you for the info - I misunderstood my doctor.  I thought that the
Clomid sped up the development of the uterine lining but that my cycle would
remain at 26 days.  Sometimes I feel so stupid!!!  I was beginning to think I
wasnt going to ovulate this month for some other unknown reason.

Thank you!  You've put my mind at ease!

Maureen

 I hope that I am another success story with infertility problems.  My husband
 and I began trying to get pregnant 3 years ago.  Since that time I have had
 two miscarriages (first at 14 weeks and the second at 12 weeks), tests
 galore including blood work, endo biopsies, HSGs, 2 hysteroscopies, 3
 D & Cs (both my miscarriages required them), a laparoscopy, and Clomid.
 I discovered that I had Ashermans syndrome (scarring of the uterus) which
 they took care of with the hysteroscopy and laparoscopy.  After this was done,
 it then turned out that I also had a luteal phase defect, and that while I could
 conceive, there was not enough progesterone to maintain the pregnancy!  I was
 put on clomid and actually conceived on the first cycle!!  I thought that this
 was the end to my problems until I had some serious bleeding at week 7 and
 week 10.  I am now 15 weeks along and actually managed to hear the heartbeat
 (something I had never done before).  So, while I am still extremely on
 edge just waiting for something terrible to happen, I am also finally starting
 to feel like I may be a parent sometime.  My due date is Christmas eve and
 if I actually make it, it will truly be a miracle to me!  Good luck to 
 everyone out there who is going through this, it can be so hard sometimes
 to actually believe that it might happen, but it CAN happen!

 Terri

Your success story is truly appreciated and I sincerely hope that all goes well 
for you and that your special miracle comes true for you.  What a wonderful
Christmas present to receive!

I am also on my first cycle of Clomid.  I usually have a 26 day cycle and Im
currently on Day 28.  My temp. finally peaked this morning so I guess its a 
matter of just waiting to see  if this month will be 'the one' for us', although
Im trying not to get my hopes up.....

Good luck to you and thank you for your story - it truly gave me some hope!

Maureen

    Hi,
    
    	I'm 30 years old.  My husband and I are trying to have a baby. 
    We've been trying since this past December.  Although this isn't long
    in some people's eyes, I would like to know how long we should continue
    to try (with no luck) before having tests and so on done.
    
    	After reading this particular note's replies, I'm learning alot,
    but also becoming concerned that alot discussed here is some things I'm
    experiencing.  For instance, since I've been off the birth control
    pill, I've had only 1 normal 28-day cycle.  The rest have been anywhere
    from 35 to 60 days long.  In fact, I'm 15 days late now and have to
    have a pregnancy test at my doctors tomorrow.  I know that I'm not
    pregnant, but have to go anyway since I really DON'T KNOW what it feels
    like to be pregnant (since this will be our first.)
    
    	Also, I'm beginning to believe this thing about being on the birth
    control pill so long.  I too was on the "pill" for 10 years and do
    believe that perhaps this may cause or relate to infertility.  I
    constantly bring up with this subject with my OB/GYN, but he insists
    that being on the "pill" does not affect a woman's fertility.  Perhaps,
    but maybe length of time would?
    
    	Anyway, my very simple question is how long should we try before
    having fertility tests etc. done?  I really don't feel confident that
    my doctor, although I like him very much, will be proactive in
    suggesting this to me.  I'm in an HMO and don't feel that when you get
    into specialized types of things that they give you the attention you
    need.
    
    	I'm new to all of this and not very educated in the area of
    childbearing, fertility etc.  So please bear with me if my questions
    sound vague, naive or whatever.
    
    	Thanks,
    
    	D.
          

    
    Re: .90
    
    FWIW: I was on the pill for 10 yrs also before concieving my son.  I 
    	  stopped the pill for 2 mos before having unprotected sex to 
    	  "cleanse" my system, and concieved 6 mos later.  My doctor told
    	  us at the time to try for at least 6 mos before starting to get
    	  concerned (seeing as neither of us had major med problems that 
    	  we knew of). 
    
    	  Chris
    

The standard answer is that you should try for 1 year without success before
seeing an infertility specialist.  That's because, statistically speaking,
85% of couples who have unprotected intercourse over the course of a year will
conceive.  The remaining 15% is what is termed 'infertile' and goes on for
tests etc.

In your case, with such long periods, you may want to start asking your 
doctor for a referral after a shorter time such as 9 or 10 months.  I think
you need to give it about that long before starting to worry that something
may be wrong. And I don't know which HMO you have, but I had no difficulty
getting an appropriate outside referral.  And I know folks in other HMO's who
have been able to get referrals as needed.

I also was on the Pill for about 10 years prior to trying to conceive.  I don't
think it had anything to due with all my infertility problems, and I was
finally able to have children though the available hi-tech methods.

Best of luck.
Cathy

    I was on the pill for 2 years and stopped because I wanted to get
    pregnant.  It took us 6 months.  Then I stopped again 6 years later 
    and again it took about 6-7 months.  
    
    Marie

    When we decided to have a child we were told that most couples take 6
    months or so before success.  After 6 months passed without any luck,
    we were told that some couples succeed after one year.  After the year
    passed, the doctors finally got serious and suggested my husband get a
    complete exam including sperm analysis etc.  
    
    Since everything was ok with my husband, I began an infertility workup
    and was actually pregnant (but did not know) at my first appointment.
    I guess I suffered from stress since we were not able to conceive right
    away, and the relief came when the doctor finally took my case
    seriously!  
    
    good luck!
    beth

    Thank you all for your information.  It makes me a feel a little more
    sane.   In the meantime, I'm going to keep my fingers crossed and
    continue to read and learn from here and from books that were
    referenced earlier.
    
    I may be popping in and out with questions that may come up so please 
    bear with me.  Thanks again,
              
    

I also was on the pill for 10 years and other hormone treatment to control very
painful periods before that.  I stopped the pill for the 2 months and then got
immediately pregnant.

For the second pregnancy which ended in miscarriage, I inadvertantly became 
pregnant immediately upon stopping the pill.  For my third one, I wated two
months after the miscarriage and then was pregnant.

I do not believe the pill affected my fertility in the slightest.

Cheryl

    Another success story!!!  
    
    Just yesterday I found out that I was pregnant...on my first cycle of 
    Clomid.  Im very nervous but very elated and hope all goes well in the
    upcoming months.  I have my first apptmt next Tuesday to determine
    due dates, etc.  
    
    I would like to thank you all for your support and concern.  It has
    been very comforting talking with you all.  I hope you all have the
    same luck that I have had and honestly hope your wishes come true for 
    you soon!
    
    Maureen 

    
    Congratulations Maureen...!!
    
    I've got goose-bumps just hearing your good news!
    Its nice to hear these sucess stories!
    
    Chris
    

    
    First of all congratulation.My wife was on Clomid.....we had
    Twins.@:^))
    
            SCott

    Scott!
    I was wondering about this.  Was she on Clomid for a long time? at what
    dosage?  I wouldnt matter to me - Im just happy to be pregnant but Im
    wondering what the chances are for me to have twins..,.
    
    Maureen

    
    Maureen,
    
           She was on it for 5 months,I don't know what dosage.We weren't
     told that there was a risk of twins till after my wife was pregnant.
    
             SCott

    Maureen,
    
    Congratulations and good wishes.
    
    
    Bernie

re .100:

You mean your doctor didn't discuss the chance of multiples before putting
you on Clomid?

    My doctor told us there was a 6% chance of twins on Clomid and a rare
    chance of triplets.  As I was only on one cycle and at the lowest
    dosage I was just wondering if twins were more prone to happen if you 
    were on Clomid for a longer time, at higher dosages...just a thought.
    
    
    Maureen

I don't know about Clomid, but with Pergonal higher dosages do increase the
chances of multiples.  We were told that certain doctors who "used Pergonal
like water" had many patients with multiples, but that with reasonable
doses, the likelyhood was low.

Just a reminder:  Note 22.* is for discussion of Clomid, Pergonal, and
other fertility-related drugs.  Having the majority of drug-related questions
there will speed searches by other noters in need of information.

     Carol duBois, PARENTING co-moderator

    Thank you all for your congratulations and well wishes.  I sincerely 
    hope the best for you all!
    
    Maureen
    

    Maureen,
    
    Please keep us informed on how you are doing and when the baby is due.
    
    Joyce

    
    
    	Questions..    In active thyroid
    
    	They final found something but, even asking all kinds of
    	questions I don't understand how a inactive thyroid can
    	cause problems with infertility?
    
    	Has any one had this problem?

    My sister-in-law had this condition... but I can not be of any help as
    to why this causes infertility!  She went on thyroid medication and
    almost immediately got pregnant with her first... she has since had 2
    more children!  The Dr. told her she would never have become pregnant
    if she had not been on the medication!

This note is being entered at the request of our anonymous noter, F.E.

Carol Stolicny, PARENTING co-mod

------------------------------------------
Hi Everyone,
First of all, CONGRATULATIONS MAUREEN! I've read your notes entries
over and over this past month when ever I felt down.  It's so
energizing to hear of your success (especially since I originally felt
our infertility background was quite similar.  I'm very very happy for
you.  Hope you are enjoying every minute of pregnancy!  Please do keep
us posted.

For those of you who read my notes last month (I'm the anonymous F.E)
and wondered what's up..Last month was pretty disappointing.  I was suppose
to go on Chlomid about the same time as Maureen.  However, I couldn't go on
it because I had either a small cyst or left over folicle on my left ovary.
So, I had to wait til this month to start chlomid.  In addition, my cycle
was a mess last month.  According to my ultrasounds I never ovulated.

So, this month I took chlomid for the first time (from the 3rd-7th). Today
(7/14) I had IUI...and I go back tomorrow for my 2nd IUI.  After my ultra-
sound shows that I've ovulated, I will use progesterone suppositories.
Between the chlomid that I took and the prosterone, I'm suppose to get
a better uterine lining (I was diagnosed with luetal phase defect 2 cycles
ago).

I wish more than anything that I can have the luck that Maureen has had.
These next to weeks of waiting are going to drive me bonkers!  I'm working
out at a customer site on contract - at at times I can't concentrate on
anything but 'baby' thoughts.

Thanks for listening
F.E.

Hi everyone.  Well Im about 2 months along as of yesterday.  I had to undergo an
ultrasound already to test for twins.....there's only one in there though. It 
wouldnt have mattered either way as far as we're concerned though.  The ultra-
sound showed us this very small embryo about 4mm long.  But the most amazing 
thing was seeing the heart beat.  It was so reassuring to me, as Im constantly
worried about miscarrying.  My due date is March 13 and we are truly excited.
(my husband is hoping for a St Patty's Day baby!). Ive been very lucky so far.
Ive felt very fatigued at times but have had absolutely NO morning sickness!!!!
Things are absolutely wonderful.  If I had but one wish, I would wish for you all
the same wondrous luck that we have had.  We are very thankful for our little
miracle.

Thank you for your continued interest.  Ill keep you all posted and wish you all
the very best.

Maureen 

    
This reply is being posted at the request of an anonymous noter who
signs herself "F.E".

Carol Stolicny, PARENTING co-mod
-----------------------------------------------------------------
re: 112
Maureen...out of curiosity, what is your plan with respect to progesterone?
I can't remeber if you went on suppositories after you ovulated?  If so,
are you still taking them (i.e., will you take them throughout your 1st
trimester)?  Also, I'm sooo excited to hear of your
continued good news.  It 'really' gives me hope!

Another question...are you working with an infertility Dr. that will also
act as your OB/GYN Dr and do the delivery?  Or does the Infertility Dr.
move you to an OB/GYN Dr. at a certain point in your pregnancy??

As an update, I tested positive for pregnancy yesterday (Day 26 in my
cycle), but negative today.  So tomorrow I'll be having another Endo
Biopsy.  My rollercoaster ride continues - but, I'm feeling very
determined to hang in there.  We really want a baby.

Thanks,
F.E.

re .113:

My understanding is that at a certain point in your pregnancy, you switch
to a obstetrician who specializes in high-risk pregnancies.

re: 113

Hi.  I was never on progesterone - just the Clomid for that one cycle.  So Im off
all medication as of the last Clomid pill I took sometime in June.  I do 
understand that there is a very good chance that Ill have to use the Clomid when
we decide to get pregnant a second time - if my cycles go back to being too short

As for my doctor - I was seeing an OB/GYN who also specialized in infertility
through Matthew Thornton (Hitchcock Clinic in Nashua).  He would continue to 
be doctor through my pregnancy and possibly deliver my baby (if he were on call
at that time).  Unfortunately, I learned yesterday that he is moving to St.
Josephs at the end of September.  Matthew Thornton only uses Nashua Memorial and
you have to see 'their' doctors.  So, I don't know whats going to happen but I
do have an apptmt with him on August 11 at which point Ill ask for more details.
I know that he is presently the only infertility specialist they have. Im quite
disappointed because this man is a wonderful doctor, whom I respect a great deal,
and I was very comfortable with him.  Im not sure if they are considering my
pregnancy a high risk or normal pregnancy at this point...  So that's my dilemma
for now.  Ill know more when I see my doctor on August 11 before he leaves....

Maureen

    Normally, once you become pregnany you have one or two appointments
    with your infertility specialist and then they refer you to an OB/GYN
    for the remainder of the pregnancy.  That makes sense for a lot of
    reasons.  You probably wouldn't want to be going to an OB/GYN for
    infertility where you'd get to sit in a room full of pregnant women
    while you are still trying to conceive (I know that would have
    certainly depressed me!), and infertility-type things tend to require
    rigid schedules for appointments.  You wouldn't want to be sitting in
    the waiting room with sperm sample in hand waiting for an AIH, IUI, or
    whatever while the doctor gets tied up with a delivery.
    
    And as an aside to Maureen, you may find you don't need Clomid to
    conceive another time, or you still might need it.  I'm wondering if a
    woman's body changes after pregnancy such that it would be easier the
    second time.  I never thought I'd say this, but since we just managed
    to get pregnant on our own (we like to say 'like normal people') after
    having a host of problems and being told we'd only conceive again via a
    procedure such as GIFT or IVF, I think it's possible for the body
    chemistry to change.  I managed to miscarry almost immediately,
    probably due to my problems still existing but not enough to prevent
    the pregnancy just enough not to support it, but we're thrilled we
    could do it on our own.
    
    And as far as progesterone goes, women usually only have to use it for
    the first trimester for things like a luteal phase defect where the
    body doesn't produce enough progesterone (I had to do it for 11 weeks),
    but I imagine even that is decided on an individual basis.
    
    Cathy

21.116: I have to agree that since my OB/GYN was my infertility specialist as 
well, it was very hard waiting for an apptmt in a room full of pregnant women
(most of whom complained about how big they were, etc when you only wished you 
were in their shoes).  There were even one or two appointments that got shifted
due to the fact that he had a delivery.  BUT, a good doctor is a good doctor, 
I am comfortable with him and he helped us out a great deal...so, Id still opt
to staying with him if i can....

Maureen

>              You probably wouldn't want to be going to an OB/GYN for
>    infertility where you'd get to sit in a room full of pregnant women
>    while you are still trying to conceive (I know that would have
>    certainly depressed me!)

New England Medical Center's infertility clinic used to share a waiting room
with the regular OB/GYN department.  My wife once witnessed a kid asking a
woman if she had any children.  It was clear from her reaction that she
was an infertility patient.  BTW, they now have a separate office area
with a separate waiting room.

    We have a friend who is in need of RESOLVE.  All our newsletters, etc.
    are packed up in the attic, and I wondered if someone would be kind
    enough to post the address and phone number of the national RESOLVE
    office in Arlington, MA?  Thanks in advance!
    
    Steve

RESOLVE has moved to Somerville.  I'll try to remember to find their address.

    
    
    	What is RESOLVE????	

1310 Broadway
Somerville, MA  02144-1731

Business office 617-523-1156
HelpLine 617-623-0744

re .-2:

RESOLVE is a national infertility support/advocacy group.

I've discovered lots of useful information in this and other notes about 
infertility and I thank everyone for sharing their knowledge and most of 
all their experiences.  I am puzzled that no mention (that I can find) has  
been made to the effect of DES (Diethylstilbestrol, a synthetic estrogen 
taken from the late 40's through the 70's as an "inhibitor" of
miscarriages)

My wife has been aware for over 15 years that she was exposed to DES and 
has been poked, prodded and abused by unsympathetic doctors due to the   
high risk for developing clear cell carcinoma.  Now, we are trying to    
understand and deal with the DES caused damage to her reproductive organs,  
only recently discovered, and how we will proceed in our quest for children. 
Have any of the other noters dealing with infertility been exposed to DES?   
We would be very eager to hear your stories.  Pointers to other notes or  
conferences would be appreciated.

Given the damage this "harmless" drug wreaked on so many women, we are 
extremely gunshy to use other drugs, stamped as safe, that may prove 
to have ugly side effects in the future.  Clearly, there are many 
success stories but doctors were very quick to tout DES as an 
anti-misscarriage drug when in fact it probably had no effect on 
miscarriage.

Thanks in advance.

Peter

    I have a close friend who is a DES daughter. She discovered she had
    a partially separated uterus. She was still able to get pregnant, but 
    due to the small size of the cavities, was unable to carry to term. She 
    has adopted one child and is in my adoption group for Albania. 
    
    I agree, it is scary to take drugs that are relatively new. A possible
    approach would be to start with the least invasive drugs and evaluate
    each step as you move along the treatment track. However, I've met 
    couples through adoption who felt very strongly about not taking any
    drugs, and instead moves into adoption when faced with the prospect. 
    
    Are you seeing an infertility specialist now? If not, that would be my
    first approach. Regular ob/gyns can prod and poke a lot without getting
    anywhere. 
    
    Cyn

    i too am surprised that DES is not referenced more in this file. 
    
    i went to 7 doctors before one determined that i was DES exposed...i
    was going to alot of doctors to find out why i couldn't get pregnant
    (this started when i was about 31)
    it was relatively easy to diagnose with a hysterosalpinogram (xray)
    but he was the only doctor who suggested the procedure...i had already
    had 2 laparoscopies from others which did not reveal any abnormalities. The
    hysterosalpinogram showed immediately that my uterus was T-shaped
    instead of V-shaped, meaning that it failed to develop properly
    due to the DES given my mother and that probably the inside wall
    of the uterus was not too hospitable to implantation.
    
    i am more than a little irritated that NONE of the previous 6
    doctors even mentioned DES to me. I was born in 1952...right
    when this was going on everywhere. My mother does not
    remember taking it but she did have problems carrying, etc. so
    my xray confirms she took it. 
    
    the doctor who found this is the most thorough fertility
    specialist i have found in the Boston area, Gary Gross in Brookline.
    He is also associated with RESOLVE. He also has a woman working
    in his office (call me for her name) who is a DES activist...
    she has reproductive organs so deformed she was unable to carry...
    she sued the LILLY pharmecutical company but i do not believe
    she got anything from it. From what i understand most people
    who have gotten settlements are those who had the special kind
    of cancer linked with DES exposure. There have been class
    action suits over the years but the problem is that
    the doctors and pharmacy records
    are long gone. It has been proven that the companies knew the
    drug caused reproductive deformities in lab mice offspring.
    Nice, huh ?
    
    The scary problem is that we don't know how this
    carcinogen will affect us as we grow older. So there is the
    fertility issue and the cancer issue.  Recommendations are that
    DES daughters have a colposcopy every so often which is an
    exam with a very special instrument to examine vaginal and
    cervical cells for abnomalities. 
    
    The good news in my case is that after 4-5 years of trying, 2
    miscarriages - i had a baby boy at the age of 36 and had a good 
    pregnancy to full term....my cervix is totally flat so that they
    thought it might not hold the whole term but it did. But the
    4 years of infertility were pretty tough.
    
    If anyone has any questions, call me. This is really alot more
    common that we realize. One of the shows (20/20 or something)
    just did a show about DES men, etc...because they are showing
    high prostate cancer rates).
               
    

    I am a DES daughter too - luckily I have no abnormalities and have
    been able to carry my two pregnancies to term with no problems. I
    think there may be a lot of "silent" DES daughters like me, who know
    their history but may be fortunate about fertility, etc.
    
    I have colposcopic exams every 18 months or so.
    
    Lucy

                      <<< Note 21.127 by PHAROS::PATTON >>>
Thanks for the replies!

My wife and I are in the early stages.  Although we know she (my wife) 
has a T-shaped and small uterus, stenotic cervix (very tiny opening) and 
adenosis, we are "only" 12 months into the process.  She's been through 
the Hysterosalpinogram, Endometrian Biopsy and several other tests 
recently confirming her suspicions about something being wrong.  Each month  
is a heartache and time is running out. (She is 36).  I am heartened by the   
statistics suggesting that most women affected by DES do deliver healthy  
babies but the gut-wrenching, painful path is rarely mentioned let alone 
the costs.  HMO's DO NO UNDERSTAND the need for special treatment in these 
cases and going outside the HMO is outrageously expensive but necessary.

- .126	Is the woman named Andrea (forgot her last name), a member of the  
DES Action Committee?  We have been meeting with her informally Wed. evenings,  
along with another couple in the same situation, to discuss DES and      
infertility. Others in this situation are welcome to join.  I would also  
be eager to hear more details of your (.126) experience.

Re .127 My wife older sister, also DES exposed has had a miscarriage 
before giving birth to her second and has no apparent difficulties.

Again, our major concern is using hormones to induce the body to act 
normal when it isn't given that prescribed hormones were the cause of 
this tragedy in the first place.  My wife was told not to take the pill 
due to her DES exposure.  Intuitively there seems to be a connection.
Most of the procedures we are considering involve the use of more drugs.

Anyone have experience with homeopathy or Chinese medicine for 
infertility, specifically DES related?  

Thanks again.

Peter

    Peter,
    
    The acupuncturist I use, who is in Chestnut Hill, MA, claims  to be
    successful in treating infertility. He also practices Chinese medicine.
    I have used him for other things (some related to pregnancy, like
    nausea). Let me know if you want his name. Warning: it's expensive
    unless you are in the John Hancock plan, which is why I rarely go
    anymore.
    
    Lucy

re .126:

I'm surprised that you had two laparoscopies before having a
hysterosalpingogram.  Were the laparoscopies for infertility or
for some other reason?

>    He is also associated with RESOLVE.

I wasn't aware that any doctors are "associated" with RESOLVE.
RESOLVE does referrals, but I don't think they have any doctors
on their staff (they do have an RN).

    yes, about having 2 laparoscopies before a hysterosalpinogram...
    knowing what i know now, i would have pushed for the latter. they 
    led me to believe nothing was wrong with me and the laparoscopies
    didn't show anything wrong from the outside of the uterus. 
    the laparoscopies were done to check for fertility problems. 
    the doctors SHOULD have seen my birth date from 1952 and 
    automatically done the h-gram.  the guy who finally did the
    h-gram also gave my husband and i more tests than you can imagine
    in a very short time span. he doesn't waste any time.
    
    re doctor being associated with RESOLVE - he was listed as some sort
    of an external consultant to RESOLVE. you would not see him if
    you went there. 
    
    re - a few back - yes, i am talking about andrea g....
    

    
    
    	Questions.. 
    
    	Yesterday I purchased a Basal thermometer - am having the
    	hardest time reading it.. They say to do the reading frist
    	thing in the morning but, I can hardly see it ... never mind
    	read it.. Has any one else had this problem.. ?  Wouldn't a
    	Digital thermometer work better?
    
    	Donna

    When I was taking my temperature in the mornings I used a Digital
    thermometer. It was so much easier and I especially like being told
    when the temperature taking is finished (beep).

    My pharmacist said that there is absolutely no difference between
    thermometers, *except* that years ago, the basal thermometer was
    considered easier to read than the regular thermometers. That is no
    longer the case with Digital. (I also use a Digital thermometer
    rectally on the baby, much easier than the old glass ones).

    				Wendy

Digital thermometers?  I didn't know we made thermometers.

The only difference between basal thermometers and regular glass fever
thermometers is that basal thermometers have a smaller range, and therefore
more space between the numbers.  Assuming that your digital thermometer is
as accurate as a basal thermometer, there's probably no reason not to use it.

You don't have to read the thermometer first thing in the morning, you
just have to take your temperature then.  You can have your first cup
of coffee before you read it.

 My mother took DES throughout all eight of her pregnancys.  My two sisters
and I have the classic problems associated with DES exposure.  We are lucky
in that we each have a child (all born 3-4 weeks early, due to incompetent
cervix).  Each of us were on bedrest from the 28th week on and were also 
prescribed varying doses of terbutaline to ward off premature labor.

 That said, as we ponder the idea of second pregnancys we are investigating
the cervical circlage (rhymes with collage) procedure.  In simple terms, it
involves putting a stitch in the cervix to keep it closed.  The procedure can
only be done before the 13th week and requires a spinal anesthesia.

 Has anyone out there has the procedure or know of anyone who has.  Any
information would be a great help.  RESOLVE did not have any literature.

 Thanks Laura

>That said, as we ponder the idea of second pregnancys we are investigating
>the cervical circlage (rhymes with collage) procedure.  In simple terms, it
>involves putting a stitch in the cervix to keep it closed.  The procedure can
>only be done before the 13th week and requires a spinal anesthesia.

    Actually, a Cerclage can be done up to 24 weeks.  I went into labor
    four months early with my last pregnancy (see note 20.*).  I was
    immediately scheduled for a cerclage.  Cervical ultrasound studies
    before the actual operation revealed that my baby was larger than
    the average 23.5 week fetus and very active with one foot dangling
    near the cervix (dangling breech).  Because of all these factors,
    the cerclage was cancelled, much to my dismay.  My OB explained that
    because Michael was so active, it increased the chance of rupturing
    the "bag of waters" if he kicked at the same time the doctor pulled
    the cerclage 'drawstring'.  Hence...not worth the risk.
    
    Before she (my OB) had had a chance to fully examined the ultrasound 
    studies, I was prepped for the surgery. The anesthesiologist was 
    prepping me for an epidural if I'm not mistaken. I didn't actually
    get as far as the spine puncture, so I could be mistaken.
    
    
    Jodi-

A friend of mine had multiple spontaneous miscarriages and it was found to 
be due to an incompetant cervix.  By the time she became pregnant with her
one successful pregnancy they had already adopted two Indonesian boys (they
are Dutch so they have a lot of contacts to that part of the world).  When
she became pregnant they had determined what the problem was and done the 
cerclage.  She delivered a normal healthy girl by Caesarian.  Don't know if
it was early or not.

Cheryl

 I think I saw this non profit organization mentioned in the last 
PARENTING notesfile, here it is for those of you who may not know it 
exists.  DES Action is an organization that provides current information
about DES exposure on DES daughters,sons and mothers. The main numbers
for DES Action are (516) 775-3450 (east coast) and (415) 465-4011 
(west coast).  

 There are local chapters in almost every state. Massachusetts
is shown to have the greatest population of DES exposure due to the large
number of teaching hospitals, their chapter is quite active.  I also found
out that DES Action concerned about the third generation, something I never
thought about.  This possibility is really frightening to me. 

 When I called about information on the cevical cerclage they were very
helpful. I received their current newsletter and information about getting
past newsletters.  If anyone would like a copy of any of this, please let me 
know.    

 Laura

    Another success story for F.E. and everyone else with high hopes and
    crossed fingers out there.
    
    In my particular instance we found out that I do not ovulate.  So after
    a year of trying to become pregnant we went to a fertility specialist. 
    The first thing that was tried was a pill, not clomid but something
    similiar.  I was up to 5 pills per day and still not ovulating, so the
    next fertility program was injections.  Luprin, Pergonal and Profasi. 
    Two of these drugs where taken every day, the third (I think it was the
    Profasi) was given after ultrasounds showed that the eggs where just
    the right size, and it forced ovulation.  For anyone that has been on
    this program you know how stressful it can be.  For me because I had to
    have the injections and for my husband because he had to give two
    of them.  No fun being pricked every day twice a day, and no fun having
    to give someone you love pain.
    
    The successful side is that after only two cycles we became pregnant. 
    Even my Dr. was amazed.  He knew that I was a good candidate for this
    program, but told us not to expect anything for at least a year, 6
    months the earliest.
    
    We are now proud parents of twin girls.
    
    For F.E. and the rest my positive thoughts for success are with you.
    
    Maureen congratulations that is simply marvelous!
    
    Cynthia

    Regarding the cervical stitch procedure.
    
    According to my Mom, my brother and I are miracle children.  My mother
    conceived me nearly 30 years ago after having 3 miscarriges.  My
    mothers body automatically went into labor at 5 months.  By having her
    cervix stitched closed and keeping the weight gain down (12lbs total
    pregnancy) she was able to deliver 2 children at term.  My mother said
    that she was a guinea pig for this procedure all those years ago.  It
    was worth the risk.
    
    Donna

 I do not have a problem with infertility.  Yet a relative of mine does.
 I have read through most of these notes on infertility but I haven't 
 found enough information about specifics.  My relative (on my husbands
 side) is a bit shy so I want to know how to discuss the subject with
 her.  My involvement, besides from a purely hopeful standpoint, will
 also be monetary.  She is from an area where fertility treatments are
 not part of an insurance package.  The costs are beyond their means.
 
 We would do anything to help her and want to plan to help her as much
 as we can.  We would like some help in finding a means to talk to 
 her...what to ask...what not to ask...etc...what is supportive...what 
 is not.  

 Also, I don't understand the difference between IVF and GIFT.  Perhaps
 someone could summarize that for me.  And let us know what to expect
 time-wise for how long and what the costs are in the U.S and if/how
 they are subsidized.  This person is in Ireland.

 Your help is appreciated.

 Regards,

 Carol

Re .141

I went through infertility and finally had twins via GIFT.  My cousin has just
started on the roller-coaster, and I've got friends in various stages of
the infertility work-up.  

I think it makes a difference talking to someone who has been through it when
you're doing the infertility work-up as it is first-hand experience, and that
someone going through it is more apt to really understand the process and
give advice.  That's not to say that someone not going through it can't
provide the same things, but I think the perception is that someone in the
same boat can provide a different kind of support.  

I don't think there are any really bad questions as long as what you're asking
is done in a supportive way.  My family always asked us about the process,
how we were doing, what such and such meant, what the success chances were
etc.  I didn't mind talking about it because I knew they were asking out of
love, interest and the desire to provide a support mechanism.  Similar questions
from people I perceived as not being interested, being insensitive, or
looking for a way to be malicious were not appreciated.  That includes things
like my mother-in-law making things for the baby that we couldn't quite 
conceive because she just wanted another grandchild. There was no concern for
us nor understanding of the painful situation.  Things I found helpful were
articles my aunt cut out of newspapers and magazines about new infertility
treatments, success stories etc. because she was looking for things that might
help us and give us more information.  It meant they were learning, too, and
thinking about us.  You might try getting some of that type of information for
your cousin.  Also, contact RESOLVE for information to both inform you and
her.  If she's got someone to talk to who understands the medical terminology,
that might be helpful to her.  

And if you know other people going through infertility, you might share that 
with her so she gets a flavor for what sorts of tests are done, what problems 
other people are dealing with and what some of the treatment alternatives 
are.  That may help her if some of her problems are similar as she will have
a knowledge base from which to ask questions.  I know that I am giving my
cousin questions to ask her doctor now as she starts the Pergonal route 
because it's so new to her, she doesn't know what to ask but knows she's got
questions.  To me, it's hard to ask questions if you have no knowledge because
you don't know what to ask.

One thing that always got to me was people trivializing the infertility.  
Comments like "but don't you want children?" like I had a choice in my 
inability to conceive.  And things like "why don't you just adopt?  It only
costs $4000." as though money were an issue or you just went down to the
corner store to pick out a baby.  I considered those types of comments 
incrediby insensitive and usually snapped something back.  There are ways to
suggest or ask about adoption as an alternative, but that can also be a touchy
subject.  And adoption is a whole different roller-coaster, so it's not the
easy solution that a lot of people seem to think, so if you ask about it as an
alternative, do it in a supportive, sensitive way.

As for your technical question.  GIFT and IVF are very similar. Both typically
involve injections of Pergonal or Metradin to mature many (hopefully) eggs
to give a better chance of success.  Both involve egg retrieval usually via
a laparoscopy, though IVF can use other retrieval methods.  With GIFT, the
eggs are then put back into the Fallopian tubes via a catheter followed by
the sperm being put into the Fallopian tubes via a catheter in the hopes that
they will find each other, fertilize, and implant in the uterus as 
fertilization is believed to take place in the tubes.  With IVF, the eggs and
sperm are put in a petrie dish in the hopes that fertilization will take 
place. Then the fertilized eggs (embryos) are put back into the uterus (I
think about 2 days later, but I'm not sure) in hopes that one or more will
implant in the uterus resulting in pregnancy. The basic difference between
GIFT and IVF is that fertilization takes place in the body with GIFT and 
outside the body with IVF.

Hope this is helpful.  Feel free to send mail.

Cathy

    Is your relative going to pursue treatments in Ireland?  When I first
    started treatments, I went to a secialist in Dublin who was attached to
    Trinity College - he was recommended to me as a leading specialist and
    I found him to be very compassionate.  However, I did not stay with him
    beyond the initial testing because we moved to the U.S.  I will look up
    my records and post his name if that would be helpful.
    
    I am not sure if he does IVF or GIFT.  Is your relative at the stage
    where she would be pursuing that level of treatment.  I have a vague
    impression that IVF was not done in Ireland because of the ethics issue
    with the fertilized embryos that would not be part of the initial
    transfer - perhaps a noter in Ireland would have better information
    than me.  If it is the case that IVF is not done, I am assuming that
    your relative would be looking at treatment in England.
    
    As regards insurance, I was covered by the national insurance
    policy, VHI, which stipulated that infertility treatment would be
    covered after 5 years of joining, and so I was a private patient.  The
    specialist would also take public health patients, but it took MUCH
    longer to get an appointment.  That was in 1989, and the public health
    scene may have changed.
    
    I second what -.1 said about showing a genuine, concerned interest.  It
    is very hard for people who have no infertility problems to understand
    how tramatic this can be.  Comments I have heard that really bothered me are
    ones like "just relax", "at least you can always adopt", "maybe God
    doesn't think its your time yet".  What has helped was an acknowledgement
    that the pain I felt was valid, even if it was not fully understood
    by my fertile friends. 
    
    Cathryn 
    
    

    If your relative is having her tests and treatment done in Ireland,
    VHI will cover most of it, at least until she gets to the Gift stage,
    I am not sure if they cover that or not.   As the last reply states,
    I do not know if IVF is carried out in Ireland, but Gift certainly
    is.
    
    When I went through the infertility bandwagon, it took approx. 11
    months from my first appointment with the specialist until I became
    pregnant.
    
    I wish her luck.
    
    
    
    Bernie

    re: last couple
    
    Thanks for the notes.  I agree that it makes a difference talking
    to someone who has been through it.  I am taking extracts from this
    file and sending them on.  I think it will help her to see others
    who have gone through this as well and have similar feelings.  (Much 
    in the same way, that when I went through the first 6-weeks at home 
    with Sean, I found this notes conference to be a great comfort to see
    others who had been through the same situations.)
    
    A question:  Is RESOLVE worldwide?  US-based?  I am in France.  She is
    in Ireland.
    
    Yes, she will be pursuing IVF treatments this January.  That is when
    she will start in Dublin.  She mentioned 2000 pounds/month.  She did
    not sound like it was covered by insurance.  
    
    Right now the treatments which she is taking are costing $100/pounds
    a month.
    
    Thanks for all the replies.  Any information I can get is greatly
    appreciated.
    
    Regards,
    
     Carol
    
    
    

What, if anything, do you know about your relative's problem?  Many infertility
problems can be treated with less invasive procedures than IVF and GIFT.
Some are untreatable.

I'm pretty sure RESOLVE has publications aimed at friends and relatives of
infertile people.  I suggest you contact them and ask for a list of
publications.  You can also try a bookstore or public library.

Here are some ballpark figures of costs in the U.S.  They're off the top
of my head, so feel free to correct or refine them.  We've done a bunch
of these, so I could look it up if you need more accurate information.
I have no idea how these compare with costs in Ireland or England.

An IVF or GIFT cycle costs thousands of dollars ($5000?).  A full workup
except for a laparoscopy probably runs about $2000.  Day surgery,
like a laparoscopy or a varicocelectomy, runs maybe $3000.  A cycle of
insemination with Pergonal costs about $1500.

I believe the Roman Catholic Church is opposed to IVF and GIFT, so that
may be a factor in the availability of those procedures in Ireland.

    re: 21.146
    
    What do I know?  Not much...
    
    I know that she has alway had irregular periods.  They tried for
    a year before they went to a specialist.  She underwent an operation
    (exploratory surgery?) which indicated that everything seemed to be 
    okay.  
    
    I know her husband had an operation in August.  He was tested to have 
    a low sperm count and/or(?) low mobility???  And had an operation 
    which they said 'he would have needed later in life anyway'...???
    
    The husband's surgery was done in August.  They told him it would
    be the 3 months before they would know anything.  I assume that is
    because it takes 3 months to regenerate the sperm??.  That brings
    them to December.  
    
    I think that if in December they find that his problem is not
    resolved (???) then they will be trying IVF/GIFT after the beginning
    of the year.
    
    As I say, I am only just starting to ask questions, so I am only
    just beginning to understand....
    
    You have all been helpful as is this notes file!  Thanks for the
    help/concern.
    
    Cheers,     
    
     Carol

    We tried GIFT twice...the second time we thought we
    were pregnant for about 2 weeks.  We were actually scheduled
    to be interviewed for a TV spot on the procedure until
    my wife's period started.  I guess they only wanted successes.

    GIFT is more 'natural' than IVF in that the sperm and egg are
    deposited directly into the ends of the fallopian tubes and left
    to travel down into the uterus 'naturally'.  This is the
    procedure of choice when the tubes are open but the ends
    are blocked/scarred due to endometriosis.  In IVF, the
    fertilized eggs are placed directly into the uterus.  This would
    the choice when the tubes are blocked.

    I would not imagine either procedure would help much if the husband's
    sperm show low motility or count.  Perhaps since the sperm
    and eggs can be directly mixed (in both cases) this might
    help with 'low count' problems.

    When we went through all this, we really enjoyed talking to
    our friends and relatives about it..we were learning a lot
    of new stuff and it was a MAJOR part of our life.  We did not
    much enjoy the way we 'talked' to my wife's mother about it...
    she didn't want to hear about ANY of the medical stuff, had
    no appreciation that these things are MAJOR surgery (she came
    down to visit my wife in recovery and was incensed that was
    not made the center of attention, left before my wife came out
    of anethesia).  We were just denying her some grandchildren...
    that was all that was important.

    They both involve a real dedication....I can talk about GIFT.

    She will choose a month to dedicate to the procedure.  She'll take
    drugs and get shots pretty much every day.  She will go to the doctors
    just about every day for a sonogram.  The prep for that is to
    get up and drink massive quanities of fluid, hold her pee till
    she's about to burst, sit in a waiting room full of other women
    who are going through exactly what she is, all cranked up on
    hormones and anxiety.  On a day that her doctor chooses (when
    the ovaries are just about to pop out their eggs), she'll take a
    final shot and head for the hospital.  Her husband will
    ceromoniously be shown a bathroom to produce his donation (or
    he'll 'produce' it before they come in).  The operation will
    take an hour or so....her reaction will depend on how
    she reacts to anethesia.....this is real surgery.  Her doctor
    will have rummaged around in her insides, and it'll feel like it.
    And....then the hardest part.  Waiting......

    Give her all the support you can...from far away, a lot of
    talking will be hard.   I wish her all the luck.
    bob

re .147:

>                                             She underwent an operation
>   (exploratory surgery?) which indicated that everything seemed to be 
>   okay.  

That was probably a laparoscopy.

>   I know her husband had an operation in August.  He was tested to have 
>   a low sperm count and/or(?) low mobility???  And had an operation 
>   which they said 'he would have needed later in life anyway'...???

Until the part about needing it later in life, it sounded like a
varicocelectomy.  I have no idea what it was if that part is correct.
And as Bob pointed out, that's "motility."

>   The husband's surgery was done in August.  They told him it would
>   be the 3 months before they would know anything.  I assume that is
>   because it takes 3 months to regenerate the sperm??.

Right.           

>   I think that if in December they find that his problem is not
>   resolved (???) then they will be trying IVF/GIFT after the beginning
>   of the year.

Many IVF programs in the U.S. don't accept cases with a male factor.
Some are set up for a male factor.  There's a relatively new procedure
called Partial Zona Dissection (PZD) whereby the sperm is assisted
in penetrating the egg.  Some programs use this if the eggs aren't
fertilized within a certain time period ("PZD rescue").

    I have a question regarding varicocelectomy.  First of all, can someone
    tell me how to say it?
    
    My husband and I have been seeking a pregnancy for 3-1/2 years, sure
    seems longer.  I have been with 3 different types of medical coverage,
    which translates to many doctors and appointments.  I have finally
    found a doctor who **really** wants to help me get pregnant.
    
    I have had an HSG and the tubes are clear.  My husband has had numerous
    sperm analyses and several (but not all) have come out low, the last one, 
    was extremely low, 4.3 million.  He has an appt. to see a urologist Sat.
    
    Now to my original question... I have been reading about
    varicocelectomy (from "How to get Pregnant with the new Technology")
    and Dr. Silber (author) seems to think that this procedure has
    absolutely no effect on the patient.  It used to be done quite
    frequently and was thought to be the answer to low sperm counts, but
    now that is not so, and they believe that the couple would have gotten
    pregnant anyway, regardless of the surgery.  Can anyone who has either 
    HAD the surgery or knows of someone who has had it please give some more 
    information?  We have not been told that this procedure is necessary, but 
    if my husband's doctor tells him that he needs this surgery, my first 
    reaction is to not let it be done, given my limited knowledge of the 
    subject.
    
    Any and all help will be greatly appreciated.
    
    Janet
    
    P.S.  You are all wonderful people... I've been following this note a
    long time and I am so impressed with the level of support given to all
    who need it.  Congrats to those successful pregnancies and the best of
    luck to all who seek one.
    

    Just for the record.  Some women do have periods or are late and can be
    pregnant.  If in doubt, try a home test.  I had a two-day period in
    October of '84, but come to find out I was pregnant.  I had no period
    in November of that year so I took a home test.  It came out positive
    and I did have "spotting" for a few days.  From December on I had no
    period or spotting.  My first was born in late June (although the
    doctor told me I was due late July) - the baby showed no signs of being
    premature.  I guess the doctor didn't believe me when I told him the
    October period was not normal.
    
    Now with my second, I knew the day of conception and my second was born
    9 months to the day later.  I guess I will believe that the doctor was
    wrong on "guessing" the due date the first time around.
    
    This is not to say that your wife is pregnant and I hope I don't
    elevate any hopes unnecessarily.  I have since had some of the usual
    "symptoms" but not been pregnant - even to the point where I could have
    sworn I was, but had those feelings all disappear when my cycle
    started.
    
    Good luck in your search to find the answers you are looking for.  This
    is certainly the place for "layman's" help!!
    
    -sandy
    

    re: <<< Note 21.151 by CNTROL::STOLICNY >>>
    		-< Anonymous Entry >-

    To 'anonymous':
    The waiting is hell.  The period every month becomes a small death.
    It's a LOT harder when periods are late.  We only had a few.    

    Hope you don't mind, but I had to smile when I read:

    >I know the doctor is going to check for low sperm count.  I am also not
    >looking forward to the process.

    Most likely, what you'll go through will be nothing compared to what
    your wife will endure.  Go with her to as many appointments as possible.

    What i'm smiling about are the memories of my getting my sperm
    tests done.  Everyone tries to keep a straight face during the
    whole thing.  I had a note from my doctor as to the 'procedure'
    I needed.  I show up at the hospital, not exactly sure what to
    say to the receptionist.  So I just hand her the note.  Oh...
    you want the lab...she gives me directions.  So I walk over to
    the lab and hand another receptionist my note.  Oh..ah...did..ah..
    did you bring it with you?  Well, I say.....sort of.

    It was all pretty painless in the end.  But thinking about it
    still makes me laugh.

    I wish you the best.  I hope your journey is a short one.
    bob

RE: .151

I'm teary eyed as I just read your note, so please forgive me if at times
I don't make sense.  My husband and I started out the same way you discribe
except it hasn't been 3 years it has been 6.  We were married Sept. 1986
and started to "try" to get pregnant during our honeymoon.  In April
of 1992 we were told there was nothing more that could be done.  I had 3
major surgery's, took every hormonal treatment available, took fertility 
drugs until I couldn't stand the pain anymore (shots given to me by my
husband), and we started this process with fertility doctors after we had
been trying only 6 months!  At the end of February, 1992 we started looking
for a baby to adopt.....we wouldn't have it anyother way.....we WANT a 
family.

If you haven't already please research your area for an experienced 
fertility specialist (NOT a Gyn/OB that does fertility on the side)!!!
start there.  The reason is that what ever testing your regular doctor does
will have to redone if you are unsuccessful and need to be seen by a
fertility specialist.  Also, the fertility specialist deals with these
problems on a DAILY basis not a monthly one.  If you are in the Boston area,
I can highly recommend Brigham's and Womens Hospital and their referral
listing...the doctors there are wonderful!!!!  They also have knowledge of 
up to date treatments many of which no longer require surgery (especially
for the man).  If the people giving you advice have never had an
infertility problem DO NOT LISTEN TO THEM!!!  It is NOT anything YOU are 
doing wrong!!!  The crap about relaxing and practice is horse pucky!!!
You need intelligent answers not stupidity.  DO NOT WAIT ANY LONGER!!!! 
Any Metropolitan area Hospital should have good referal lists for 
fertility specialists.

If You asked me today after 5 years of very intense treatments in Boston,
"Would I do it again"? YES, YES, YES......it was worth every bit of the 
pain....because I know deep in my heart I REALLY TRIED!!!! And even though
I was unsuccessful I watched as women who like me had little chance got
pregnant.....and John and I actually shared in their joy!!!!  One particular
couple comes to mind, she was 46 years old, he 49, and they had been married
one year (no other marriages and children for either).  In THREE months
what they thought impossible happened.......she got pregnant....and had
a HEALTHY baby boy, he was perfect! she had beat the odds.  Another couple
the husband had a extremely low sperm count and they were able to separate 
the strongest sperm and reintroduce them vaginally to her and after 2 attempts
got pregnant (she had twin girls).  These are only a few examples from my
office only.......

If it wasn't for my husband.....and his continual support.....you see the 
problem was ALL mine....he is fine.  I had to deal with the guilt of having
my period each month and only thought of myself as a failure! I HATED myself
for many years...it was very difficult getting rid of those feelings! I tried 
to divorce him....I picked fights with him so he would stop loving me and
find someone who could have children, again I was unsuccessful!  Thank God!
I love him more because he has stood beside me every step of the way....
after 6 years I have learned to accept what life has dished out and I 
thank God every day for my wonderful husband he has given me to love!  

If you want to be one of the lucky ones.....you have to get the best 
fertility specialist you can find and let him/her do all the work...they
WILL find the answer, the odds are in your favor.  If you sit back and wait 
for "nature to take its course" you may never have the answers.  And NEVER 
forget there are LOTS of us out here who just like you have felt the pain....
and if you ever "just need to talk" or have questions about any of the
procedures/tests, (My husband and I have had them ALL), or what to 
expect when you make your appointment......please feel free to call me
or write me a note off line.  



Good Luck (remember sometimes Mother Nature needs a good kick in the
pants) and my prayers are with you both!!!!

Donna Kelleher
ROYALT::D_KELLEHER
235-8688

re .150:

>    I have a question regarding varicocelectomy.  First of all, can someone
>    tell me how to say it?

Var-i-co-see-lec'-to-mee.  It's basically the removal of a varicose vein
in the scrotum (called a varicocele).

>    Now to my original question... I have been reading about
>    varicocelectomy (from "How to get Pregnant with the new Technology")
>    and Dr. Silber (author) seems to think that this procedure has
>    absolutely no effect on the patient.

I wasn't aware of that.  In his earlier book ("How to Get Pregnant"), he
says it works, but no one knows why.  I did a literature search a couple
of years ago, and I didn't see anything about it not working.  I seem to
remember that the success rate was something like 80%.  Dr. Silber is
one of the top urologists in the world.  He has pioneered some fertility
procedures, so he's no schlump.

Varicocelectomy is done as day surgery, usually under spinal anaesthesia.
A small incision is made in the groin.  Most varicoceles are on the left,
but it's possible for there to be varicoceles on both sides.  It takes
a couple of days to recover.  Since it takes about three months for sperm
to develop, results aren't known until three months after the surgery.

    
    
    	My husband and I are going to the doctor today to start what
    	ever it is to find out what is wrong with me that I can't get
    	pregnant.  
    
    	What questions do I ask the doctor.. ?????
    
    	What should I expect when I go????
    
    	Donna

What to expect on your first visit:

He'll look for "obvious" things like hormonal imbalances, environmental
factors, and physical problems.  It's mostly done through taking both your
histories and doing blood tests.  He may give you a pelvic exam.  He'll
probably schedule a sperm test for your husband.  If you haven't been
charting your temperature, he'll have you do that.  He'll tell your
husband to switch from briefs to boxer shorts, and to avoid heated car
seats and hot baths.

What to expect later:

There seem to be some differences of opinion regarding the order in which
other tests are done, but you should try to get the least invasive tests
done before the more invasive.  That means the order should be something
like post-coital, endometrial biopsy, hysterosalpingogram, laparoscopy.

If your husband's sperm test shows problems, he'll refer him to a urologist
for further testing.

    Donna, (.156)
    
    Gerald gave you a good synopsis of what to expect at your visit....My
    doctor first started with the sperm analysis since we suspected my
    husband (due to a long medical history) and temperture charting for me.
    
    She gave me a kit (chart and thermometer) and an appointment for 12
    months out.  At the second visit, we brought the sperm analysis report
    and the charts (and a pregnancy although we did not know at the time)
    
    Good luck, I hope the road is as short for you as it was for us!  
    
    -beth

    RE:  Varicocelectomy
    
    I had entered a much more detailed note about this, but it was
    apparently too large for my buffer to handle, so I will now paraphrase
    from the book "How to get Pregnant with the new Technology" rather than
    copy directly.  The book is by Dr. Silber and I recommend it to anyone
    who has had trouble getting pregnant.  If nothing else, I have learned
    a great deal about the female and male reproductive organs, and how
    miraculous it is that any of us are here.
    
    Varicocelectomy used to be considered the "cure all" for low sperm
    count.  In fact, 15 to 20 percent of all males on this planet have
    a varicocele of the testicle.  It is a varicose vein.
    
    It has been determined from many in-depth studies that a
    varicocelectomy doesn't have any affect on whether or not a pregnancy
    is achieved or even on the sperm count itself.  There are so many
    changes in the sperm count from month to month that some men were
    labeled with low sperm counts when they probably did not even have a
    low sperm count.
    
    Dr. Silber goes on to say that many urologists rely on varicocelectomy
    for their income, and that 30% of men whose wive's gynecologists have 
    refered them to a urologist are diagnosed with varicocele and have this
    unnecessary surgery.  It's a scam.  The section in his book is aptly
    titled "The Varicocele Scandal".
    
    Some of his patients were also told they had varicocele by another
    urologist and he found none at all.  One of them had the surgery (by
    another urologist) and the clumsy surgeon tied off the spermatic
    artery, leaving him azospermic (without sperm)!!
    
    I am only entering this note to help educate those who may be diagnosed
    with this common problem.  As a matter of fact, my husband was
    diagnosed with it on Saturday.  They have not recommended the surgery,
    but have requested another semen analysis.  If it is recommended,
    we will not be going through with it.
    
    It's just so frustrating.

re .150

Gerald gave a good description of the procedure.  

I consider both he and I "veterans" of the infertility rollercoaster.  It
took my husband and I *EIGHT* years of treatment to produce 2 children. Until
his surgery he consistently had a low count and low motility scores. He had 
at least *25* tests performed.

My husband had the surgery performed on both sides, 4 years ago.  

Our infertility specialist had us wait 3 months and 
then started with monthly inseminations.  He predicted it would take about 9 
months for my husband's sperm count and motility to enter the "normal" range.
They tested his "sample" with monthly for each insemination.  I got pregnant
after the 7th insemination (10 months) -- his count and motility rate had 
reached the higher limits of "normal".

Best of luck,

Rochelle


P.S. A word of advice - Be careful what you pray for....
This procedure worked a little *too* well for us.  Our third child is
now 11 weeks old.  Dad had a vasectomy just 2 months ago (3 years and
8 months after his varicelectomy)!

    
    Well, now I'm totally confused.
    
    The operation *obvisouly* helped you, Rochelle!  Congratulations on your 
    FAMILY!  And believe me, I would rather have three beautiful babes than
    none at all.
    
    As Gerald said, he's (Dr. Silber) no schlump... so what now?
    
    Maybe I'm getting all worked up over nothing.  Maybe they won't
    recommend the surgery after all.  Maybe my brain is fried.
    
    All I know is that I don't want anyone going near my husband's privates
    with a knife if it isn't necessary.  You know what I mean???
    
    Janet
    

    >Well, now I'm totally confused.
    
    you mean as to whether this operation is necessary?  I think
    Dr. Silber just means that it sometimes may be, but it is performed
    much more often than it needs to be (like a great many operations).

    Good Luck...ask questions.  Find some one you really like...you
    may be visiting your doctor a lot.  Find someone you REALLY trust.
    You want confidence that you are getting the correct advice/treatment,
    etc.

    Try to have your husband come for as many doctor visits as possible.  He
    will better understand what you are going through and this is really
    team effort!

    And i liked the advice about being careful about what you pray for..
    we have 4 beautiful kids and our lives are upside down!

    Let us know how it goes....if you want any advice, you know where to
    ask.
    bob

    
The following is note is entered at the request of the anonymous
noter, "F.E."

Carol Stolicny, PARENTING co-mod
-----------------------------------------------------------------------

Well, for those of you who read this notes file regularly, I'm entering
this note after a couple months of not sending any notes.  It's been
a very tough road so far.  I was reading the recent notes and just started
crying uncontrolably.  I thought I handled my miscarriage (2 weeks ago I had
my 2nd one) just fine.  But, then, reading the entries, just opened up the
flood gates for me.

After months of testing it was determined that I have
luetal phase defect (low progesterone in 2nd half of cycle).  So, I've
been doing IUI and progesterone suppositories over the last 4 months.  2 of
the months I was able to also use clomide (months in which I had no cysts).
Well, I got great news on my last try! POSITIVE TEST...Boy were we happy!!

But, at the same time my boss was laid off.  My new boss requested that
I take a 2 week business trip.  I had very short notice for the trip.  I
wanted to turn it down and say I was pregnant.  But, in these turbulent
times, I was afraid he'd remember that and I'd be put on a future lay off
list.  Call me crazy, but, these thoughts do go through my mind these
days.

Well, while I was on the trip (unknowingly) my progesterone level dropped.
Turns out I needed to increase my dose.  I miscarried 3 days after I returned
from my trip. If I hadn't been out of town, by Dr. would have been able
to monitor me closely and change my progestone dose.

Now I am waiting for my next period to come, so I can continue to try.
I keep punishing myself for being a wimp and going on the business trip.
I never should have gone.  I wish so much that I was still pregnant.  My
close friend called last week, she's pregnant (by "accident") with her
2nd child.  It's so frustrating!!

***Maureen, how is your pregnancy going??? If you still read this notes
file please let us know.  Hope all is going well!!!

Take Care,
Forever Hopeful

    
    Forever Hopeful...
    
    Keep your chin up....and don't give up trying. I'm sorry to hear your 
    news...stay positive...we're all here rooting for you!
    
    I don't have any experience with infertility, but just wanted to send a
    few hugs, we all need them once in awhile.
    
    Keep smiling!
    Chris
                                              

In this day and age, I don't blame you for thinking that you would be on
the "hit" list if you refused the trip.  But, please, the next time (and
there WILL be a next time) tell your boss that you are unable to make the
trip but that you would be happy to go next time.  I am sure he will 
understand.  

They are'nt supposed to punish you for being pregnant.  it is hard enough
without the extra pressures.

Hang in there.

Ed..

    Keep your dreams close to your heart and know that someday they will
    come true!
    
    Please don't beat up on yourself for taking the trip...try to trust
    that all things happen for a reason.  On my second IVF cycle I had
    hyperstimulation, a urine infection, and seven kidney stones...but
    Chelsea managed to implant and hang on!  I guess I'm a fatalist and
    trust that it will happen when the time is right.
    
    The good news is the doctor seems to have a handle on your problem
    (i.e. progesterone levels) and the next time will be able to monitor
    you closely.
    
    Take care of yourself..
    
    ..Lori

I realize it may be difficult with a new supervisor, but it's very helpful
if your boss knows that you're undergoing infertility treatments.  How else
can you explain your schedule?

I agree with Gerald.  Your boss should definitely know what you're doing,
and that you may not be able to travel. You may be pleasantly surprised
with your boss's reaction. I know that when I took my job before this one,
I told them I was doing infertility stuff, the extent of it, what was 
involved, and how I thought it would affect my performance prior to even
accepting the position.  I also asked how they thought it would affect the
position, and everyone was more than willing to accommodate my flaky 
schedule.

And when I took this position, I was about 8 weeks along, so I already
knew it was twins.  I told my hiring manager that I had done the infertility
work-up, was expecting twins, and did he think that was a  problem.  The
only concern he had at the time was if I was planning to come back, which
I hadn't even thought of as a concern since it never occurred to me not
to come back.  I also had a luteal phase defect, so was on progesterone
for a full 12 weeks, then another 2 weeks when I had some spotting.  My
doctor recommended that I not travel on an airplane, though he said there
was no proof airplane travel would cause miscarriage, but that I would
probably blame myself if something happened so to avoid flying.  So when I
needed to go up to Maine for a meeting, I couldn't fly up with everyone 
else.  My boss approved an overnight stay for me so that I could drive
up the night before. It cost Digital about the same (maybe even less), so
was not a big deal.  Based on all my experiences over my 5 year infertility
work-up, I would say definitely tell your boss.

I also have a question for you.  Did they monitor your progesterone level
because of the luteal phase defect?  I'm wondering because I have that also,
but there was no monitoring, just what seemed like the standard practice of
doing the progesterone suppositories for the full 12 weeks.  And if you
do end up doing that, the progesterone can cause spotting which certainly
panicked me the first time it happened.  I guess it's abrasive.

Best of luck.

Cathy

    
The following reply is posted for the anonymous noter who signs
herself "F.E."

Carol Stolicny, PARENTING co-mod
-----------------------------------------------------------------

Thanks for the hugs and support.  I really appreciate it.  I'll keep
you all posted as I progress....


re: .168

>I also have a question for you.  Did they monitor your progesterone level
>because of the luteal phase defect?  I'm wondering because I have that also,
>but there was no monitoring, just what seemed like the standard practice of
>doing the progesterone suppositories for the full 12 weeks.  And if you
>do end up doing that, the progesterone can cause spotting which certainly
>panicked me the first time it happened.  I guess it's abrasive.

Yes, they monitored my progesterone because of my luteal phase defect.  My
Dr does this (especially when she puts someone on the suppositories).  She
said that the suppositories don't "always" do the job. So, if she sees
a problem or a dropping level, through the periodic blood tests, she
switches her patients from the suppositories to the progesterone shots.
She uses the suppositories initially because she feels they are the best
and easiest for the patient when they work.

As for the spotting, she warned me that the suppositories can sometimes
irritate and lead to spotting.  But, she also said that the spotting would
be minor and pinkish.  Is this what you experienced?

re: 167

>I realize it may be difficult with a new supervisor, but it's very helpful
>if your boss knows that you're undergoing infertility treatments.  How else
>can you explain your schedule?

If I get pregnant again, I plan not to do any airplane traveling.  However,
I will only tell my boss that I am in therapy which requires me not to
travel (that's what I should have done last time). I won't be telling him
specific information about what type of treatment I am going through.  As
for my schedule, I have very early morning appointments for the most part
that don't carry over to my working hours.  Obviously, twice a month when
I have my IUI I have to take some time off....but, it's worked out ok
so far.  (Thanks for the input though...I can see that in some scenarios
telling my boss would be helpful.  In his case though, it would not be good
for me)


Thanks,
F.E.

    
    
    	Question (mostly just curious)?
    
    	Say your husband couldn't have children because of a vacectomy(sp?)
    	or something like that.. 
    
    	and you both decided to go to a donor (sperm bank) what would
    	you tell your child when he was old enough.
    
    	He/she is not a adopted.. 
    
    	Signed 
    	Curious

    
	When my child was "old enough" I would tell him/her that we both
    decided to go to a sperm bank to have a child.
    
    			Wendy
    

    I'm no expert on this, and I'm sure that people who've made this choice
    can offer a more informed opinion, but it seems to me that it's best to
    wait until the child is 18.  There's just no purpose in a child knowing
    before that age.
    
    I think that telling a younger child would just upset his/her identity.
    The primary (only?) reason the child needs to know is to have his/her
    true medical background, both for health planning and for genetic
    screening before becoming a parent.
    
    My own opinion, of course.
    
    This applies when the child has a father.  But how do single mothers
    and lesbian mothers handle it when a child asks "Who is my father?"
    
    L

  There is a book called Having Your Baby by Artificial Insemination by
Elizabeth Noble.  (An MD who with had a baby this way, her husband was the
baby's legal father, but they used a friend as a donor).  This book goes into
all of the implications of having a baby this way, as well as practical
considerations.  She feels strongly that openness is the best policy.  There
are a lot of parallels to adoption, where now it is realized that secrecy is
damaging to the child in the long run.  Her daughter knew from a very early 
age that this other man helped to create her.  Anyway I would recommend the
book.  
	Linda

    I have a question that I haven't seen in here yet...
    
    They say that hot baths, hot seats, boxer shorts, etc are
    believed to contribute to low sperm count....
    
    What about waterbeds?  They're heated...
    
    Any thoughts?

    
    >They say that hot baths, hot seats, boxer shorts, etc are
    >believed to contribute to low sperm count....
    
    Boxer shorts are supposed to alleviate the problem because they allow
    the testicles to descend below the body and remain cooler, whereas
    bikinis etc hold them tighter to the body and therefore hotter.
    
    Yes, water beds can have an effect, as can electric blankets.
    
    Also, they say this can also have a bearing on the male - female
    balance of the sperm too, because male sperm will not survive heat
    as well as female sperm.
    
    Stuart

    Forever Hopeful, 
    
    Don't give up hope.  My best friend's mother had 3 miscarrages before
    she was able to have the next four children.  Don't blame yourself. 
    Things will work out.  Just keep your chin up and go on.  Remember,
    there is always hope. (Even if it comes in the form of adoption.)
    
    Keep the faith. 
    
    RE
    

Hi,

	Up until now I've been a read-only member of this conference,
        especially this note.  I'm extremely grateful to all the people
	who have contributed to this topic, it's been a real big help for me.

	I've been infertile for over three years and just recently I 
	completed my first cycle of Pergonal treatments. To my surprise and 
	delight, we were successful ... I actually got	pregnant on my first 
	attempt!  But, unfortunately, my joy was short lived, I miscarried 
	soon after testing positive.

	My infertility problem is lack of ovulation due to amenorrhea 
	(no menstrual cycles).  I haven't had a period (without drugs to 
	induce) since going off the birth control pill 3 and 1/2 years ago.
	Although I'm anxious to start my next round of Pergonal, I can't help 
	wonder what went wrong.  Since it was the first time I ovulated in 
	over 6 years,  I was amazed I made it as far as I did.  What causes 
	such an early miscarriage? ... it was only about 18 days after 
	ovulation.  I used progesterone suppositories twice a day as 
	instructed ... is there anything else that I could do to enhance my 
	chance of a successful pregnancy for the next time?  It seems that 
	most of the literature 	available tells you how to 'get' pregnant, 
	not how to 'stay' pregnant.

	I'd appreciate any advice you can share with me.  

Thanks,
Nancy
                  

I also suffered a miscarriage in the first trimester.  In reading through my
books, I read a staement where a very high percentage of miscarriages in the
first trimester are due to a non viable fetus.  It is often nature's way of 
dealing with the problem.

But I still wonder myself what life what have been like if...  I have two 
boys (the miscarriage was between the two).  Would it have been a girl?  But
then I wouldn't have had my Markus.  

At least you now know that you can be pregnant so good luck with your next
try.  I wish you a pretty little bundle of joy in the new year.

ccb

    
    
    A friend of mine told me about a fertility stone, that I should
    wear.
    
    Has anyone had someone try to give home remedies - what were 
    	they?
    
    Donna
    	

    Donna:
    
    I wanted a baby something terrible.  We tried and tried for two
    years with no success.  My doctor wanted to put me on clomid.
    We said no.  I decided that I was only 24, and had a few years
    ahead of me.  We gave up trying.  I thought I was too young to
    have a child, and decided to wait.
    
    My very next period never came.  I was 8 weeks pregnant.  ;-)
    
    The stress I feel caused me, not to conceive, in some strange way.
    I stopped basing all my goals on having a child.
    
    Just my .02 worth.  I know it is hard to "put aside" but it 
    worked for me, with a lot of faith, and my prayers were 
    answered.  Jaime is now seven months old.
    
    cj

    cj,
    your story reminded me so much of 2 friends' tales - 
    the first was a woman I had known in highschool - she'd been
    trying for 8 years to concieve - she had a very severe hormonal
    problem and was only ovulating sporatically. After every
    kind of drug and physical exam, they decided to stop the 
    interventions - shortly after she found she was pregnant - 
    their boy is now a year and a half old.
    
    The other story is of a co-worker who told me how desperately
    she wanted to get pregnany after her miscarriage - the more
    she focused on it, the less success and more stress it
    seemed to cause both of them - She told me the month she decided
    to "let go" of the obsession, was the month they had success.
                                                           
	good luck to all you potential moms!
    	Monica

As earlier replies in this topic testify, saying "relax" to people with
fertility problems is a sure way to get them worked up.  See .64-.75,
.143, and .154.

    
    I started this on light note.. Has anyone done gotten any suggestions
    for things to wear and or vitmins to use.. 
    
    	I don't want to get started on word RELAX....  
    
    I thought it would be nice to share some of the things that we hear
    to wear.. 
    
    Donna 

    One of my favorate RESOLVE quotes is:
    
    "Stress DOES NOT cause infertility.....infertility causes stress!
    
    From someone who knows,
    
    Deb

And on the other side, a good friend of mine went the entire infertility
route for a long time and finally gave it up.  She, unfortunately, did NOT
become pregnant when she was once again "relaxed".  It must be very very hard.

ccb

Cheryl brings up a good point.  Everybody's heard anecdotes about couples
who've (a) given up on infertility treatments, or (b) adopted, and have
then become pregnant.  But I'd venture to say that such cases are far
outnumbered by those who haven't.

about 1 in 1,000 couples ......not great odds when you
look at it this way!!!

also as of 1992 statistically only 1 out of every 40
couples end up adopting a baby (this is only counting 
those that purposely begin the process, not just talk 
about it) - instead fall out at sometime in the process 
- too stressful, too expensive, too painful, and some 
just plain give up!

No one guarenteed me Life was going to be easy......
we all have our personal cross to bear......

Donna & John

    
    
       Here's 1 couple that finally found success!!  I just found out
    Monday that I'm pregnant after a year of going through the Invitro
    Process...........I couldn't be happier!!
    
    Physically I don't really know what I'm feeling yet except I've
    developed an aversion to coffee, whic is fine cause I'd have to
    give it up anyways.
    
    I'm all of 16 days pregnant so wish me luck!!
    
    Deb
    

Congratulations!  If you don't mind my asking, how many cycles of IVF did
you do?  Where?

    That's spectacular!

    
    
    	All right - I love to hear good new..  
    
    
    	Best of luck keep us informed.. 

The following note is being entered for a member of the PARENTING
notesfile community who prefers to remain anonymous at this time.

Carol Stolicny, PARENTING co-mod

----------------------------------------------------------------------
	I have a question regarding my ability to conceive.  I was on
	the pill for nine years but I've been off it for 7 months now 
	and my husband and I have been trying to conceive for three months 
	with no success.  I happen to know about when I ovulate since 
	I've been taking my temperature so it isn't a matter of missing 
	the right time of the month.  I know that three months isn't
	long to be trying and I'm not getting too worried about it, however
	something somebody said to me got me wondering.

	My question is basically this, since I've been off the pill,
	my periods have been extremely light, even lighter than when
	I was on the pill, and much lighter than 10 years ago.  They
	last only a few hours, then I spot for 2 days.  I'm wondering
	how a fertilized egg can be implanted if I have so little 
	lining in my uterus.  If this indeed could be a problem, I'd
	rather go to the doctor soon, rather than wait several more
	months and be unable to conceive.  For all I know, conception
	could have happened for the past three months but implantation
	was not successful.

	I'd appreciate knowing if anybody had problems getting pregnant
	due to extremely light periods.

	Thanks,

	... anonymous ... 

    My personal experience.  
    
    I was on the pill for 14 years with only a couple 3 month breaks in 
    there.  When I went off the pill I had extremely light periods and 
    was rather excited because heavy periods were the reason I went on 
    the pill in the first place.  However, I did get very frustrated 
    and tried to get pregnant for 16 months.  I  had just scheduled an 
    appointment with a fertility specialist.  I never went, I now have  
    a beautiful daughter.  My periods never did get heavy although I
    was very crampy and some months I would just spot.  I do remember
    having 1 or 2 heavier periods in that year and a half stretch but
    they were not the months I concieved.   Unfortunately since the 
    birth of my daughter I remember what real periods are like.  8.(  
    
    
    lori
        

    
    
    	A doctor will probably not do any work up on fertility until
    	a year has gone by... Doing the temp chart is a really good
    	idea because it's the first thing they ask for.. 
    
    	The second is for your husband to donate sperm so that 
    	they can count how many he has.. (Simple procedure but
    	it took me over a year to get my husband to do it).
    
    	He wishes that he did the test in the begining (hind site is 
    	always 20/20.. 
    
    	I took the pill and was light for about 6 month's but then
    	they started to get longer.  If your concerned ask your doctor.
    	
    	If you have any other questions please feel free to write me
    	off line zeke::fultz.
    
    	Donna

    
>    	The second is for your husband to donate sperm so that 
>    	they can count how many he has.. 

    'Donate'....I love all the little ways we have to describe this!

    As I teenager, I never would have imagined that I would
    be expected to sit in some stall in the hospital and in front of God
    and everyone 'donate' some of these little guys.
    bob

    
The following is being posted for the anonymous author of note 21.192.

Carol Stolicny, PARENTING co-mod



	re: 21.193, 21.194, 21.195

	Hi folks,

	Seems I should have waited a week before posting my anonomous
	reply in 21.192.  I missed my period last week, took a home test,
	it was posititive, and had it confirmed at the Docs this morning!
	I'm pregnant!

	I am still concerned about the uterine lining being sufficient.
	Since I'm now 10 days late, can I assume that the embryo has
	successfully implanted and that if I have a miscarriage, it will
	be for other reasons?

	Actually, I'm going for my first prenatal checkup tomorrow and
	that will be one concern that we will address.  I'm also having
	abdominal pains, unlike mentrual cramps, but they are worrying me,
	especially Monday when I could barely stand up for the pain.
	It only lasted an hour or so, then I was fine until last night.
	Not as bad the second time though.

	Thanks for your earlier input!  I'll go public (non-anonomous)
	in a few weeks ... end of the first tri-mester if I can keep my
	mouth shut till then!

	... anonomous ...
	

If you are concerned about having a possible lack of uterine lining, ask
your doctor about it.  He can check your hormone levels, and can even keep
an eye on it to see if you need supplemental progesterone which you can
take as suppositories.  I did it for the first 12 weeks due to a diagnosed
luteal phase defect, and the only side-effect was some spotting due to the
abrasive nature of the progesterone.  Wish someone would have told me that
_before_ the spotting started ;)

And you can also ask your doctor about the cramps, but it's possible that
those are the cramps that are associated with the baby implaning firmly
into the uterine wall.  I had similar cramps when I got pregnant, except
I was positive they were to announce the impending arrival of my period,
and since it was a GIFT procedure through which I got my kids, I was not
pleased about them.  The cramps lasted a good week from just before I 
expected my period to just after the second blood test confirming my 
pregnancy.  Cramps like that are fairly common.

Congratulations!
Cathy

    
The following note is entered at the request of a member of the
PARENTING notesfile community who prefers to remain anonymous at
this time.

If you wish to contact the author by mail, please send your message to
me and I will forward it to the anonymous noter.    Your message will
be forwarded with your name attached unless you request otherwise.

Carol Stolicny, PARENTING co-mod
****************************************************************************

Hi - I am interested in hearing from others who may have a similar experience
with infertility.  I have undergone the standard tests, post-coital, endo
biopsy, sperm analysis.  I was treated for mycoplasma, which was the only
thing they could find that was wrong.  The same month I was treated for this,
I had the Hystersalpingogram (sp) - dye in the tubes - which was normal, I
for some reason became pregnant on my own right after, but it ended in
a miscarriage at 12 weeks.  (The reason I'm entering this anonymously is 
because it was uncomfortable for me to return to work after this, so if I 
get pregnant again, I want to keep it to myself for a while!)  Anyhow, I 
thought I'd get pregnant again right away, but not!  Now it's been almost 
a year, and I've had another endo-biopsy, a laparascopy, and tried a few months
of clomid, which didn't work.  SO, now I've just started my first round
of Pergonal.  I need some encouragement at this point, and would like to
hear if anyone else has unexplained infertility and if Pergonal has help
them, or other routes you've taken.

- Trying 

  

    I'm sorry....

    We've been trying everything for a few months now to become pregnant
    and haven't had any luck yet.  My first pregnancy took over 9 months to
    achieve, we lost our son at 5 1/2 months.  In talking to various
    doctors about both why we lost our first and why is it taking so long
    to become pregnant, one doctor wants to perform the dye in the uterus/
    tubes testing to see if there's a problem there.  He said that they
    aren't sure why, and no formal statistics have been done on this, but
    many women who have had problems achieving pregnancy for months/years
    have become pregnant immediately after this test.  He said that it's
    possible that scar tissue in/around the cervix is broken up during the
    procedure and would therefore allow more of an entrance way for sperm.  

    I can't offer any info on taking Pergonal, I just thought it was
    interesting that you became pregnant after the dye injection.  Maybe
    it's something you might want to bring to the attention of your doctor?  
    Since my doctor told me this, I've asked around and have heard similar 
    comments by many people.

    Keep trying, I keep trying to reminding myself that it worked once, it 
    *will* work again.  I know it's not easy, best of luck.

    

    
The following is being entered for the anonymous noter of
note 29.198.

Carol Stolicny, PARENTING co-mod
*****************************************************************************

re: .199

I too am sorry to hear of your loss, I know how you must feel, having been
through it myself.  And it is interesting about what you were told about
scarring around the cervix.  I did ask my doctor why he thought I conceived
the same month right after the dye in the tubes, and he said he did not know,
but that sometimes there may be something small in the tube that gets flushed
out.  However, I don't think that was the case for me, because I just had
the laparoscopy last month, which included pushing dye through the tubes, but
no luck this time.  I do not know if scarring around the cervix can be 
detected during the laparoscopy?  I started Pergonal this month, because my 
according to my dr. it was the next step, even though I do ovulate and every
thing seems to be fine.   I even did ask him about having another dye test, 
since it worked the last time!  But he said he didn't think it was a good
idea.  (why i don't know).  So, I guess I'll just have to wait and see
if Pergonal works this month. My best of luck to you also.

- Trying

Pergonal is usually used in conjunction with IUI (intra-uterine insemination)
or assisted reproduction (IVF, GIFT, ZIFT).  I gather you're not doing any
of these.  Why is the doctor giving you Pergonal?  Is he a fertility
specialist?  How is it being monitored?

    I became pregnant after one months course of Pergonal.    I was due to
    have AIH that month, but on my scan the Gyn spotted what he though
    was a cyst.   So we decided to put off AIH and give me the Pergonal 
    differently the next month, I was on daily doses.   He though the 
    Pergonal had caused the cyst.   I went home pretty much fed up.   
    Would you believe it, I made love to my husband that night and
    became pregnant.    I now have a beautiful nearily 17 month old
    son.     
    
    Hope this helps.    Good luck.
    
    
    
    Bernie

    
The following is being entered for the anonymous author, "Trying",
of note 21.198.

Carol Stolicny, PARENTING co-mod
________________________________________________________________________


I'm glad to hear it worked for you after one month's try on Pergonal!  Maybe
I'll be so lucky!  8*)

My dr. is not a specialist, he is a regular gyn. who treats infertility also.
He does not do gift or any of the more technical things.  I believe he
started me on Pergonal for the fact that we can't find a problem anywhere.  He
did say he wanted to attempt IUI next month, after one month if just pergonal
alone doesn't work.  I'm going talk to him about trying IUI this month though,
Maybe my problem is the sperm just not reaching the egg somehow.  I am being
monitored by blood tests and ultrasounds, my next one will be tomorrow.

Keeping my fingers crossed...

-Trying

Given the range of procedures you've been through, I'm surprised you're not
seeing a specialist.  I think it's unusual for a non-specialist to administer
Pergonal -- it's very easy to give too much, resulting in hyperstimulation of
the ovaries.  Monitoring should include daily ultrasounds and blood tests
(estradiol levels).  Even with this, even the best fertility clinics in the
country occasionally hyperstimulate.

I'm also surprised that a general doctor is going the Pergonal route.
Given where you are in the process, I would definitely recommend a
fertility specialist especially if you will be starting IUI, GIFT or
IVF all of which require some special equipment for the procedures
such as the sperm washing.

I did 6 cycles with Pergonal and IUI, 1 cycle with Pergonal, Metradin
and Lupon for a cancelled GIFT that was turned into an IUI, 1 cycle
with Pergonal and Lupron which was also a cancelled GIFT that turned
into an IUI, and 1 Pergonal for a successful GIFT attempt.  With things
like GIFT and IVF, a lot of clinics do 1 month on and 1 month off.  With
the IUI's, the clinic I used did 2 months on and 1 month off.  This is
to give your body a break from all the drugs.  You might ask your doctor
what his plans are for how many cycles you will be doing before taking
a break, how many cycles he wants to try IUI (6 is common) before moving
on to IVF or GIFT, and how many of those attempts he recommends. Also,
you might ask where he will send you for the more advanced procedures if
you should need them.

Has your doctor checked for sperm antibodies? You didn't mention that
test, and it can affect the treatment planned.  I did about 3 1/2 years
of infertility work-ups with a specialist who never checked for that,
and when I got referred to a different specialist for the more advanced
techniques like GIFT, that was the first thing he checked.  And I did
have them, so the chances of me getting pregnant on something other
than GIFT or IVF were slim given the antibodies.  It's just one more
question to ask your doctor.

Best of luck.

It's unusual for Pergonal to be given without IUI or assisted reproduction.
In the only case I've heard of, it was needed for *any* follicles to mature.
Has your doctor explained why he's using Pergonal?

Regarding the number of IUI cycles tried before moving on, I think 6 is
on the high end these days.  Our doctor thought 3 was enough.

    
The following note is entered at the request of a member of the
PARENTING notesfile community who prefers toremain anonymous at
this time.   This is not the noter who signs herself "Trying".

Carol Stolicny, PARENTING co-mod
******************************************************************************
Hi,

	I've recently become pregnant using Pergonal without requiring
	IUI, IVF or GIFT.  I actually became pregnant on my very first 
	cycle but I lost it at 6 weeks.  However, on my second try
	(without taking any time off after the miscarriage) I was once
	again successful, this time though, very successful.  We managed
	to create 5 healthy embyros, including 1 set of identical twins.
	I carried the 5 until my 13th week when we chose to reduce ( a very
	difficult decision) to triplets.  I'm now 18 weeks along in my
	pregnancy.

	Obviously, I'm very happy with the results.  Pergonal was the answer
	for me since I have ammenorrhea, the absence of menustrual cycles,
	so I never ovulate.  However in your case, I would be cautious.  I too,
	am surprised that your doctor is prescribing this drug without knowing
	more about your specific problem.  I agree with the others that  you
	may want to go to a specialist at this point.  The mere fact that you
	were able to successfully conceive once makes me think that your
	problem should be looked at further.

	Two comments about my experience on the drug:

	I never had any trouble while using Pergonal, I felt fine.  However,
	my OB has recently discovered a few lumps on my breasts.  I had
	a biopsy done and they are just fibroids which will be removed after
	I deliver.  I know that these lumps are very recent, and my doctor 
	explained that they are most likely a result of the drastic
	rise in hormone levels that my body underwent while I was on Pergonal.

	The other warning I can give you is that this is a very inexact
	science.  During the cycle that we conceived the quintuplets, I was 
	told that my body was reacting slowly to the medicine and that at most, 
	I had two viable follicles!  So, even with the very close monitoring,
	miscalculations can be made.

	Just food for thought.  To me, the fact that my infertility problem
	was solved far outweighed the minor complications.  I have no regrets.

Good Luck

    
The following is another reply from the anonymous noter "Trying".

Carol Stolicny, PARENTING co-mod
---------------------------------------------------------------------------


Hi all, thanks for your replies.  My doctor has recommended that I try
Pergonal for 6 months.  I also felt that there really wasn't any effort that 
went into finding out why I concieved once, and I did ask him about this but 
all he said was "we don't know, could have been....bla bla bla"  but thats as
far as it went.  I now wish I had known enough to ask him exactly why he
thought pergonal would work -- I guess I was just going by what he wanted to
do.  That and the fact that after waiting so long, (it'll be 2 years now
that I've been going through this) you get to the point where you hope something
will work!  But you have all brought up some good questions for me to ask,
and I am most likely going to try another doctor (specialist!) if this does
not work, since I don't think he can do much else after this.  Oh well,
I guess I'll just have to wait and see.  Sigh.

-Trying  

    
    
    	At first I had a obgyn which in my opion was complete waste of time
    	(a years worth).  I am now going to a fertility specialist and
    	in 3 months he knows exactly when ovlating what problems that might
    	occur.  He is always straight forward and holds no punches.
    
    	How did I get referred to a specialist?  I became a b*tch, asked
    	questions the obgyn couldn't answer.
    
    	Next month we start AI.. I am really excited and scared but 
    	waiting for the process to start is over.. There might
    	be other problems but, I know the fertility specialist will 
    	handle them.
    
    
    	Good luck..  

The following note is entered at the request of a member of the PARENTING
notesfile community who prefers to remain anonymous at this time.  This is
a "new" anonymous noter who signs herself "Cautiously Hopeful".

Carol Stolicny, PARENTING co-mod

----------------------------------------------------------------------------


	I'm looking for some help/guidance.  My husband and I have been 
trying to conceive for a year now.  I have just been given the ok from my 
primary physician to begin infertility workups/treatments.  

	It's strange, how over the past several months with each period I
have gotten very depressed, and now I seem to be feeling much better about
things (although still not pregnant) becuase I feel that I may now be able
to find the answer to why we have yet to conceive.

	My primary physician has said that it's up to my husband and I if we 
want to begin with my OB/GYN for all the preliminary work or go straight to 
Brookline to IVF Boston Clinic.  I'm not sure which route to go.  I am very
comfortable with the GYN I use, and he is located much closer to home and
work, but are there reasons/benefits for me to go straight to the clinic?

	Also, a more general question.  What are some of the things that we
should be cautious of with the doctors/clinics?  What questions should we be
asking?

	I have been doing th basal temp. + the Ovulation Predictor kits for
about the past 8 months.  I have all of that data to bring with me for my
first visit.  Anything else we should bring?

All help would be greatly appreciated...........

Cautiously Hopeful.........

I think the consensus is not to bother with your OB/GYN.  In my experience,
the specialists want to redo tests done even by other specialists, so I'm
sure that if you do eventually go to a specialist, they'll want to redo
everything.  BTW, there's often a good reason for redoing the tests -- we've
had specialists do tests at the wrong time or skip important tests.

    
    
    	The specialist will do the test all over again and it just
    	takes that much longer.. 
    
    	The first test there going to take is a sperm count.. 
    
    	If you have any questions or concerns please feel free to
    	contact me.. zeke::fultz
    
    

> IVF Boston Clinic.  
     
    I'm sure that Gerald's advice is first rate so my question can probably
    be dismissed. 
    
    When I saw your reply I was surprised that the first path of treatment 
    is to go to an IVF clinic.
    
    But, maybe they just put IVF in the name and they cover all aspects/
    possibilities ?
    
    Malcolm (noting from England)
    

I almost said the same thing as Malcolm.  I was particularly surprised because
it seems that the noter's in an HMO, and HMOs are interested in saving money.
Perhaps someone who's used Boston IVF can comment on their philosophy regarding
less expensive/invasive methods.

    Boston IVF's name is somewhat of a misnomer; their speciality is the
    treatment of infertility.  Boston IVF is highly regarded, not just in 
    the area, but nationwide.
    
    As for success rates, I have a 16 month old son, thanks to them!
    
    Leslie

I've been a read only noter for a few months and will use this opportunity to 
make an entrance.  I've been hesitant to become overly involved in my pregnancy
(such as participating in the Parenting Notes File) because I've gone through
8 years of infertility - too many to count cycles of clomid and IUI's (1 
miscarriage), 6 cycles  of Pergonal/Metrodin IUI's at Brigham and Women's, 5 
IVF's (1 resulted in miscarriage) through IVF America (used to be called IVF 
Austrialia) in Waltham, 1 cancelled GIFT and 1 successful GIFT through HCHP/
Boston IVF.  

I was ready to move on from IVF America when I decided to enroll in HCHP. I knew
they contracted with Boston IVF for IVF/GIFT and had heard, for the most part,
good things about them.  I already had such an established infertility history 
that HCHP just reviewed my records and then referred me to Boston IVF for 
consultation. I chose to see Selwyn Oskowitz at the recommendation of a few 
people. He is founder or cofounder of Boston IVF and one of the top GIFT 
practitioners.  After a few consultations with him, he sent his recommendations
back to my local HCHP office in Action.  They approved me to go on and I was
then hooked up with an infertility group at HCHP in Kenmore.   The HCHP people
in Kenmore were the managers, so to speak, and Boston IVF followed me for the
daily blood tests, ultrasounds and performed the procedure.  The HCHP infertility
physician also worked in rotation with the Boston IVF doctors to perform the
IVF/GIFT procedures.  I did 2 cycles of this: 1st was a cancelled GIFT and 
the second resulted in pregnancy.  I'm now 31 weeks along.

For those people who would use HCHP, I got the impression from their Kenmore
office (which is where HCHP does all infertility work) that initial workups/
tests and hormone treatments, like Pergonal/Metrodin/Clomid along with IUI's, 
etc., would be done there.  If one graduated to IVF/GIFT, then then contract 
with Boston IVF.  I liked the Kenmore HCHP Infertility people very much.

I am pleased with Boston IVF because the treatment worked. Comparing them between
IVF America in Waltham, I liked some things about one place over the other. I
like the physician consultation better at Boston IVF and liked the nursing staff
and OR setup better at IVF America.  I think IVF America has slightly better
stats for IVF's and Boston IVF has better stats for GIFT.  When I started at
IVF America they didn't even do GIFT.

With any of these places I think the patient has to do a tremendous amount of
research in order to stay  in semi control of what is done to you.  You have to
be quite demonstrative sometimes just to move along, not have to have certain
tests done or redone. This is difficult to do when you are in an insecure 
emotional state. I know some of my IVF cycles and my first GIFT cycle
were failures as a result of bad medical guesses.   

My strongest advise is not to waste any time with a regular OB/GYN physician.
Infertlity is too emotional and can take too long to overcome. The entire field 
is still so inexact that the specialists don't all work the same and make 
numerous mistakes.   In the 8 years I have been intensely involved in this I
have gone from producing a gzillion eggs to maybe 2-3 good ones.  This  is a 
result of age. I never thought I would be 41 and having my first child.  Most
people are luckier and don't  (or won't) go this long.  

I guess this is quite enough for now.  If I can be of help, would be happy to be 
contacted offline.

Kathy

>With any of these places I think the patient has to do a tremendous amount of
>research in order to stay  in semi control of what is done to you.

Absolutely!  I couldn't have said it better.  If you're even thinking of
starting infertility treatments, educate yourself, and don't let the doctors
push you around.

Kathy, why did you switch from IVF to GIFT?

In response to the question why I switched to GIFT from IVF is that it seemed
to make sense at the time.  When I switched to Boston IVF and had consultations
with Dr. Oskowitz, we reviewed my entire history.  I knew he was partial to
GIFT but after hearing his point of view I thought it was worth a try.  Since
I had achieved pregnancy, and had achieved fertilization through 5 prior IVF's,
we knew we could fertilize. He also said they had a higher success rate with 
GIFT and given my history he felt I had a better  chance with that.    (I had 
also heard it has a slightly higher success rate in certain cases.) He felt the 
fallopian tubes were more hospitable to the sperm and egg vs. a petri dish.
I could have heard the same story 3 years before but chose IVF because of the
assurance of knowing fertilization takes place. However, by now my eggs were 
getting pretty old and I thought I should give it a shot.  I should say they
did warn me there is slightly more incidence of ectopic pregnancy with GIFT, 
especially with DES exposed women (me) but they felt they can diagnose it so 
soon after conception, that it would not be dangerous.  I went for the odds. 

Kathy

This note is being entered for a member of our community who wishes to
remain anonymous.  You may reply to this note or you may send mail to me
and I will forward it to the noter.  If you wish for me to forward your mail
to her without your header please specify this when you send me the mail.
This noter will be using the pseudonym "Trying".  Please reference this
in your replies.  Thank you!

      Carol duBois, PARENTING co-moderator

***************************************************************

Hi,
    I wish this note to remain anonymous because of its nature.  I'll try to be
quick and to the point although I feel like rambling.  I've been read-only to
this conference for about 1 1/2 years.  My husband and I decided more than a 
year ago that we wanted to start trying for our first child.  Since then
it has really been an emotional rollercoaster.  My husband started suffering
from performance anxiety.  From that point it just got worse, to the point
where he is now seeking help.  It has gotten better, but he still has problems
right around the time that we both think is the "right time".  It has been
tough and I haven't told anyone about this; the more I see babies, hear about
"baby news" and get asked about when we are going to start a family, the more
difficult it gets.
    I know this is a sensitive topic, so I don't expect replies from people
with similar experiences.  What I would like to know is how long did you
wait before you started getting tested for fertility problems?  There have
been times that I thought we might have "hit it right", but no luck, so I'm
starting to wonder.  I feel like I can't seek help on the possibility of 
a fertility problem; in a sense, we haven't really been trying.  Maybe I 
should buy an ovulation kit or thermometer and do some charts for a few months
first?  I'm getting close to calling my GYN anyway.    
    I'm a blubbering idiot each month when I get my period.
    I'm hoping that I didn't start an illegal discussion, but I needed to vent.

Trying

Normally, if you've been having unprotected intercourse for a year with no
resulting pregnancy, it's time to investigate infertility.  From what I
gather, you think that you didn't stand a chance for several (or all?) of
those cycles because of your husband's performance anxiety.  How many cycles
do you think you may have had intercourse around ovulation?  If the answer
is a small number, I think you should try for some cycles where there's
a chance for pregnancy.

Perhaps you could deemphasize the time of the month.  Can you avoid keeping
track of how many days it's been since your period?  Spontaneity will
definitely help.  Dwelling on infertility, using ovulation predictor
kits and keeping temperature charts at this stage are counterproductive.
If your husband has problems when you *think* you may be fertile, he'll
almost certainly have problems when you *know* you may be.  Once you've
had several cycles where pregnancy is possible, get some good recommendations
of specialists.  It will take a few months to get an appointment, so you'll
have plenty of time to do charts then.

RE: Trying

The first thing you need to do is to sit down and
talk with your husband (communicate & most importantly
listen to EACH other)

As difficult as it might seem now (everytime you get
your period, or hear stuff about babies) only the two
of you can make it easier!  

When my husband and I first realized we were having 
"problems" we sat down together first and decided we
were in this TOGETHER! There was NO pressure!!!!
As each step of the infertility and adoption processes
have progressed we have given each other a whole lot
of room and understanding.  There were times we just 
couldn't "do it" again, even though it was "the right
time" - we had made an agreement that each month 
wasn't important but that we were never going to give 
up.  Some of our friends and family call us foolish
because after 6 1/2 years we have not given up - and
we are still together as strong in our love for each 
other as when we first were married - actually our
love is stronger for all that we have gone through.

I guess the point is - make sure you work this out 
together!!!!!! If you have not been using contraceptives
for a year, I think it is time to do something.  I would
first purchase a basal thermometer and follow the 
instructions that come with it - take your temperature
every morning (important that you do not get up until
this is done) for 3 months - then make an appointment
with your OB/GYN and take the three charts with you - 
it will help him determine if you are ovulating 
properly - then he/she can recommend what your next
steps should be.  Even if you made an appointment right
now you OB/GYN would ask you to do this - it's routine.

Hang in There,
We're pulling for you!

Donna and John  

    To anonymous....
    You are in the company of a great many of us who have
    gone through exactly what you are feeling!  Each month is
    a mini funeral for the baby you did not conceive.  Each
    month is another small death inside, another dashed hope.

    Sex was no fun when we were 'just' trying to get pregnant.  As
    a teen-ager, I never thought I would believe that!  Hopefully
    you will take note at how many of us now DO have families...
    so take heart...it'll come.
    bob

    
      I have a question, has anyone out there used donor eggs for 
      Invitro?  I announced last month that I finally had gotten pregnant
      through invitro at IVFA of Waltham.  Well sad to say, I just
      experienced having to have a D&C done last week because at my ultra-
      sound, there was no longer a heartbeat found.  I was obviously
      devastated but at the same time I have an awful lot of faith in God
      and I truly believe he made the decision that had to be made.
      Something must of been wrong.  My husband and I have worked to hard
      to get pregnant and then this.....  I'm really feeling so sad that
      all I've done is hibernate and cry to myself in my office.  People
      react in such different ways that its hard to face them sometimes.  
      I'll get through it.
    
      Since I have 2 more attempts that John Hancock will pay for, I want 
      to get the best results possible.  In my attempts so far only 1 or
      2 embryos have been implanted as thats all that was available.  I
      know I will try again (after 3-6 months rest that my husband and I 
      both need) I'm wondering obviously if I have more embryos implanted
      it will increase my odds of pregnancy.  
    
      Has anyone used a donor's eggs?  can you tell me the experiences 
      either through here or off-line?
    
      thanks and wish me luck...
    
      Debbie Companion
    
      CSLALL::COMPANION
    
    
    

The more embryos they put back, the greater the chance of pregnancy.  When
there are lots of embryos available, they typically put back 3 or 4 and
freeze the rest.  If they use more there's too great a chance of multiples.

Since you can produce eggs (though not a lot), you might consider going to
a different program rather than using donor eggs.  Another program might
be more successful in getting you to produce more eggs.

This note is being entered for the anonymous noter "Trying", who wrote 
note 21.219.

      Carol duBois, PARENTING co-moderator

*************************************************************

	An update from Trying (note 21.219).  I'd like to thank those who
replied to my note.  When I wrote it, I had come to the point where I just
needed to "get it out" and talk to someone else about it - thanks for letting
me do that.
	I had decided to buy a thermometer and start charting, and call my 
Doctor after 3 months.
	However :^), this will not be necessary.  We had a successful try 
this month.  I just found out that I am pregnant!!!!!!!!! I had some
slight spotting over last weekend and I did 2 home tests after I was 2 days
late - both positive!  I just got confirmation from my gynecologist.
	I never thought that it would take me over a year to get this good
news.  I am more excited than I can express.

Trying
	

    
The following note is entered at the request of the anonymous noter of note
21.210, who prefers to remain anonymous at this time.   This noter is
referred to by the pseudonym "Cautiously Hopeful".

Carol Stolicny, PARENTING co-mod

-------------------------------------------------------------------------


	Hi, I'm the annonymous noter frm note 21.210 (4/29).  Thank you 
to all that responded with some very good advice.  Due to your suggestions
my husband and I went directly to Boston IVF instead of starting with 
the local OB/GYN.  To answer some of the questions that arised, Boston
IVF is an infertility clinic that does diagnoses, and treatments of 
all kinds (IUIs, IVFs, GIFT, etc.).

	Well, since our initital visit and subsequent follow up visits/
tests/etc. (no, we haven't gotten through all the tests yet) we have
found that we are facing some very severe infertility issues.  This has
been very hard to deal with, but luckily my husband and I have a very
strong marriage and very good communication skills.  This helps us
help each other a great deal.

	I have read through all of the notes in this string.  There is
a lot of information about female infertility, however very little
about male infertility.  The problem we are facing is a very low sperm
count and an extremely low morfality rate.  The survival rate and
progression rate are ok.

	We have to see a Urologist to see if there is a physical reason
for this or not.  Has anyone else faced these issues, what could be
the causes/possible cures/etc?

	Boston IVF said that once we went to the Urologist and got
a diagnoses, etc. that we would begin immediately with a Metradin/IVF
cycle.  That IUI would be futile in our case.  If we could not
achieve fertilization they would try a very new proceedure called
(I think) Micromanipulation Technique.  That is where they help the
sperm to penetrate the egg.

	Has anyone any experience with this proceedure/technique?
All help would be greatly appreciated.  In a vey short time we have
encountered much more that we ever could have imagined.


Trying to stay cautiously hopeful..................

re: .226

See also note 377.

Clay

    
The following reply is entered at the request of a member of the PARENTING
notesfile community who prefers to remain anonymous at this time.   This
noter will make entries under the pseudonym "Still on the Journey".

Carol Stolicny,  PARENTING co-mod

-----------------------------------------------------------------------------

Re: .226

You have my sympathies--I've been through something similar, but as one
discovers with infertility problems, there are many, many variations, so my
experiences may be different from yours.

We found out after two IVF cylces that we had a male factor as well. Initially
we were diagnosed as unexplained infertility with an assumption that my tubes
were a possible cause as I'd had surgery. There was no fertilization on the
first IVF cycle, and my husband's sperm count, motility and normal forms (IVF
America uses the strict morphology, or Kruger test) were really low. As earlier
semen analyses had been "normal", this was a real surprise. He'd had pneumonia
about 90 days earlier and fever can have a damaging effect on sperm in
development, so the Doctors supposed that was the cause.

We went to a urologist; sperm count OK, normal forms OK, but low; hamster egg
penetration test OK and no antibodies (they tested both of us for that). The
urologist also did a physical exam for a variccocele (?sp) which was negative.
That's an area with much controversy--some urologists swear this is a cause of
low sperm counts/quality, others claim it's just an excuse to do unnecessary
surgery.

Most fertility clinics now pay attention only to the strict semen analysis
criteria, and most regular doctors still do the traditional
count/motility/progression. The urologist we saw had some very negative things
to say about the quality of semen analysis techniques as most regular labs.

So we tried a second IVF cycle assuming the problems on the first were just a
fluke. Only one egg fertilized (a total of 20 eggs in 2 cycles and only 1
embryo to transplant). Again, the counts and sperm quality were relatively poor
(~10 million, 5% normal forms pre-treatment). However, Dr. McShane made it
clear that they do have success in IVF with very low sperm counts (I think 500K
is their cutoff), so low counts per se do not mean that fertilization will
fail. Sometimes, however, low counts are a symptom of other problems which can
lead to fertilization problems.

Micromanipulation (aka microinsemination) is considered experimental (i.e. John
Hancock will not cover it although they will cover the rest of the IVF cycle.
IVF America charges $1,500 per cycle for micro--an HCRA is a handy thing! The
fertilization rates are low (about 20%-35% I believe), but in general better
than what folks with problems get unassisted.

In our case, based on two failed cycles, they had observed that the sperm
failed to bind to the zona (shell) of the egg. The reasons for that aren't
known or knowable with today's tests. My eggs are apparently healthy, and all
Dr. McShane can say is that when things like this happen, it's generally
assumed to be a sperm problem because egg problems are easy to detect by
inspection.

There are a number of micro techniques (I got several articles from the
PaperChase database on CompuServe to read. If you're not a member of Resolve,
you might want to consider that--their newletters and other fact sheets are
very helpful in keeping up with things). Partial Zona Disection is where they
cut a slit in the zona to help the sperm make it trhough. Sub Zonal Insertion
(which is what IVF America uses at the moment) is where they put about 10-15
sperm in the sub-zonal space (actually inside the egg shell, but not puncturing
the egg itself.

There's a very new technique which they may start offering later this year
called intracytoplasmic injection--they actually inject one sperm into the egg
itself. Apparently the early studies on this had fertilization rates of 45%
(but they claimed 18% fertilization for sub zonal insertion in their tests).

The place that has been dealing with micro the longest, and where much research
is done, is Cornell Medical Center in New York. We contemplated going there,
but decided to use IVF America. We did 3 micro cycles--the first got 4
fertilized eggs, the second 3 and the third none (a total of 30 mature eggs
inseminated). I'm sorry to say that things didn't work for us.

As I mentioned earlier, there are so many factors at play here, that you cannot
draw conclusions about your own prospects from other people's experiences. You
should, however, be aware that as IVF is itself a fairly high-tech, high-risk,
low success technique (by low success I mean the number of people who try it
who take home babies; it does work, but the odds are not great),
microinsemination is even more high tech, with even lower success rates. One of
the notes made in the recent study of intracytoplasmic insertion was that they
saw a correlation between low percentages of normal forms in the strict
morphology semen analysis and poor implantation rates. In other words for a
given number of embryos to transfer, fewer implanted where the normal forms
were 4% or lower (4% is where we are). However, if you feel as we did, you just
have to try micro--it's too important not to given the alternatives.

Except for the extra lab work (which is very labor intensive, hence the
expense), a micro cycle will be the same for you as a regular IVF cycle.

I wish you all the luck in the world. It's a tough experience and you'll need
each other and lots of stamina.

    Hi,
    
    My sister just found out, after years of trying, that her probability
    of conceiving is pretty much non-existent.  She had surgery about a
    year ago to clear a blockage from her tubes.  She became pregnant
    shortly after that, in what turned out to be a tubal pregnancy, and she
    ended up losing the baby.  They've still be trying, and were just
    recently told that her tubes are blocked again - they don't know why.
    She was told that if they try to unblock her tubes, they felt it would
    be only 50% successful.  The surgery that she had last year was
    extremely painful, so she doesn't want to go through that again.
    
    Their Dr indicated that they could try IVF, but that it was $5,000.00
    for each attempt, and usually took 3 times.  They just don't HAVE that
    kind of money.
    
    I'm not sure what Dr they're using.  Her husband has 2 (older) children
    from a previous marriage.  She has never had a baby, and they both want
    one desperately.  She's 34 years old, if this matters.
    
    I was wondering, if there's any place that you know of that is less
    than the $5,000.00, or perhaps some other surgery to "unblock" her
    tubes that shouldn't be painful?  I'm sorry to be so vague with all the
    details, but it's a subject that is very difficult for her to discuss,
    and it doesn't help much that I have 2 children and am pregnant again.  
    I just want to help .... any help or phone numbers that you could
    provide would be MOST appreciated by everyone!
    
    Thanks,
    Patty
    
    p.s. He's retired from the service, so they have whatever medical
    insurance the army provides.  She works part time, so doesn't have any
    medical insurance herself - just his policy.

re .226:

As .228 mentions, Cornell is the top place for micromanipulation.  Jones
Institute in Norfolk, VA is also in the top ranks.  Depending on your age
and insurance situation (e.g. JH only pays for five IVF attempts), you may
want to consider one of these clinics.  I know a couple who are doing
an IVF cycle with micromanipulation at Cornell in July.  I'll let you
know how it turns out.

re .229:

Sad to say, $5000 isn't out of line.  I doubt if they'll find anything
significantly cheaper.  BTW, some states (Massachusetts, for example)
mandate insurance coverage of infertility treatments, but this only
applies to insurance companies, not self-insurance, and presumably
not the insurance he has.  In any case, your sister and brother-in-law
should definitely join Resolve.  They'll be able to advise her about
what to do next.

    
    Does anyone have a phone number for Resolve??  This is for my sister
    who lives in NH, but her husband is employed out of MA.
    
    Gerald, what is the requirements for insurance companies in MA??  I
    believe his only health insurance is through the army, but he may have
    something through his current employer, who is in MA 
    
    Thanks!
    Patty

Including everything - medication, procedure, medical staff, etc...my IVF's cost
8-10K  *PER* cycle.  These were through IVF America in Waltham.  I then switched
to Boston IVF through my HMO but never knew the costs of this. However, would 
imagine the costs were about the same - very expensive.

Kathy  

See 21.122 for Resolve's contact information.  They'll be able to answer
insurance questions.

I second Gerald's advice on contacting Resolve.  They will probably have current
information on insurance issues.  For what it's worth, I had John Hancock
coverage when we went through it.  We did that purposely so we wouldn't be 
restricted to any doctor/s and/or clinic/s.  Our out-of-pocket costs were ~$2K. 
Since then, I've switched to Tufts, but only after making sure they would cover
a return to IVFA for an embryo transfer.  Under Tufts, we should only have to
pay the office visit co-payment.

Based on my experience and conversations with others at the clinic (it's amazing
what people reveal to strangers when there's a common bond of infertility), I
think "structural" problems are easier for the clinics to deal with than
hormonal problems.  In my case, my tubes were badly scarred and damaged by prior
surgery to remove fibroids.

We were told, by those who'd been through it, not to count on success on our
first cycle.  It's really just a chance for the dr's. to see how you're going to
respond to the medication.  In our case, that was true.  I was extremely
sensitive to the drugs and they cancelled us prior to doing the egg retrieval to
avoid hyperstimulation.  The dosages were reduced for the second cycle and we
had a successful transfer.

We did meet couples who were paying the entire tab themselves...and wiping out
their savings in the process.  One option might be to check with the clinic for
donated drugs.  I know IVFA patients sometimes donate unopened vials of
medication for distribution to couples who need it but are having a hard time
with the cost ($2K for one cycle, according to our pharmacist).

If your sister-in-law would like to talk to someone who's been through it, she
can call me.  Please contact me via E-mail.

Elaine

    Has anyone had problems with the tubogram? I had 3 attempts at it last
week with no success. Two tries were with the balloon and catheter and the 
first was with the wider tube with no balloon. They did manage to get some dye
up into 1 tube but not enough to tell much. The dye just kind of puddled 
around the catheter. 
    The Drs. don't know if it was an equipment problem or if I have major 
blockage. Wonderful!! So they are now recommending a laporoscopy. I'm not very
thrilled about this and was thinking of asking for another try at the tubogram.
Not that I enjoyed it! But I've also heard it may help clear minor blockages.
    I guess I just need to mull this over with people who have been through it.
Any thoughts or comments?  

Teanne

    From where I see it, the Laparoscope may not be a wonderful option, but
    after experiencing major pain from the Hystogram I was advised to to
    the exploratory Lap.  I had no post op pain, was home that night and
    back to work the next day, and oh even better PREGNANT the next month!!
    
    The doctor and I always joked that all it took was the lap to "flush
    out" the tubes!
    
    My opinion is to do the laprascope, it is ultimately less painles, and
    will most likely give you a more accurate diagnosis, maybe even a
    child!
    
    Lyn

I've had both and, like most of the diagnostic procedures associated with
infertility, they weren't a lot of fun.  

The HSG was painful, but was over quickly.  (I took the 2 tylenol they suggested
but I don't think it did a darn thing to help!)  That evening I was very
tired...not sure if the cause was physical or emotional stress.  A couple days
later I had a bout of terrific nausea which the dr. said might be the dye
working its way out of my system.

I've had 2 lap's.  They weren't as painful because you are under general
anaesthesia.  However, it *is* surgery which I think takes it's own toll on you.
I went home the same day, but I found it took 2-3 days (at least) to get back to
normal.  The lap can show them things the HSG can't, which may be important.  In
my case, the HSG showed the tubes to be open.  They may have been, but the lap
found them very badly damaged...so much so we've had to go to IVF (and have a
beautiful baby as a result!).

If the dr. suspects a problem, you may end up with the lap anyway.  I'd talk to
him/her and see what advice is offered.

Good Luck (and take the tylenol anyway.  Who knows, maybe it *does* help!)

Hi. I havent been in this file for a long time.  I was undergoing alot
of testing and was taking Clomid last year.  On the first cycle I got 
pregnant and in March had a beautiful baby girl that we named 
Meredith Carolina.  She's about 9 months old now and she's made out 
life so happy that we've decided that we would like to try again for
another baby.  

Ive been back on the Clomid and this time things did not work out
for us on the 1st cycle  (I was not surprised) so we're trying again this
month.  Are there any others out there who have had to go this route the
2nd time around and if so, what were your experiences (timing, how long
did it take, etc).??

Maureen Kane

Hi Maureen,

CONGRATS on your 1st pregnancy...how exciting!  I remember you from your 
earlier notes (21.26 etc..)  At the time you were writing, I was going 
through similar treatment (my note 21.36).  I was so happy to hear about
your success.  Unfortunately clomid did not work for me.  I ended up 
switching specialists.  My current specialist found that I have the luetal
phase defect (low progesterone) and lack of 'blocking antibodies' with
my immune system.

I am happy to say that I am now starting my 5th month of pregnancy!  My
husband and I are so excited - we can still hardly believe it.

To correct my problems I went through something called Lucocyte Immunization.
I did this procedure 3 times.  It provides the blocking antibodies that
tell my immune system not to terminate a pregnancy.  (I always miscarried
very early due in part to this problem).  Secondly, I took daily progesterone
oil shots following ovulation (through the first 3 months of my pregnancy)
Clomid did not do the trick for me.  I also experienced visual side affects 
and mood swings from clomid.  Instead I used pergonal.  

Good Luck with the second time around.  I wish you happy thoughts...think
positive.

Thanks -
KC
(formerly anonomous noter - F.E. Forever Hopeful)

Kathy,

Congrats again!  I was going to point you to this notefile but I see you are
already wise to it.

Happy for you...Iris

    re .238
    
    We have a 4 year old daughter "Alyssa" as a result of 3 months worth of
    Clomid.  We are now trying for our second and have been trying for 10 
    months.  I have been through the Hysterolpinogram, Ultrasounds and 
    blood test after blood test.  This time the Clomid is not doing the 
    trick (I am not ovulating).  The doctor says that I have polycystic 
    ovaries and that there is a 30% failure rate with Clomid.  This cycle we 
    are going to try the Pergonal and see what happens.
    
    It is strange, we went in with the attitude that we would conceive
    within the next 2 months, but it didn't happen.
    
    I hope your luck is better than mine.
    
    **I did feel some side effects with the Clomid (Hot Flashes and towards
    the end of the month a feeling of anxiousness), could anyone out there
    that has taken Pergonal or Metrodin tell me if they experienced any
    side effects?**
    
    Thanks and Regards,
    Bethany
    

I took Clomid for 6 months, and had the side effects mentioned.  I had
hot flashes and these incredible mood swings that my husband said turned
me into the bride of Frankenstein.  And with me, the effects were cumulative
so that on the first day, I had mild hot flashes and mild mood swings, but
by the last day of the Clomid, I was a raving lunatic.  And I knew it was
the medication making me like that, but that didn't matter much.

With the Pergonal, Metradin, and Lupron, I did not have any side effects
except the sore butt from all the shots but then at one point I was getting
a shot of Metradin on one side in the morning with a shot of Lupron in
the thigh, and a shot of Pergonal at night, so my butt never got a break
and got kind of tender.  But other than that, there were no side effects
for me.

Cathy

Some women experience mood swings with Pergonal and Metrodin.  The HCG shot
they give you at the end seems to exacerbate it.

Well I feel like Im starting all over again.  The first time we went through
all the testing we were with a great doctor but we were only allowed to see him
through my pregnancy (once we got pregnant) and after that had to go back to
Hitchcock Clinic.  The ob/gyn there, once finding out we were ready to try for
#2 automatically put me on Clomid after reading my files .  Since the new year
we have changed health carriers, which enabled me to go back to the original
doctor who helped me through all of our infertility testing, etc and he's taken 
me off the Clomid.  He feels the other doctor put me back on it too soon and
he wants us to try on our own for another 3 months (we've been trying for 7 
months already). If Im not pregnant by April we'll "revisit" the issue and I
may be put back on Clomid at that time and my husband may need to be retested
as well. In the meantime Im charting my temp every morning.  In a way this is 
so very frustrating...but I have to keep in mind that I have been able to get
pregnant .....with help, so we're keeping our fingers crossed.  In the meantime,
when I get really sick of the 'process' I just look at my (now 10 month old)
daughter Meredith and she is a very quick reminder of how blessed we are to have
even one child.

Maureen

    
    
    Wait a minute, you have a 10 month old and you've been trying for the
    last 7 months to get pregnant?! (let's see 10 - 7 = 3 months).
    
    	Ok, you win, you've got baby lust far worse than I. ;-)
    
    
    		Best wishes and good luck, 
    
    				Wendy

    Maureen,
    
    Good luck with your charting...etc.  I remember doing 'the temperature
    thing'.  My husband use to crack up when he would open his eyes and see
    me glued to the bed with a thermometer in my mouth.  Anyway, keep us 
    posted when you feel up to sharing with us. In the meantime, I'll be 
    sending a lot of positive thoughts and prayers your way!
    
    Kathy  

    This is the first time we're trying the thermometer. I just wanted to
    see if I was on track...
    
    Day 12    Day 13  Day 14  Day 15  Day 16 Day 17 
    97.6      98.2    98.0    98.0    98.2   *98.7*  (the spike)
    
    Here's what I understand is happening. apparently woman's temps are 
    low until ovulation and then rise for a short span as the egg is getting 
    ready that's the 98 range, then when ovulation occurs the temperature 
    spikes that's 98.7.  it would appear then according to the charts, 
    I'm fertile today (smile) and should be home ;^) right?
    
    The little document with the thermometer cautioned about heating
    blankets and movement that may cause an increase.... well, I have a
    waterbed, which I should treat, I guess, as a heating blanket, and the
    movement part, uhhhm, would reaching behind me for the thermometer cause
    my temp to rise .5 degrees?  or would my husband changing position thus
    causing me to float around a bit raise the temperature .5 degrees.
    
    and Day 17??? is this possible... I've always thought of this as my
    safe time.  When I used the ovulation test kit, it showed that I should 
    be fertile around Day 12, and my body fluids fluctuate....
    
    So according to the kit, we've been using the every other day method for 
    a few months (without success 8-( ), but not without hope 8-)
    
    And a *big* thank you to all of you for your help.  Every note entered
    has been so helpful in keeping us hopeful....
    
    Pauline
    

                     <<< Note 21.247 by SOLVIT::TRUBACZ >>>
                         -< we're just beginning 8-)) >-

<    This is the first time we're trying the thermometer. I just wanted to
<    see if I was on track...
    
<    Day 12    Day 13  Day 14  Day 15  Day 16 Day 17 
<    97.6      98.2    98.0    98.0    98.2   *98.7*  (the spike)
    
<    Here's what I understand is happening. apparently woman's temps are 
<    low until ovulation and then rise for a short span as the egg is getting 
<    ready that's the 98 range, then when ovulation occurs the temperature 
<    spikes that's 98.7.  it would appear then according to the charts, 
<    I'm fertile today (smile) and should be home ;^) right?

    You *could* be ovulating today.  Once I started charting my cycles,
    I could detect the twinge associated with ovulation.  
    
<    The little document with the thermometer cautioned about heating
<    blankets and movement that may cause an increase.... well, I have a
<    waterbed, which I should treat, I guess, as a heating blanket, and the
<    movement part, uhhhm, would reaching behind me for the thermometer cause
<    my temp to rise .5 degrees?  or would my husband changing position thus
<    causing me to float around a bit raise the temperature .5 degrees.

    If you sleep on the heated waterbed every night, it isn't a factor
    unless you recently turned the heater up.

    If you arent't ovulating today, other things can contribute to a rise
    in your temp:

		   pregnancy (temp goes up and stays up)
	           illness (you could be catching something)
	 	   sunburn (not likely?)

   I had to chart for about three months to get a good indication of 
   my normal cycle.  My doctor needed at least 3 months to make a diagnosis.
   Cathy Giunta or Constantine can explain the next part better than I, 
   but I'll make a stab.....
   If one ovulates late or early in a cycle, fertilization may occur but
   the uterine lining is either too <mumble> or not enough <mumble>.  Therefore
   implantation doesn't happen. Several drugs can be used to treat this
   condition, its been 4 years so I won't even speculate on what the latest is.

   Good Luck,

   Rochelle

Hi Pauline,

I did this for months myself.....  

Your most fertile times are the days *before* the spike.  The spike shows
up after you've ovulated, which if there isn't sperm already present, you 
aren't going to fertilize the egg.  

Of all the questions I had asked regarding this, the most frequently offered 
advice was to use the every-other-day method during the days prior to when
your most likely to ovulate.  If your periods are regular, then you should
be able to predict from month to month the approximate days that you should
ovulate.  If your periods are not that regular, like mine, then this becomes
harder to predict.

That's the problem with the temp method, it's only good for telling you 
after you've already ovulated, which is too late.  However, I tried the
ovulation prediction kits and didn't have much luck at all with them.  I 
was so irregular that I would have to use 2-3 kits per month, which adds 
up to lots of $$ after a few months.

Oh, and about the waterbed...  we have one too.  As long as the temp in
the bed stays the same and your always in your bed when your taking your
temp, this shouldn't be a problem.  We did go on vacation during one of my
months of doing this and since I wasn't in my own heated waterbed, the
numbers were thrown off somewhat.  And the little movement that your doing
to reach for the thermometer shouldn't have an effect either.  Seems like
they caution you about not rolling around or getting out of bed, etc.  Just
reaching for the thermometer should be fine.

And most important, give it time!  It's certainly easier said then done, I 
know, I've been there.  It took us months of using that *(&^*!# thermometer.
However, my due date is only 3 weeks away!

Best of luck, if you have any other questions feel free to send me a note.

Jean

    

I read a lot on this subject a couple of years ago, but this is all from
memory...

I notice that you had a .6 spike between days 12 and 13 and I wonder
if that was when ovulation ocurred.  The "classic" temperature chart should
display a small dip the day before you ovulate, a spike the day of ovulation,
approximately 14 days of sustained higher temps followed by a sharp drop
(if you don't succeed at achieving pregnancy).  

I charted temps for around 6 months, but I was not "classic" -- I had a
gradual rise from around day 13 to around day 17 with no precursor dip.
Basically, I could not tell from my temp. charts when ovulation was occurring
-- only that it had happened.  And I could count on getting my period on the
day (or was it the day after?) that I saw the sharp drop at the end of the
cycle.  

If your period is usually around 28 days, then it's possible for you to
be ovulating around day 17 and have a slightly shorter luteal phase (latter
half of your cycle) than the "average" woman.   

Activity (like getting up to go the bathroom) can cause a rise in temp as can
taking certain drugs (even an aspirin, I believe).  It's certainly okay to
reach for the thermometer, and your husband rolling around should be okay too
as long as you don't exert yourself by rolling him back :-)

It can be kind of fun to have a clearer picture of the changes going on in
your body.  I remember feeling like I was the subject of my own scientific
experiment, and it was magic when I saw that sharp temperature drop at the
end of my cycle.

This note is being entered for a member of our community who wishes
to remain anonymous.

  Carol duBois, PARENTING co-moderator

************************************************************

	My husband's sister has been trying to conceive for about a 
	year now.  A couple of months ago, her ob suggested she have 
	an HSG (xray of the tubes).  The study showed that both tubes 
	were blocked.  Her ob then suggested that she visit a fertility 
	specialist, who could advise as to what to do next.  

	There are only TWO fertility specialists in my sister-in-law's 
	town.  She wasn't impressed with the first (don't know what the 
	advice was, but she told me the office wasn't clean, so that turned 
	her off right away).  The second doctor advised her to try IVF.  

	Now... none of this is completely foreign to my husband and me.  
	I also had an HSG after having trouble conceiving.  In my case, 
	one tube was blocked, but the other was cleared by the dye 
	running through it, and I got pregnant three months later.

	As a result, I have since asked two OBs what my options would be 
	if the second tube became blocked.  The first told me that he'd 
	suggest laperoscopic surgery to find out the cause of the blockage.  
	The second told me that this was possible, but that "In-Vitro would 
	be a lot easier".  Since it wasn't necessary, I never pursued this.

	Back to my S-I-L...  My husband and I both feel that, if it were 
	us, we'd at least want an exploratory, to find out the cause of 
	the blockage (so far, all they have is the results of an xray).  
	But, we're afraid to say anything, since my S-I-L is upset enough 
	as it is.

	I'd be curious to find out if others have been through similar 
	experiences.  If so, did you have surgery, or go with IVF as a 
	first option?  As I said, the physician choices in my S-I-L's 
	hometown are limited.  But, if it would be better to have the 
	surgery, I'm sure she would be willing to go outside her area.

RE .147

I guess I should take a stab at this now that I've been referenced.
Here's my guess at what's happening:

    Day 12    Day 13  Day 14  Day 15  Day 16 Day 17 
<    97.6      98.2    98.0    98.0    98.2   *98.7*  (the spike)

It looks to me like you had a small drop on day 14 and a gradual rise to
day 17's spike, so I'd say you already ovulated and that's why your temp is
high.  What Rochelle was reffering to in her note was a luteal phase defect
which is what I have.  It means that there are either too many or not enough
days in your cycle after you ovulate. If there are too many days, your lining
ages too much, and if there are not enough days (my case), your lining is
not lush enough and cannont support a pregnancy.  Given that it looks like
you ovulated around day 16, if you normally have a 28-30 day cycle, you're
probably OK. In my case I normally only had something like 10-12 days after
ovulation before having a period where the norm is 12-14 days (14 seems to
be ideal).

We used to do the every other day routine from day 9 through day 15, so
continue with that.  That's a much better way than trying to guess which day
you are ovulating, although after years of charting and infertility, I now
can tell when I'm ovulating by the mild cramps I get.  But once you've 
ovulated, it's too late to conceive which is why they tell you to do the 
every other day routine as that gives the sperm a chance to regroup and 
has you starting your efforts prior to ovulation which is when you need 
to be trying.

Regards,
Cathy

Re .251

I don't think it would hurt to suggest the advice your doctor gave you 
regarding having the lap to see what caused the blockage, but I think that
knowing the cause won't necessarily help with conception.  Since there's
already a blockage, IVF seems a reasonable way to go.  If your SIL thinks
that finding the cause may help to find a way to remove the blockage, then
that may be a good alternative, but I didn't think there was much that could
be done for blocked tubes other than going around them which is essentially
what IVF does.  At least that's how I remember it being explained, but since
my tubes were patent, I didn't really get a lot of information about that.

I do know that one of my cousins is currently trying to get pregnant and has
had IVF recommended to her as the best alternative in her situation.  It's
a tough case with her and my cousin because they got married because she was
pregnant, but she lost that baby.  She got pregnant again a few years later,
but that was tubal and she lost the tube. So now they're going the IVF route
to try to conceive, and she's still got one tube. So I don't find it unusual
that they would recommend IVF to someone who has both tubes blocked.

Cathy

re .251:

The conventional wisdom is to have a laparoscopy and possible tubal surgery.
I believe the chances of success from tubal surgery aren't all that great.
The counter-argument is that IVF doesn't have such great chances of success
either, but if the woman is relatively young and the only problem is tubal
blockage, there's actually a very good cumulative chance if a few IVF cycles
are done.

I'm a firm believer in seeing the best specialists, even if it involves
considerable travel.  This is particularly true for IVF, where there's
a significant difference in success rates.

    (well jean, looks like I'll take the plunge)
    
    I had my annual physical on Day 11, that's when my physician
    recommended the thermometer and told me to start charting the next
    morning and he also advised intercourse that night, sooooo
    we did,,,, and then again on day 13, day 15 would have been a plus but
    things don't always work out
    
    Day 12    Day 13  Day 14  Day 15  Day 16 Day 17
    97.6      98.2    98.0    98.0    98.2   *98.7*  (the spike)
    
    I am a regular 28 day cycle with rare changes.  On day 11 at 4:00a.m.,
    to be exact I had cramping which continued for a short time.  I then
    started to monitor and chart changes in body fluid (boy it does get
    scientific doesn't it)
                          
    Other small details, I am a healthy 38 year old.  I haven't been on the
    pill since I was 22.  I have been able to have intercourse from day 17
    without *ever* conceiving.
    
    and, thanks for all your help so far.  Each one of your notes has not
    only given me hope but taught one more thing...
    
    Pauline

    	This brings back such memories.

	When we started trying for what would then be Spencer, we were very
    scientific about it. We had read that it takes an average of 8 months
    to conceive, I had read about the temperature and how to take it, we
    were ready to start this baby making thing.

    	The first month, I took my temperature faithfully and Marc just as
    faithfully plotted the points in his little computer program.

    	Only thing was that I did not follow the book, I spiked on the
    18th day and the temperature never went back down. Being alarmed that I
    was not following the "textbook examples" I read as much as I could to
    figure out what was going on. None of the books explained an elevated
    temperature and I figured that I was sick except that I just did not
    know it (some people will call that denial). It never occurred to me
    that I was actually looking at the first few days of pregnancy.

    	So what we ended up with was a beautifully charted graph of
    Spencer's conception and the first few days of his life. 

    				Wendy

    	

  Day 11   12     13      14      15      16       17      18
          97.6   98.2    98.0    98.0    98.2     98.7    98.3
    **            **
    
    I won't post more on the temp unless it really, really changes.  But,
    now I wish I had made more of an effort to find a thermometer.  It was
    interesting or frustrating that most of the drug stores I went into
    didn't carry them, just the Ovulation Kits.
    
    Pauline
    
    

	Pauline,

	For me, I have found that ovulation occurs on the day of the *lowest*
	temperature.  My temperature rises .3 - .4 degrees the next day, and
	may go a bit higher the day after that, then stabilizes for the
	duration.  

	Karen

Pauline,

Where are you?  I'm pretty sure I've got my thermometer somewhere, and you
can have it if you want it. I've recently seen the basal thermometers 
everywhere (CVS and other drug stores).  Have you tried asking at the
pharmacy?  I can't remember if they stock them with the ovulation stuff
or with the thermometers.

Cathy

Many pharmacies keep basal thermometers behind the counter for some reason.
Try asking the phramacist.

Probably so people don't mistake them for the other type and get
upset when they get home and see that it doesn't make a great 
fever thermometer.  Perhaps someone can answer this for me:  is it
still necessary to use a basal temp thermometer if you have a digital
read out thermometer ?  My understanding was that the basal just made
it easier to read small variations in temperature by making the scale
a little larger.  If that's so, then the digital readouts should make
it unnecessary to have a special basal temp thermometer.  Anybody know
for sure ?

Leslie

    I only know from my own experience, but I used our family thermometer
    (digital), and it provided the fine gradation of readings that you
    require.  I don't think a basal thermometer does any more than this,
    but someone who's used one would know better.

    Having a metal sensor, the digital thermometer is also safe to take 
    children's temperatures orally.

    Ali

	I have used a digital thermometer for temperature charting.

	Karen

    I used a digital househole thermometer too!!  Worked just fine!
    
    -b

Well I had to have some ankle surgery in january and because of the 
anesthesia involved we didnt try that month.  We did try in Feb and will know
by the end of the week (hopefully) if Im pregnant.  My temp has been anywhere
between 98.3 and 98.8 for the past 2 weeks (I ovulated on the 14th)....so Im 
just waiting......

Our daughter Meredith will be turning one next month ....and we did start trying
to get pregnant not soon after she was born (by this I mean not using any kind
of protection) as I assumed it would be as difficult to get pregnant the 2nd
time as it was the 1st time - so far the assumption turned out to be somewhat
right.  My personal plan is to have no more than 3 children, but I do NOT want 
to be getting pregnant after the age of 35, so because Im 33 now it means 
pretty much that Im having my babies a year apart from each other.  I may choose
to quit after #2 if we end up going the Chlomid route again - im just not up
for this frustration over and over again - I consider myself blessed to have 
one!

Maureen

-  My personal plan is to have no more than 3 children, but I do NOT want 
-  to be getting pregnant after the age of 35, so because Im 33 now it means 
					   ^
					   |
					   |
					   |

   As a mother of 3 (twice past 35) and a recipient of *8* years of infertility
   treatments - you might want to loosen this restriction a bit.....			     
				


Rochelle

Well today is the 28th day of my cycle and my temp has been at the 98.5 mark for
the last 3 days (jumping between the  mid to hi 98 range for the past 10-14 days). 
Im usually like clockwork so Im expecting my period tomorrow or Friday (but 
hoping it wont happen).  These last couple of days are the worst as that sudden
drop is just that - so sudden it cant be detected till it takes that dive.  If I
dont see it Ill have to wait a few more days before I bother getting tested. 
When they were testing me for my first pregnancy I actually tested negative - my
doctor told me to go back in four days if I hadnt started my period and it took
those extra four days for me to test positive.  Those over the counter (test the
first day your late) pregnancy tests dont work for me - at least not that soon.

Maureen (waiting and hoping).....

 

    Re: 265
    
    Don't answer this if too personal but I'm wondering why you don't want
    children after 35? If you're 33 now and you want 2 more children,
    you're putting an awful lot of pressure on yourself. And you'd be
    squeezing in your kids. It's tough on your body too to go right into
    subsequent pregnancies. Relax alittle and you probably will have a better 
    chance of getting pregnant.  
    
    FWIW, one of my neighbors is pregnant with her 2nd and she's 39. She
    had her first one when she was 34. She just got started alittle later
    than some people. 
    
    Good luck!
    Karen

    
    
    I always said I would have all my children by 35 too.  It's the "magic
    number" quoted by many sources for "safe" childbearing....but as the 
    age approaches, I wonder what one or two years beyond 35 matters.
    
    

    
    I'm having the child I wanted before 35, 2 months before I hit
    35! (8
    
    

I always wanted my kids at a young age (20-30). When I hit 35, I was convinced 
that I would never have children.

At age 37 I gave birth to my first, and now, at age 40, I'm considering having
another.

I just went with the flow, which was not the path I had planned, but I have no
regrets, as Daniel is the most precious gift I have ever received, whatever my
age was at the time.

    I was 34 when Chelsea was born.  I thought for sure that I would want
    to get pregnant again right away....wrong!
    
    I'm having to much fun enjoying her and am very glad that I don't have
    to divide my attention between her and a newborn.  Even though Chelsea
    is almost two (May), she is still very much a baby in my eyes (probably
    always will be!).
    
    I do look forward to the next baby and have no problem with starting
    to try next year at which time I will be 37.
    
    ..Lori

    I was 37 when my third was born and he was my easiest delivery!

    
    	Count me amongst the 35(and something) people who already have
    (two) and still want (two - maybe ;-)).
    
    
    				Wendy
    
    				

    Iguess I could be curious about this too.  I had my first at 18, the
    second just prior to 30 and the last at 37.  I got to enjoy my children
    as babies and into school and adjusted befor the next one came.  Also I
    am the child of parents who had me and two others in my mothers late
    30's to early '40's .  I never noticed the difference in my parents to
    my friends.
    
    Meg

I also had my first at 35+.  I felt great during the pregnancy 
and had a 3 hour labor so age is only one of many factors to
consider.  I also had the option of an amnio since I would be
just over 35 at the delivery date.  The amnio relieved my mind
of any problems due to "old eggs" :^).

Well its official  - #2 is on the way.  I went to the doctors office to
get tested this morning and tested positive.  Im very happy.  

re: 35+ its just my personal preference not to get pregnant after this point.
    Everyone has to set their own goals for themselves for their own reasons. 
    My sister and I were Irish twins (10 months apart) and I dont feel that
    I was less loved or got any less attention than my sister - if anything
    we grew up to be very close as well.  My older sister and I 
    are 3 years apart and we were never close as
    children and really still aren't.  My husband and I adore our firstborn
    and we will go out of our way to make sure that she knows she is loved
    just as much as the new baby.  

>Well its official  - #2 is on the way.  I went to the doctors office to
>get tested this morning and tested positive.  Im very happy.  

Wonderful news! Congratulations!

Many blessings

Rochelle

    Maureen,
    
    That's wonderful news!!!!  May you and yours be blessed with health and
    happiness!!!
    
    -beth

Someone gently reminded me that I promised in .230 to tell what happened to
a couple I know who were going to do an IVF cycle with micromanipulation at
Cornell.

Unfortunately, the woman didn't respond adequately to ovarian stimulation,
so Cornell cancelled the cycle.  The couple has since decided to adopt.

I think they would have done better going to Jones Institute, which seems
to do a better job of individualizing treatment.

    Maureen !!!!!
    
    (re: 21.277)  I just read your note today.  I'm so excited for you. 
    Congratulations!  Keep us posted from time to time.
    
    (All is still going well with me.  I'm now 6 months and 1 week
    pregnant.)
    
    Take Care & Enjoy your happiness...
    KC              
    

HI.  Well for a while I was really very worried. I was threatening a 
miscarriage for a while and went through many blood tests and one ultrasound.
Another is scheduled for next week.  For about 2.5 weeks I was having some
bleeding problems but as of this weekend this has completely stopped and
Im hoping for the best at this point.  The doctor said it could have just
been implantation bleeding.  Thank you all for your support - it has really
meant alot to me.

Maureen Kane

    
The following is being posted for a member of the PARENTING notesfile
community who prefers to remain anonymous at this time.   If you wish
to contact the author by mail, please send your message to me and I will
forward it to the anonymous noter.    Your message will be forwarded with
your name attached  unless you request otherwise.

Carol Stolicny, PARENTING co-mod
-----------------------------------------------------------------------
I just need to share/vent this.

When is two weeks an eternity?   When you're waiting through days 15 - 28 to
see if your clomid cycle worked...

I'm on cycle one for our second child.  It only took one cycle for us to
conceive our daughter (granted, after all the trying pre-treatment).
The doctor said "don't get upset if it takes longer this time, it doesn't
always work on the first cycle".   Yeah, right, "don't get upset".
I appreciate him warning me, but let's get real.

The ovulation predictor kit was inconclusive.   It was darker days 12 and 13
than after that, but not dark enough to be called "positive" per the kit.  I
don't remember if it really got dark enough to be called "positive" the last
time we did this.    Maybe I produced enough LH for ovulation, even though the
test was not "positive".    Maybe it was "positive" day 11, even though I did
not start testing till day 12.   Because of this, I'm particularly depressed
right now, just a sinking feeling it didn't work and I still have to
wait for and go through the day 28 let down, and then wait for the
next day 5 to start my next cycle.

The non-ovulatory mind starts to wander.  What happens if it didn't work?
Will it next time?   I can handle that I can't do this by myself, but what if
it doesn't work even with the clomid.   I'd be a wreck.  I know, it's only
the first cycle, and besides, maybe it worked.     I know there are more
clomid cycles, and higher dosages, and other technology, but my expectations
got set by how "easy" it was (thank God) the first time on Clomid.

I keep looking for a sign.  Maybe I'll wake up tomorrow morning and get sick?
(who would imagine I'd be wishing for this).

Patience, patience.    Next week at this time I can go for the test if I'm late.
7 days and counting.    I WANT TO KNOW NOW!!

"Waiting"

    
    Somewhere along my 8 years of mind torture because of infertility I
    embraced the AA (and others) philosophy of learning to take 1 day at a
    time.  It might sound easy for me to say as you are going through 
    the mind games right now but I know EXACTLY what it is like. Hoping this
    cycle will be positive perhaps makes it sound too difficult to learn to do 
    for so short a period of time. I never found any other way of making the
    (often repeated) process more bearable. I still fall back on this
    philosophy and find it very helpful.  The other doable things while
    you are waiting are to treat yourself beyond what your normally do,
    keep busy with things you like to do and if you can control it, don't 
    take on any added stresses - this one is big enough.
    
    Hoping for the best,
    
    Kathy
    
                                         

    
    Anonymous -
    
      Hi, good luck with this cycle.  I just wanted to let you know
    that if you did not ovulate this cycle, it does not mean that
    clomid will not work this time.  I just conceived (I guess this
    is an announcement) on my third cycle of serophene (a clomid
    cousin).  In the first cycle it did not look like I ovulated.  In the
    second and third cycle I ovulated in about the 3rd week.  So, if it
    does not work this month (I hope it does!) it might work next 
    month.  
    
      BTW: I was started on 100mg on days 5-9 as everyone in the office
    is so nice to tell me, I am a 'big girl'.
    
    Amy
    
    BTW: how do I find out if anyone is interested in studies 
    of second generation Clomid babies?  I was conceived in 
    clinical trials for Clomid in 1965.

(Congratulations, Amy  :-)  )

To the basenoter:  if it didn't take this time, ask your doctor to use
ultrasound next month to find out whether or not you really did ovulate.
No sense in going through all the emotional trauma (and extra expense, if
you are using AI, etc) if you didn't ovulate!

This is not the external ultrasound they do with pregnant tummies, but an
internal (bleh!) ultrasound where they put the dildo-like camera-thingie inside
your vagina to get a peek.  Not the most pleasant experience in the world (an
understatement for those of us who are not used to the more "traditional" ways
to attempt pregnancy...), but at least you'll know whether or not this month
even stands a chance! 

    Carol

>        <<< Note 21.285 by NODEX::PINCK::GREEN "Long Live the Duck!!!" >>>
    
>     BTW: how do I find out if anyone is interested in studies of second 
>     generation Clomid babies?  I was conceived in clinical trials for 
>     Clomid in 1965.


What I wonder is if anyone has studied the pattern of daughters 
following their mother's reproductive patterns.      Obviously, you 
did.      My mom had a terribly irregular/long cycle with no evidence 
of ovulation.   It was prior to the Clomid trials, and they "treated" 
her with various birth control pills on and off to "shock" her system 
into ovulation.   Some combination of that and 5 years of trying 
evidentally worked.     I have the same pattern, and had to use Clomid 
to have our daughter.     

I wonder how much of the female cycle pattern and reproductive issues 
(obviously not those caused by infection or other "occurances") are inherited.

    That's an interesting theory about mothers and daughters having similar
    patterns. I know that my mom had difficulty conceiving us, and only got
    pregnant every 5 years, but she had 2 miscarriages between me and my
    brother and her doctor told her she was a habitual aborter and that her
    body wouldn't support a pregnancy. Since I have a luteal phase defect
    [my body won't support a pregnancy without supplemental progesterone],
    I wonder if we really had the same thing.  It'd be interesting to find
    out.

    
    I do know in many other ways I am very much like my
    mother.  Hair, eyes, weight tendencies, looks...
    
    Once when I was 13 someone came up to my mother and me 
    and asked if she was Linda Stier (maiden name).  It was
    a Jr. High teacher of my mom's who recognized me!  :-)
    
    I wouldn't doubt that I inherited my mom's ovulation
    problems.  I will see her tonight, I think I will tell
    her that it is all her fault! :-)
    
    Amy

Interesting theory, and I have a sort-of fact to back it up.

My brother and sister-in-law have two kids after 6 pregnancies
(in 4 years).  (It went: loss, baby, loss, loss, loss, baby).
She would lose the baby with no warning in the 9th or 10th week.
(You can imagine our collective breath holding during the
10th week of the last two pregnancies).

After the 3 loss, they did some testing on the parents and
on the discharge and found that each of them had a particular 
gene that in combination would statistically cause a 50% loss rate.

It sounded very similar to the Rh factor, in that the
miscarriage was caused by my sister-in-law's antibodies
attacking the baby, but they swear that wasn't the name
the doctor called it (not the hemolytic syndrome, or
whatever).  But apparently, the same genetic laws and
protein factor rules take place.

Since they could identify a genetic connection, one would expect
this could be passed on...

(BTW, since the topic is fertility - they've decided they are done
with their family.  Neither of them feels they can stand the
anxiety of waiting that two weeks another time and that they have
plenty to be thankful for.  Many people here who can understand how 
hard that waiting can be...)

Pat

A laparoscopy is done as day surgery.  A small incision is made near the navel.
The abdomen is inflated with carbon dioxide to give the surgeon room to look
around.  The laparoscope is inserted through the incision.  Think of it as a
tiny illuminated periscope.  The surgeon can look for abnormalities in the
tubes, ovaries, uterus, etc.  If necessary, a laser is used to remove
endometriosis and lesions.  In addition to the abdominal pain you'll
probably experience after surgery, there's usually some pain in the shoulders
from the migration of the CO2.  You'll need to have someone take you home,
and you may want to take a day or two off to recover.  

The laparoscopy is indeed the final step in an infertility workup.  As such,
I'm surprised that you've gone this far without seeing a specialist.  Even
(some of) the specialists mess up some of the tests, making them worthless.
I'd be very wary of having a non-specialist do a laparoscopy -- you don't
want to do this again if you can help it.

    My wife had a laparoscopy during our infertility workup and
    later had essentially two more during our 'GIFT' procedures.
    In her case, it was 'full anethesia' type surgery with her
    'coming to' in the recovery room.  She was quite sick from the
    anethesia as well as from the doctors rummaging around with her
    innards.

    We found that when we went to the 'expert', he wanted to repeat
    all of the tests that we had already done.  No one wants to trust
    any previous doctor's work.  So I advise starting with the expert
    as soon as possible.

    We were not all that impressed with the experts....They were real
    focused on 'success', meaning their success ratios.  We were just
    numbers, and when we would have an appointment, they would not
    have any memory of who we were, etc.  We would have to walk them
    through our history at each visit.  They would say 'well, I think
    its time to try X', and we would have to remind them that we had
    already done X.

    Just for information....we did all the stuff and nothing worked.
    We did measure 'pregnant' on some super early blood test after
    one of the GIFT procedures, but Judy's period started right on time.

    A few years later, Judy got pregnant.  We expect that as she got
    older, her body changed and 'adjusted' to where everything meshed.
    We had adopted 3 kids by that time (our youngest are 8 months apart).
    Adoption is a great road to take.  But resolve your infertility
    before you get too serious.  Once you have been assigned a placement
    and you are waiting, you will be expected to follow some form
    of birth control to make sure that you dont get pregnant.  If you
    are still hoping for pregancy, you will find this very hard.
    bob

    Thank you, thank you to the responses, and so quick! It is truely
    invaluable to me!  I appreciate this, since no one I know is going
    through any of this.  All my friends get pregnant so easily!
    
    Anyway, I think I'm going to have a chat with my Dr about seeing the
    "super" specialist.  I don't want to go through any of this again. I
    have Harvard Insurance and they originally told me to go to Boston to
    the "real" clinic.  This was difficult for me to travel to, so I asked
    for something closer and they recommended my current Dr in Acton, MA.
    
    As for the adoption agency, we passed the home study test, gave them
    their home study fee and are now waiting for our "assignment". They
    never once said not to try and have kids. I did have to mention this
    infertility problem and they phrased it on the home study as having
    "Unexplained infertility and have gone as far as they can".
    
    This wasn't exactly true, but they seemed to assume it and didn't ask
    questions. They only wanted a note from my primary physician to verify
    I'm healthy.  Never wanted a note from the "specialist".  We just
    thought of it a "formality" thing.  As for us, it's ok to have adopted
    and natural children. We would love to have more than one child.
    
    Bob (note 21.293), since our adoption is becoming more of a reality
    (more than becoming pregnant soon) I'm interested to hear how it is
    with adopted and natural children in one family. If you want to discuss
    it.  Thanks!
    
    Again thanks for all your help!!
    
    -Pam 

>    Bob (note 21.293), since our adoption is becoming more of a reality
>    (more than becoming pregnant soon) I'm interested to hear how it is
>    with adopted and natural children in one family. If you want to discuss
>    it.  Thanks!

    When you have adopted kids, I think it is much more common to have
    discussions around 'where kids come from' than when all your kids
    are biological.  From the day our kids were born and placed with us,
    they've been raised being read books about adoption and hearing
    all their 'adoption' stories.  Our older kids can remember going to
    the courthouse and finalizing the adoption of the younger ones,
    and our son remembers actually flying in the plane to get Katie.

    So then along comes Anna....just born from 'Moms tummy'.  In many
    ways she feels a lot less special....she'ld like to be adopted too!
    The kids talk about it a lot.  As we drive around our town, we often
    pass by 'Annas Hospital' where she was born, and the older kids
    like to talk about seeing her for the first time.  We were hit by
    a truck when Anna was a day old, and our car was totalled when i was
    taking the kids in to see Anna....lots of family stories.  We talk about
    the hospitals where the other kids were born, and hope to visit them
    again some day.  One of our friends was in the town and took a photo
    they sent to us of Katie and Molly's hospital.

    I think one of Anna's favorite stories is that she actually flew in the
    Airplane to get Katie too.....she was in Mom's tummy already and we
    didn't even know it yet.

    All kids are special.  They are all very different.  They are great
    friends.  Your biological kids will be a lot more 'like you'.  That
    can be good and bad.  We have three gourgeous, athletic, string beans
    (all adopted) and one plump, clumsy cherub (apple doesn't fall far from
    the tree!).

    If you want to talk about this off line, I'ld be glad to.
    bob

Hi All,

I just wanted to add a note of thanks for all the support that this notes file
provided me over my years of infertility treatment. I gave birth to my baby
boy last June...he just turned 9 months old. Everyday I still have moments
when I can't believe I actually got pregnant and was able to 'stay pregnant'.
All the peaks and valleys my husband and I climbed through during our
infertility treatment were so worth it.  My hopes and wishes for good luck 
go out to any of you that are currently pursuing your baby dreams...  

Thanks again -
KC

    Well I needed to let all my parenting friends know that we are on the
    IVF cycle adventure again!  All of you were such an important part of
    our life when we started this fun stuff three years ago and we were
    so wonderfully blessed with our little miracle Chelsea Rose.
    
    It's really strange going thru this again.  If I ramble please bear
    with me.  I was so filled with emotions when we found out that we
    would not be able to conceive naturally and that IVF was our only
    option.  Going thru that first cycle was an emotional experience I
    can't even put into words.  Everything is a first and the chances of
    the cycle working are so low.  It felt like I breathed our IVF cycle
    during every second of my day and I couldn't remove myself from the
    process.  When it didn't work there was a part of me that died and
    I lost a big part of that zest I had for living.  
    
    Going thru the second cycle was like night and day from the first.  I
    went into the total negative mode and refused to give one ounce of my
    heart over to hope.  I fell to far the first time and I was going to
    set myself up for another crash...boy was I ever surprised that it was
    the second cycle that took!
    
    Now here we are three years later and a big part of me feels numb.  I
    know we are so lucky because it worked for us once and Chelsea Rose is
    a part of our life and has given us more joy in three years then I
    ever could have imagined.  My friends tell me that if it doesn't work
    atleast we have Chelsea.  My heart knows this is true, but another
    part of it wants to shout "But I still want this next baby as bad as
    I wanted Chelsea", so if it doesn't work, I will grieve the loss.
    
    I'm not exactly sure what I'm trying to say here.  I'm excited...I'm
    scared, I'm hopeful and doubtful.  Once again the IVF roller coaster
    has taken me passenger and I know that I will ride it out until God
    gives us the answers.  
    
    I am so grateful that we were blessed with a daughter.  
    I am so grateful that we have insurance that allows us to afford IVF.
    I am so grateful to have friends and family that support us and give
    so much love which helps us along this path we walk.
    
    I will keep you all posted and I know that if it works you will be
    there to share our joy and if it doesn't you will be there with your
    hugs and kind words which mean the world to me!
    
    ...Lori

	Praying, Lori!

	Karen

    Good luck, Lori!
    
    Susan
    

    
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-----------------------------------------------------------------------

I've been trying to get pregnant for a year and two months now (after having
been on the pill for 9 years). We are both in our late twenties. My cycles are
pretty regular, averaging 26 days (some as short as 24 days, some as long as 29,
apart from the last which was 31!). (Slight rathole, dividing the year into
quarters, the first cycle of a quarter is the longest, getting shorter as the
quarter goes on). Because of this I'm able to work out the week or so when I
could be fertile and we "do our best" around those times!

Anyway, we've both decided to see our doctor this week to ask for tests to be
done on us to see if there is anything wrong with either of us that could stop
me conceiving. My opinion is that there is no harm in asking for these tests,
at least we'll find out one way or the other if I could conceive or not. Then
we either try and fix the problem (IVF etc) or can sit back, relax and wait for
Mother Nature to take it's course. I've mentioned why we're seeing the doctor
to a couple of close friends (both male) and both seem to think it's too early
to have tests done and that there's probably nothing to worry about, easy for
them to say, neither of them had trouble producing children.

I've made my decision and want tests done, but I'd be interested to hear other
noters' opinions on whether it's too early to be having (in)fertility tests
done.

Thanks.

--------------------

    
        .300  Just a little personal view. I think that if you've been
    trying for over a year and nothings happened, I don't think it would
    hurt to have the tests. It's a decision you've made. 
    
        Also, I've heard of people going for the tests and finding out
    little problems that they were glad that they had taken care of.
    Like a blockage or something.
    
        Good luck, 
    
        Rosie

    
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-----------------------------------------------------------------------

**************************************
I think you should go for the tests.  We tried for 6 months before we went to
see an infertility specialist.  If I remember correctly, there was a series of 5
tests that are considered the 'basic' tests and can uncover the majority of the
problems.  One was a sperm count test, one involved me getting to the clinic
prior to 24 hours after having sex to see if we were compatible (was I killing
the sperm), one was similiar to a cervical biopsy and another involved having
dye injected to see if there was a blockage in my tube (I only have one).  I
forget what the other test was.  Since these tests all occur at different times
in your cycle, it took about 2 months to have them all performed.  All results
were good with the exception of a slight blockage they found in my tube.  The
doctor suggested I take a month off and then return for the next series of
tests.  We went on vacation for 10 days, and I was pregnant when we returned.
The doctor believes the dye removed the blockage and that MAY have been why I
didn't get pregnant earlier.

So, my advice is to go see your doctor and have the testing done.  It seems a
shame to try for a long time only to find out it MAY be something minor that is
easy to correct.

Hope this helps.

>                     <<< Note 21.300 by CNTROL::STOLICNY >>>
>                       -< Anon: when to start testing? >-

    If you're concerned, then it time for testing.

    I'll assume you're a woman (my cycles), and I'm assuming when you
    say 'we are going for tests', your husband is going too.  Testing
    the guys is a lot simpler than testing the gals.  At least for
    the basic tests.

    I'll share my experience.  I got a note from my doctor about the 'test'
    that I needed done.  So I walk into the hospital and dont know quite
    how to describe exactly what I want.  So I show the note to the young
    receptionist and, trying not to smile, she directs me to the lab.

    I get to the lab and again just hand them the note.  Again, we're
    all business...and she says 'Well, did you bring it with you?'.
    I'm not exactly sure how to answer this.  So I say 'Sort of'.
    And she says 'Is it fresh?'.  So I answer 'Very', or something like
    that.  Eventually I manage to explain that I haven't actually PRODUCED
    it yet.  So I'm handed a little cup and told to come back when I've
    got something for them.  And so I'm wondering around the hospital
    looking for an empty bathroom to do my clinical duty.

    As we went through the years of infertility studies and procedures,
    I actually got quite good at it!
    bob

	I agree that you should go in for the tests.  My OB recommended 
	the dye test (HSG) three months after an ectopic pregnancy.  One 
	tube was obviously blocked (scarred from surgery).  But, we also 
	saw the dye get caught in the second tube, and then release.  I 
	was pregnant a couple months after the test.

	When my son was just under two, I tried to get pregnant again.  
	After no luck for over six months, I asked my doc if he'd perform 
    	another HSG.  The first was inconclusive (poor experience with 
    	the radiologist, but that's another story).  A couple of months 
    	after the second attempt, I was pregnant again.  
    
	As I understand it, there are two types of dyes that can be 
	used.  One is oil based, and there are OB's who believe this 
	extra lubrication can help the egg to travel more easily. In 
	my case, I believe that my tube just blocks for some reason.

	I know of at least three other couples who went in for dye tests 
	after no luck getting pregnant on their own.  Two got pregnant 
	within a couple of months.  Unfortunately, the third found that 
	both tubes were blocked, and is now trying IVF.

	Peggy

    
    My husband and I tried for a year (timing was recommended by my OB
    based upon stats of how long it "can" take).  Depending upon your age
    and your own concerns, some doctors will start basic infertility after
    6 months of "active" trying.  I say "active" because in the beginning
    you may need to understand cycles using the basal body temp method so
    that timing your "trys" would give you the hopefully best results.  
    
    After a year my basic testing included not a cervical biopsy but a
    uterian (sp?) biopsy.  That told if my body did the right/normal
    hormonal things for my cycles and if a pregnancy would "take".  (By the
    way that test did tell me I had a short luteum (sp?) phase which said
    my body might normal have a period before the impantation would happen
    afetr fertilization).  My husband also had to give a sperm sample which
    proved normal.  I also had blood test at certain times to identify more
    hormonal issues, and I was scheduled for the die test, but I was lucky
    enough to get pregnant right before that was to be performed.  The die
    test is a hospital procedure (day surgery) and is done normal the fist
    few days of your cycle and pregnancy tests have to be done if there a
    chance.  That's what happend to me.  The test was scheduled on Day 3
    and I hadn't gotten my period yet, so they performed a blood test the
    day before and low and behold!!  Andrew Patrick was conceived!  One
    note, I guess personally my body had to get on track once, because
    subsequent pregnancy's were welcomed but a surprise.

    
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-----------------------------------------------------------------------

An update to 21.300:

We saw our doctor last night who was very helpful and supportive. My husband
has to provide sperm samples for a sperm count and I'm being referred to a
gynaecologist, I should get an appointment through within 12 weeks.

Thanks to all those who replied to my original note and who sent me mail,
all were very reassuring and supportive and I feel much more positive now.

-------------------------------------------------------------------------------

    21.300 & 21.306:
    
    How are you doing with your testing??  I hope all is going well. 
    Having the initial infertility tests done can be an exciting yet
    emotional time.  When you get the chance, let us know how you are
    doing.
    
    Wishing to the very best!
    KC

    Over the past 2 years I have gone through all the infertility tests
    that are available.  I also did about 6 Clomid cycles, 3 Metrodin
    (because Pergonal was not available) and 1 Pergonal cycle.  None of 
    the attempts have been successful.  My doctor has now recommended that
    I go into an IVF program.  After all the tests were performed we were
    classified as a case of "unexplained infertility".  I am a little
    nervous about doing IVF but I am scheduled to meet with an IVF
    specialist on October 16.  That was the earliest date I could get an
    appointment.  So now I have about a month in which nothing will happen
    and I am feeling very anxious about it since I see it as time slipping
    away.  I am 38 years old at this time but will soon be 39.  
    
    In an attempt to deal with my feelings, I have become a member of RESOLVE. 
    One of the reasons I joined was because they had support groups for
    people like me.  However, when I joined RESOLVE I did not know that
    there would be additional fees to be paid for joining the support
    groups.  I would like to know if anyone else has been part of these
    support groups and if they are worth the money. 
    
    Any reply will be greatly appreciated.
    
    					Maria
    
      

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**************************************************************

Well, I've just had miscarriage number 3.  Still no reason provided by the
path results, nor by the chromosomal analysis done earlier this year.
The ob is considering referring me on to a professor who specializes in
infertility disorders, or may put me on Clomid (as I'm rapidly
running out of years to experiment with annual, failing pregnancies).

I'm feeling less despair than I'd expected, but a heck of a lot of anger - not
directed at anything or anybody, just anger.  And I'm *tired* - physically and
emotionally.

Does anyone have any hints/tips for sanity/emotional muscles retrieval?
Is Clomid OK for post-35s (as I will be in the not-too-distant future?).
I know very little about it.

    re. clomid for post-35s
    
    I took clomid for the 2 months that it took to conceive my son, Evan.
    
    I was age 39yrs7mos when I began taking it. I did fine. In fact, it
    effected me less than many younger women I know who have taken it.
    
    Some of this could be psychosomatic, most an individual reaction to the
    hormones.
    
      Annie

    No advice or experience to offer, but just wanted to say that I
    sympathise with your plight, and hope good things for your future.

    Hugs,

    Leslie

    
    re .309
    
    My sister-in-law had 3 miscarriages in a row, she had no problem
    getting proegnant, but she kept miscarrying. They found out
    that she was "allergic" to the fetus and her body was rejecting
    the baby like a transplant patient rejects the organ. When she
    was pregnant the 4th time, she went somewhere to Pennslynia for
    anit-rejection treatment. She carried the baby to term and the
    little girl is 7 yr old now. She did not have any problem with the
    subsequent child. Your situation may be different, you may ask
    your doctor if this is a possible cause.
    
    Best wishes.
    
    Eva

    
    A reason for my repeated early miscarriages was my lack of progesterone
    production. This can be corrected with suppliments.
    
    Kathy

    
    
    I had a hysterosalpingogram after my second child was born prematurely.
    
    From what I understand, the test looks for physical deformities via
    xray.  It was *very* unconfortable for me, and it was not supposed to
    be.  My doctor wanted to drive me home, so I would encourage the
    author to have someone accompany her.
    
    Good luck.
    

    When I had my HPS, I was uncomfortable, but no terribly so. My doctor
    had told me ahead of time to plan on having someone drive me home. Not
    so much because of the procedure itself, but because he'd given me a
    mild muscle relaxant to mitigate the discomfort.
    
    I watched the monitor to see the radio-opaque fluid flow through my
    fallopian tubes. It was neat!
    
    I was a little crampy for a couple hours afterward. I was also tickled
    that there were no abnormalities to be found.
    
      Annie

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**************************************************************

Staying pregnant is the biggest problem, but getting pregnant in the first 
place is an issue too.  The time/age factor is looming.

    I think most HPS's ARE  uncomfortable.  I had one  related
    to checking for causes of infertililty.  My tubes turned out to be fine
    but the test itself was very painful for me. I wish they gave me a
    muscle relaxant before hand. I believe there were some anatomical
    reasons mine was SO uncomfortable.  My doctor insisted I have someone
    to drive me home because of the procedure!  The procedure is a physical
    shock to your system and some people's bodies react.  I was very glad I 
    had some support afterwards. 

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**************************************************************

So far the pathology tests have shown no reason for the miscarriages.  Each 
miscarriage has been slightly different.  The first there was major loss via 
what looked like huge menstrual clots, the second was just a "feeling" of 
wrongness, and lack of feeling pregnant, which was confirmed by 2 scans a week 
apart showing no heartbeat.  The third started with what felt like my waters 
breaking, but was in fact the loss of about a cup or more of bright blood and 
amniotic fluid (I think).

On Monday I am having a hysterosalpingogram (HSG) which seems to involve a 
mild x-ray trace of fluid to be directed through my fallopian tubes, just in 
case there's a problem there.  It's supposed to take about 30 minutes to do.

The following is being posted for a member of the PARENTING notesfile
community who prefers to remain anonymous at this time.  In order to 
distinguish her from the other anonymous noter in this string, I have
given this noter the pseudonym "Robin".  If you wish to contact the author by
mail, please send your message to me and I will forward it to the anonymous
noter.  Your message will be forwarded with your name attached unless you
request otherwise. 

      Carol duBois, PARENTING Co-moderator

**************************************************************


I'm looking for suggestions on how to gain control of my emotions while
trying to get pregnant.  I already have a child and have been wanting a 
second for years, but my husband wasn't ready.  Now he's ready and I'm so
anxious (because I feel like I've been waiting forever) that I'm a basekt
case.

I got pregnant the first time after two tries, and I was very low-key about
it that time.  This time I'm obsessed.  It's all I think/daydream about.
Each month that I'm not, I feel so devastated that I can barely function.

I know I have no right to feel this way, that there are plenty of people out
there that would give anything just to have one, healthy child.  It's just
that I always thought I'd have at least two, close in age, and I'm very
dissapointed that it didn't happen that way.

We've only been trying a few months and I know I need to chill out, but I
can't seem to.  I know that the best thing to do is to calm down, relax, not
focus on it....  Instead I've made myself so crazy that I didn't get my last
period even though I'm not pregnant.  Now I don't know how to time my cycle
for this month and I'm even more uptight.  Not to mention the fact that I
feel like I'm in a permanant state of never-ending PMS.  I called the doctor
and was told to wait it out - no help at all.

To make matters worse, I've been so uptight that I'm gaining weight.  About
5 pounds a month.  At this rate, I'll blow up like a balloon if this keeps up!

At home I'm managing to put on a happy face for my child.  But to my husband
I'm agitated, angry, and irritable.  (Part of me thinks this is all his fault
for making me wait so long, even though he had perfectly valid reasons.)
I've never cried this much in my life.

Any ideas on how to get off this road before I drive myself into clinical
depression for good?

        "Robin"

    
    
    Hi "Robin",
    
    	Sorry to hear that you've been frustrated. 
    Here is what I do when I get into mode. I try to 
    sit down and think about the whole thing, try to
    think about the positive things in life, be 
    thankful for what I am given, accept the *fact* 
    that I am not in control and try to enjoy what
    I have to the fullest. If I stay focused on what
    I don't have (thus I want to have), I will at the same
    time lose (not enjoy or even resent) what I already 
    have. I would try to remember no matter what happens
    in life, my husband and I will face the challenges,
    the joys and the disappointments together, on the
    same side of the train track. I would try to understand
    the real meaning of mumbling at the wedding "To love 
    and to cherish, for better and for worse..." Maybe
    I got disappointed this time, maybe I'll disappoint
    my husband some other time, but we in it together.
    
       Best wishes in finding peace.
    
    Eva   

    Robin,
    
    I had infertilitly for 8 years before I had my son.  I know
    disappointment, and stress very well, and, frankly, every emotion that 
    exists.  Over the years there were several tricks  I learned which
    help me go on but the biggest help was learning to take each moment
    as it comes.  I know how difficult this is because I am a big planner.  
    Once I was doing all the possible things I could be doing (in the 
    whole world) I still had to just sit there and wait. Finally, instead of 
    looking at the end goal (having a baby) because that just got me
    depressed since it was not working, I broke down into tasks what are
    all the possible things I could be doing to help me get there. Usually 
    there were 1 or 2 "things" I could be "doing" and that helped me not be as 
    frustrated such as medical tests, consultations, readings, etc.  It also 
    meant taking care of my body by working out, eating right and being good 
    to myself for myself because these are all activities to help reach the 
    goal.  Being good to yourself can take numerous directions such as time 
    off from work, shopping, massage, vacation, taking a course, taking up a
    sport, professional counseling, joining a support group. When you feel 
    you're at the edge, check out (as much as it is possible.) and do for 
    yourself. All these take time and took my mind off what was really 
    troubling me, sometimes I even felt better. 
    
    Finally, you feel what you feel.  I reached a point to allow myself to
    get very sad for a day or so perhaps at the end of a failed cycle. If I
    needed I cried my eyes out, felt incredibly sorry for myself, etc. Then I
    was ready to move on and it renewed my strength to continue trying. I 
    realized it would be counter productive to stay depressed as it would
    add to the factors already causing the infertility. Difficult?
    Incredibly, but absolutely necessary..
    
    Good luck,
    
    Kathy
                                         

    Has anyone had Clomid affect their basal temperature?
    
    I have just started taking Clomid this month (secondary infertility)
    and my temperature rise after assumed ovulation has been at 97.9 98.0.
    When not taking Clomid my temp. after ovulation has been from 98.5 to
    99.0.  I have begun to get discouraged thinking that the Clomid is 
    worsening things rather than helping.  My Dr. believes that I ovulate,
    I had a miscarriage in Nov 94, but my cycles are irregular and usually 34
    - 36 days so he thinks the Clomid will regulate them.  The first half
    of they cycle was pretty similar to my months when not taking Clomid.
    
    Any comments/advice would be appreciated.
    
    Thanks!

    I have a question for a friend (HONEST!!!!)...
    
    When you chart you basal temperature, what happens when you get
    pregnant?  Does the temp stay up after ovulation as usual?  Or
    something else?
    
    Thanks!

Re:-1
When I got pregnant, I was charting my temperature; the temperature went up
after ovulation and then just stayed up. The temperature would only come
down when signalling the onset of menstruation; in the case of pregnancy 
that doesn't happen.

Lucy

    I'm popsting a note in here to let folks know about anohter
    "Private members-only" note for infertility issues.
    
    It's a small private file that is stickly confidential. 
    
    If you are, or know of a co-worker who is experiencing or
    has experienced infertility and would like some support or
    like to share your experiences.....
    
    Contact me via EMAIL and I'll be happy to get you a membership.
    
    
    Deb Alexander (WMOIS::ALEXANDER_D  or SALEM::ALEXANDER_D) 

    The author of this note has asked to be anonymous at this time.  If 
    you wish to send anonymous mail to the noter, please feel free to send
    me mail and I will forward it on.

    meg for the parenting mod's
    
    I have a question for 'veteran' infertility patients: why is (or is it) 
    a basal body temp. chart more valuable than the ovulation predictor 
    kits?  My OB/GYN insists on a BBT chart.  For various reasons, I can't 
    get several months in a row of significant data, mostly because I get 
    interrupted during my sleep by things that require IMMEDIATE action, 
    thereby ruining that particular day's temp. results.  Once you wake up 
    and move around, your temp. goes up and the results are useless. So I 
    switched to the ovulation predictor kits, which seem to indicate a 
    potential problem ; according to the kits I ovulate on day 9 of a 28-30 
    day cycle.  Am I dealing with a very stubborn OB/GYN, or is there some 
    compelling reason why the temp. charts are more useful?  I'm rather, 
    um, mature shall we say, and I really can't keep waiting months after 
    month to get the perfect data to be referred to a fertility specialist. 
    Doing the HMO dance...  If anyone can recommend a more flexible OB/GYN 
    with the Fallon Clinic in Worcester, MA. please let me know through the 
    moderator.  
    
    Also, a question on the kits for anyone who uses them. According to the 
    kit, once the little line in the window shows up, that means ovulation 
    will take place 24-48 hours later.  So what happens to the LH during 
    the next few days?  Does it remain high?  If I continued to do the test 
    kits will I show LH until AFTER ovulation has occurred?  To rephrase, 
    at what point does the LH subside and no longer show up on the test 
    strip?  
    Thanks for any help.

<    why is (or is it) a basal body temp. chart more valuable than the 
<    ovulation predictor kits?  My OB/GYN insists on a BBT chart.  

I don't understand why doctors think so, either, unless it is just that some
doctors are stuck to the "old ways."  My charts were always erratic, and I
was as *faithful* as I knew how to be.  

In my opinion, you should be referred *now* to the fertility specialist and
let him/her make the rules.  Push back on your doctor.  From what you've said,
you don't have time to wait.

    Carol

    Hi,
    
    I agree with the last noter...seek a real "infertility specialist"
    now.  Take it form someone who waisted over 2 years with a
    GP and then OBGYN...do it sooner, rather than later.  You don't
    realy say how long you've been trying to conceive but if its a
    year they should refer you....and with your age factor they 
    should even refer you sooner.
    
    I know at the begining I went through alot of denile and thought
    our problem whouldn't require that much treatment and we would
    not get to the poin of needing a specialist...but 8 year and 
    many surgeries, and high tech proceedures later we finaly 
    are parents.
    
    I always HATED those basal charts...IMO they are just too
    inaccurate.  If you see a specialist they will run you through
    an evaluation cycle with blood hormone level checks and 
    ultra sounds to know for sure what and when your body is doing.
    You can chart and do prediction tests all you want but as soon
    as you end up at a specialist they will do their own evaluation
    cycle anyway.
    
    Let me clarify "infertility specialist", you should be looking
    for a Reproductive Endocronologist that does IVF.  I think for 
    Fallon they use Boston IVF...but I'm not sure you should probably
    call the HMO and ask.
    
    Good Luck...it IS worth the rollercoaster ride!
    
    Deb

There may be information to be gained from BBT charts, but if it's impossible
for you to come up with accurate BBTs, there's no point in pursuing it.  Some
doctors think BBT charts are quite useful, others think they're overrated.

    I did BBT charting before ovulation kits were around.  I probably took those
    readings for 3-4 years!  There were many mornings I woke up with a
    thermometer in my mouth, or on the pillow because I had fallen back to
    sleep in the 2 minutes or so I had to keep the damn thing in my mouth.
    Since I don't know anything about the kits I'll only speak to the
    charts.  I think the charting helps them determine the average length
    of your cycle, when and if you ovulate and if you have any leutial
    phase defect.  The regular ob/gyn will automatically know you need a 
    referral if there doesn't seem to be any ovulation or if there is a
    leutial phase problem. (this means having less than 12-14 days from the
    point of ovulation to menstruation. if there is a problem it is caused
    by a lack of progesterone production. Progesterone is the food  for the 
    first 12 weeks of pregnancy and a fetus cannot survive without it or
    without a certain level.)  So, I think charts are very helpful and it
    would be great for you to really try to do the thermometer thing.
    However, not having used the kit, if they are supposed to be as
    accurate and tell as many details as a chart can, pushing back on the
    doctor is in order *especially* id this physician is not a specialist
    in this area.   As to not getting a reading every day, this is only
    a problem on the days you are waiting to serge/ovulate.  If you miss
    day 3 or 5 or a day after you've definitely ovulated, it is no big
    deal.  The big dates are day 1, time of ovulation and menstruation.
    THey also want to see the overall "pattern" of the cycle for the month
    but a few days without readings won't mess up the pattern.
    
    As for time running out because of age, etc. this is a legitimate
    concern. I think age 35 and up typically gets a specialists attention
    as well.  However,  unless someone has a glaring problem, I think ideally 
    they still want some history of knowing you have been timing intercourse 
    right over several months before they see you. If you are over 35 and
    have been trying for 6 months or more I would push on the ob/gyn to
    be flexible about the chart vs. kit thing and/or push to give you the
    referral.  
    
    Kathy 

    The author of the following reply wishes to remain anonymous at this
    time.  usual courtesies on anonymous replies pertain.

    Meg for the parenting mod's

    For myself...  if I went more than six months, and was unsuccessful in
    getting pregnant, the first thing I'd do is insist that my OB give me a
    HSG (dye test) to insure that my tubes weren't blocked.  I've had this 
    test two times.  In both instances, the dye stopped for a short period, 
    and then flowed freely.  Also, in both instances, I conceived within a 
    couple of months after this test was run.

    As for predicting ovulation, you might want to consider looking for a 
    hospital, or other organization, that provides "Natural Family Planning" 
    seminars to better help you understand your cycles.  I attended one with 
    a friend, and made a few follow-up visits as well.  As a result, I think 
    I can pretty well tell when I'm ovulating better than any temperature 
    chart would tell me.

    One of the hospitals in Nashua (I think it's St Joseph's) holds them.  
    If you don't live in the Southern New Hampshire area, they might be 
    able to point you to someplace else that also holds these seminar.

Ditto on the dye test.  I know a *lot* of women (myself included) who
conceived within a month or two of this test, even if the doctor said the
test didn't show anything.  Our speculation is that the tubes may be just
*slightly* blocked, but that the force of the dye through the tubes opens
them up.

     Carol

The author of this note prefers to remain anonymous at this time.  If you 
wish to send anonymous mail or to reply anonymously please send me mail 
and I will forward it on to the author or post in notes

Meg

Can anyone here share any stories relative to their experiences (and hopefully
positive outcomes) of having fibroid tumors found while trying to conceive?

I know the various types; one of the four found in me is a large "submucous"
fibroid - pushing into the uterine wall.  The others are apparently not that
type.                                                                 

What was your doctor's opinion about fibroid tumors affecting fertility?
We just completed a laperoscopy and hysteroscopy and he reviewed the results
with me last week.  The doctor is now pondering (the pros and cons of)
myomectomy (laperectomy?)... I would love to hear from anyone who's had that
surgery:  how long is the recovery, positive outcomes, etc.?
                       

    I had fibroids that did not affect my fertility at all as far as we can
    tell.
    
    They were found in the early 80s and I have them today.
    
    They were and are completely non-issues. I've never needed surgery.
    
    I got pregnant with Evan my second month of trying. The fibroids grew a
    little bit during the first trimester my pregnancy, but not enough to
    be noticeable except on ultrasound. They actually had shrunk to smaller
    than their pre-pregnancy size by my 6-week postpartum check-up.
    
    Hope this helps.
    
      Annie

    What is the optimum time to "try" during your cycle?  Is it the day
    the temp drops to its lowest point before starting to rise or is it
    24-48 hours AFTER that?
    
    thanks

    I believe that the optimum time to try is 1-2 days prior to the
    temperature drop, which makes planning a bit difficult.  From what I
    remember, the drop in temperature indicates that ovulation has
    occurred, and not soon after that, it is too late.  The best bet,
    according to my doctor, is to chart your cycle for a couple months to
    get a good idea when the drop occurs.  Hopefully, the drop is
    predictable so that you can determine the optimum time to try.

The following is being posted for a member of the PARENTING notesfile
community who prefers to remain anonymous at this time.  If you wish
to contact the author by mail, please send your message to me and I will
forward it to the anonymous noter.  Your message will be forwarded with
your name attached unless you request otherwise.

      Carol duBois, PARENTING Co-moderator

**************************************************************

For the past 11 months I have been taking Serophene in the hopes of
getting pregnant.  Without the Serophene I don't ovulate.  During
this time I have been doing the temperature charts and timing
intercourse appropriately (when possible- my husband is on the road
a lot!), to no avail.  With the exception of 2-3 months in that time 
span when the Serophene didn't work, I do appear to ovulate according 
to my temp charts but my cycles range from 30-36 days and it is not 
predictable as to when I ovulate.

I should probably also mention that my husband has been tested and 
he passed the fertility test.  I just had an HSG test and everything 
appeared to be normal with me as well (by the way, for you women who
said the test was "uncomfortable," can we talk?  For me the pain was 
so bad I lost conciousness!).

This month I used an ovulation predictor test for the first time
and think that we may actually have a shot at having timed things
correctly.

Two questions:  The test appeared to be positive for two days 
(day 16 and 17 of my cycle) and then went negative the following day.  
Is this normal?  The test states that a positive result means you will 
"probably ovulate within the next 24-48 hours."

For those of you who have used the test, would having sex on days 
17 and 18 of my cycle be too late or would it be the appropriate 
time to try?  It seemed to me to be the "right" time according to the
information on the test...but does not seem to follow the temperature
chart theory that well (i.e., you see a dip at ovulation then a rise).
My temperature was already rising when the test came out positive.

My second question is for you veteran fertility patients who can maybe
tell me what the next steps are in the process if I do not get pregnant
within the next month or two.  What can I expect?

I look forward to reading your answers.  I've read all the infertility
notes in this version and the previous version of Parenting and I 
am thankful for any information I've been able to find.  I must say that
it has educated me along the way in my quest for pregnancy.

hopeful

Dear hopeful,

I went through the temperature charts and Serophene/Clomid also.  I also have 
long cycles, irregular periods, *and* I was on the urine (ovulation) tests.

The temperature charts were *never* reliable for me.  The ovulation kit was
*far* more helpful.  I found that no matter how long my cycle was, on the
Clomid I ovulated around day 17-18.

As for the HSG, I had it when I was unconscious, while they did other tests
at the same time.  However, my spouse had the same intensity of pain that
you did when she had an HSG.  I've known other women who had that much pain,
and I know one woman for whom the HSG was nothing. 

The good news:  many of the women I have spoken with have gotten pregnant
within a couple of months of their HSG.  We theorize that there is often a
blockage that goes undetected, even a partial one, and that the HSG clears
it out, making way for conception.  Have hope!

My advice:  use those ovulation kits religiously, especially in the next
few months!  Ask your doctor if you can get rid of the (annoying) temperature
charts if they don't match your ovulation kit results.  As *soon* as your 
ovulation kit shows the right color, hit that bedroom!  (or sofa, or doctor's
office, or wherever - "Honey, let's go to Lookout Point tonight; the stick 
turned blue!").  :-)

If after 2 more months you are not pregnant, sit down with your doctor and
find out *all* of the tests that you can have.  My doctor listed *several*,
each performed on a different month.  There was no way I wanted to wait that
long to hit the "right" test, so I asked if they could all be done at once.
He agreed, but note that *he* hadn't brought it up; *I* did.  Be proactive.
If you choose that route, then tell your doctor that after the next cycle
(3 months from now) that if you aren't pregnant that you want to undergo
these tests.  

Now that you are using the ovulation kit and have had the HSG, you may never
get to that point.  :-)

Good luck.

     Carol

Dear hopeful,

We went through quite a few years of mourning our monthly
disappointment just as I'm sure you are.  Fortunatley for us,
fate presented us with an opportunity to adopt and for a year
we put our fertility issues on hold.  After a year we tried
GIFT for a second time, again unsuccessfully.

I dont want to be pessimistic, but all of our fertility attempts
were unsuccessful.  We had some 'near misses' where we tested
pregnant for a few weeks, and then Judy's period started up.

We were incredibly fortunate to be able to adopt two more
kids over the next couple of years. And miraculously we then
got pregnant without any medical interference at all.

There are so many 'folklore' accounts, for example that people
often get pregnant after the HSG.  Our doctor told us  this
10 years ago.....he claimed it is likely a sort of 'kicking the
coke machine' effect.  Not sure why it works but it sometimes
does.  I agree it may be freeing up some blockages.  Another
folklore is that people get pregnant after they adopt.  the RESOLVE
statistics are that only 5% of adoptive parents later conceive.
But EVERYONE says 'Oh, it happens all the time'.  And it did for us.

Think hard about what level of medical interaction you feel comfortable
with.  Consider adoption....We have 3 wonderful kids  who weren't
born to us but came through an equal miracle.
bob

RE: Pain with the HSG

My sister had this done, and the next month was pregnant.  Unfortunately, it 
was a tubal pregnancy, and she lost the baby that she so desparately wanted, 
and they had tried so long and hard for.

Her Dr. told her that she was okay, and that if things didn't work for them, 
he could do another HSG, and sounded pretty confident that she would get 
pregnant again after that one.  They were unsuccessful, and she would not even 
CONSIDER allowing another HSG after all the pain she'd had with the first one.

In spite of wanting a baby more than almost anything, she couldn't put herself
through that amount of pain again.

Really makes you wonder .... who's doing the testing on whether this should 
hurt or not?!

Patty, your sister's doctor was using an HSG as therapy rather than for
diagnosis?  Bizarre!

My wife's HSG was very painful, but according to the xray tech, it was
the doctor's fault.  He came to the hospital late, blamed it on his
secretary, and was visibly angry.  Needless to say, we switched doctors.

>Patty, your sister's doctor was using an HSG as therapy rather than for
>diagnosis?  Bizarre!

Yup ... the Dr felt that the post-HSG pregnancy rate was so high, and 
particularly since it worked for her once, that it had a good chance of 
working again.

I always wondered if it's just one of those things they haven't really 
"perfected".  Like when I had an epidural w/ a c-section for Jason.  I swear I 
felt every touch the whole entire time (and screamed accordingly).  The 
epidural (that I tried to refuse, fearing equal ineffectiveness) I had for 
'natural' delivery w/ Jonathan was so effective, I was numb up to my shoulders 
.... 

I will say, the RISK that it could hurt that much ever again, is enough to 
make me say there's no WAY I'd ever rely on one.  Not sure what (if?) they
use for anethesia for the HSG - but my sister sure wasn't impressed.

-Patty