What You Must Know About Infertility

Making a Baby: Everything You Need to Know to Get Pregnant
by Debra Fulghum Bruce, Samuel Thatcher, M.D., Ph.D.

You may have waited a long time. You may have tried and tried.
Now your chances of having a baby are better than ever!

There have been remarkable advances in fertility technology and choices in the last few years, with pregnancy success rates skyrocketing. Now Making a Baby provides the information you need to become your most fertile-and increase your chances for having the baby you've always wanted. Up-to-date, comprehensive, written with compassion and clarity, this book reveals how to protect, increase, and extend your fertility, with essential information on:

• The optimal frequency, timing, and sexual positions for getting pregnant

• Surprising new findings on which foods and exercise programs boost fertility-and which ones actually decrease your chances

• Advances in baby-boosting medications-and a complete assessment of risks, costs, and alternatives

• Breakthrough medical techniques that help achieve pregnancy without the risk of multiples

• Avoiding the common-and often hidden-threats to fertility at work, at home, and in public places

• Choosing the A.R.T. (assisted reproductive technology) that's right for you

• Special issues for midlife mothers

• What every man should know about his long-term reproductive health

• How to minimize emotional stress and keep your relationship strong

• How to work with your HMO to get the right treatments-at the right cost

This detailed, insightful, and meticulously researched book will help guide you to a wonderful new beginning as a parent!

"This was the first time in my life that I was faced with failure," 31-year-old Megan said about her inability to get pregnant. "Since I was a child, I always set lofty goals and worked hard to meet these. When my doctor said we had 'unexplained infertility,' it was as if my life was in chaos and out of my control."

Lorri had a successful dental practice and finally married her college boyfriend at age 34. "I could not believe that I was a successful pedodontist, dedicating my life to helping young children, yet I could not have my own baby. After three years of trying to conceive, we finally turned to in vitro fertilization and now are the parents of twins. But I will never forget the emotional upheavals and feelings of grief and anxiety we went through."

When 26-year-old Rob played college basketball, he suffered a groin injury that resulted in a ruptured testicle. "It doesn't take a rocket scientist to know that this problem slashes the chances of making a baby. After undergoing a battery of tests, my urologist said I have a low sperm count. Yet medical technology is amazing. Our team of doctors used some high-tech methods to sperm to fertilize my wife's eggs so we could make a healthy baby. The result? Two active boys, now ages two and four. They are my life!"

Remember how, when you were eight, you dreamed of having a family some day? For 32-year-old Jennifer, being a mother was her ultimate childhood wish.

My good friends talked about having children but also being teachers or doctors. Not me. I just wanted to stay at home and take care of babies, and I wanted a house full! Mark and I waited until our late twenties to start a family, then tried for over a year to get pregnant with no luck.

You probably know how I felt when my doctor said I was infertile due to ovulation problems. I wanted to run, to cover my head, so I didn't have to hear the words. But I couldn't escape this reality.

That was two years ago. Tonight Mark is struggling with a colicky baby who refuses to honor one o'clock in the morning as quiet time. I am rocking her twin sister, lying in my arms wide-eyed and grinning. I'm reminded of the old saw "Be careful what you wish for, you just might get it." Of course, we did more than just wish for a baby, we engineered it. At times, it has felt like we were birthing a Martian rover rather than a storybook bundle of joy.

Many people dream of having a family some day, even before they meet Mr. or Miss Right. In fact, most of us assume that making a baby the old-fashioned way is a natural birthright. After all, we are made to be sexual beings, so anyone can get pregnant, right? Wrong. For an estimated 5 to 8 million infertile couples in the United States, making a baby is difficult, if not seemingly impossible. Whether from your irregular menstrual cycles, from his reduced sperm count, or for unknown reasons, infertility is a fact of life and a vastly growing concern.

"My friends tell me it's all in my head," 37-year-old Allison said. "We've tried to get pregnant for three years now, and all my friends are either expecting or pushing strollers. If it is in my head, I need to know what therapist can help me reverse it-now." Infertility is not in your head. It is not the result of something you did as a child or rebellious acts as a teenager. Nonetheless, a chief barrier to overcoming infertility occurs when well-meaning friends and family members suggest that infertility is "imagined." You have probably heard the following statements:

• Maybe if you weren't so obsessed about getting pregnant, it would just happen.

• Since the medicine the doctor gave you didn't work, maybe it's a mental thing.

• Just relax! You're so uptight no wonder you cannot get pregnant.

• Isn't about time you had one of your own?

• Your sisters and cousins had no problem conceiving. I just can't imagine why you can't have a child.

• You can always adopt. Then you will surely get pregnant.

Who's in the Driver's Seat Now?

After trying for months to conceive-with no results-you may start to think that perhaps the high anxiety you feel is keeping you from getting pregnant. The first insidious feeling of infertility is the sense of a loss of control. Up until this point in your life, you have been in the driver's seat, controlling most of your major life decisions-whether or not to attend college, whom to marry, when to marry, what to do as your life's work, and where to live. Now, no matter what you do or how hard you try, you cannot conceive a child. This may be the first major decision in your life over which you have no control.

You must know that infertility-no matter which type you encounter (see Table 1.1)-is not in your head; it is a very real disease of the reproductive system that impairs one of your body's most basic functions: the conception or making of a baby.

Table 1.1    Types of Infertility

Infertile    When a successful pregnancy has not occurred after more than one year of unprotected sex

Primary infertility    Infertility without a previous pregnancy

Secondary infertility    Infertility with a previous pregnancy

Sterility    No chance of conceiving

You Have Great Company

Studies show that 15 and 20 percent of reproductive-age couples in the United States have difficulty becoming pregnant, and the causes are multifaceted. Some cases are due to easily identified medical problems or diseases and success depends on conventional medical treatment, including drugs and surgery. Other causes include lifestyle problems such as diet, overuse of alcohol, or use of recreational drugs, requiring a natural, drug-free, mind/body approach.

Fertility Treatments Have Come a Long Way

Although twenty years ago, the diagnosis of infertility was etched in stone, times have dramatically changed since then. Comprehensive research indicates about 90 percent of all diagnosed infertility cases can be linked to definite reasons, and two out of every three infertile couples who seek medical answers are able to have children. Seeking medical answers is the first step to increasing your odds of getting pregnant. Once you understand the causes of infertility-know which treatments are likely to be effective, and which probably will not work well-you can begin to manage infertility just as you do other areas of your life.

Treatment may be as simple as proper timing of intercourse with ovulation. Other, more aggressive therapies might include ovulation drugs (see Chapter 13) to assisted reproduction, or egg, or sperm donation, as discussed in Chapter 14. Knowing that the statistics of making a baby may be changed in your favor can motivate you to dig in and understand what causes infertility, get to know your own body, make important lifestyle changes you can control, and experiment until you find the best treatment available.

Truth or Myth?

If you or someone you love has been diagnosed as infertile, much of the anxiety and distress may result from a lack of knowledge about this disease. Not only are there fears about upcoming medical tests or invasive procedures, but the uncertainty about your future family can be overwhelming. While a quick fix for infertility may not be possible, using the large amount of information in this book, you can learn how the reproductive system functions, along with low- and high-tech solutions to making a baby.

Before you begin reading the ins and outs of infertility and treatment, check the following beliefs to determine your Baby-Making IQ (Infertility Quotient).

BABY-MAKING IQ (INFERTILITY QUOTIENT)

TRUE	FALSE
——	——	1. Infertility is a woman's problem
——	——	2. Everyone else gets pregnant when they choose.
——	——	3. If I could just relax or quit my job, I know I'd get pregnant.
——	——	4. I think infertility is all in my head.
——	——	5. If we try long enough, we're bound to get pregnant someday.
——	——	6. Maybe we're not meant to be parents.
——	——	7. If we adopt a newborn, it's easier to get pregnant.
——	——	8. Infertility is a sign that we're not sexually compatible.
——	——	9. My doctor tells me that I'm too thin, but I think if I could lose a bit more weight, it might be easier to get pregnant.
——	——	10. Because my doctor said I'm infertile, that means I'm sterile.
——	——	11. We're in our late thirties, so it's too late to even consider making a baby.
——	——	12. If we delay having children while we develop our careers, the chances of having a baby grow dim.
——	——	13. I'm not only infertile, but I'm single, and there's no hope for me to have a baby.
——	——	14. We cannot afford infertility treatments, and health insurance companies don't touch this.
——	——	15. We need to have sexual intercourse at least once a day to overcome infertility.

Excerpted from Making a Baby by Debra Fulghum Bruce and Samuel Thatcher, M.D., Ph.D. Copyright © 2000 by Debra Fulghum Bruce and Samuel Thatcher, M.D., Ph.D.. Excerpted by permission of Ballantine Books, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

About the Author

Debra Fulghum Bruce is an expert health writer who has published more than 2,500 magazine articles and authors or coauthored many books, including The Super Aspirin Cure for Arthritis and the Snoring Cure. She lives in Atlanta, Georgia.

Medical editor Sam Thatcher, M.D., Ph.D., is a reproductive endocrinologist and directory at the Center for Applied Reproductive Science in Johnson City, Tennessee. He received his training in reproductive medicine at Yale and Edinburgh Universities. He is a noted educator and patient advocate with numerous clinical and scientific publications.