Contents

Foreword by Nathaniel Zoneraich, M.D. xi

Acknowledgments xiii

CHAPTER 1 The Causes of Infertility 1

The Definition of Infertility 2

The Roller Coaster of Emotions 2

Potential Causes of Infertility 2 Causes of Infertility: Health and Lifestyle Concerns for Women 3

Specific Causes of Infertility for Women 9 Causes of Infertility: Health and Lifestyle Concerns for Men 19

Specific Causes of Infertility for Men 22

Unexplained Infertility 24

Conclusion 25

Summary 26

CHAPTER 2 Miscarriage and Other Early Pregnancy Loss 29

Introduction to Early Pregnancy Loss 30

Miscarriage 30

Recurrent Miscarriages 32

Ectopic Pregnancy 42

Molar Pregnancy 45

Coping Emotionally with Early Pregnancy Loss 47 Positive Actions You Can Take to Reduce the Chance of Early Pregnancy Loss 49

viii

Contents

Conclusion 49

Summary 50

CHAPTER 3 Basic Male and Female Anatomy and How

Things Work 53

Male Reproductive Anatomy 54

How the Male Reproductive Process Works 57

Female Reproductive Anatomy 58

How the Female Reproductive Cycle Works 62

Fertilization 64

Conclusion 67

Summary 67

CHAPTER 4 Testing for Infertility 71

Types of Doctors: What's the Difference? 71

Finding a Fertility Specialist 73

You've Chosen Your Specialist—Now What? 76

Fertility Testing for Women 77

Fertility Testing for Men 83

Conclusion 90

Summary 91

CHAPTER 5 Natural Ways to Become Pregnant 93

Diet and Nutrition 94

Healthy Weight 95

Keeping Fit 97

Reduce Your Stress 98

Vitamins and Nutrients 98

Lifestyle: Things to Avoid 103

Natural Ways to Monitor Your Own Fertility 107

Other Natural Ways to Maximize Your Fertility 111 Alternative Medicine: Exploring Nonconventional

Treatments 114

Conclusion 116

Summary 117

Contents

CHAPTER 6 Fertility Drug Therapies 121

Clomiphene Citrate (Clomid, Serophene, CC) 121 Gonadotropins (Follistim, Gonal-F, Bravelle [FSH]

and Repronex, Menopur [FSH and LH]) 125 Gonadotropin-Releasing Hormone Agonists (GnRHa)

(Lupron, Synarel, Nafarelin, Buserelin) 129 Gonadotropin-Releasing Hormone (GnRH) Antagonists

(Cetrotide, Ganirelix) 132 Human Chorionic Gonadotropin (hCG) (Novarel,

Pregnyl, Profasi, Ovidrel) 134

Bromocriptine (Parlodel) 136 Progesterone (Progesterone in Oil, Vaginal Suppositories, Crinone Gel, Prometrium,

Provera) 139

Aspirin and Heparin 143

Risks: Ovarian Hyperstimulation Syndrome (OHSS) 145

Conclusion 146

Summary 147

CHAPTER 7 Assisted Reproductive Technologies (ARTs) 151

Intrauterine Insemination (IUI) 152

In Vitro Fertilization (IVF) 156

Intracytoplasmic Sperm Injection (ICSI) 162

Embryo Assisted Hatching 166

Cryopreservation 166 What About Gamete Intrafallopian Transfer (GIFT)

and Zygote Intrafallopian Transfer (ZIFT)? 168

Conclusion 169

Summary 169

CHAPTER 8 Moving On: Alternatives for the Infertile Couple 173

Sperm Donation 174

Egg Donation 176

Embryo Donation 179

Surrogacy 183

Contents

Adoption 185

Conclusion 187

Summary 187

CHAPTER 9 Emotional Issues 193

Dealing with Others 195

Fertility Counselors 200

Conclusion 202

Summary 202

CHAPTER 10 New and Emerging Technologies 207

Preimplantation Genetic Diagnosis (PGD) 207

MicroSort 212

Ovarian Tissue and Egg Freezing 215 Emerging Technologies Not Yet Available in the United States 217

Conclusion 221

Summary 221

CHAPTER 11 Ethical Considerations and Decision Making 223

Assisted Reproductive Technology (ART) 224 Third-Party Reproduction: Sperm, Egg, and

Embryo Donation 225

Surrogacy 227

Sex Selection 229

Selective Reduction in Multiple Pregnancies 230

Cloning 230

Interesting Ethical Scenario 231

Conclusion 231

Summary 232

Glossary 235

References 243

Index 251

100 Pregnancy Tips

100 Pregnancy Tips

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