Conference moira::parenting_v3

Both male and female should have a workup done, even if a problem
is found in the partner.  Here's what's covered in a basic fertility work-up:

Male:
  Sperm Analysis which includes count, motility, clumping (aggulation?),
  and shape (such as head size and tail size).  If that comes back low
  or not normal, then a urologist will check for verricole vein and
  will make suggestions such as no hot baths or jaccuzi's, wear boxer
  shorts, etc.

Female:
  In doctor's office:
  o menstrual history
  o at least 3 months of basal charts reviewed by physician -
    to make sure ovulation is happening, happening soon enough,
    the uterine lining is building up, intercourse is done at opportune
    time
  o post coital test - done 2-12 hours after intercourse to make
    sure the sperm are getting into the cervix.
  o endometrial biopsy - sample of uterine lining is taken around day 22
    of cycle to make sure that the woman has ovulated and that the lining
    is building up properly for implantation of the fertilized egg. 

  In Hospital:
  o hysteropingogram - dye put into uterus to check size and shape of
    uterus and tubes and possible blocking of tubes.  Some doctors can
    also tell if any endometriosis (blood deposits) exist on the outside.
  o laparoscopy - physician looks at outside of uterus and tubes
    through incision in belly button with fiber optic light to check mainly
    for endometriosis but also for general shape and condition.

If these all come out OK then other tests can be performed, but these are
the basic ones.  Most of the problems found in these tests can be treated,
often with a simple drug.  If I got anything wrong, please post additions and
corrections, this was all from memory.

How to cope?
  o The best thing I could have done was to get the workup.  I always felt
    so much better when I was actively doing something about it instead
    of just sitting there worrying.
  o Get some books and do some reading.  "How to Get Pregnant" by Silber
    is a good start.  I'd be happy to loan mine to you.  Most books will
    cover all these standard tests and also have many tips like:
       - Stay in bed, lying on your back with your knees slightly bent
         for at least 30 minutes after intercourse.
       - Don't use any lubricants, such as KY jelly.
       - Have intercourse before your basal temp. rises, not after.

Best of luck.  90% of infertile couples will get their problems diagnosed.
50% of couples who go for help get pregnant within 1(-3?) years.

-Amy

    My first suggestion is that you contact your regular gynecologist and
    talk to him, explain your situation, charting, etc., then ask him to
    recommend someone to talk to.  It's best to start AT the beginning.
    I don't know of any doctor that specifically specializes in fertility
    testing, but my gyn moved from Emerson to Worcester Memorial and that
    hospital has access to a NUMBER of neonatal specialists and
    gynocologists which all kinds of specialties.  If you feel comfortable
    you may want to call and inquire through their referral service.
    
    You don't know if either of you have a problem at this point. 
    Sometimes it's something very simple.  Sometimes if you gain or lose 5
    lbs that makes a difference!  It's strange, but true.  If it's really
    bothering you emotionally, I would recommend talking to someone as
    well.  Sometimes it helps just to "get it out" with an outsider.  You
    don't have to be "wacko" to need someone to talk too.
    
    Like I said, at this point, I would try to relax somewhat and you've
    made the first big step, i.e., knowing you want to find out what's
    going on.  
    
    Best of luck, keep your chin up!
    
    Rebecca
    

    In addition to the tests referred to in .1, there is a BUNCH of
    bloodwork to check for infections and viruses of various kinds.
    
    I did a lot of the stuff in .1 with regular OB/GYNs, figuring that 
    a) they weren't going to refer me to a fertility specialist
       until THEY were satisfied that they couldn't do anything more
       (should have been MUCH MORE assertive)
    b) they could do the tests
    c) it would be less expensive than having a fertility specialist
       do them
    
    Only c) proved true.  The general OB/GYN community doesn't have a
    very good understanding of the state of the art of fertility
    medicine (some individuals may, but you really can't count on finding
    one). They performed the tests, some incorrectly, some timed
    incorrectly, some with poor lab conditions, and completely
    misinterpreted some of the results -- it was a colossal waste of time
    and money.  When I got to the fertility specialist, he re-did almost
    all of the work.  
    
    The sperm analysis and temp charts should be the first thing you do,
    since these are the least invasive procedures.  Don't spend more than
    3 months at it, then INSIST on getting referred to a fertility
    specialist. 
    
    BTW -- the health plans vary quite a bit on what they will pay for
    fertility tests and treatments.  Check out what yours pays before
    you start.  JH is pretty good in this respect.
    
    Good luck,
    Beth
    

    I absolutely agree with the remark in .4 that you should see an
    infertility specialist.  I have had a common hormonal imbalance since 
    I was a teenager (I'm 30 now), but it was never diagnosed.  I had 
    gynecologists and general practitioners do lots of blood tests, but
    they just never interpreted the results correctly.  As soon as I went
    to a specialist, my problem was diagnosed and I received treatment,
    resulting in a pregnancy 9 months after I first saw the specialist.  In
    my case the doctor specialized in reproductive endocrinology.
    
    There are lots of treatments out there and it's worthwhile to find
    someone whose business is keeping up with the latest research in the
    field.
    

    Absolutely ... find yourself a good infertility specialist.  I believe
    many of them are reproductive endocrinologists specializing in
    infertility.  The difference between their approach to infertility and
    the approach of a typical OB/GYN is significant.
    
    Good luck!
    
    BTW, one of the replies listed the order of tests for the female, and
    indicated the endometrial biopsy done in the doctor's office, followed
    later by the hysterosalpingogram in the hospital.  Pat's doctor had the
    HSP done first (in the lab, not the hospital), because it is
    much less unpleasant than the endometrial biopsy.  The HSP showed two
    blocked tubes, so the biopsy was never needed.
    
    Steve

    After seeing and responding to your note earlier, I have talked to a
    friend of my sister's this week who had the same similar experiences as
    you.  I spoke to her about this (she's a non-deccie) and she said that
    if you'd like to call her with ANY questions, etc., she'd be happy to
    talk with you.  
    
    She had all the tests and was taking fertility medication, which helped
    produce 2 of her three children.  She said that there are alot of
    questions you should be aware of to ask, that you don't know until
    you're "in the thick of it".  
    
    She said she understands your desire for children as she went through
    the same thing and didn't know where to turn as well.  Rather than
    post her name and home number here, if you'd like it please send me
    mail at the above node, or just call me at dtn 226-7119, I'd be happy
    to give it to you, and you need not give me your name.  She also 
    lives in the Stow area so it's local to the area you were asking about.
    

I agree with (almost) everything that's been said so far.

I'm surprised that nobody has mentioned RESOLVE, an Arlington, MA based
national organization for infertile people.  I'm pretty sure the address
and phone number are in Parenting V2.  They provide a wealth of information,
and can give you referrals to doctors and support groups.

re .6: My wife's hysterosalpingogram was much more painful than her
endometrial biopsy.  Endometrial biopsies aren't as painful as they
used to be, since they're now done with suction rather than scraping.

    My hystiosimpngogram was literaly painless.  My tubes were not
    blocked and I have heard that if they are blocked it can be
    painful.  However, my endometrial biopsy was very painful.
    It only lasted a minute, but it sure hurt alot more than
    the hystio.
    
    I also agree that you should start with a specialist right from
    the begining.  I did'nt and had to re-do all the test that
    my OBGYN did wrong.  
    
    Communicating to others who are going through the same thing as
    you is a good start in coping with the emotional rollor coaster.
    I bet you feel a little better just by getting involved in this
    notes file.
    
    Keep up the faith,
    
    Deb

    I see that several people said that you should start with a specialist
    because ordinary OB/GYNs don't know what to look for, give tests at
    the wrong time, etc.  We had the same experience with out first
    *specialist*, who's a big name in Boston.  When we switched doctors,
    the second one said that some blood tests were missing and that
    one test was useless because it had been given at the wrong time
    (we probably should have been suspicious when it was scheduled for
    their convenience without taking the cycle day into account).

    When it comes to infertility, it's vital to be well-informed and
    get other people's opinions.  That's one reason that RESOLVE is
    so valuable.  Here's the contact info:

	RESOLVE, Inc.
	5 Water Street
	Arlington, MA  02174
	(617) 643-2424

    I've been there, but it doesn't ease the pain for you as you are the
    one going through this ordeal now.

    I will try to keep this brief, but if you want to talk, call me at DTN
    293-5126.

    About 5 years ago, when I was married to my first husband, we decided
    that we were ready for children after 5 years of marriage. Well, were
    weren't as ready as we thought we were.... We went through the Sperm
    analysis, which showed that he had a low sperm count. My menstrual
    history was as sporadic as they come (cycles averaged from 30 to 50
    days). I had Basal charts for two years, the post coital test was done
    and then the laparoscopy. 

    The final out come indicated that my ovaries were not ovalating. The
    OB/GYN put me on Clomid for 6 months. My husband and I performed on
    schedule for over a year.

    After all this, our marriage started to break down and we decided it
    would be best to stop trying to have a baby until our marriage was
    stronger. It ended in divorce two years later.

    I have since remarried, never using protection and for some unknown
    reason, we are expecting our first child in October. Don't ask me what
    changed or how I finally conceived, as I don't know.

    Best of luck on your pursuit of happiness. I wish you morning sickness,
    as only folks as you and I would really appreciate it.

    Regards,
    Norma

This note is being entered for a noter who wishes to remain anonymous at
this time.  The note is a response to the basenoter.

       ****** Carol dB, PARENTING co-mod *******


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

First I want to assure you that you are not alone.  There are ALOT of us
out here that have gone through the same thing that you are going through
now, I speak from experience, I'm one of them.  I hope that the information
that I can provide for you will help, and will show you that there is truly
hope.

My husband and I tried for almost 4 years to start our family.  After a year
and a half with no success and given my past menstrual history, my GYN 
referred me to a fertility specialist in Auburn.  I am on the Fallon plan,
and if you're not on an HMO now, I would STRONGLY suggest that you switch.
More on that later.

The first thing that was done, was that I was instructed to start a temperature
chart, and my husband's sperm count was tested.  They preform the first tests
on the male, since any problems with him are much easier to diagnose and treat.
When he was found to be normal, the next step was to do specific blood work on
me at very specific times (around my period) and fluid after intercourse was
taken from me and tested.  My Dr. concluded that with the test results and my
past history and the inconclusive temperature charts, I did not ovulate!   I
can tell you what a shock that was!  What do you mean I don't ovulate, I have
a period, albeit not on a regular basis unless I was on the pill, but I did
have one!  I learned the first or many medical facts that most layman are
misinformed about.  One can menstruate without ovulation.

The next step was to start me on a fertility drug, Serephin if memory serves.
I started out on 1 pill a day, and over time with no success graduated to 5
pills a day.  The 5 pills a day lasted a very short time, this high level
dosage can have harmful side effects and I was monitored closely.  I would say
that I was on the pills for roughly 6 - 8 months.  During this time I 
ovulated only once, and my Dr. decided that this was deffinately not the route
to go for me.

The next series of fertility treatment was to have injections everyday.  Please
keep in mind that fertility treatments are VERY personalized things, meaning
I don't believe that same thing is done in every case.  I can only tell you
what was prescribed for my particular case.  The injections consisted of 
Luprin - a hormone that stopped my pituitary gland from producing and secreting
the hormones responsible for the development of the folicles (eggs), Pergonal -
the hormone that makes the folicles develop, and finally Profasi - the hormone
that actually cause the folicle to break off thus ovulation.  

The Luprin and Pergonal where give every day at night.  The Luprin shot was
done alone for about 3 weeks to make sure that my pituitary gland was under
control, lots of blood work done during this phase.  When all was as it should
be, the Pergonal started. The Luprin was a very easy injection, very thin
small needle that I gave to myself in the leg.  The Pergonal had to be given
in the fatty tissue around the hip area, and my husband (bless his soul) did
that one.  During this phase alot of ultrasounds were conducted, I'd say 
at least twice a week.  The growth of the folicles had to monitored closely
because their size determined when the Profasi injection was to be given.
At the right time, the Profast was given in the hip area again by my husband.
Intercourse took place 24 hours later, for two days.  Another ultrasound
was given after this injection.  One of the side effects beside emotional
mood swings, was that the folicles that had not broken off became enlarged
to the size of cysts.  Bed rest was what I was instructed to do until the
folicles decreased in size, this was usually about a week.  This side effect
is called hyperstimulation, and can be mild (as in my case) or extreme which
can be dangerous.  Extreme cases are very rare these days because the patient
is monitored so closely.

My Dr. informed us that we should expect to stay on this fertility program
for 6 months to a year before expecting any positive results.  That was the
normal time frame for success.  I decided that I would give it 6 months and
then decide how I was handeling the whole thing at that time.  We went through
the first cycle with no success, on my second cycle with this program we bacame
pregnant and are now expecting TWINS.  My Dr. was very surprised that this
program worked so well so quickly, he never expected it to.  Not only am I a
star patient from that perspective, but in the 5 years that he's been using
this technique, I am his first multiple birth patient.  The possibility of
multiple births is enhanced with this program.  I think it's something like 20
- 25% for twins, and 15% for triplets or more. 

I'm not the only success story.  Since having been on this program I have
run into and heard about ALOT of women that have been on the same or similar
programs, and ALL have been successful, some in the 3rd cycle of the treatment.

Don't dispair!  There is truly hope, this science has progressed so much
in the past 5 years, and they are finding new things every day.  

I would recommend getting on a HMO plan because this treatment can be 
astronomical.  To give you an idea, the vial of Profasi that I was on, 
had enough in it for one cycle...the cost would have been $325.00 per vial.
Because I was on an HMO I paid $2.00.  The Luprin, Pergonal and needles, 2
different types were also only $2.00.  I also had to undergo surgery to 
enlarge my cervix and get rid of some endometriosis, all 100% covered
by the plan.  Did not have to even pay $2.00 for that!

My heart goes out to you because I feel what you are going through.  Learning
that I did not ovulate, and knowing that the choice for having children was
no longer in my control was devastating.  Having experienced going through
the fertility program, I would not hesitate to do it again.

If I were in your place now, I think that I would ask my Dr. to refer 
me to a fertility specialist.  Mine is in Auburn and is known as one of
the top specialists in this field in the New England area.

I wish you all the luck in the world.  If there is anything that I can
do further to assist you in anyway, I will be happy to help and answer
any questions.  

If you'd like to, I'd love to hear of your progress and lend support along
the way.

Take care, and I hope that this information helps.

All the best..

reply to .12 - wow, what an education!  Thank you.

One caution, HMOs differ in what they will pay for.  Some will NOT
pay for donor sperm.  Check carefully into what yours would pay.

    It's a side issue, and only my idle curiosity, but I don't understand
    why would anyone want to remain anonymous when posting that note--there
    was nothing embarassing or really personal about it.
    
    What am I missing?
    
    		-John Bishop

	John,

	I think the note itself answers that question.  The noter said that 
finding out that she did not ovulate was devastating to her.  You or I may 
not understand that, but that is not the point.  She felt more comfortable 
posting anonymously.  The parenting moderators support anyone's wish to
to post this way. 

Tracey 
Parenting co-mod

John Hancok covers drugs like Pergonal for $4/prescription.  We just paid $4
for 10 vials ($489 worth), which may cover one cycle.  To correct -.?, Profasi
(HCG) lists for about $25 a vial, and in our experience, only one or two vials
per month are needed.  Again, we pay $4/prescription.

We're on JH, and find it *MUCH* better for infertility.  We're dealing with
our third specialist.  I very much doubt if an HMO would let us switch merely
because we were not satisfied with the doctor.  We pay 20% for office
procedures, and 0% for hospital procedures.  We should be hitting the
out-of-pocket maximum for my wife soon enough, after which we won't pay
anything for office procedures -- just $4/prescription for drugs.

This is an anonymous reply from the basenoter.

      ********* Carol dB, PARENTING co-mod *********

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

	This is a response from the basenoter.

	Thank you all for your words of encouragement and support
	both here and in mail.  The pressure is getting to be more
	than we can bear right now.  I'm seeing a therapist next
	week, my husband isn't interested in going (he thinks it's
	all in my head).  So I think we'll be taking a break from
	the baby business for a little while.  I sincerely hope we 
	can work this out - I love him dearly and don't want to 
	compromise our marriage.  

	Don't bash him because he thinks it's all in my head, he's 
	always had difficulty voicing his feelings and I think he's 
	having a hard time dealing with the fact that something may 
	be physically wrong - even though it's probably me.  I've
	had endometriosis since the age of 17 and have had 3 surgeries
	for it so far.  Those procedures (laparoscopies) keep me in 
	the hospital for days (I've never managed to get in and out
	the same day) so I hope they don't have to do any more.  My
	GYN checked my tubes that last time and they seemed OK, but
	that was a few years ago.

	I still have that nagging feeling that I've got to find out
	why we haven't gotten pregnant yet, so I expect we'll pick
	up again later.  I can really "hear" my biological clock
	ticking so I hope it won't be too long.  I've just called
	RESOLVE to get their information packet, and hope that it
	contains lots of good information.  By the way, they have
	and "800"  number just for requesting the info packet (no
	questions/messages) - 1-800-662-1016.  I think we'll both
	feel better once we start taking some concrete steps to
	find out what's going on rather than just sitting back
	wondering.

	This is a great forum - keep it up!

	<Hopeful>

    RE:17
    
    I too was told that it was all probably in my head the fact I wasn't
    conceiving, that maybe I was thinking too much about it.    Well
    after three years of marriage and aged 32 I decided it was about
    time I got some infertility tests done.   The net result is after
    four months of testing, they have discovered I have fibroids.  
    My doctor told me that no way could I become pregnant with these
    fibroids, so I will be having them removed sometime in September.
    So here is hoping that everything will work out afterwards
    
    
    
    Bernie

    Boy.....I can't believe that there are so many women out there that
    have gone though infertility problems.  Sometimes you think your so
    alone.  I think DEC should offer some lunchtime seminars or support
    groups to give everyone a chance to share some of their experiences!
    
    I am 38 years old and we tried to have a baby for about 8 years.  I
    have been through every conceivable test there is and had several
    surgeries.  Recently, I went down to Boston IVF in Brookline and had
    in-vitro.  Much to everyone's surprise, especially mine...we're ex-
    pecting TWINS!!!  Talk about instant family!  
    
    I wouldn't hesitate to go through everything again.  All I can say is
    hang in there and keep plugging away!  Try to keep things in
    perspective and take everything step by step or you will become
    overwhelmed.  The invitro consisted of fertility drugs, shots,
    ultrasound monitoring, blood work, trips to Boston everyday for a week
    (from New Hampshire!) egg retrieval, waiting to see if
    any embryos developed, the implant and then the waiting for the
    pregancy test.  Just take one step at a time...thats how I coped.
    
    God bless...and good luck!!!  
    
    Laura

re .19:

>            I think DEC should offer some lunchtime seminars or support
>    groups to give everyone a chance to share some of their experiences!
    
Here at ZKO, the EAP sponsored a seminar on infertility a few months ago.
The speaker was Ellen Glazer (I think), author of "Without Child," a
recently published book on infertility.

    re: .18 - Yes, depending on the size and location of the fibroids they
    can interfer with pregnancy. I had three removed last September. It's a
    very major (at least to me!) operation, long recovery, but very
    necessary both for getting pregnant and for general health.  You'll
    probably have a six-month delay before you can start working on getting
    pregnant.
    
    Cyn

    I'm not sure what I will refer too deals soley with infertility.
    I have been married for 5 years and am having great difficulty with
    the matter of invitro and of having children at all.  
    
    My wife had a very great desire to have children very early on in
    our relationship, a desire that I did not hold at all.  After months
    of arguing about it I finally thought that, I either walk away from
    the relationship or set my eyes on fatherhood.  I chose the later,
    reluctantly.  We tried for a few months and as it turns out she
    had a pretty bad case of ENDO.  Well it turns out she can't get
    pregnant it seems without the aid of invitro.
    
    I still am not so keen on the idea, and its 4 years later.  If I
    back away from it now our lives are surely to split as I can't see
    that she will accept us any other way.  
    
    Another concern of mine is the HUGE desire she has, it doesn't seem
    rational or based in any reality.  Her whole life revolves around
    getting pregnant as if that were what having children are all about,
    just getting pregnant.  She denies this thought at all, and maybe
    it doesn't exist.  Please help me understand this monstrous desire,
    I guess sometimes I don't get it.
    
    Thanks - Brian

I can't really explain the desire to have children.  Fortunately for us,
my wife and I share this desire.  The only question for us is how far
we're willing to go.

As the technology of infertility treatments has become more sophisticated,
it's become more difficult to decide where to stop.  If you and your wife
had been born 20 years earlier, you'd have nowhere near the range of
possibilities that you have today.

Infertility tests marriages.  It can be a destructive force, but it can
also strengthen your relationship.  In any case, it's not an easy thing
to deal with on your own.  You should consider joint counseling to help
you both deal with your issues.  Talk to the EAP people.

    Re: .2 - I don't think of the decision to have children as a rational
    one...there's too many reasons to NOT have children! For us it's a
    purely emotional desire, totally impractical and impossible to define.
    It's similar to when we got married after living together - there
    wasn't a specific practical reason why we got married although we could
    invent some; instead it was emotional and irrational. 
    
    I don't know what we would do if we didn't share this feeling because
    it's very hard for the person who has the desire to explain to the
    other person the *reasons* for the desire. Some things can't be
    explained or reasoned. The desire to be a family with children goes
    very deep. Sure, there are all sorts of other emotions that get mixed
    up with it: "everyone else can get pregnant so I have the "right"
    also", "I'll do anything to be pregnant", "I'll be too old to get
    pregnant if I wait any longer" etc. These emotions don't explain why
    someone wants to get pregnant, though, they reflect the frustration
    of not being pregnant yet.
    
    Keep talking and chat a lot with friends, that helps.
    
    cyn
    

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

Tracey
Parenting co-mod
 
*******************************************************************************


Has anyone has any experience with the drug Tamoxifen (Nolvadex) for the 
treatment of male infertility?  How long was it taken?  What were the results?

My husband was given this drug a couple months ago by a doctor who is the head 
of endicronology at a reputable medical center.  We *thought* he told us that it 
was frequently used and had no side effects.  (A sperm count/blood tests on my 
husband will not be done again for another month).

I went to an infertility specialist (not just an OB/GYN) who commented that he 
had never heard of tamoxifen used for this purpose.  He looked it up in the PDR 
and it was not there.  He called their pharmacist and they explained that the 
drug is usually used in woman with breast and ovarian cancer.
This doctor would have recommended Clomid for my husband.    

I plan on calling the endicronologist for more information but before I call him 
with the attitude of "are you using my husband as a guinea pig?", I thought I'd 
poll the parenting community and also call Resolve.  I'd appreciate any help you 
can give me.

Thank you.

    
    Has anyone had experience with their morning temperature appearing to
    disagree with the doctor's assurance that ovulation is happening? The
    doctor thinks "it's working" this month, but my morning temps have been 
    extremely low and I don't see any progress in the ovulation test. Of
    course the doctor can't be sure, but he thinks it looks good from the
    ultrasound.  Very frustrating every morning!
    
    thanks,
    
    Cyn

The doctor's doing ultrasounds and having you do BBT charts and do ovulation
tests?  Does he wear a belt and suspenders?

Are you very careful to do the BBT the same way every morning (before you
move a muscle)?

Ultrasounds are more accurate than either of the other methods.  If the
ultrasounds indicate that you've ovulated, you've most probably ovulated.

    
    Ha, belt and suspenders! I was doing the temp. charts and tests before
    the ultrasounds began and I have continued them for my own benefit,
    though he recommended trying the ovulation kit. Yes, I am extremely
    careful about taking my temp before breathing when I first wake up.
    I just wondered if I could be creating follicles, but when the surge
    happens to release the egg it doesn't happen and that's why the temp.
    doesn't go up? The doctor can't see eggs, he can see follicles. And
    maybe that would explain the 45-day cycles? Of course I am discussing
    this with my doctor, who says that temps could be misleading, but I
    wanted to know if anyone else has had this contradiction occur.
    
    Thanks,
    
    Cyn

With ultrasounds, they track the growth of follicles.  When the follicle
releases the egg, they usually can't find the follicle anymore.  In some
cases, the follicle is still visible, but there's fluid nearby that
indicates that the egg has been released.

Are you taking any drugs?  If so, it's possible that they render ovulation
tests worthless.  I'm not sure if they have any effect on BBT.

    
    I'm taking Seraphine, which supposedly doesn't interfer with the 
    ovulation tests. Any who has taken it also take their temps? Were
    they lower than usual?
    
    Cyn

    Has anyone out there taken their temperature each morning and at the
    end of the cycle had a drop, and still found they were pregnant?  I
    have 4 days to go for the outcome of last month.  This was the first
    month we used an ovulation predictor kit, so I'm hoping I'm pregnant,
    but am discouraged because of my temp. drop.  
    
    What were some of your discoveries/experiences using BBT?  How
    accurate do you think it is?
    
    Thanks,
    
    Hoping again...
    

    My experience has been that when the temp. drops below 98, I
    was not pregnant and it usually proved true within a few days.
    
    Cheryl
    

    I think the drop is to whatever your base temperature is (in the
    first half of your cycle) which for different people may be different
    numbers.
    	Linda

    
    My husband and I have recently (within the past month) decided
    to try to have a baby.  I've seen my ob/gyn and asked all  kinds
    of questions, but there is one I haven't asked so I thought I'd
    throw it out to this community.
    
    I know that, on the average, women ovulate on the 14th day of
    their cycle.  This can vary with different women, as everyone has
    a different body, different cycle, etc.  My question is, how can
    a woman tell if she's ovulating?  I've heard of taking your temp,
    using the ovulating kits, but isn't there some way that your
    body tells you when things are happening?  I know this will vary
    with different women, like everything else, but I'd be interested
    in hearing from women who are "in tune" (for lack of a better term)
    with their bodies and can tell when they're ovulating.  Is this 
    even possible without testing/temp taking??
    
    Thanks for your input!
    Regards,
    Cherie (keeping her fingers crossed that we're successful this month!)

    For a 28 day cycle, ovulation typically takes place somewhere between
    11-15 days prior to the onset of menstruation. That means 
    somewhere between day 13 and day 17.
    
    Some women feel  a slight "ping" or cramping around ovulation. Most
    women will notice a change in their vaginal mucus - moving towards
    ovulation it gets increasingly watery and clear. During the "fertile"
    period, it appears more like egg whites (clear and stretchy). Moving
    away from the fertile time, it may thicken and/or disappear to little
    discharge.
    
    If you're not accustomed to your body's cycles, it takes a few months
    of observation to discern the differences, since many women's mucus
    changes more than once in a cycle.
    
    best of luck,
    

    You (or your partner) can also do cervical observations, using a
    speculum and a hand held light.  The cervix changes alot throughout
    your cycle.  The os (opening in the cervix) should become wider 
    (more open) near the time you ovulate.  You can get long q-tips 
    and test the fresh mucus; when the consistency is like raw egg 
    white (stretchy) it is easiest for the sperm to swim through.  
    Some women's mucus never gets completely clear, so you are looking 
    for a change to more stretchy.  However, by "trying" every other 
    day, I think you have a good chance of hitting your fertile time,
    while maintaining a high count.
	Linda

    Hi,
    
    I tried this last year for three months to check whether I
    was ovulating before we tried for a baby (which is expected
    any day now!!).
    
    I used the temperature method and found it really good and
    easy.  It only took a couple of minutes each morning to take
    my temp, and on the 12th day of each month it suddenly dipped
    and rose sharply on the 13th day.  Exactly the same all three
    months.  So I could be sure I was ovulating and I knen when.
    
    When we tried for a baby, we know the right days to try and
    I fell pregnant the first month - so it was well worthwhile.
    
    Good luck,
    
    Sarah

    
    Cheri...
    
    My husband and I just started "trying" to concieve. A book I found
    (and a friend found) interesting to read was a book by a Dr. Shettles
    called "How to Choose the Sex of Your Child"....  I'm not really
    referring to the parts on "how to determine the SEX" persay (although
    there were some interesting facts), but the information about figuring
    out WHEN you ovulate was very interesting and informative. (for this is
    a major part of trying to choose the sex of your child)...  
    
    It talks alot about the BBT Method, (thermometer), and the CM method
    (cervical Mucas)..and about some old methods about how you can FEEL
    yourself ovulate if you are intune with your body.  it talks about how
    often you should try, the lifespan of sprem and eggs, etc.
    
    My friend is in her first tri-mester now after reading it and following
    a few steps. I am in the process of trying the BBT method (which I
    NEVER thought I could get myself to do consistantly). But you would be 
    suprised how you can get yourself into the habit if you really want to.
    
    I'm not saying it all works...this is our first try also...but..it is a
    very informative book in my opinion. Backed by alot of published
    research.
    
    Heres to sucess for BOTH of us!
    
    Chris
    
     
                                                                           

    My wife used BBT with all our pregnancies (currently working on #4 :-) 
    and with her, the temperature never dropped unless she was *not*
    pregnant. And if it dropped she would usually get her period 2-3 days
    later (sometimes sooner, sometimes later, but always got it). She's as
    regular as a clock, so if her temp. was still up the morning her period
    was due, we knew she was pregnant. And that's how it always worked out.
    --dave-

    Hello,
    
    I read thru all of the topics and couldn't find one on tube problems,
    mine being blocked and positioned incorrectly.  I was wondering if any
    one out there has had tube repair surgery and been successful in
    getting pregnant.  
    
    We have been trying for a year and I finally got off my duff and
    started taking the basic tests, it was the HSG that indicated my
    troubles.  They want to try for surgery, before considering IVF as an
    alternative.
    
    I'm trying to keep positive, but I feel like I've been hit with a
    brick.  I use to think getting pregnant was the easiest thing to do,
    little did I know that I would fall into the category of not so easy.
    I just feel numb when I even consider the possibility of not being able
    to have a child, but I'm hanging on to hope and the thought that there
    is always another miracle around the corner.
    
    If anybody knows anything I would really love to hear from you....and
    if anybody has a warm fuzzy they want to pass my way, well I could really
    use that too!
    
    Hugs from California,
    
    Lori
          

I know two women who've had babies after tubal surgery.  Sorry, I don't know
the details.

I suggest you contact RESOLVE to make sure that you're dealing
with a top-flight tubal surgeon.  There are many sub-specialties in the
the infertility field.  For example, we used to go to a doctor who's
supposed to be a great tubal surgeon, but he was worse than useless for us.

    My sister in law had two kids after tube surgery (plus two tubal
    pregnancies and I think an ordinary miscarriage . . . )
    
    Sorry, I'm afraid I can't tell you any more about what kind of
    surgery she had, but I don't think it was very long between when
    she had the surgery and when she conceived the first one.  Between
    the first and the second babies she had more surgery (the balloon
    thing they do to open the tubes).
    
    --bonnie

    I have had no problems knowing when I am ovulating.  Over the last year
    or so, I was experiencing very bad pains (ones that made me double up),
    and they were worse than period pains.  The first few times, but
    hospital checked me out for appendisitus (sp?)  and were completely
    baffled, but after a few more months they realised it was happening the
    same time every month (about 14 days after my period), and told me that
    these pains were when I was ovulating.
    
    So as you can see I had no problems knowing when, my problem was having
    intercourse, whilst experiencing these awful pains.  Until we started
    trying for a baby, sex was a no no at this time of month, but obviously
    trying for a baby I had to grin and bear it (and it wasn't pleasant),
    but I did manage to conceive - baby due January.
    
    Have to admit though, I wish nature didn't tell me in this awful way
    when I was ovulating and I am enjoying these 9 months without the
    pains.  Lets hope they don't come back after January.
    
    Barbara
    
    ps.  The hospital says there is nothing they can do for me.
    

    I just heard about the balloon surgery on the news yesterday, it truly
    sounds just short of a miracle!  In the cardiac world they call it
    "balloon Angioplasty", but in either case I think the number I heard
    was something like 90% success rate within the first 6 months of
    surgery.
    
    Not sure where you live, but in this area there's a good infertility
    clinic at Umass Medical Center.
    
    Good luck, and don't give up!
    Lyn
    

    Lyn,
    
    I heard the balloon surgery for unblocking tubes story yesterday
    as I drove home.  I thought that said it wasn't always succesful
    and quoted a 50% success rate....but I was only 1/2 listening.
    
    cj/

re: .45

>    and quoted a 50% success rate....but I was only 1/2 listening.
    

Maybe you were listening to the wrong half.   :^)

Clay

    It only works on blockages near the uterus.  For the more common
    blockage of the end of the tube that receives the egg, it doesn't
    help much . . .
    
    --bonnie

I read an article about it in the Boston Globe.

It only works on soft blockages (mucus, etc.), so it doesn't work on fibroids.
According to one opinion, its success rate is no better than catheterization.

Beware miracle breakthroughs, particularly when reported as such in the
general press.

    I wanted to thank everyone for the info. on blocked tubes.  I also
    heard about it on the news.  I live in California, Laguna Hills to be
    exact.  I will be seeing a Infertility Specialist/Tube Repair Surgeon
    on November 7th.  He works out of the Hoag Fertility Center in Newport
    Beach.  I contacted Resolve and found out that both the hospital and
    my doctor are on their list, so that was a comforting piece of news.
    
    I am not sure exactly what kind of blockage I have yet, just the one
    tube is totally blocked and one is 3/4 blocked.  The other problem
    which I am sure will present an interesting challenge for my doctor is
    that my tubes are in a very unusual postion.  They are mid-line down
    the front of my uterus, pretty much on top of either other and may be
    connected by scar tissue.
    
    I have had 4 previous surgeries for bowel repair and the question that
    now appears is did they push my tubes around while they were working on
    my bowel?  If I do have surgery for this condition, I want the doctor
    to be on the lookout and document if he thinks this is what happened.
    I am not sure if I really want to pursue a law suit, but doctors are
    suppose to put your parts back in the right place, especially ones that
    are so important!
    
    Keep my in your prayers and thanks so much for all the support!
    
    Hugs from California,
    
    Lori
    

Since the ovaries and tubes are close to the bowel, it's possible for
gastrointestinal problems (colitis, etc.) to cause lesions on them.
So it may have been the disease, not the cure, that caused your tubes
to be in the wrong position.  In some cases, the lesions can be removed
by lasar laparascopy, which may be the kind of surgery that you're
having to clear the tubal blockage.

    
    This is probably a very basic question, but I'm going to ask it
    anyway.
    
    When doing the temperature charts to determine when you are
    ovulating, does your temp rise or drop when you ovulate?  I
    need to know the specifics of temp taking for fertility!
    
    I'd appreciate hearing anything you all may know!
    
    Thanks,
    Cherie

The basic pattern is that the temperature is low before ovulation, rises at
the time of ovulation, stays high until just before the start of the
menstrual period, and then drops to the pre-ovulation level again.

But there's a lot of variety in individual temperature patterns, and some
subtleties in actually keeping a basal body temperature chart.  I'd strongly
recommend getting a good book on natural family planning (same technique,
different objectives).  Unfortunately, I don't have any names available
off hand.

	-Neil

    
    	It's possible to buy an ovulation thermometer (like a clinical
    thermometer but more sensitive). This will come with instructions on
    maintaining and interpreting a temperature chart.
    
    
    		Ian G.

    
    Probably another basic question, but...
    
    I've looked at these ovulation predictor kits in the store, but it
    says for only 5 days...and then there are refill kits for another
    3 days...  how does this process work?  You must not test every
    day of the month??  When then??  Just during the week or so in the 
    middle of your cycle...   Has anyone used these and found these 
    effective?
    
    Chris
    

    Chris,
    
    It's probably in the instructions with the kit, but... If you presume
    your body to be working properly, you should be ovulating 14-16 days
    before your period.  Therefore, if you usually have a 28-day cycle,
    you probably ovulate between days 12-14.  So if you start testing
    around day 10-11, you should catch it.
    
    Of course, this gets trickier if your cycles are all over the map.
    Beth

    .53
    
    When I first read your words "It's possible to buy an ovulation 
    thermometer" I thought you said "oven thermometer" -- and that would
    be close to the truth, in a way! 
    
    Lucy (sympathetically)
    

    I've been using First Response for quite a few months and it seems to
    be working.  What really kills me is this:
    
    At the CVS (and, sometimes, Osco) in So. NH, they've got the 5-day
    package priced at ~$25 ($5/test, yes?).  Then, they've got the 3-day
    priced at under ~$11-12.  I experimented, found that both kits contain the
    same product (3 in one, 5 in another), and guess which ones I buy, now?
    
    The "refill" kit is not a refill of anything!  It's the ultimate
    marketing game, and it works.  Course, eventually the mfg will catch on
    and change the price.  Anyway...
    
    If you can get good at predicting when you'll ovulate within 2-3 days,
    then don't bother with the more expensive 5-day test.  Also, I've
    noticed that the pink color (which you're looking for) may vary ever so
    slightly in shade.  You'll get used to seeing mostly a non-color or
    greyish color when nothing's happening.  When you ovulate and see the
    pink next to this grey the first couple of times, you'll have a better
    idea of what to look for.  It can be tricky at first.  But, with
    patience, you'll get to be an old pro.  It's more expensive than the
    thermometer.  But, for me, more efficient in the long run.
    
    "I enjoy being a girl!"  :-\
    
    -d 

    Well I guess this is what you call entering the next phase of my quest
    to try and conceive.  I had my appointment with the Infertility Spec./
    Tube Repair Surgeon.  Having had three previous abdominal surgeries and
    suffered from Chrons Disease for 7 years, he pretty much feels that
    were gonna find a mess when we take a look at the condition of my
    tubes.  The news is hard, but I appreciate his honesty rather then
    building my hopes and inturn getting let down.
    
    Instead of going straight for major surgery and having to open me up
    full view, he wants to 1)Do a Laproscopy and see if he can get a good
    view; if not 2)Do a Laprotomy and if that is unsuccessful for getting
    the big picture then 3)Do major surgery.  He's gonna have it all lined
    up so that he doesn't have to bounce me back and forth from the
    hospital three times.
    
    The good news is that I am a prime candidate for IVF, so there is
    always hope around the corner.  Its just that accepting all of this
    gets really tough, it doesn't fit with my picture of how easy it was
    going to be getting pregnant.  I never thought this would happen to me
    and I think how many people say that same thing about so many different
    issues during their life.
    
    So its back to one-day-at-time and scheduling the procedures to check
    out the condition of my tubes.  I am grateful that medical technology
    has come so far to be able to give me another chance if my tubes are
    non-functional.  I know there are alot of mixed feelings on IVF, but
    for me this is another opportunity to try and get the blessing I have
    always dreamed of.
    
    Just needed to get some of this stuff out of my brain and I felt this
    was the best place to dump it, with friends that can understand the
    pain and frustration of infertility.
    
    Wish me luck and I could use your prayers!
    
    Lori
                                 

    Without getting into a very long discussion (and without making it all
    seem trite, either, since I'm in the same boat), one of the things I
    recommend, mainly because I am in the same boat, is to re-focus your
    thoughts, activities, etc.  It's *very* hard to do.  But, once you've
    learned the trick and gotten a grip on reality (because I really do
    think that going through this sort of emotional ride can put your head
    at a not-so-normal level), you'll feel better, you'll be able to accept
    any consequences better, you'll be able to *re-focus* your efforts
    (adoption, fostering...) and, in good time, you may even find that
    having s child of your own is not the number one priority in life. 
    You'll have to examine your, and your mate's, motives for having a
    child.  This is extremely hard to do, since many time you'll hear
    people admit (as I do) that the reasons are purely selfish.  I find
    that, once I can admit those reasons, it makes other options (adoption)
    look more appealing.
    
    Obviously, this all goes deeper than just my few lines of "self-wisdom". 
    But, since we've been looking at the possibility of not being able to
    have our own, we've found *so* many others that have been or are going
    through the same thing, it's just incredible!  I don't feel at all like
    a minority, even if we are a small percentage of the population.  I 
    feel like there's lots of people out there trying to deal with this. 
    We grow up assuming (most of us, anyway) that we're another generation
    in the traditional role of becoming adults, finding a mate, and having
    our own children to carry on the same (always hoping better) vision.
    When that "end-all" aspect called giving birth can't be achieved, we
    feel cheated, sometimes abnormal, and a multitude of other feelings
    that really tear us apart.  Even worse, some feel like a label's been
    slapped on them and that others may think less of them.  This is where
    some of the thinking goes wrong.  I believe that the days of "she's
    barren" are gone.  (I've got to stop rambling...)
    
    Wanting to have a child of your own is the ideal for so many (maybe
    most?) people.  My husband and I know we'd be blessed.  But, if you can
    look at that aspect of your *whole* life as just an aspect and not the
    ultimate reason for living and loving your mate, then it might help to
    ease the emotional strain you go through for what seems like so long.
    
    Enough rambling.  Good luck!  We do find that prayer helps us, too, to
    believe that we will have children if it's meant to be.  And, if it's
    not, then my husband and I are together for another reason...and we'll
    find that reason somewhere in our lives.
    
    -d

    .59  Thank you very much... for a wonderful and heartfelt note.  

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

          Carol duBois, PARENTING co-moderator

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

	I have been trying to get pregnant over the last year and
	have monitored my cycle using both the Basal body temperature
	method and the ovulation kits available at pharmacies.  One 
	thing that concerns me is that my cycle has become irregular
	in the last 2 years.  It used to be exactly 28 days but it 
	has gone to ranging from 25 to 34 days.  Also, the portion of
	my cycle from when I ovulate to when I get my period is 
	completely irregular.  I have heard that this part should
	be consistent.  Has anyone had this problem and had it linked
	to a hormone deficiency?

I don't know whether this information will help you, but since it *might*,
I will share it.

When I was trying to get pregnant, my cycles were also irregular.  They 
would go anywhere from 28-42 days, although usually 31-35.  I *always*
ovulated on the same day of my cycle, though, so the period of time 
after ovualation to next period was irregular.

When they did the surgery on me (laparoscopy, tubal insufflation, endrometrial
biopsy) then they found that I did have a hormone imbalance, but the doctor
never mentioned the hormones in connection to the cycle, so I don't know
if they were related.  I was told that the hormones were killing the sperm
as they entered my body (which is why after a year of trying, I still wasn't
pregnant).  They also found a cyst, and drained it.  The doctor said that
the cyst *could* have caused the hormones, but he wouldn't bet on it.
However, I got pregnant a few days after the surgery.

          Carol

    Which hormones were killing the sperm and were you on any medication or
    hormone treatment at the time?
    
    -d

re .61:

It's not clear from your note whether you've had an infertility workup.
A proper workup will tell whether there's a hormonal problem.

<  <<< Note 105.63 by TLE::MACDONALD "Why waltz, when you can rock'n'roll?!" >>>
<                            -< This is interesting >-
<
<    Which hormones were killing the sperm and were you on any medication or
<    hormone treatment at the time?
    
Sorry, I don't know if I ever got that info.  The only medication I was on,
though, was Serephine/Clomid, 50 mg.  I had been on that for the better part
of a year.

I don't know if that info will help the author of .61 or not.  I hope so.

     Carol

    I have, and have always had, irregular periods.  But as with
    Carol, I appear to always ovulate the same number of days into the
    cycle, with a varying time to the start of my period.  (I say
    "appear" because I've never had a formal workup.)  I have read
    that it doesn't matter whether the second phase of your cycle is
    irregular as long as the first phase, when the uterine lining is
    building up, is long enough.  Does anyone with more experience
    know if that's true? 
    
    I didn't have any trouble conceiving any of three kids -- though
    the second one took close to a year.  
    
    It is caused by a hormone "imbalance", in the sense that if I had
    the standard balance I'd have a more regular cycle.  But
    apparently the ones that are unbalanced for me aren't unbalanced
    in a way that causes problems with conception -- if that makes any
    sense.  I think a complete workup as mentioned in .64 would
    pinpoint which hormones are out of balance in your cycles and
    whether that would be causing the problem.  
    
    --bonnie

    Does any one have any experiences with male infertility?  My husband
    has a good count, but real low motility.  Any suggestions on what 
    could be wrong?  He has an appt. with a Urologist, but I'm dying to
    know what can be done, and once something is started, how long does
    it take to get the motility high?
    
    Also, anyone have any experiences with AIH?  My doctor recommended
    that.
    
    Thanks,

This note is being entered for the anonymous author of .61

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

>It's not clear from your note whether you've had an infertility workup.
>A proper workup will tell whether there's a hormonal problem.

	My question should have read, has anyone had irregular cycles like
	this and found out that they were a sign of an infertility problem?
	I haven't had any infertility tests done yet and the point of my
	question was whether I should.  (Although I have been monitoring my
	cycles for the past year, we have only actually "tried" about 5
	times.)

    re: .67
    
    I know that a friend of mine (this is in another note, too...this
    note?...another notesfile?  can't remember...) finally found that their
    problem was hubby's and he had a hamster egg test done through his
    urologist.  They ended up doing minor, in-patient surgery on him and
    she got pregnant.  
    
    re: .68
    
    If you feel you don't want to keep randomly trying for the next five or
    so years, for whatever reason, then don't waste time starting a work-up. 
    Start with your ob/gyn.  There's a number of blood tests, possibly
    minor procedures (e.g. I had an in-the-office endometrial biopsy), and
    monitoring of your bio system.  This all happens over time, depending
    on previous test results and what it looks like your system is doing. 
    But don't think that the work-up is one or two quick visits,
    especially if the doc puts you on one of the many drug treatments
    possible.  Patience is a key factor!
    
    -d

re .67:

    The day surgery that Debbie mentioned is a varicocelectomy.  Many men
    (40%?) have a varicocele, which is a varicose vein in the scrotum.
    In most cases, of course, there's no infertility.  But in men who have
    problems with sperm motility, removing the varicocele (which is usually
    on the left side) often results in improvement.  According to Dr. Sherman
    Silber's book "How to Get Pregnant," no one knows how it works, but
    there's solid evidence that it works.  BTW, Dr. Silber is a renowned
    urologist.  I recommend his book.

    Since it takes 3-4 months for sperm to mature, any improvement from
    a varicocelectomy will take that long.

    AIH is used as a workaround for a number of problems including poor
    sperm.  The semen is processed to increase the sperm's ability to
    fertilize the egg.  The sperm are washed, separating them from the
    seminal fluid and any impurities.  Then they're "raced," so only
    the best swimmers get into the sample.  To further increase their
    chances, IUI (intra-uterine insemination) is used.  The sample is
    injected through the cervix directly into the uterus, giving the
    sperm a head start.

    FYI:  I also have learned that injecting unwashed sperm (not sure why
    anyone would do this, except by accident) is quite painful and causes
    severe cramping.  I assume it's the impurities going directly to a very
    sensitive tissue area?
    
    -d

    Does anyone have any kind of timeframe of how long it takes once you
    see the Urologist to when you can actually get scheduled for surgery?
    Assuming my husband has a verocele vein.  I did read that that was
    the number 1 cause for male infertility.   
    
    I'm just tired of waiting, I thought I would have been pregnant 9
    months ago.....
    
    Thanks,

re .71:

There can also be cramping with washed sperm.  It depends how much they
wash it and what they wash it with.  Different women have different
reactions.

    Impurities? We are not talking about a commercially manufactured
    product here. Is this another case of 'improving on nature'?  I
    believe the cramping is due to the hormones in the semen which 
    stimulate cramping in the woman, I am not sure why they stimulate
    cramping though.  My wife had this problem.... cramping associated
    with artificial insemination, but the semen was not washed.
    
    Jeff

Yes, there are impurities in the semen, but normally the semen passes through 
the cervix and the cervical mucus which removes the impurities before they 
pass to the uterus.  Since with IUI (intrauterine insemination), the semen
is placed directly in the uterus, it needs to be washed to remove the impurities
so that infection does not set in.  Also, a much smaller amount of semen is
placed in the uterus during this procedure than would be there during either
regular artificial insemination or by having intercourse because too much of
a concentration of semen in the uterus also causes cramping.  That's why 
cramping occur more frequently on the second day of IUI (they are usually 
done 2 days in a row) since there is a higher concentration of semen.

    How successful is IUI?  And, how long does it take to be successful?
    
    

re .74:

    Consider urine samples.  Labs prefer "mid-stream" samples so that any
    microbes in the urethra can be washed out by the first urine to pass
    through.  With semen samples, the entire ejaculate is normally used.
    Hence, there's more likelyhood of microbes.  BTW, this is how one
    doctor explained the limited usefulness of semen cultures (used to
    see if there's an infection).

re .75:

    In our experience, there's quite a variation in cramping, and the
    only pattern we've established is that it depends on who does it.

re .76:

    Since every case is different, I don't think you'll find any useful
    statistics.  The best you can say is that there are certain problems
    for which IUI greatly increases the chances of conception.  Among
    them are poor sperm quality and poor cervical mucus.

I've heard varying statistics on IUI, and it really does depend on what your
particular problem is, but the most recent statistics that I have heard were
around 50%.  I had 8 IUI's done (that's 8 cycles which is really 16 IUI's since
they do 2 per cycle), and never had any success, but that is most likely because
I have sperm antibodies.  I finally had success with our first, and what would
have been our only, attempt at GIFT.  I'd had enough, so we decided we would try
GIFT once and quit whether it worked or not.  We were fortunate in that it did
work the first time, and we are now expecting twins at the end of July.  However,
I have a friend who has done GIFT twice unsuccessfully already, and is planning
on going the full 4 times that is recommended by the doctor. GIFT has a 30%
success rate (measured by live births, not pregnancies which can end in
miscarriage).

    What is GIFT? 
    
    So far, we only know that my husband has low motility, but his count
    is good.  They won't check me out yet, because I've never had any 
    problems, and my cycles are 28 days right on the money.  I'd like to 
    try IUI right away, but my Dr. wants us to wait to see if the Urologist 
    can do anything for my hubby.
    
    Thanks for everyone's answers.
    

GIFT is Gamete Intra Fallopian Transfer, and is very similar to IVF (In Vitro
Fertilization).  I thought there was a note in here somewhere explaining the
procedure.  Basically, you take fertility drugs (Pergonal, Metradin, Lupron) for
the first 2 weeks of your cycle, and go to the doctor every day for bloodwork
and ultrasound to see how the follicles are maturing so that they can adjust
the medication dosage.  Once the follicles are mature, you take the HCG trigger
shot 36 hours before the laparoscopy is scheduled.  The sperm sample is provided
by the husband 1 hour before the surgery so that it can be washed and prepared.
The laparoscopy is performed, the follicles are drained, and the mature eggs
are harvested and inspected under a microscope to make sure that they are good.
The good eggs are put back in the Fallopian tubes, and the sperm is put in the
Fallopian tubes with the hope that they will find each other, fertilize, and 
then go on to implant in the uterus resulting in pregnancy.  Typically, you
go home about 4 hours after the laparoscopy has been done. Two weeks later, a 
pregnancy test is done to see if the procedure was successful.  

That's GIFT in a nutshell.  If you want more details, let me know.

re -.2:

I think that all infertility problems should involve tests for both partners.
There could be problems on your end too.  You say you've "never had any
problems," but I think you mean you've never had any symptoms.  If, for
example, you had tubal blockages, you'd never know.  I think there are also
certain hormonal problems with no symptoms.  It's a good idea to have your
husband's motility problem checked out, but I'd avoid a varicocelectomy
before an initial female infertility workup.

To my way of thinking, the least invasive things should be tried first.
A varicocelectomy is more invasive than most of the female workup (blood
tests, endometrial biopsy, hysterosalpingogram).  If the next step was
either a laparoscopy or a varicocelectomy, then a varicocelectomy may be
appropriate, but if the wife hasn't even had blood tests, I think it's
premature to consider surgery for the husband.

    I'm sure they'll check me too.  It wouldn't make sense not too.  They
    did say that they would take care of the low motility first since that
    looked like the "obvious" problem, and might be an easy fix.  I guess
    the problem could also be hormones.  The percents were between 10 and 25, 
    which is extremely low.
    
    

    
    I have a specific question regarding temperature taking to determine
    when I'm ovulating.  My temperature rises about 6 degrees on the
    14th or 15th day of my cycle.  When it rises has the egg already been
    released or is it about to be released?
    
    My husband and I have been trying to conceive since August and it's
    getting very frustrating.
    
    Thanks for your help!
    Cherie  

    Your temperature rises the day after you have ovulated.  In my case, I
    expected my ovulation to occur on my 12th-14th day of my cycle and it
    occured the 16th day.  hubby and I got together Saturday morning, the
    kid was conceived the next day and my temp rose Monday morning. 
    
    My ovulatory cycle is weird, not always the 14th day, so I was
    surprised that I got pregnant (but pleased!) in November.   
    
    Good luck!
    Kath

    
    I need a little support.  I've entered a few replies to this
    fertility/infertility note to clarify questions I have surrounding
    getting pregnant.  I'm 28, my husband is 33, and we've been trying to
    conceive since last August.  I was on the pill for several years to
    be sure I didn't get pregnant (how ironic that seems now) and stopped
    taking them last March.  We let down all the barriers in August.  For
    some reason, we just haven't conceived a baby yet.  I'm getting really
    down and can't stop thinking about having a baby of our own.  I thought
    I was pregnant last month, but wasn't.  Now I'm sitting on pins and
    needles again this month, waiting to see if my period starts this
    weekend.  Friends try to be supportive, but I'm tired of people telling
    me to just relax and it'll happen.  It's on my mind constantly, I don't
    think I'm obsessed about it, but the possibilities of not being able
    to have a baby is weighing heavily on my mind.  I always thought that
    having sex once without birth control would make me pregnant, I never
    imagined it could be so difficult to get pregnant.  After all, look at
    all the pregnant women around us!  It's going to be a difficult weekend
    as I'm going to a baby shower for a friend of mine.  I feel constantly
    on the verge of tears, very emotional.  This note and it's replies has
    been a source of comfort for me and I'd like to thank all of you for
    that.  But, as each month goes by without conception, it's getting
    harder and harder to deal with.  
    
    I guess I just needed to get that out...thanks for listening.
    
    Cherie                    

    Hi Cherie,
    
    We have been trying since August 89, and I know *exactly* what you are
    going thru.  I think about it *every* second and relaxing has
    absolutely nothing to do with it.  All our friends get pregnant easily
    and we don't.  Although they are very good friends, they do not
    understand what I feel like.  Talking to women who are going thru the
    same experience must be a lot more helpful (I have not encountered any
    yet).  RESOLVE is a great source of information and they have support
    groups for couples and women only, if you so desire.  One women's group
    is being formed in my area soon and I can't wait.
    
    Every month is the same: taking temperature in the morning, and the last    
    2 weeks are the worst!  The last week of the cycle is even more
    horrible because I keep looking for signs of pregnancy (eating a lot,
    morning sickness, temperature is still up, etc ...).  We have both had
    extensive work ups (laparoscopy, hysterosalpingogram, endometrial
    biopsy, PK test, sperm tests) and nothing is "wrong" except for a few
    spots of endometriosis which were taken care of. 
    
    It helps to read books concerning fertility.  It raises your hopes and
    understanding on the subject.
    
    Meanwhile, try not to get angry at people who say "relax".  I get angry
    and I hate myself when I do.  But, if I never conceive and do not have a
    bilogical child, I do not need to feel the guilt that if I had
    "relaxed" I would have conceived.
    
    Good luck and try to enjoy the moments.
    
    Debby

    Can anyone tell me what the solution is for a poor post-coital?
    
    I had my first last month on the 15th day of my cycle.  The Dr. took
    the mucus from 3 different areas, the opening of the cervix, higher in
    the cervix and yet higher.  He said there were alot of healthy, live
    sperm at the opening but none at the higher 2 points.  He is doing
    another one later in my cyle this month to see if he gets the same
    results.  My cycle is usually 32 - 34 days.  We're doing it on day
    16 this time.
    
    Is there medication of some sort that is given to thin out the mucus?
    He didn't mention the solution yet.  He wants to see what this next
    test shows.  Intercourse was about 5 hours before for the first one,
    he wants to wait 6 hours for this test.  I'm hoping that he finds
    somthing as the next test is the dye test and I'm not looking forward
    to it.  
    
    It is amazing tho, how fast the time goes by while the testing is being
    done.  We have been trying for 1 1/2 years.  The past 4 months have
    flown by without much time to think about a baby, only when to schedule
    the next test.
    
    Any comments will be appreciated.
    
    Thanks.

    
    Debby,
    
    I know what you mean about the last week of your cycle being the worst.
    I'm in the midst of it right now and, like you, I keep wondering if
    that twinge in my belly is the beginnings of a baby or just the
    beginnings of my period.  I have a friend who was on the pill for
    several years, went off it, had sex once the next month and ended up
    pregnant.  Here I am, taking temperatures, checking mucus, standing
    on my head in the corner after sex ( ;^} only kidding, but it's 
    starting to sound like something I should try), and nothing.
    
    I'd love to chat with you more off-line, if you're interested.
    Feel free to send mail anytime.
    
    Cherie

    There isn't a solution to poor mucus that fixes the mucus itself.  What
    they have to do instead is to go around the problem.  Do you also know
    if you have sperm anitbodies with the poor mucus?  I have both, and had
    to use intrauterine inseminations (IUI) since regular artificial
    inseminations (AIH) does not work with sperm antibodies, though I guess
    it has a chance with poor mucus.  We did 12 AIH's before they checked
    me for sperm antibodies at which point we switched to IUI.  Then we did
    8 cycles of IUI's with Pergonal (that's a fairly potent fertility
    drug), and finally tried one cycle of GIFT.  The theory in my
    particular case is that my antibodies were so strong, that the sperm
    couldn't even live long enough to get to the egg with the IUI's where
    they were put past the mucus and so we tried GIFT which was successful,
    and I'm expecting twins in July.  However, we were trying for 4 1/2
    years before I finally got pregnant.
    
    If anyone would like more information, please feel free to send me mail
    or call me.
    
    Best of luck, and ignore all those people who tell you to just relax. 
    Tell them that infertility causes the stress, not that the stress
    causes the infertility, so relaxing has nothing to do with anything.
    
    Regards,
    Cathy

    re .89,
    
    How is your doctor determining the timing of the post-coital?  The
    cervical mucus at most times of the month is *supposed* to serve as
    a foreign-objects barrier to prevent infections etc from getting into
    your abdominal cavity -- and sperm count as "foreign objects".  The
    mucus changes for just a few days around ovulation to allow sperm
    through, and there's really only a few hours of that time that the
    mucus is "easy passage".  So if the test is not timed well, it is 
    absolutely useless.
    
    I had 2 done by OB/GYNs timed via the dartboard (let's see, your cycle
    was 28 days long, so we'll do it on day 13!) and the doctor's
    convenience, with abysmal results.  I have had a couple more done
    by a specialist who does mucus exams to predict when the "best
    conditions" will occur, and performs the test then -- even if it's
    6 o'clock on a Saturday night.  The difference in results is amazing.
    
    Re: your question (what's to be done), it depends on the problem they
    find.  Reasons for poor post-coital may include problems with the sperm
    (low count, low motility, antibodies), problems with the mucus (bad
    timing, too thick, not enough, antibodies), bacterial and viral
    infections, and any combination of the above.  Treatment varies with
    the cause.
    
    Good luck!
    Beth

re .89, .91:

We did one better than Beth with mistimed post-coitals.  Hers were done
by regular OB/GYNs, but ours was done by a prominent infertility specialist!

We're on our third specialist, and this one doesn't consider post-coitals
that important.  He says that as long as there are *some* living sperm,
the test is a success.

FWIW, one doctor we've dealt with recommended Robitussin for increasing
cervical mucus.

    Are you serious??!  (Did you try it?  If it worked, I'll give it a
    shot.)
    
    Beth

    Beth
    
    I haven't tried this myself as we haven't had fertility problms, but I
    remember reading an article in some magazine a few years back that
    robutussin had been used with some success.  
    
    I would try the strictly expectorant variety as the idea of that is to
    thin mucous in your upper respritory tract.  The antihistimine variety
    thickens mucous, so I wouldn't use it.
    
    Meg

re .93:

Yes, I'm serious.  No, we didn't try it (for various reasons).

re: <<< Note 105.86 and 105.88 by SWAM2::DERY_CH >>>

    Cherie,

I understand.  My spouse is going through the same things that you are.
We have been trying since September.  We have had 3 inseminations, complete
with ultrasounds to make sure that she is ovulating, and the "normal"
basal temperature, ovulation kits, etc.  Every month she is hopeful,
looking for signs everywhere.  She even was hopeful this last month,
when she hadn't been inseminated, since she kept thinking, "Well, maybe
my last period was just 'spotting.'"  She has been going through as much
depression in these last 4 months as I did in the year it took me to get
pregnant.

I had been urging her to get support around her, to go to Resolve, but
because we are lesbians, she has not felt comfortable going to Resolve.  
She didn't want to add the trauma of possible rejection onto the pain that
she is already experiencing.  However, I am happy to say that she has decided
that support is what she really does need right now, and is organizing it
for herself, much as you are trying to do in entering notes here.
She is starting up a local chapter of LCC, Lesbians Choosing Children,
so that Colorado Springs lesbians who are trying to get children (through 
birth or adoption) or who have already gotten children (after they knew they
were lesbians - there are other groups for those who have kids from previous
heterosexual marriages) can give each other the much needed support and
information.

I hope that PARENTING is able to fill some of your own needs, but even so,
please do pursue RESOLVE more, and other groups like it, or start your own
like Shellie did.  It's really tough to be going through this, and you need
to know that it is not "your fault".

    Hugs,

     Carol

re .94

>    I would try the strictly expectorant variety as the idea of that is to
>    thin mucous in your upper respritory tract.  The antihistimine variety
>    thickens mucous, so I wouldn't use it.

I am curious about this.  What does the mucus in your upper respiratory 
tract have to do with the mucus in your cervix?  Does the cough syrup also 
thin the cervical mucus?  Is that desirable?

Waiting expectantly (for many things),

Margaret

    Apparently, mucous is mucous.  if you thin it in one location, you thin
    it in all.  Also, the thinner cervical mucous is, the more likely sperm
    is to penetrate the cervix.  
    
    Meg

As I said in .92, the doctor recommended Robitussin for *increasing* cervical
mucus, not for thinning it.

    
    FYI - it looks like my husband and I have been successful this month.
    A home pregnancy test I took yesterday came out positive - now on to
    the doctor!  I took this test before I went to the shower so I had
    a great time!  Thanks to all of you for your wonderful support...I'm
    sure you'll be seeing much more of me throughout the Parenting
    notesfile!!
    
    Cherie :^)  :^)  :^)

    
    ***CONGRATULATIONS  CHERIE***
    
    Cherie,
    
    I am so happy for you and your husband.  You know how to reach me if 
    you ever need some one to talk to!!   
    
    Best of Luck,
    -Nadine

    re: cervical mucous
    
    Mucous is mucous.  I've noticed that some antihistimines make my
    cramps drastically worse and make intercourse painful.
    
    --bonnie

    
    Congratulations Cherie!!
    
    I just logged in here after not reading much these days, and in reading
    your reply .85, I would of sworn I had written it!!!  And then to see
    your reply in .100....I guess it gives me a slight bit more hope.
    
    Congrats!!!
    
    Still trying,
    Chris
    
    

re .25 (anonymous note on tamoxifen and male infertility):

I was just reviewing old notes and came across this.  I was doing some
research and came across a reference to the use of tamoxifen in treating
male infertility (it may have been for oligospermia -- low sperm count).

I don't have any other information on this, but I do have a recommendation.

There's a wealth of medical literature available and accessible to the
public.  Even specialists don't know about all the research that's
going on in their field (sometimes they know, but have prejudices or
vested interests in a particular therapy).

Go to a medical library and do your own research.  There's a menu-based
computerized index of recent literature called Medline.  If you can use
Notes, you can use Medline.  Read the abstracts and look up the articles
that seem interesting.  Look up the jargon in a medical dictionary.
You'll learn a lot.

If you're in Massachusetts, you have free access to the UMass Medical
Library in Worcester (508-856-2511).  They're open 7 days/week till 1 AM.

    I would like to hear from other people who have charted their basal
    temps.  This is the first step my doctor and I have agreed upon to
    determining if/when ovulation is occurring.  We will in fact, meet
    after it is completed and discuss next steps.
            
    There is a sample chart on the paper which doctor gave me.  It shows a
    "normal/average" woman's basal temperature gradually rising following
    the first day of the cycle.  Finally, it peaks just around/after
    ovulation.
    
    What if the temp never rises?  Has anybody else experienced that?  I
    have had some pretty low temps... not real concerned, just curious. 
    Yesterday and today... 96.6.  No wonder I have COLD feet at night :-}
    
    I would also welcome anyone else's input/comments regarding basal temp
    reading.
    
    Rgds,
    marcia

    BTW:  My husband and I didn't trust the "BASAL" thermometer the
    pharamacist sold me, since I kept getting low readings.  So I went out
    and bought another thermometer - this one is digital.  Same low
    readings!
    
    'Nother Q:  What is the chemical that they give you to bring on
    ovulation?  Is that Clomid?  And how is that administered?  Ohhhh,
    questions, questions, questions...  If you want to point me somewhere
    else where I should be reading, I'll happily go there!
    
    Thanks!

    BBT should be taken with the BBT thermometer.  I have been taking
    my BBT for the past 14 months and on the 5th day of my cycle (day
    1 being when I get my period) my temperature is 97.2.  Then it goes up
    to about 97.6 on day 12, it drops 0.1 degree right before ovulation and 
    after ovulation it takes off to 98, 98.2, 98.5, 99, and then on day 20-
    21 it goes back to 98.5 - 98.2 until I get my period.  That definetly
    shows ovulation.
    I tried the digital thermometer for 3 months because it was easier to
    use (it beeps when temperature stabilizes) but the temperatures were
    not as accurate as the BBT thermometer.
    
    Clomid is used to help you ovulate and so is Pergonal.  I have been
    taking Clomid for the past 3 months and doing IUI (intra-uterine
    insemination) and it has not worked yet.  Statistics shows that Clomid
    is most successful during the first 3-4 months.  After that, the
    success rate diminishes.   Clomid is taken orally, and I have had
    little side effects, such as constant nagging headaches, hot flashes
    once in a while, and depression once in while. 
    
    Pergonal is the next logical step along with one-two cycles of IUI and
    later IVF.   I understand Pergonal treatment to be much more involved.
    
    Good luck ... I have "unexplained" infertility, which can drive me
    nuts sometimes. 
    
    A good source of information, which I suggest you do, is books.  There
    are many good ones out there and I read 3 of them: Couple's Guide to
    Infertility, How to Get Pregnant, and another one that just came out a
    few months ago is (I forgot the exact name of the title) something like
    how to get pregnant with new technology.
    
    Debby

Note 39 discusses Clomid and Pergonal.  I believe BBT is discussed in Note 105.

    I wouldn't really worry about the low temperatures.  When I was using
    the BBT, my temperature would be in the high 96's or low 97's at the
    beginning of my cycle, then dip just below ovulation, and then shoot up
    to the high 97's or low 98's.  It would stay there until the day before
    or day of my period at which point it would drop right back down, so I
    always knew when my period was going to start.  Also, there were some
    months where I didn't really have a dip-rise around ovulation, but more
    like a very gradual rise over the course of the month.
    
    I also took Clomid for 6 months to regulate ovulation and to help with
    a luteal phase defect (short time between ovulation and period), but I
    had worse side effects than .2.  I had lots of hot flashes and was
    incredibly moody (my husband referred to me as "the bride of
    frankenstein" to give you an idea how pleasant I was).  I noticed that
    the effects were cumulative, and were just minor on day 5 when you
    start to take it, but that I was a raging witch by day 9 which is the
    last day you take it.  Then it went away til the next month.
    
    Pergonal will also regulate (more like force) ovulation, and is taken
    as injections.  If you get that far, I can give you lots of information
    on that.
    
    If you have more questions and would prefer to talk off-line, please
    send me mail at MEMIT::GIUNTA or call me at 223-0314.
    
    Best of luck,
    Cathy

    i know luteal phase defect is when you ovulate too close to the
    start of your period and the egg doesn't get a chance to implant.  
    Is there a name for the opposit problem, ovulating very early in
    your cycle?  I ovulate between 7 and 10 days after the start of my
    last period, and it will be between 12 and 21 days before the
    start of my next period.  It doesn't appear to interfere with
    fertility -- I've had three pregnancies -- but it's kind of weird
    and the PMS-like symptoms associated with it are getting worse. 
    Is it something any of you have run across? 
    
    --bonnie

    According to the brochure on PMS distributed by the DEC nurses, early
    ovulation is part of PMS.  The brochure has some pointers on managing
    PMS.  I had PMS too, before my pregnancy.  Haven't started menstruation
    again so I don't know if PMS will continue.  I also ovulated early, as
    proven when I got pregnant then.  I was taking my temperature every am
    and the chart made it clear.

    Ah.  I didn't know the two problems were connected.  Thanks for
    the reference.  I'll pick up the brochure from the nurses later
    today.  
    
    I know I ovulate early 'cause my first child was conceived while I
    was still having my period. . .
    
    One thing you might watch out for -- I don't know if this is
    typical or not, but I found that when my PMS symptoms started
    returning (about a year after delivery), I got post-partum
    depression.  Serious the first two times, not so bad this time.  
    
    --bonnie

    My husband and I have been trying to have a child for 3 years
    now.  I've been going to an infertility specialist for about
    1-1/2 years now.  I just want to say that this notes file has
    really given me alot of comfort and support.  I don't know about
    all you guys but I feel that these tests are so scary and the whole
    idea of "not knowing" scares me.  It is really nice to read all
    your notes and to draw support and comfort from it.
    
    Thanks for all the notes and I'm sure you'll be hearing more from
    me.
    
    Angela
    

    The Infertility Specialist that I have been going to has just
    recommended that my husband now go to a Urologist (spelling?).  I have
    completed all of my tests and now it is my husband's turn.
    
    Does anyone know what type of tests are usually involved with the
    Urologist?  Is it just sperm testing or ???
    
    Thanks for any help you can give.
    
    Angela
    

    My husband just finished with a Urologist.  They do a physical,
    blood tests, semen analysis (a few times), and in my husband's case,
    they did an ultrasound.  The end result - they couldn't find anything
    wrong even though he has a very inconsistent motility rate.

    I have just started going to an infertility specialist.  After poor
    post-coitals (which occurred on the 11,12, 14,16,18 day) only one sperm
    was found.  It was determined by my doctor that I have a mucus problem
    which he said is very common and easy to treat.  On the fifth day of
    my period I am to take 2 tables of ESTRINYL (estrogen) and this will
    thin my mucous for the month of April and we can do some more
    post-coitals.  With this medication I cannot get pregnant the month of
    April, but the results will stay with me for 3 to 4 months.
    
    Anyway, yesterday I started taking the pills and from 3:30 - 8:00 AM I
    was hugging the porcelin god.  It was awful.  We have a call into the
    doctor and I am currently waiting to hear from him.  Until I do the
    nurse said don't take anymore.   My questions are
    
    o  Has anyone else been treated for thick mucus and if so how
    o  Within this note Robutussen has been mentioned as both increasing
       and decreasing mucous.  Which one is it?  Can I have more info.
    
    What I want to do is found out other ways people got treated so I can
    ask my doctor some questions.  I'm concerned that estrogen is the only
    way to treat the problem.
    
    Any insight, info would be greatly appreciated!
    
    carrie

    
    Carrie..
    
    There is a really interesting book out that I read when I was "trying"
    called (I think) "Fertility and You"......and its major topic is
    "cervical mucas".  I lent it to my Mom to give to a friend just last
    night. I'm not sure of the author, but I will get the name and post it.
    I found it in a book store in the Leominster Mall (lrg softcover, tan
    binding, red rose on cover).  It may not solve all your questions, and
    of course your doctor will hopefully be able to help you, but you might
    find it interesting reading. I found it very informative.
    
    Good Luck to you!
    
    Chris 
    (entering 3rd month, and STILL hugging my porcelain god, yuck!)
    

I'm the one who brought up the Robitussin issue.  As both my wife and I
remember, the doctor said that it increases cervical mucus, not that it
thickens or thins it.  We're no longer using that doctor, so I can't
really ask.

    FYI on thick mucus-  I finally got in contact with my Doctor and I am no 
    longer going to take the estrogen but go on the Robutussen (spelling?).  
    He does know of a study where Robutussen has been used to thin mucus.  He 
    tried it on some of his other patients in pill form and wasn't happy with 
    the results. (The pill taken was just the ingredient in Robitussen that
    thins mucus).  He has never tried it in the syrup form and said lets give 
    it a go.  He did tell me some interesting stories.  He had one patient
    who he couldn't find anything wrong with (good mucus and post-coital).
    Her mother told her about Robitussen, tried it and got pregnant that
    month!  He also read from a science journal the results of one doctors
    use of Robitussen and the results were very positive! 

    
    Carrie...
    
    The name of that book about Fertility (mucas) is.....
    
    "Your Fertility Signals" by Merryl Winstein
    
    I found it very informative...
    
    Chris
    

    
    My first child was conceived the first month my husband used the
    Robitussen therapy.  I had also had a hysterosalpinogram the previous
    month so we were never sure what worked. However the second time around
    the Robitussen didn't work, after 1 year of taking it, I think he would
    gag if he ever smells it again! BTW, the hysterosalpinogram worked the
    second time too!
    
    Good luck to all who note here, I can sure empathize with you........
    
    Rochelle
    
      

    
    I thought the Robitussin was taken by the WOMAN to help thin the
    cervical mucous?????   Now I'm really confused!
    cj/

    I, too, conceived within 2 months of having a hysterosalpingogram (sp?)
    not 1, not 2, but 3 different times!!!  I think for me it helped clear
    the tiny "cobwebs" or whatever was in the way.
    
    Dale

    My husband and I were trying for almost a year, and I'm finally
    pregnant.  Just found out, so I'm only 5 weeks.  
    
    I went though a few tests, and had the dye test done in February,
    and got pregnant in March, so it took on the second cycle.
    
    Sue

    For the record, I also got pregnant with my first on the second cycle
    after the dye test - we had previously been trying for three years !!
    

    
    Well... here goes,
    
    I've been reading this note only for about a month.  My husband and I
    have been trying to get pregnant for over a year now.  I've had one
    ovary and tube removed 6 1/2 years ago, (ruptured ovarian cyst), 
    and about three months ago had two ovarian cysts drained (with a 
    "laperscope thru belly botton and needle into abdomen" procedure).
    In a couple of weeks, (tentatively May 2) I'm suppose to go and have 
    the dye test done.  Is there a specific day in your cycle your suppose
    to have this done?  What is the procedure and does it hurt??  I'm a 
    little scared, and a big baby when it comes to pain, needles and I
    don't get along very well.  But I'll do what I have to do.
    
    Appreciate response,
    Stacey
    
    

The "dye test" is a hysterosalpingogram.  A syringe is inserted into the
cervix and clear fluid that's opaque to X-rays is injected.  The fluid
goes through the uterus and out the tubes, thus checking whether the
tubes are blocked.

There's bound to be at least some cramping when anything is inserted in
the cervix.  I believe there are some notes in here in which women say
that their discomfort was minimal, but my wife experienced a lot of pain.
A lot has to do with the doctor's technique.  In our case, the doctor
was late (his fault, but he blamed it on his secretary) and was in a hurry.
The X-ray tech agreed with us that his technique was brutal.  In any case,
there'll most likely be less pain than you had with your laparoscopy.

    Re: timing in your cycle.
    
    They had me come in before ovulation, to make sure I wasn't pregnant.
    
    I had some cramping, about like a normal period, but it's not that
    bad.  Ask your doctor about taking some Advil before you go in for
    the test, I think that probably helped a lot.  The cramps subsided
    immediately at the end of the test and quit completely about half
    an hour later.  Remember to breathe!
    
    Hope it's good news!
    Beth

    I've had this test 6 times!  Three times the test was very painful --
    (all three times both my tubes were blocked and the force of the
    injected liquid was making my uterus have spasms).
    
    The other times the discomfort was minimal, some minor cramping like
    you could expect from your period.  One thing I found interesting, was
    that some doctors put you on an antibiotic BEFORE the test, and some
    doctors don't.  Another interesting tidbit is that many women (and I've
    read quite a few responses to atest to this) get pregnant shortly after
    having this procedure done.  It worked for me 3 times within 1 - 3
    months after the test each time.  I have only one tube myself (lost it
    1 1/2 years ago when a tubal pregnancy ruptured), and after trying for
    eight months, I had the dye-test and was pregnant two months later!  
    
    Here's hoping everything works out equally well for you!
    
    Oh yes -- it was performed BEFORE ovulation to make sure I wasn't
    already pregnant.
    
    Best wishes,
    
    Dale

    Well, another success story to report.  My husband and I have been
    trying for a baby for almost 2 years.  For the past 6 months I have
    been going thru the usual fertility testing.  I had my dye test on
    March 18th which wasn't bad at all and I never got my period again. 
    
    I just found out yesterday!  I was so shocked I had to ask the nurse to
    repeat herself.  From what I have read I'm probably about 5 1/2 weeks
    along.  I'm not telling everyone right away but who knows who will see
    this note.  I really haven't had any symptoms except my hair falling
    out and being extrememly tired no matter how much sleep I get.
    
    I had finally decided it WASN't going to happen and it did.  So keep
    your chins up!  This file is a great source of information and comfort.
                                                                           

For a discussion specifically dedicated to IVF (In Vitro Fertilization), see 
note 828.

    RE: 105.130
    
    CONGRATULATIONS!!!  That's wonderful.  I'm 7 1/2 weeks pregnant, and I
    went through the same kind of testing, etc....  I've been in 7th heaven
    ever since, and NO symptoms yet.  Not even tired or sore breasts.....
    Lovin' every minute of it - so far....
    
    RE: 105.126
    
    I had my dye test done on the 9th day of my cycle, and I was pregnant
    the following month.  The dye test was very painful for me, and I have 
    a high threshold for pain, but my uterus was and still is tipped all
    the way forward, so the utensil they were trying to put through my
    cervix wasn't curved at the right angle.   They did manage to complete
    the test, and my tubes were open.  
    
    

    
    Thanks to everyone who has replied to my note on the "dye test", (.126)
    I'm still nervous, but not as scared, or "in-the-dark" about the
    procedure.  It really does help to hear about other peoples
    experiences, especially the success stories!!
    
    I called my doctor last week, because I was scheduled to go in to have
    the test done on the 2nd of May.  Apparently I didn't call them soon
    enough, becaue the 2nd of May would be day 17 in my cycle, and that
    is to late in my cycle to have the test done, (they do the test on
    day 11).  So I have to wait another month, I'm suppose to call the
    doctor on the first day of my cycle, and then they'll schedule me for 
    the test on my 11th day.  Another MONTH!!!!! 
    
    Thanks again everyone,
    Stacey

    We were trying for a baby for nearily four years.   Just over a year 
    ago I went for tests.   My post-coital and hysterosalpingogram tests
    showed up ok.   My laparoscopy showed some fibroids.   My gyn told
    me at the time I would need an operation to remove them.   He later
    changed his mind and said he would leave them alone as they were not
    too big.   He then started me on a three month course of clomid.
    The clomid failed much to our regret, we even took a holiday around
    the time I ovulate thinking the change might do some good.   My gyn
    then gave me a two months rest from treatment.   In February, I
    started a course of pergonal injections.   I would have a ultrasound
    every day followed by a injection.   He started this on day 5 of my
    cycle.   My course of injections lasted five days.   At the end of
    all this I was supposed to have artificial insemination by husband,
    but on day 11, a cyst showed up on the ultrasound.   My gyn decided
    not to do the artificial insemination as it would probably not 
    work owing to the cyst.   He presumed the cyst came from the
    injections and he said the following month he would start the
    injections on day 2 and give them to me every second day.   You can
    imagine how down I felt at this stage, I was fed up with the whole
    process.   Would you believe, my period was late, I was afraid to
    hope thinking it might be late owing to the cyst.   After two weeks,
    I tried a home pregnancy test.   It gave a negative reading I think,
    you see, it was very hard to read my test.   After another two weeks
    I went for a urine test, much to my surprise it proved positive.  
    Even then I was doubtful, thinking would they be getting a reading 
    from the pergonal that might still be in my system.   I rang my gyn.
    He arranged an ultrasound.   Sure enough I am pregnant, thanks bit
    to God.   I am twelve weeks today.   All going well, God willing,
    I am due on November 23rd.
    
    To all you still trying never give up hope as you can see from my
    case it can happen when you least expect it.   Good luck to you all.
    
    
    Bernie
    

    
    
    Congratulations Bernie!  
    
    					Darlene

    A friend of mine has been trying to get pregnant and has gone through
    some of the standard infertility tests.  When they monitor her follicle
    growth through ultrasound the follicles keep growing past the point
    were they are supposed to rupture until they are over 30 in size.
    One month her doctor gave her a shot of HCG (?-or whatever hormone
    is supposed to cause ovulation) when the follicle was the right
    size but nothing happened even though it was a high dose.  Is there
    a way to tell if the ovum has been released if the follicle doesn't
    rupture?  Has anyone else had the same condition?  What sort of
    hormone monitoring can they do to determine if you are ovulating
    correctly?
    	Linda

    Linda,
    
    My understanding is that there is NO direct test that determines 
    "you have ovulated" -- rather, they measure a whole bunch of different
    things that are symptomatic (but might be wrong) and draw conclusions
    from them.  The  closest thing I've heard of to a direct test is the
    ultrasound of the ovaries.  They see the follicle get bigger.  Then
    they see that the follicle has ruptured.  Therefore they conclude you
    have ovulated.
    
    Someone correct me if they know differently, but I think it is
    necessary for the follicle to rupture in order to release the egg.
    
    Beth

    
    I can't believe it after 2 years, 2 dye test, clomid for 6 months,
    laposcrapy (sp), pergonal, progesterone, IUI's, and anything you can
    think of I'm pregnant!!!!! Yipeeeee!! I was due to start the IVF/GIFT 
    program on May 20, 1991. My Dr. told me to take no medication the
    month before we started IVF/GIFT. On Thurday May 16, 1991 I found out
    I was 6 weeks pregnant. I already saw the little heartbeat!! It's hard 
    to believe it some days. I thank The Good LORD. For those of you
    starting the process.... HANG IN THERE! Your prayers will be answered.
    
    
    
    
    
    
    

    The following question is being entered on behalf of a community
    member who wishes to remain anonymous at this time.
    
    +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
    
    What follows is a long note about problems I am having conceiving. 
    I am looking for advice and/or support.

    Last June I had a miscarriage, when I was 14 weeks along (although
    they determined that the uterus stopped growing around week 10). 
    It was discovered through an ultrasound and I ended up having a
    D&C. About two weeks before the ultrasound I experienced some
    bleeding, but it stopped on its own.  I also experienced pain on
    my right side throughout the pregnancy, which I was told was
    ligament stretching (so why did it continue to get worse after
    week 10?).  I was told to wait 3 months before trying again. 
    Because of other problems that cropped up, we did not start trying
    again until December.

    Well, this is now our seventh cycle of trying and no luck.  The
    problem is that in the past six months, I think that I have
    actually gotten pregnant 3 times.  Those three months I
    experienced the exact same  symptoms as when I was pregnant the
    first time (slight nausea, increased urination, gas, fatigued,
    temperature up to 99 (other months it stays steady around 98.5) -
    all within 4-5 days after ovulating).  The problem  is that around
    day 22-23 in those months I started getting the same pain  in my
    right  side, and my temperature started dropping until my period 
    started, usually a day late and much heavier than normal.

    After the second time it happened I tried to get an appointment
    with an OB/GYN in my HMO (I'm new to the HMO).   Unfortunately,
    because they are so backed up, the earliest appointment I could
    get was the end of July!  I can't get in any earlier because it is
    not an emergency, I'm a new patient, we've only been trying for
    six months (not considered a problem until trying for 12 months),
    and I don't think the nurse believed me when I said I thought I
    was getting pregnant.  So I am faced with going through two more
    cycles of trying, possibly getting pregnant, and then losing it!

    Has anyone else gone through something like this?  Could I be
    getting pregnant but losing it so quickly, or  is it just wishful
    thinking? It is just so frustrating because I really want to be
    pregnant!

    
    What youre going through sounds a little like what I experienced
    when we were "trying". Except for the fact that I have never had a 
    miscarriage.  The first month I was lax with my pills, I started
    experiencing cramps in my lower abdomen(ovaries) in the middle of my cycle.
    Enough that it sent me to the dr's and they gave me an ultrasound
    and determined I had a small cyst on my right ovary (pain was on the left). 
    They said it would go away, and to stay on my BC pills. Well, I didn't
    listen about the BC pills, because I had been all ready to stop them
    altogether, to clean my system out for 3 months before really "trying"
    in August/Sept. and didn't want to be delayed.  Well, the pains
    proceeded every month for 6 months, I went through 5 dr's, and I swear
    they all thought I was making it up. Finally they gave me a laparoscapy
    in December, expecting to find Endomitriosis, but to no avail. I had a 
    slight bit of scar tissue, that he cut, but other than that it looked 
    fine.  The following month was the first time I didn't have cramps. 
    The month after that, in Feb, the cramping started up again, and I was
    determined to go back and MAKE them find out what was wrong with me.
    We had been trying for 6 months, and I was sure there must be something
    wrong. 
    
    So, I went to a new dr's office with these cramps, as I said, all
    determined that I was not going to sit there and listen to them tell me
    this was my imagination, that I was going to DEMAND they help me.  When
    after the urine test, he comes in and tells me I am pregnant!  I almost 
    dropped to the floor. I wouldn't beleive him, he had to get the nurse
    to convince me.  
    
    Bottom line of this story is, that my mother and I think, that all
    those months of cramping, may have been pregnancies that just didn't 
    "take" for one reason or another (spontanious abortions?).  Maybe it
    was a hormone thing, maybe the small amount of scar tissue made a
    difference, the small cyst, etc....  we don't know.
    
    I don't know if this will help, but it was what happened in my case.
    I wish you the best of luck in your pursuit of "fertility"! 
    
    Chris
    (5 mos along, and still in shock!)   :-)
    
    

    I am not a member of an HMO, and don't know the "rules", but the next
    time you are experiencing cramping and it's around the time youthink
    you are pregnant and might be miscarrying - why not rush off to your
    local emergency room complaining of severe cramping and telling them
    you might be miscarrying - they will get an OB to look at you
    immediately!
    
    Worth a shot if the HMO isn't taking your situation seriously.
    
    -sandy
    

    re previous --
    
    Having HMO coverage might "disallow" going to the Emergency Room - and
    the cost could be stiff to pay.
    
    Instead, the person might stress to the HMO appointment people that
    they're bleeding and potentially miscarrying, thereby maybe getting in
    for an acute care visit almost immediately.
    
    

Just a piece of info - I read (when trying to figure out if I was pregnant), 
that cramping often occurs during early pregnancy.

In my case, it was one of the first things that was "different" than my normal
cycle - cramping *before* menstruation started, instead of after.



About the HMO problem, I don't do HMOs but with John Hancock there's a number
to call to ask about coverage.  Is there someplace in Digital you could call
and ask about seeing a doctor outside the HMO and have it be covered (ask your
PSA)? Given that you miscarried last year, and you've had symptoms since, it 
may be acceptible.

Good luck.

    HMOs can and/or will deny coverage (refuse to pay) for emergency room
    coverage if you do not contact them, first (unless it's a life
    threatening emergency).  Be careful; you could end up with a whopper of
    an emergency room bill which you are resposible for paying yourself.
    
    Get to know the GYN.  The possible way around it is to talk with him or
    her and explain what's going on.  Ask if you can call the next time
    this occurs (thereby skirting around calling your Primary Care
    HMO Physician for a referral).  
    
    Your GYN should be receptive to taking phone calls (mine is).  Usually
    his or her nurse will schedule those calls at the end of the day.  Talk
    with that person and explain what you're experiencing and ask if you
    can come in the next time this occurs.  Tell him you've experienced
    roadblocks in dealing with the administrative red tape of the
    referral process (e.g., they wouldn't refer you).
    
    FYI - I had an appointment at the beginning of the year with a new GYN. 
    I had several issues, and questions as a result of problems that had
    occurred, and I wanted to communicate those to the GYN ahead of time.
    Knowing that I probably wouldn't get it all out in our first meeting, I
    wrote him a letter after I scheduled the appointment-- detailing my
    questions, issues, etc.  It was very helpful and he was very receptive
    to my questions.  He reassured me that we can talk on the phone
    whenever I feel the need to...
    
    Warmest wishes for success.
    
    Rgds,
    marcia

    RE:  He reassured me that we can talk on the phone
         whenever I feel the need to...
    

    I can also reschedule another appointment with him if and when I need
    or want to.

    This response is being entered on behalf of another noter who
    wishes to remain anonymous at this time.  If anybody else wants to
    respond anonymously, you can send me mail and I'll either remove
    all identifying info and post it, remove identifying info and
    forward it, or forward it as-is for off-line contact, whichever
    you request.
    
    ===================================================================
	I tried to get pregnant seven times and 2 and possibly three of those
	times I was certain that I had conceived.  The first time I had
	nausea, my period was late, and the cramps were much more painful than
	usual, almost unbearable.  Following this I had extremely irregular
	periods (they used to be like clockwork before I ever tried getting
	pregnant but that could be due to age).  The second time I felt pain 
	around the time of implantation, a little over a week after ovulation, 
	had lots of breast tenderness, etc..  That period involved 7 days of
	heavy bleeding which I never experienced before nor have I since.
	I eventually stopped trying to get pregnant and decided to pursue
	adoption.  (I was trying to get pregnant by donor insemination).
	I didn't want to go through any sort of infertility treatment, but
	I would be extremely curious to hear about what your doctor finds
	in case it is a health issue.  It seems like once you're working 
	with an infertility specialist they will monitor you more closely 
	than the regular ob/gyn people are willing to.

	

    Don't know if anyone still reads this note, but I'll give it a shot.
    I'm scheduled for a laparoscopy later this month.  So far, we've tried
    Clomid and IUI for several months with no luck yet.  My doctor thinks
    it's time for a laparoscopy to see if there's any endometriosis or
    other problems.
    
    I'd like to hear from anyone else who's gone through this experience. 
    Has anyone had endometriosis that's been treated/removed during a
    laparoscopy?  How risky is the surgery?  What should I expect?
    
    Thanks in advance.  Good luck to all the rest of you!
    
    Janet

    i had three laparoscopies and the only discomfort i had was after-
    effects from anesthesia. they did find some endometriosis and treated
    it. i went to work the next day. it is not a risky procedure. 
    I have seen documentaries where they show how much
    the doctor can see with the instruments using this procedure...it is
    amazing. it is a standard procedure during infertility workups.
    good luck.

    re: .148:  I think you heal a bit faster than I do.  I had two of
    these done, both on Friday, and was able to return to work Monday
    each time.  I don't think I could have managed to work the day after
    surgery, however.
    
    Most of my after-effects were from the leftover CO2 gas they didn't get
    out -- sort of bloated and achy.  (You'll want clothes that are very
    loose at the waist for a couple of days.)  They've made a lot of
    progress in this over the last few years, though, and get a lot more of
    the gas out now than they did even 4 years ago.  I was back into my
    jeans in 2 days this time.
    
    Beth

    
    I had one (lap) in Decemeber of last year, although Endo was suspected, 
    none was found. Just a couple of pieces of scar tissue that that ended 
    up cutting (and preggo 2-3 mos later!).  
    
    I pray though you don't have as much pain as I did after the surgery 
    due to the leftover CO2 gas that tends to rise up into your shoulders
    after they close you up. I felt like I had been BEATEN severely over
    the back of the neck with a 2 x 4. It was Awful.  I wasn't up and
    around for about 2-3 days. 
    
    Good luck, and hope yours is as sucessful as mine was!
    
    Chris (7 mos and counting)
    
    

    Well I guess I'll join in also - I've had three laps and found out the
    first time that anesthesia and I don't get along too well.  Yup, my
    belly was bloated and shoulders very sore too - bring loose clothes
    to wear.  Because of the extent of the endometriosis and my less
    than optimal tolerance of the anesthesia, I always ended up staying
    over night.  
    
    It really bothered me at first that I "couldn't take it like everyone 
    else and had to wimp-out and stay the night".  It took a while for me 
    to convince myself that it was OK, that everyone reacts differently 
    and it was the doctor's decision not to release me the same day.  
    
    I guess what I'm saying is that if you haven't had general anesthesia 
    before, you don't know what your reaction will be - just let yourself
    be taken care of!
    
    Conni
    

    
    I agree Conni, I wish I had stayed over night after all. And was kind 
    of embarrassed that I wasn't as "tough" as others who said their lap
    was no problem. But, as you said, I think some handle the anesthesia
    better than others. I also have asthma, and had a problem coming out
    from being "under". (which can be common for asmatics)
    
    Don't mean to throw fear into anyone...as others have said, to some
    people its a breeze.
    
    Chris
    

    A friend is going for a laproscopy in September.  It is the kind
    where they explore and cut during the same session.  For people
    who had multiple ones, was that because the first one was exploratory,
    or did the endomitriosis come back?  How about adhesions, once they're
    removed are you "clear" provided no further abdominal surgery or
    whatever causes them is done?
    	Linda
    	

    > as much pain as I did after the surgery 
    > due to the leftover CO2 gas that tends to rise up into your shoulders
    > after they close you up.
    
    I'm not doubting what you say-- just genuine curiosity, since this
    sounds scarier than science fiction!!  Leftover CO2?  What did they use
    the original CO2 for?  Does it get trapped between the organs and
    travel around through the body?  I really don't know!  A friend of
    mine, after a c-section, complained about gases "left over from the
    surgery" in her body cavity, and my reaction at THAT point was "yeah,
    right."  A year later, after my c-sec, I had gassy *intestines*, but
    none of this vague gases-roaming-the-body stuff.  I'd never heard
    anything like it since, until I read .150.  I do believe it now, but
    I'm really curious about the mechanics of it all.
    
    (Isn't CO2 heavier than air?  Why does it rise to the shoulders?)
    
    Leslie

    
    I'm not a doctor, but I'll try to explain it to you as it was explained
    to me...someone who may know more, feel free to pipe in.
    
    With the Lap, they make a small incision in your belly button, then
    blow in C02 to inflate your stomach to be able to "see" the body parts
    (ovaries, tubes, etc) more clearly. (if they left the skin down, they
    would have to probe and poke around to see anything). This is a form of 
    micro surgery I think, and if they find problems, etc, they use small
    lasers to do the cutting burning of tissue etc..    
    
    So, basically the C02 is to "inflate" the stomach to see clearly.
    Make sense?  
    
    I'm not sure how the C02 gets up to your shoulders, etc, I just know it
    did in my case. And I know next time (in my case) I would ask for some
    pain medication, or as someone stated, ask to be kept over night. 
    But, as stated, some women have no problems, and are back to work in a 
    day or so. I was on the couch for I'd say at least 3 days or so. 
    
    Chris
    

    A friend of mine just went through "sperm count" testing. They found
    that her husband had a low sperm count and that the sperm was "shaped
    weird". They are going to do the test again in 3 weeks.

    Does the shape of sperm have any significance in the fertility?

    Just curious

    I too had the lap surgery, and for me it wasn't bad.  In my case the
    doctor said they usually knock you out because the thing would be
    uncomfortable, as opposed to painful because he told me the gas expands
    your stomach, it's like becoming 9+ months pregnant in several minutes.
    
    In my case most all of the gas (I guess) was taken out, I really had no
    ill effects, but I did get one shot of pain killer just before
    returning to my day surgery room.  I was pampered, and fed dinner just
    before I left a little after 5pm, and pretty much allowed to just
    sleep.  Unfortunately the hospital has changed, and the day surgery
    unit is not as nice, you go from recovery to a recliner and home within
    a couple hours, sort of an assembly line operation now.  The rooms are
    now used for something else.
    
    For me I had the lap in September and was pregnant within a month.  I
    still swear that when the doctor pushed the dye through my tubes,  must
    have cleared them out.  Up til then I had been unable to conceive, and
    best we could figure I wasn't even ovulating.  The only catch for me
    was that I had had emergency gall bladder surgery the previous June,
    and the OB wanted to wait a few months before doing the lap, so as to
    not put any strain on the new GB scar.  I spent the night before
    surgery terrified the GB scar would burst open.  (and this is me, the
    EMT and former hospital worker speaking, how stupid of me!)
    
    Lyn

    .155 and .157 - thanks for the prompt response!  Yes, it does make
    sense.  All I knew about a laparoscopy was that it was a small incision
    and that they looked around with a tiny scope... another large area of
    my ignorance discovered (I hate when that happens!).
    
    Leslie

    re: .158
    
    Asking questions is the only way you ever find out.  That's what
    this notes file is for.
    
    They use CO2 because the body reabsorbs it better.  Regular air or
    oxygen can cause embolisms (air bubbles, basically) that can cause
    strokes or damage other organs.
    
    My sister-in-law conceived on her first cycle after her first 
    laparoscopy (Niki, now 11).  After two tubal pregnancies she had
    to have a second laparoscopy.  It took a little longer to conceive
    that time, but Joel's now 6.
    
    --bonnie

    Well this note certainly got some life back to it!  Nice to know
    somebody is out there!  Note 828 has been pretty slow and I was feeling
    a little on the lonely side, so I decided to get brave and write.
    
    I'm in the middle of my second IVF cycle and my brain is starting to
    kick into high gear.  We did really well the first cycle, the embryo's
    just didn't implant.  I figured since I've never been pregnant my body
    probably thought they were foreign objects and sent out the soldiers
    to clear 'em out!  Hopefully after a few cycles they will welcome them.
    
    The second cycle is easier then the first, but I don't think it ever
    gets that easy when you want so bad to be blessed with a child.  I'm
    just really grateful that DEC supports IVF thru their medical
    insurance.
    
    I have about 21 eggs so far, split between the two ovaries and they
    are all coming along just fine.  Looks like egg retrieval will be
    sometime next week.  This is the exciting part, going in for the
    ultrasounds and watching all the little eggies grow...it's facinating
    what they can do today with medical technology.
    
    Well I've rambled enough...just having one of those stir crazy moments
    and knew this was the place I could dump some of these thoughts.
    
    ...Lori (an IVF'er from Laguna Hills, California)

    Thanks to all of you who have responded.  It really helps to hear what
    other people have experienced.  It's also encouraging to hear the good
    news that some of you got pregnant after laparoscopies.  It's funny,
    but I'm not quite sure what to hope for out of this operation.  On the
    one hand I don't want to have them find anything too major (i.e.,
    endometriosis or whatever), but on the other hand, if they don't find
    anything then there's nothing they can do to treat it.
    
    My doctor has suggested that we try pergonal if nothing substantive is
    found during the laparoscopy.  The idea of using that drug makes me
    very nervous, but if that's what it takes, I guess we'll do it.
    
    RE: .160  Good luck to you with the IVF.  Let us know how you make out. 
    I'm sure everyone in this note is wishing you luck.
    
    Janet

re CO2:

    Of course, it's the abdominal cavity and not the stomach that's
    inflated with CO2.  CO2 is heavier than air, but your body's not
    filled with air, so it migrates up to your shoulders.

re sperm count and quality:

    There are three major factors: count, motility (how fast/well they
    move) and morphology (shape, deformities).  Sperm with poor morphology
    usually have low motility.  There are various kinds of morphological
    problems -- two-headed sperm, split tails, curled tails, heads too
    large, heads too small, etc.

    The first step in dealing with sperm problems is eliminating environmental
    factors, primarily heat.  That means wearing boxers rather than briefs
    and avoiding hot baths.  If there are still problems, about the only
    treatment available is varicocelectomy, which is the removal of a
    varicose vein in the scrotum.  There's some evidence that a zinc
    deficiency can also cause sperm problems.  Hormonal problems should
    also be checked out.

    When the sperm isn't up to par, a couple may still achieve pregnancy
    by making the woman "super-fertile" using drugs such as Pergonal.

    Re: .161
    
    Hi Janet,
    
    Just wanted to say thanks for the well wishes.  Also, I was really
    concerned about the first month I went on all the drugs, i.e. Lupron,
    Pergonal, Progesterone.  Everyone reacts differently, but I think its
    wise not to absorb to much of the horror stories you hear about all
    these hormone drugs.  My side effects have been on the very mild side,
    headaches, tired, slight mood swings...but nothing like I imagined from
    what I had heard.  For this second IVF cycle I am up to 6 amps (75/amp)
    of Pergonal a night...so far so good, I'm not growing horns yet and my
    husband hasn't filed for divorce!
    
    Best of luck to you!
    
    ..Lori

    Janet,
    
    Ask you doctor if she/he is intending to do a hysteroscopy while you're
    in surgery.  That's where the visually examine the uterine lining for
    fibroids or other abnormalities that might prevent implant.  The doctor
    who did my first lap didn't do a hysteroscopy, so it probably isn't
    "standard procedure".  I had one done with the second lap, which
    revealed a very large polyp.  This had NOT showed up on the
    hysterosalpingogram or any of the other tests anybody had run, but it
    would have prevented implant.  The doctor removed it via D&C at the
    same time.  Might as well get all the mileage you can out of this...
    
    Beth

    
    It's been awhile since I've been in contact with this note/noters.
    
    I went through my hysterosalpingogram in May, and it wasn't really all
    that painful, my one tube was very badly blocked, (I lost the other one
    to a ruptured ovarian cyst in Dec. 1984). The doctor had to inject twice
    the normal dosage of dye before it made it to the end of my tube, but
    it did manage to make it to the end.  He noticed that there were two
    small dark spots along the outside path of my tube, which indicates
    that there are two holes in my tube.  After this procedure he wanted us
    to TRY for 2-3 months, then call him back.  So we've been TRYING, and
    haven't had any luck.  Now he thinks we need to go and see an
    infertility specialist, for possible laser surgery, IVF, etc...
    
    So I called both doctors/places he suggested.  The first place told me
    that the soonest available appointment for new patients would be in
    Jan. 1992, and the second place told me they wouldn't be able to see me
    until Nov.  Is this the normal amount of time it takes to get an
    initial appointment??  Does anyone have a doctor/place they would
    recommend??  I was really hoping to see someone sonner than that!!
    Am I being unrealistic??  I have baystate insurance and I guess all I
    have to do once I have an appointment is call my GYN and he'll send a
    referal, so baystate will cover it.
    
    This is pretty scary stuff, the realization is just settling in. 
    What's the normal procedure from here?  I had a laparoscopy in Jan.
    and the doctor drained two cysts that were found on the tube, ( not
    alot of fun ).  My doctor said there was an indication that I have
    endometrosis ( not to sure what that means ).  So, I guess I've
    officially joined the ranks of the unlucky.
    
    Lori, sorry I lost touch...sorry to hear the first IVF didn't work,
    glad to hear you're trying it again, praying this one will be
    successful!
    
    Any help/comments would be appreciated.
    
    VERY depressed,
    Stacey
    
    
    
    
                                         

The wait for an initial appointment sounds about right.  We're on our
third specialist, and each one took several months to get to.

As far as recommendations are concerned, where are you located and
where are you willing to go?  I can comment on some Boston specialists
(offline of course), but you should definitely check with RESOLVE.

Keep in mind that somebody may be a great tubal surgeon and do a terrible
job of managing Pergonal -- each infertility specialist has an area of
expertise.

    Lori,
    
    This is an aside in response to you wondering if an 'old note' would
    still be active.
    
    There is a simpler way to keep up with notes than doing a directory
    to see if there are any new replies to a note that you are interested
    in. This will also keep up you up todate on all the conversations
    going on in the file.
    
    While at the notes prompt in a conference type the words 'set seen'.
    This will mark all the unread notes in the conference as having
    been read. (You can still go back and read them of course.)
    If you want to follow the recent conversations you would type
    set seen /before=dd-mmm-yyyy where the date is a few days to a week
    or so (depending on how active the conference is.)
    
    When you log back into the conference (or if you set a date), there
    will be a number of unread notes. By using the enter key on the
    key pad you will be able to move through all the unread notes. If
    you wish to skip a notes string, hit the comma key on the key pad,
    which will mark the string as having been read.
    
    Bonnie

    
    Before I go home today, I want to put good news in this note. My
    husband and I tried to conceive for 2 years and I was feeling like 
    many of you. Tired, depressed, anxiety when seeing a pregnant women
    or baby, ready to beat the parents in the mall that didn't seem to 
    appreciate their children, and most of all angry that God would give a
    child to someone that didn't want to be pregnant (That was one of
    my latest experiences, oh yeah, I forgot I'm pregnant. ahhhhh!) and 
    not give one to me and all those that want children so badly.
    
    Well the good news is on my 29th birthday God gave me the best present
    ever. We found out that I am pregnant. We are thrilled!!!!!
    
    Here is the story. For one year we stopped using all forms of birth
    control. Nothing. I started to take my temp while waiting for a doctors
    appointment. Finally got one and after a few tests (blood,sperm count,
    HSG {die in uterus/tubes} and post coital) the doctor found through the
    post coital that my cervical mucus was killing my husbands sperm. His
    sperm tests were very good, yet no sperm was living in my mucus. I
    asked what medication I should take and he recommended not wasting time
    and doing Artificial Insemination, along with Serophene. (sorry if the
    spelling is wrong but I guess it's another brand for clomid) The first
    month I used the Serophene, but since ovulation was regular for me I
    decided not to use it for awhile and just try the inseminations. (We
    were predicting ovulation through ovulation kits. What a pain, but
    worth it.) We skipped a month since we were on vacation and second 
    try!!!! YEAH!!!!
    
    The only thing that keyed me that I was pregnant was gut feeling
    and my temperature never went down. I was one day late and my
    First Response test said CONGRATULATIONS. The nurse cautioned me to
    not be too excited until the blood test came back. It did and I am!!!
    Besides being tired alot, I feel great! I think the nurse is as
    surprised as we are because we were told it could take a good 6 months
    to a year for the AI to work.
    
    I'm happy I get the chance to share this story. My due date is 
    April 22nd. My prayers go out to all of you who are trying. I know
    it wouldn't be true for me if so many friends and family weren't
    praying for me. Thanks for listening and good luck!
    
    				Joyce

    Joyce, 
    
    Best wishes, and congratulations!  I'm so glad that you shared your
    success story!  How wonderful!
    
    Rgds,
    marcia

    Oh Joyce, Congratulations from the bottom of my heart!!
    
    I know the emotional roller coaster you ride firsthand, of clomid,
    hormones, and having sex to make a baby, not for the pleasure of it, 
    and finally you get the news you never thought possible...."Yes the
    test was POSITIVE"...
    
    I had my husband hauled out of a major staff meeting to tell him the
    news once, one time he was participating in some major site event and
    had his secretary track him down for that!  Both times he proudly
    announced why he had been pulled out for "an urgent phone call from his
    wife!!  For us we had decided to stop trying just because it was
    becoming too much work, and that for us was the month we conceived.
    
    Good luck, God Bless, and keep us informed of how you're doing!
    Lyn

    I've been asked to add more information and questions regarding .156

    The sperm abnormalities found, included crooked tails and enlarged
    heads.

    Does any one out there know if this indicates a high risk of birth
    defects if the sperm ever fertilized an egg?

    re: .161 - did you have your lap. yet? Not to scare you, but my 
    "simple" lap. turned out to be major surgery, when mega adhesions were
    discovered. So I ended up in the hospital for five days. Hope yours
    doesn't come to that!!
    
    re: .165 - I called Boston IVF in June for an appt, and the first 
    available time was end of Sept. But get two or three recommendations
    of different places to try your chances (I have literature from
    Boston IVF, IVF Australia, Brig. & Woman's and New England Medical,
    if you would like to borrow them. Also Faulkner Hospital is good).
    All these places are good for fertility treatments.
    
    Cyn
    

    
    I had my laparoscopy last week.  They found a small amount of
    endometriosis -- but my Dr. didn't think it was anything that was
    causing us major fertility problems.  We're going to try a few more
    cycles of Clomid and then move on to Pergonal if there are still no
    results.
    
    I'm keeping my fingers crossed...
    
    Janet

    Thanks to those of you that gave me information, I called Resolve and
    got Dr. Robert Hunt's name and number (plus another noter had suggested
    him).  I called his office and they don't take Baystate, so he was out.
    
    I called Dr. Vito Cardoni, who's name was also given to me by many  
    recomendations, and he can't see me till Jan. 1992, he does take Baystate,
    but not for IVF.  So I don't think I want to venture into a specialist,
    go through all the test, etc, then get to the point where I might need
    IVF, and not be covered, or have to switch specialists.
    
    So I got the name of another doctor, (actually an office with three
    doctor's in it) at the N.E. Medical Center in Boston.  The doctor is
    Dr. Turksoy, (anyone ever here of this doctor or location?)  Well, the
    good news is that I have an appointment  September 27th.  That's only
    one month away, I very happy!!!
    
    I hope this month goes by fast,
    Stacey
    

    Is that the place where they are doing the new procedure I read about
    in this Sunday's Globe - instead of drugs and harvesting multiple eggs
    they encourage one egg to mature, remove it, fertilize it, incubate it
    in the woman's vagina, and then do the implantation? Much cheaper than
    regular IVF and some question now about how mulitple eggs don't 
    necessarily increase the chances (just increases chances of twins!).
    It is being done at one clinic in Boston, but I'm not sure which.
    
    Cyn

    
    Time magazine has an article on "Curing Infertility".  It talks about a
    procedure where they can actually insert a sperm into an egg with a
    microscopic needle.  They claim that not only does it increase the
    chance of fertilization, but increases the chance of it attaching to
    the uterus by as much as 5 times!  Has anyone gone through this
    procedure - or heard about it?

I haven't seen the article, but it sounds like PZD (partial zona dissection).
The zona is a layer around the ovum.  If the sperm can't penetrate the zona,
they can use microsurgical techniques to effectively cut a hole in the zona.
I believe PZD is generally done as a backup technique in IVF -- if the eggs
don't fertilize normally, they try to "rescue" the IVF cycle by doing PZD.

They've been doing this for a while at Cornell in NYC.  Boston IVF has been
doing it only since the beginning of the year.  IVF Australia is doing it
out of their Long Island location, and plan to do it out of the Massachusetts
location sometime next year.

    Ive just recently begun testing. Im 31 and I have a very regular 28 day
    cycle.  My husband and I have not used any type of birth control for
    over 9 months now and we just began our testing - mine consists of the 
    temperature taking for 3 months but my husband has already had one
    sperm count and is scheduled for a second.  Is seems that the first
    count was very low and the consistency or thickness of the sample was
    abnormal.  Anyone have any info on this?  This being October we had to
    take the sample from home and then outdoors to deliver to the lab - Im
    wondering that although we were told to keep the sample warm (room
    temp) if it could be possible to keep it too warm (car heater, a small 
    kitchen towel wrapped around the jar, I kept it near my body during the
    ride) and could this effect the test?
    
    Im scheduled for an exam next week but its a basic internal exam as Im
    due for a Pap and this is a new doctor, so my tests will continue.
    
    Any additional info is welcome!
    
    Maureen

It is possible for the semen to get too hot.  If you keep it at body
temperature or slightly lower, it should be OK.  When transporting a
sample, you can just keep it next to your body.  Even so, the sample
should be turned in to the lab as soon after it's produced as possible
(certainly within an hour).

I suggest that in addition to ready the various infertility notes
(DIR /KEY=infertility), you join RESOLVE and get some of their brochures.

    This is a very special note and I hope the moderator(s) will keep it
    separate from the recommended book list...
    
    My husband and I were getting frustrated trying to get pregnant.  The
    following book was suggested to me (and I had seen excerpts). 
    Needless-to-say, I get pregnant the month after I got the book!  It has
    a 20-point list that we VERY religiously followed (including no
    alcohol!!), and voila!!!
    
    The name is: Getting Pregnant - What Couples Need to Know Right Now.
    
    By Niels H. Lauersen MD, Phd and Colette Bouchez, Rawson Asssoc. Publ.
    New York, 1991.
    
    I can't tell you how great it is!  It has everything from the
    Roubuttusin trick to special diets, etc.

    Hello, 
    
    I believe I have some important information that every infertile couple
    should be aware of.  This information may not be pertinent to your
    exact situation but hopefully it will be useful to you to help others.
    
    My husband and I have been trying to conceive for the past 2 years and
    as we can all agree with it has been a very difficult time.  The first
    problem was thick cervical mucus.  I have written into this note about
    the mucus problem but it was under the name of CDOMENICO.  We were also
    having negative post-coitals and my husbands motility was fair but not
    great.  However, based upon the standard sperm tests he was fine. 
    
    Well our doctor was getting frustrated because he couldn't figure out
    what was wrong and decided to send my husband for the sperm/hamster
    test and to see a urologist affiliated with Boston IVF to undergo one
    of their new test....one that focus's strongly on sperm morphology
    (shape).  The results were disatrious.  We Flunked the sperm/hamster
    test and our morphology test came back with only 1% good sperm.  It is
    important to note here that all of our other sperm tests never said we
    had a sperm morphology problem.  We were informed our best solution was
    IVF.  I asked how come the sperm shape was wrong and the response was
    a shrug of the shoulders and "thats just genetically how your husband
    generates sperm".
    
    Well, we decided to do the IVF and our big question was what type of 
    child will be conceived if the sperm has defects.  Well we have birth
    defects?  We decided to research on our own and if there was a small
    chance of a problem, we would be happy to adopt.
    
    Well, that is when by accident we came across a book by Attila Toth
    called THE INFERTILITY SOLUTION.  Now please note, we have all read
    many books so what one more?  But this book was the first one I read
    that was logical and wasn't pushing everyone into IVF or other artificail
    means of conception.  Dr Toths entire premiss is due to the sexual
    revolution and the increase  of sexual partners, genetial tract
    infections are being passed back and forth between partners that are
    affecting conception.  Note: infertility is on the rise and so has been
    the increase of sexual partners.  Symptons are not noticiable but are
    caused by mycroplasmas and anerobic bacteria.  These infections can
    affect a mans sperm count, motility, morphology and a womens cervical
    mucus, uterus lining and if severe, her fallopian tubes.
    
    Before I continue, it is important to note the Dr. Toth is head of the
    MCLEAOD INFERTILITY institue in NYC, a teaching physician at CORNELL in
    NYC and a physician an the New York Hospital in NYC.  His major point
    is before anyone runs off and tries all of the up-to-date technology in
    conceiving a baby, FIRST MAKE SURE YOU ARE CHECKED FOR INFECTIONS!  It 
    is the cheapest treatment for infertility.  His success rate is over
    80% and his treatment is just 2 weeks of strong antibiotics.
    
    Well, we were so impressed with what Dr. Toth was saying, for once
    someone (to us) was making sense and we called up NYC and made an
    appointment to see him.  We went about 2 weeks ago.  What he does is
    take a sample of sperm and a sample of your uterus lining and submits
    them to a lab for 4 weeks of analysis...not your typical 2 day report
    from standard labs.  There he determines what bacteria is in your
    system and will prescribe antibiotics to combat them.  During this time
    you must have protected sex.  What doctor Toth also does is take an
    intense background history on you and your family.  Have there been any
    miscarraiges, stillbirths, etc.  He believes some infections are second
    generational...they have been passed from the mother to the child.  He
    has noted that he has treated 12 year old girls (virgins) with
    Clamedia (sp?).  The second generational part is hard for me to believe 
    yet it is interesting to note that before my husband was born his
    mother had a miscarraige and after a stillbirth.  ALso, after me my
    mother had a miscarriage.  It is interesting but I still have a wait
    and see attitude.
    
    When we discussed my thick cervical mucus he did make a good point (and
    it is also in his book).  Most doctors (mine did) will treat you with
    estrogen to thin it out or else there is good old robitussen.  His
    point is FIND OUT WHY SHE HAS CERVICAL MUCUS!!!  This is natures
    defense!  Do a bacteria check on her!  And you know what...my doctor
    never did.  It was easier to bypass the sympton with estrogen or
    robitussen then it was to FIND OUT WHY.
    
    I also want to note that we had a clamdia test and they also tested for
    mycoplasmas (the standard 2 day lab test) and the results were
    negative.  I mentioned this to Toth and he said there are many more
    things besides the above that can cause problems like anerobic
    bacteria, etc.  Plus, to be honest, I have more faith in a lab report
    that takes 4 weeks for results than one that takes a few days.
    
    We are now waiting for our lab results.  The doctors first impression
    was that no doctor should have told us we couldn't have kid and need
    IVF.  One lab report on my husband has come back and said that 50% of
    his sperm is poorly shaped.  We were expecting this because we saw the
    poor shapes in the doctors office (enlarged head).  AT that time the
    doctor told us Large heads are signs of INFECTIONS and can be treated!!
    The odds of having one man produce 99 million sperm and all be
    genetically poor (what Boston IVF said) is SO SO RARE !!!!  Yet infections
    is too quickly overlooked.
    
    Okay I've rambled.  The point I want to make is please look into your
    past treatment and note if infections have been given any consideration
    in your case.  Keep that in your mind.  Also please read DR Toths book.
    and keep his information in mind.  Meanwhile, I will post my treatment 
    and results.  The together, we can see if we are on to something that
    can help you or someone you know.  Please note:  I know that I am not
    a success story yet.  MY point is not to say RUN OUT AND GET TESTED
    FOR INFECTIONS.  It is to educate you on the possibilities of it.  If I
    am wrong or right, it will hopefully benefit someone.  
    
    Thanks for listening.....
    
    carrie

    Gosh Carrie, I hope you keep us posted, I'm really interested in
    finding out what happens!
    
    Monica

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

       Carol duBois, PARENTING co-moderator

************************************************************************
Although I have not read the book by Toth mentioned in an earlier reply
I want to believe there is some truth to the infertility approach he
suggests.

My husband and I battled infertility for 6 years.  I think I went through every 
infertility test imaginable (many several times).  It was determined that I
had mild endometriosis but I also tested positive for micoplasma (sp) some
type of micro-organism.

There is a debate within the medical field as to whether or not micoplasma
can be directly linked to infertility.  Most of the Doctors that I saw (and
there were lots) told me that micoplasma was something that all women had to
some extent and should not be considered as a possible cause of infertility.

I had an extensive lab workup (I don't remember it being a month, but it was
longer than a couple of days) to determine what drugs the form of micoplasma
I had was susceptable to.  An extensive list came back with some drugs listed
that I would not even have considered taking (possible serious side effects).

The positive side of all of this is that I was able to successfully conceive.
The down side is that I am still uncertain what treatment or combination of 
treatments led to my success. I had a laporoscopy with laser to treat the 
endo.  I also had a hyster...(the dye through the uterus) and treatment for 
the mycoplasma all within 2 months of conception.  

The treatment for the micoplasma was 2 weeks of 3 different antibiotics (based 
on the susceptable list).  The treatment starts on day 1 of your cycle.  By
day 15 I knew that I had conceived(wierd dream and feeling came to me - after
6 years of dissapointment, somehow I knew it was true).  

Like I said, all these things happened within a 2 month period. But in my
heart (call it intuition) I feel that it was the treatment of the micoplasma
that led to my ultimate success (I had previously been given drug treatment
for the endo). 

It has now been another year since I started to try for my second.  My first
reaction was to ask for another course of antibiotic treatment.  The Doctors
that I have seen (I moved since having my first) all poo-pooed my suggestion
to again look at treating a possible micoplasma problem.  The immediate 
suggestion based on my background was to go with IUI and possibly GIFT.

To me these measures seem to be extreme without first looking at a much
simpler and less expensive treatment method.  I guess what I am trying to
say by all of this is that (again without having read the book) to at
least consider looking at possible infections or micro-organisms as a 
possible cause of infertility.

I had almost given up trying to pursue this treatment path.  But now I will
get the book and look at pursuing this some more before I look at these
other costlier treatment methods.

    
    
    I thought about this one over the weekend too.  If Gerald Sacks is out
    there he can probably give us a much more technical answer - but this
    is my take:
      Both IUI and GIFT procedures would eliminate the need for changing 
      the consistency or whatever of the mucus.  I'm not as familiar with
      GIFT, but the sperm washing and intra-uterine implantation used with
      IUI bypass the mucus environment in the female and wash away that of
      the male.
    
    At one point in my 8 years of infertility treatments [at least 7 years
    ago] one of my doctors decided to pursue antibiotic therapy. 
    After almost $1000.00 of prescriptions for antibiotics {not cheaper
    than IUI}, I developed some  very strong drug allergies - even to drugs 
    which I had successfully taken for years - like Ampicillin and
    Erthromyacin {sp?}. The mucus consistency got WORSE!  When I developed
    a staph infection [unrelated to infertility] it took months to get rid of
    the bugger!
    
    This still plagues me now, quite often I can't take the most effective 
    antibiotic for whichever bug I have....
    
    Its probably the same theory for all antibiotic treatments - physicians
    hesitate to give antibiotics to a healthy person for lots of reasons. 

    TO .184
    
    I agree that IVI and gift procedures would eliminate the need for
    changing the mucus consistancy.  So will estrogen.  But the point is
    is those treatments cost a fortune and may not even work the
    first/second/third times.
    
    I am very close to running to IVF and gift.  But something is stopping
    me.  The reasons are that it can cost me between 6 - 20,000 (3 tries)
    for 1 baby!!! What if I want 3????????????   I don't want to keep on
    running to IVF and gift.  It should be the last step.  What I am
    looking for is a solution that will fix the problems so that normal
    conception can take place.  I'm not sure that antibiotic treatment will
    do the trick.  HOwever, I do believe that it is something that should
    be looked into......
    
    cdo

re .184:
    
Here I am, but there's no need to get more technical.

As .185 points out, nobody wants to have to rely on invasive medical
procedures to have babies, but it sounds like your antibiotic therapy
was pretty "invasive" in itself.
    
>    After almost $1000.00 of prescriptions for antibiotics {not cheaper
>    than IUI}, I developed some  very strong drug allergies 
 
Pretty fancy antibiotics!  We were told to take antibiotics for a month
"just in case."  We took some standard antibiotic which couldn't have
been very expensive (hard to remember when the copayment is a flat fee).
We both had some minor gastrointestinal discomfort.

Just a nit, but I believe IUI costs more than $1000 a cycle. Pergonal is
over $40 a vial, and sperm washing and ultrasounds aren't cheap.

    
    IUI - a thousand per cycle?  WOW - I've entered this somewhere in the
    previous version of notes.
    
    1990 costs for IUI - AIH 
    
    Dr. visit       $80.00
    Sperm wash      $35.00
    Ovulation kit   $10.00
    Clomid          $ 4.00 {courtesy of JH prescription drup plan}
    
    
    
    We did this 7 times - John Hancock paid @ 80%.
    
    I had the antibiotic therapy before we had a prescription drug plan.
    The cost to a Digital employee would be the flat fee per prescription.
    
    re .186  We used this procedure to conceive our 2nd child.  We aren't
             planning a 3rd! However if we did, we would probably need
             it.
    
    Rochelle
    

My figures for IUI were based on the billed rate, not the out-of-pocket costs.
We paid only $4 for 12 vials of Pergonal, but the cost without insurance would
be around $500.  I think HCG is around $25 a vial ($4 to us).  Everything else
was 80% covered by the Digital Medical Plan.  Our billings were considerably
higher than yours -- I'd guess around $100 for each of the following:
ultrasounds (5 to 6 per cycle), sperm washing (2 per cycle), inseminations
(2 per cycle).

    I'm posting this for a friend of a friend, who is looking for
    participants in a doctoral psychology study. The text below is from a
    paper flyer soliciting participants. Please don't reply to me -
    simply call the phone number listed below.

    Thanks,
    Dan Halbert
    -----------------------------------------------------------------------

    			Are you infertile?

    			Are you trying to conceive?

    Then please participate in a study about the experiences of women's
    decision-making processes while in medical treatment for infertility.
    If you:

    	* Are an infertile, heterosexual, married woman

    	* Have tried to conceive with your present partner for at
    	  least one year without becoming pregnant

    	* Have never carried a pregnancy to a live birth

    	* Are undergoing medical treatment or intervention to help
    	  you conceive

    	* Have not decided to stop medical treatment for infertility

    	* Are between the ages of 30-45

    	* Are not an adoptive mother (although you may be a stepmother)

    Participation will involve a private, semi-structured interview with a
    female researcher and a brief questionnaire and should take no more
    than 1 1/2 hours, at a time and place convenient to you. The study is a
    doctoral research project at the Massachusetts School of Professional
    Psychology.

    If you, or anyone you know, are interested in participating in this
    study, please call:

    			(617) 748-1850
    			(digital pager)

    You will reach a digital pager. When you hear three beeps, touch tone
    your evening phone number, then hang up. (You must use a touch tone
    telephone.) Your call will be returned as soon as possible.
    

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

         Carol duBois, PARENTING co-moderator

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

I am just beginning with infertility problems.  I'm still hoping that it
isn't too serious.  My gynocologist has said, so far, that it looks like
my cycle was messed up because of my being on the pill for almost 7 years.
Has anyone out there had that given as reason for their lack of ovulation?

Here's my story:  I went off the pill in April 1991 because my husband and
I were ready to start our family.  I had a period in May and then I never
had another one.  I went to the doctor and had physical exams and a blood
hormone test and everything came back normal.  I waited until 7 months had
gone by without a period (and no pregnancy) and she put me on provera to
start my period and then started clomid.  The first cycle of Clomid did not
cause me to ovulate (50mg).  She increased the dosage to 100 mg for the
second cycle and I'm going for the blood test tomorrow to see if it made me
ovulate.

Also, I'm doing the BBT charts and my temperatures are all over the place.
They go up and down, never in a straight line... I don't think the Clomid
worked this month either, if you go by the charts.  Do the charts work for
everyone?

If the clomid didn't work this month, I will give it one more try, because
the literature that comes with the pills says that most women will ovulate
by the third cycle of clomid.  Then what?  Should I go to a specialist?

I know I'm just starting with all of this, but I'm so nervous.  I have a 
million questions and no one to talk to.  I only see the doctor once a month,
my husband talks to me a lot, but he doesn't realize how worried I am, and
I'm keeping it a secret from everyone else, so it's eating me up inside!
My friends don't have any children, so they don't know anything about this
stuff, and I don't want my mom or my mom-in-law to get too excited or to
keep asking me a million questions every month.  What about work?
I don't want my manager to know I'm trying to get pregnant in case it affects
promotions, raises, etc.  Is that a mistake?

I'm 26 years old and I want to have 3 children, so I want to get started now.
I've been married for 3 years and took for granted that I would be able to
get pregnant when I was ready....I've never had any health problems.  Maybe
that is why this is so hard for me.  It's nothing compared to what some of
you are going through and I pray that all of us will have successful 
pregnancies soon!

Thanks in advance for any experiences you can share with me and thanks
for listening to me ramble!

Since you're not ovulating normally, I don't understand what BBT is supposed
to indicate.  If it *is* useful, you should be careful to take your temperature
immediately when you wake up, before you get out of bed.

Join RESOLVE.  It takes several months to get an appointment with a specialist,
so you should get to work on it.  You should probably see one who specializes
in endocrinology (RESOLVE can help you with this).

I took the pill for ten years before I had my first child.  And these weren't
the minimum dosage of today's pills but really heavy ones in the early days.
I stopped taking the pill, we used other methods for the first month and I 
became pregnant the second cycle.

But then, I had a very easy time getting pregnant the 2nd and 3rd time.  The 
2nd time was too easy and too soon, right after I'd stopped the pill (it was
unintentional) and I unfortuately lost that one.

But these are only my experiences.  I think each woman reacts in her own fashion
to the pill.  If you don't have any success, maybe you should get a 2nd opinion.

Good luck and don't worry.  You will find lots of support in here.

Cheryl

I was on the pill for 11 years before I decided I wanted to become pregnant.
We've been trying since last February and so far nothing has happened.  Im 31 and
concerned about how much longer it will take. I have been charting my temp for 
the past 3 months and just saw my doctor yesterday.  My husband has also 
been tested and underwent a varicocele repair on January 6th.  Next week Ill
have some cervical cultures taken and then, once my period starts this month Im
to call in to schedule an HCG and an endo biopsy in March.  Then in April my 
doctor wants to do a post coital (he's waiting till April because it takes 2 
months to see a change in sperm count after a varicocele repair).  Im very 
anxious at this point and quite frustrated as neither of my sisters had 
problems getting pregnant (one of them was ON the pill when she got pregnant)
and now that Im ready to have children I can't.  Can anyone tell me about the
cervical cultures, HCG and endo biopsy.  What kind of tests are they, are they
uncomfortable, etc.  Ive got a couple of books on infertility at home but we're
in the process of moving and they are packed till this weekend....

Thank You
Maureen
abyss::mkane

Are you sure that's HCG?  Perhaps you mean hysterosalpingogram, which is
an X-ray taken while they inject dye into your cervix.  HCG is a drug
given to help induce ovulation.

I know there are a lot of replies in this topic, but I think if you read
them all, you'll find most of your answers.

    
    re .5
    
    I'm so sorry about your infertility woes.  Its a rough road to follow
    but worth all of it in the end.  11 years on the pill and then hubby
    has to have surgery????  No wonder your feeling frustrated!  There are
    lots of success stories in this note string - read them and you'll 
    be encouraged.  Your dr. seems to be moving along with all the
    procedures at a fast pace.  
    
    Assuming that Gerald Sacks was correct - the procedures your dr. are
    planning are: 
    
    	Endometrial Biopsy - felt like a Pap Smear to me
                             (measures the "age" of the uterine lining)
    
    	Cervical Culture - same as above
    
    	Hysterosalpinogram or HSP - Uncomfortable for a few minutes as the
                                    uterus may cramp as the dye is
    				    injected.
    
    
    My husband also had surgery to repair his varicoceles.  His dr. told
    him it would be 9 months to 1 year before his sperm count would reflect
    the improved environment.  I got pregnant the same month as the 
    hysterosalpinogram - 9 months after his surgery. (this was a little
    over 2 years ago)  
    
    Unfortunately, the varicocele surgery was a bit too successful as we are
    now expecting our third child in August!
    
    Best of luck to you,
    
    Rochelle    

9 MONTHS!  Wow - we were told that there would be a marked difference in 2 months
This is frustrating! 

Thank you for the info on the tests - I start with my first next Tuesday and I
am glad for the fact that we're finally doing something other than just 
charting my temp every day.  The success stories here are also quite 
enlightening.

Maureen 

    Another thing to bear in mind, there is a strong correlation between
    long-term pill use and the development of polyps (fleshy appendages)
    inside the uterus.  Polyps of sufficient size can prevent a fertilized
    egg from implanting.  
    
    None of the three tests mentioned in .195 will detect the presence of
    polyps, but a  hysterocopy will -- they actually LOOK at the lining of
    the uterus with a scope.  A D&C will correct the problem.  I had both
    of these done at the same time as a laparoscopy, so was out cold for
    the whole thing.  I don't remember any pain afterward from this
    procedure, although I spotted "a bit" for a few days.
    
    Re: the three tests mentioned:  the endo biopsy and HSG seem to vary a
    lot from woman to woman, about how much discomfort is involved.  (The
    physical SHAPE of your uterus affects this a lot.)  I would advise you,
    if your doctor gives you a range of options, to take whichever one is
    likely to reduce the chances of pain the most -- some doctors just tell
    you to take Advil; some offer a local anesthetic.  The doctor is probably
    best qualified to judge his/her own skill level and gentleness, and
    will (hopefully) be more familiar with your physical responses.   
    
    Best of luck to you.
    Beth

Everything I've heard and read indicates that any improvement from a
varicocelectomy shows up within 3 months.  Since it takes about that
amount of time for sperm to develop, it makes sense to me.

    
    
    I have to confess - It seems insensitive of me to be replying in this
    notes string.....(We're expecting our little mistake in August) BUT -
    babies 1 and 2 took four years of infertility treatments EACH!!!!
    
    
    I spoke to my husband about this last night.  He remembers having
    noticable swelling for at least 2 months after the surgery. His doctor
    claimed that the swelling interfered with sperm development.  Gerald
    is right (as usual :-), there was some improvement after 3 months - but 
    it took a full, looooong nine months before his counts were in the "normal"
    range. In the meantime, my doctor compensated by putting me on drug therapy
    (Clomid) in effect making me "super" fertile. I suspect that this is
    the plan of .5's doctor.    
    
    Again, at the time I really didn't share my infertility woes with
    anyone at the office - so all of the tests mentioned by .5 were done
    either before work or on my lunch hour.  I don't even remember taking
    ADVIL.  PARENTING-V2 has several notes which discuss the procedures -
    there might be more varied responses there.
    
    Rochelle
    

<    Re: the three tests mentioned:  the endo biopsy and HSG seem to vary a
<    lot from woman to woman, about how much discomfort is involved.  

I'll second that!  I know a woman who had very little discomfort from her HSG.  
I also was *with* Shellie when she had hers.  Shellie was in agony.  The doctor
kept missing and had to do it *3* times.

When I had mine (5 years ago or so), I had them put me under, since they were
also doing other tests at the same time.  Now I'm really glad that I did.  :-} 

       Carol

I think a lot of the variability of experience with hysterosalpingograms
has to do with the doctor's technique.  When my wife had hers, the doctor
showed up late, blaming his lateness on his secretary.  When the dye
wouldn't go where he wanted it to, he got very rough.  My wife was in
agony.  After the doctor rushed off to his next victim, the X-ray tech
said that she'd never seen it done so brutally.  BTW, the doctor is one
of the big names in infertility in Boston.

    My spouse conceived twice in a row using fresh semen as opposed to
    frozen (donor insemination).  This after trying for 1 1/2 years and 
    going through the initial infertility tests which showed nothing other
    than the follicle did not shrink immediately after ovulation.  She had 
    just been referred to an endocrinologist when we found out she was
    pregnant.  That pregnancy ended in miscarriage, but after the three
    month wait she immediately conceived again.  I suspect that in her case 
    the difference in count and motility of a fresh sample was necessary for 
    her to get pregnant.
    	Linda

Well I had my endo biopsy yesterday and it was indeed painful and it may have
to be taken again.  I have a very hight threshhold to pain but from what my
doctor told me each person is different and the amount of pain comes from how
tight the cervix is.  In my case he couldnt get the plastic tube into my
cervix and had to use another special tool to keep the cervix open in order to
push the tube through.  In the end he couldnt be sure if he got through even
then - he wasnt sure if the tissue taken was cervical tissue or the tissue needed
from my uteres as he couldnt be sure if he got through or not.  He also mentioned
that he did not want to take the risk of pushing through any harder than he was
as he could take the risk of puncturing my uteres (GREAT!).  Well, now I have
to wait 10 days to see if they did in fact get the right 'stuff'....

Im now scheduled for the HSG next week so I guess Ill start getting myself
psyched up for that one....

This is sooooo frustrating.

maureen

Well my HSG was last week and although it was uncomfortable it wasnt as bad as
the endo biopsy.  It seems my left fallopian tube was indeed blocked.  My doctor
wants to see if the HSG unblocks the tube before going any futher so he wants to
wait a month or 2 before any more tests are run.  In the meantime Im still 
waiting for the results from my endo biopsy.

Maureen

Well I had my HSG on Feb 27 and I am now 3 days late for my period, my BBT
temp has been way up around 98.7 for the past 3 days and Ive taken a home
preg. test that tested as positive.  I havent had a blood test yet as Im hoping
my body isnt playing a cruel joke on me.  how long should I wait before an
accurate blood test can be taken.  5 days late, 7...???

Keeping my fingers crossed


Maureen

    I believe you can have accurate blood work done within 24 hours of
    conception (I could be wrong)
    
    But, when I got pregnant with my 16 yr old, I was only 3 days late when
    I went to the Dr....  I KNEW I was pregnant!  The Dr. told me that the
    urine test would probably turn out negative, as it was too early to
    tell.  It came out positive!
    
    I wouldn't mess with the home pg test, as those can give false positive
    readings... call your Dr. and tell him/her that you are late, and you
    would like a blood test.  Tell him/her that the wait is killing you,
    and you don't think the stress is good for the situation!
    
    GOOD LUCK, my fingers are crossed (makes it hell to type)
    
    M-L

A blood test for pregnancy can be done as soon as 1 day late.  In fact,
for GIFT and IVF, the blood test is done 14 days after the procedure,
so you're technically not even late yet since that's the day the period
would start.

Call your doctor now and ask for the blood test. 

Good luck.
Cathy

re .205:

Have you taken any drugs for infertility?  HCG can give a false positive on
home pregnancy tests.

No I have not taken any drugs for infertility = we hadnt reached that point yet.
As a matter of fact I have a repeat endo biopsy w/cervical block scheduled for
April 9th that I hope Ill be able to cancel if all goes well.  I called my
doctors office and they told me they wanted me to come in after Im 5-7 days late.
I don't understand the wait.   They told me anything prior to that could give a
negative result.  More waiting ...I hate this.

Maureen

                      <<< Note 105.209 by SMURF::MKANE >>>
                             -< infertility drugs >-

Maureen,

Sounds like good news to me!  The home pregnancy tests have an accuracy
rate of 100% for us.  (4 times)

Rochelle

P.S.  I ALWAYS had a tiny bit of spotting for the first 10 days or so....
      

    You think this waiting is tough.  Let us know how the next 8+ months
    feel!!!  With my first I found out I was pregnant on November 19th, and
    had the baby June 24th - relatively short wait for a normal pregnancy. 
    With my second, I found out the day I was late (but I already "knew")
    and he was 12 days late.  I much prefer the first method!  Nine months
    is a loooonnnnggggg time....Right Monica????
    
    -sandy

    
    >>Nine months is a loooonnnnggggg time....Right Monica????
    
    Yes Ma'am!!!
    
    - Monica
    

Well I was a total of 5 days late and I started my period today.  Maybe next
time.

Heavy sigh,

Maureen

    Damn!

Sigh.  It's a familiar feeling.  After many such disappointments ("But it's
never *this* late!"), we've learned to try not to think about it.

    Sorry Maureen....keep positive thoughts for next time and know that
    our thoughts and prayers are with you.
    
    ..Lori

Thank You for all the positive replies - I ended up being put on a drug called
Anaprox this entire weekend as I was going through some Extremely heavy bleeding
to a point where if the drug didnt help I would have had to have undergone a 
D&C.  Luckily the Anaprox worked.  I now have to have protected sex for the next
cycle as I have to have a repeat endo biopsy on the 8th of April. This frustrates
me as I feel this defeats the purpose but I undertand the reason for it ....so
I guess Ive got to wait another cycle before trying again.....

Maureen

    
      HELP!!!!!!
    
       I don't know if I am placing this in the right file or not!! I hope
    so,, I have been told of a drug that is apparently very affective as a
    birth control method. The drug itself is called Depro Provera,, my
    problem is I have been told that this drug has been tested and is used
    very frequently but not for this purpose.. My question is does anyone
    know or have they heard cases where this indeed has, or can cause
    infertility.. I am still young and would like to have children possibly
    in two - three years,, but some of the stories I am hearing are pretty
    scarr
    indeed.. My doctor has assured me to no end that I would not have any
    worries,, therefore I went for a second opinion just to make sure but
    again was not satisfied with the result.. This by the way is a shot
    which is given in the upper hip once every three months....
    
    Any information possitive/negative would be greatly appreciated..
    
    Thank You..
    
    Rose..