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Archive-name: medicine/infertility-faq/part1
Posting-frequency: weekly Last Modified: May 14, 2001 URL: http://www.fertilityplus.org/faq/infertility.html See reader questions & answers on this topic! - Help others by sharing your knowledge This FAQ is maintained and updated by Rebecca Smith Waddell. Copyright (c) 1997, 1998, 1999, 2000 by Rebecca Smith Waddell, Meg Fiegenschue, Lynn Diana Gazis-Sax, William F. Panak, Rachel Browne, Jennifer Clabaugh, Kate MacKenzie, and Ian Scott Speirs. All rights reserved. Information in this FAQ may be distributed as long as full copyright information is attached, including URL, and use is strictly not for profit. ______________________________________________________________________ ______________________________________________________________________ SECTION 1 - DISCLAIMER This FAQ is intended to provide some basic information about the alt.infertility and misc.health.infertility newsgroups as well as a very general overview of infertility in as simple terms as possible. It is not intended as medical advice. The accuracy of the information is not guaranteed and the authors are not responsible for how readers use this information. ________________________________________________________________________ ________________________________________________________________________ SECTION 2 - TABLE OF CONTENTS 1. Disclaimer 2. Table of Contents 3. Defining Infertility 4. Infertility and Related Newgroups 5. Netiquette for alt.infertility and misc.health.infertility 6. Getting Ready to Seek Medical Help 7. Infertility Tests 7.1 Evaluation Process for Men 7.2 Evaluation Process for Women 8. Common Causes of Infertility 8.1 Causes of Infertility in Men 8.2 Causes of Infertility in Women 9. Treating Infertility 9.1 Treating Male Factor Infertility 9.2 Treating Female Factor Infertility 9.2a Corrective Surgeries for Women 9.3 Drugs Commonly Used in Infertility Treatment 9.4 Assisted Reproduction Techniques 10. Infertility Insurance 11. Recommended Reading 11.1 Books 11.1a Online Sources for Ordering Infertility Books 11.2 Periodicals 12. Links to More FAQs and Internet Resources 12.1 Places to Start 12.2 Infertility FAQs 13. Statistics 13.1 Pregnancy Rates for Average Couples 13.2 Success Rates for ICI, IUI, ITI 13.3 Success Rates for IVF, GIFT and ZIFT 13.4 Cumulative Odds of Success Through Multiple Cycles 14. Acronyms and Abbreviations 14.1 Newsgroup Specific Acronyms and Abbreviations 14.2 General Internet Abbreviations 15. Appendix 15.1 Charter for misc.health.infertility ________________________________________________________________________ ________________________________________________________________________ SECTION 3 - DEFINING INFERTILITY Infertility is a disease or condition of the reproductive system resulting in the inability to conceive after one year of unprotected well-timed intercourse. Infertility also includes the inability to carry a pregnancy to the delivery of a live baby. Infertility is a medical condition, not a sexual disorder. Sperm can be inseminated for 12 well-timed cycles as a measure of infertility for women with no male partner or for couples unable to have normal intercourse for medical reasons. There are some cases of inability to conceive due to failure to achieve intercourse for medical reasons, such as spinal injury in the male partner. One in every six couples of childbearing age have a problem conceiving. Over 80% of all infertile couples can be helped to achieve pregnancy with proper medical treatment. Infertility is a female problem in 35% of the cases, a male problem in 35% of the cases, a combined problem of the couple in 20% of cases, and unexplained in 10% of cases. It is essential that both the man and the woman be evaluated during an infertility work-up. Most physicians advise you not to be concerned unless you have been trying to conceive for at least one year. If the female partner is over 30 years old, has a history of pelvic inflammatory disease, painful periods, recurrent miscarriage, or irregular periods then it might be prudent to seek help sooner. Waiting only 6 months before having an initial consultation for women 35 years and older is often recommended since if a problem is found there is less time for correction. If the male partner has a known or suspected low sperm count, then it would also be prudent to seek help sooner than waiting a year. RESOLVE Inc. is a support group with information about infertility. Resolve is online at http://www.resolve.org. ________________________________________________________________________ ________________________________________________________________________ SECTION 4 - INFERTILITY AND RELATED NEWGROUPS news:alt.infertility This newsgroup relates to all issues related to infertility. Some discussions might include: - Impact infertility has on self-image and self-esteem. - Impact infertility has on a couple's relationship. - Impact infertility has on relationship with family and friends. - Impact of infertility on jobs and dealing with co-workers. - Dealing with the fertile world (pregnant women everywhere). - Doctor-patient relationship issues. - Advice on finding and personal recommendations of doctors and clinics. - Discussion on low-tech methods of improving the odds of pregnancy. - Medical diagnosis and treatments (personal stories and advice). - Medical discussions range from the setting up of the first doctor consultation to doing high-tech treatments like in-vitro and new areas such as immunological infertility. - Emotional and medical issues related to pregnancy loss after infertility treatment, as well as infertility resulting from inability to carry a pregnancy to live birth. - Alternative medical methods (acupuncture, herbs, visualization . . .) - Coping methods of dealing with stress and treatments. - How personal beliefs (religion) overlaps with infertility. - Money and insurance issues related to paying for treatments. - Humor by those who have been there. - Emotional vents about anything related to infertility issues. - Pregnancy announcements, which include brief personal history. - Adoption as a family building choice. - Discussion about life without being a parent (childfree choice). - Discussion about using donor sperm, donor egg, or surrogacy. - Other miscellaneous topics related to life while infertile. news:misc.health.infertility Discussions about medical issues related to treating infertility. Messages are often cross posted from alt.infertility since not everyone gets the alt groups. news:alt.infertility.pregnancy Created in Fall of 1996 by Jamie (survey done by Meg F.) This group addresses the unique emotional aspects of pregnancy after the struggles of infertility. The group is in addition to an on-going email list of over 100 members called 'Panfert'. The pregnancy group is for special emotional support for those who have achieved pregnancy after enduring infertility. The group is for the special support of those who will understand the conflicting feelings of finally achieving pregnancy with the normal need to discuss the discomforts and changes that occur during pregnancy. The group provides a forum for those who will also understand the fear and uncertainty often felt by women who are pregnant after infertility. The main pregnancy group news:misc.kids.pregnancy can be full of difficult posts for women finally pregnant after infertility. news:alt.infertility.secondary Created Fall of 1996 by Debbie Catalano (no FAQ or charter available) Secondary infertility is the inability to conceive again after one or more successful pregnancies. This group is open to all who wish to discuss infertility, but be aware that most in the group have already successfully birthed and are raising at least one child. Some in the group have multiple children in their home. Children are discussed in many posts. The group hopes to have an open forum for anyone wishing to discuss infertility issues along with discussion of children. The group primarily encompasses emotional issues related to secondary infertility. Parenting after infertility is also discussed. The group includes those who had no prior infertility with having a child/children, but are now experiencing trouble achieving another pregnancy. The group also includes those who have had prior infertility perhaps of long duration involving extensive treatment to have a child/children and are now trying to achieve another pregnancy. Cross posting to other infertility groups should be avoided to prevent inadvertent upset by the mentioning of children to those who may be feeling sensitive. Some discussions might include: - Fear of a growing age difference between siblings. - Concerns of having an only child. - A child asking for a sibling. - Pressure by society to have a second child. - Overprotection issues of raising an only child. - Discussions about adoption as way to raise additional children. - Fertile friends, family, and co-workers having children easily. - Finding a babysitter so you can have medical treatment. news:alt.infertility.primary Created Fall of 1996 by Rick and Becky Steele Newsgroup FAQ written by founders posted at: http://www.fertilityplus.org/faq/primaryfaq.html Primary infertility is infertility without ever conceiving or successfully carrying a pregnancy to a live birth. The group also welcomes anyone without any living biological children after suffering infertility. Those who have biological children, even after infertility, should be prepared for not being welcome on this group. The group is for the emotional issues related to primary infertility (those with no living biological children as defined in the FAQ for the primary sub-group). Cross posting to or from other infertility groups should be avoided!! Posting by any other than primary infertiles as defined for this group should be avoided. Anyone with biological children, even if after enduring infertility, should probably avoid posting or making comments on this group to prevent possible hurt feelings. This group is a sanctuary for the special and sometimes strong feelings for those who do not and may NEVER have biological children after infertility. Some discussions might include: - "Any topic written by a primary infertile discussing any range of emotions, or opinions." - from FAQ. - Strong feelings related to coming to terms with never having a biological child. - Jealousy and comments about others being parents or being pregnant. - Living a life without being a parent (childfree choice). - Adoption as a way to build a family. - Frustrations of being a step-parent only. - Venting of many very strong emotions. - Discussions to keep the group solely for those without biological children (yet). news:alt.infertility.parenting Created in August 1999 by Alyson Peltz Newsgroup FAQ posted at: http://www.fertilityplus.org/faq/parenting.html The newsgroup alt.infertility.parenting is set up to be a natural progression from alt.infertility and alt.infertility.pregnancy. It is for the discussion of all emotional and practical aspects of parenting after conceiving as a result of infertility treatments or parenting after adoption. This could include discussions about how people are coping with parenthood and discussions about the emotional aspects of undergoing treatment again for another child. Another topic for discussion would be practical suggestions for those having difficulty dealing with their new family. news:alt.infertility.alternatives Created February 1997 by Rick and Becky Steele "Alt.infertility.alternatives will be a place to explore the alternatives to a medical resolution to infertility. Among these are adoption, foster parenting, and child free living. It will be a place for the discussion of these subjects as well as moving on from treatment. It will be a place to learn from each other the processes we are going through and sharing the pitfalls and the joys." - from FAQ news:alt.infertility.surrogacy Infertility group for the discussion of issues related to gestational and traditional surrogacy. Information on surrogacy can be found at: http://www.surrogacy.com and http://www.surroparenting.com. news:sci.med.obgyn A moderated group to discuss the science and practice of obstetrics and gynecology (OBGYN). The newsgroup includes professionals, researchers & general public. Posts should be kept as impersonally stated as possible. This group provides a good source to ask questions to medical professionals in the area of OBGYN. news:soc.support.pregnancy.loss http://web.co.nz/~katef/sspl/ includes FAQ on Tips & Suggestions for Coping after Pregnancy Loss and the soc.support.pregnancy.loss charter. This newsgroup is for discussing all aspects of pregnancy loss. "Its objective is to provide support and information for everyone experiencing or concerned about the trauma of miscarriage (including blighted ovum), ectopic pregnancy, therapeutic terminations, still birth or neo-natal death. Postings should be supportive and non-judgmental." - from Charter news:alt.support.pco PCOS is Polycystic Ovarian Syndrome. PCOS is the most common endocrine disorder, affecting approximately 6% of premenopausal women. The condition is characterized by multiple small, follicular cysts of the ovaries, irregular or absent menses, excessive body hair growth, insulin resistance and infertility. Information on PCOS is available at: http://www.pcosupport.org and http://www.inciid.org/faq/pcos.html news:alt.support.endometriosis and news:alt.med.endometriosis Endometriosis is a condition in which tissue resembling uterine lining occurs outside the uterus, such as the ovaries, Fallopian tubes and pelvic ligaments. Symptoms may include pain with menstruation or intercourse. Endometriosis is quite commonly associated with infertility. Information on endometriosis is available at: http://www.bioscience.org/books/endomet/babaknia.htm news:alt.support.des This is a group to discuss the problems associated with prenatal exposure to diethylstilbestrol (DES). Tubal (ectopic) pregnancies, miscarriages, premature labor, and both male and female infertility are all relatively prevalent in the offspring of women exposed to DES during the first half of pregnancy. A large study was recently completed and it is now known that over 50% of people exposed in-utero to DES suffer infertility and/or pregnancy problems. DES information and FAQs website by Prof. Sally Keely at: http://www.teleport.com/~skeely/ DES Daughters Listserv Website at http://www.surrogacy.com/online_support/des/ ________________________________________________________________________ ________________________________________________________________________ SECTION 5 - NETIQUETTE FOR ALT.INFERTILITY AND MISC.HEALTH.INFERTILITY Electronic communication is a relatively new phenomena when compared to the age-old standards of proper behavior (e.g., what Mom told us to do, and what Miss Manners continues to tell us to do). Fortunately, the standards of polite society work just fine within electronic communities and USENET communication. Occasionally, due to the impersonal nature of USENET communication, conflicts and arguments can arise. The purpose of this netiquette section is to assist new USENET users in general, and users of the infertility-related USENET newsgroups in particular, in avoiding improper behavior on the Internet. Persons who are new to USENET newsgroup participation may benefit from reviewing general netiquette standards. World Wide Web copies of these standards is available here: http://www.fau.edu/rinaldi/netiquette.html and here: http://access.tucson.org/zen/zen-1.0_6.html#SEC44 A more global overview of Internet communications can be found here: http://access.tucson.org/zen/zen-1.0_toc.html Additional insights into the Internet culture can be found here: http://www.fau.edu/rinaldi/net/culture.html In general, the rules of USENET netiquette can be summarized briefly: 1. Do not type messages in all uppercase letters; this is considered as shouting and is most appropriate only in USENET headers that are of interest to a wide audience, and as emphasis within a message. 2. Avoid unnecessary and prolonged debates on controversial issues. These debates can deteriorate into flaming which is not needed in the a.i./m.h.i. newsgroups. 3. When involved in a debate, consider moving the discussion from the USENET newsgroup to private e-mail. 4. Do not post back to the newsgroup any information that was received through private e-mail. This is considered very bad netiquette. 5. Do not cross-post messages to inappropriate newsgroups. This last general rule has specific importance for the specialized infertility newsgroups such as alt.infertility.primary, alt.infertility.secondary. In general, pregnancy announcements that are posted to a.i/m.h.i should not be cross-posted to a.i.p and a.i.s. because a.i./m.h.i. are open forums for all infertility-related issues whereas a.i.p., for example, focuses on issues that are specific to those dealing with primary infertility. Discussions of how to deal with a child who wants a sibling should be kept to a.i and a.i.s. Posts about how it feels to not have children should be kept to a.i and a.i.p. Please note that subgroups are primarily for discussion of emotional aspects of infertility and medical/treatment questions should be posted to a.i/m.h.i. 6. Do not post graphics (photos, drawings, etc.) as attachments or part of your signature file. It is considered rude as it takes longer to download and costs some people more money. If you want to share a picture, post a link. In addition to these general USENET netiquette rules, there are some specific a.i./m.h.i. netiquette procedures. For example, it has become common practice to add a "sensitivity tag" and give people a little warning in the subject header for certain kinds of posts: (pg) in pregnancy posts (child) for child mentioned (vent) for emotional vent The pregnancy and child tags should be used whenever either topic is mentioned, even if only in one's signature. These "sensitivity tags" or "warning tags" can be modified and used whenever a USENET participant is posting information that may not \be of interest to all newsgroup participants, such as: (abortion mentioned) (religion mentioned) (miscarriage mentioned) or (mc) (newborn mentioned) (humor) Because the a.i./m.h.i. newsgroups have specific protocols for announcing pregnancies, births, etc., there is always the opportunity for a well-meaning new participant to violate netiquette standards of the group. In those situations, it is best to unobtrusively message the new participant through e-mail, encourage them to read the FAQ section on netiquette, and assure the new participant that violations of netiquette standards by "newbies" are quickly forgotten. Also, the fact that a warning tag did not appear does not mean that netiquette was violated. Each participant in the a.i./m.h.i. newsgroups has the ability to stop reading a post or a thread of posts whenever he/she becomes uncomfortable with or offended by the material. In other words, the conclusion that "netiquette was violated" cannot be logically drawn from the premise of "your post made me feel uncomfortable". Finally, all a.i./m.h.i. participants should realize that not everyone views infertility in the same way that we, the conceptionally challenged, do. Infertility is one of many interrelated issues (including abortion, adoption and related moral and religious beliefs) that are seen as controversial by many people. Because infertility and infertility treatments are sometimes seen by others as a controversial issue, there is an increased likelihood that flame-trollers with less-than-helpful motives may lurk the groups, looking for opportunities to stir dissension. For clarification, a flame-troller is an individual who participates in a newsgroup for the primary reason of stirring up controversy. This can be distinguished from a well-meaning participant who creates or contributes to a controversial discussion. Flame-trollers can be particularly disruptive for newsgroup participants because of the ability of a flame-troller to post information anonymously and forge e-mail addresses to essentially create conflicts among newsgroup participants. Flame-trollers can often be recognized by the inflammatory statements within their posts, the level of controversy associated with their posts, and, most importantly, a reader's strong negative reaction to these posts. It is best to avoid labeling anyone a flame-troller and try to ignore posts by not responding either through the newsgroup or privately through e-mail. Flame-trollers quickly disappear when they are ignored, but they will remain so long as attention is paid to them. If a controversial post originated from a well-meaning participant, this will usually become apparent through the way that the person responds within the current discussion thread or in subsequent threads. In general, it is better to ignore those things that offend you than to draw more attention to those things through follow-up posts. Commercial posts, for the most part, are not welcome on a.i/m.h.i. Anything that does not have to do with infertility is inappropriate, as is anything that provides no real information and just tries to sell a product. ________________________________________________________________________ ________________________________________________________________________ SECTION 6 - GETTING READY TO SEEK MEDICAL HELP The first thing you need to do is decide how you want to start. For couples who haven't been trying for 6-12 months, it may be worth working on timing intercourse and gathering information for a few months before seeking medical help -- for example, taking basal body temperature and using ovulation predictor kits. If you suspect ovulation problems -- having long cycles, discomfort, any recent change in cycling, etc. -- or suspect a problem with sperm production, seeking medical help as early as possible makes sense. There are three specialists infertile couples are referred to: a gynecologist (OBGYN), a reproductive endocrinologist (RE), and a urologist for male factor. An OBGYN will be able to help women with simple fertility problems, but even one that claims a specialty in infertility probably has fewer credentials than an RE. The advantage to seeing an RE is that getting people pregnant is all they really do, and they tend to be more aggressive in looking for the problem as well as in treating infertility. Most likely one would get more thorough monitoring with an RE as well. It's a good idea to have both the man and woman checked at the same time. Having a semen analysis before the woman goes through any invasive tests makes a lot of sense in order to prevent any unnecessary discomfort. A general practitioner, OBGYN, RE or urologist can order this test. Often couples need to see their primary care physician in order to get a referral. You may wish to do a bit of homework to find out about good doctors in your area -- a good place to check in the U.S. is RESOLVE, http://www.resolve.org -- and also find out what your insurance will cover costs if you don't have ample funds to cover treatment. Once you have a referral, make sure all relevant medical records are forwarded to the doctor and also send any of the information you've been gathering ahead of time. Make a list of questions you want to ask at your first appointment and bring paper and a pen so you can take some notes. Ask questions about anything you don't understand and try to participate in your treatment and in the development of a plan. ______________________________________________________________________ ______________________________________________________________________ continued in Infertility FAQ (part 2/4) ~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~ mailto:bec@fertilityplus.org Fertility FAQs and Info - by patients, for patients http://www.fertilityplus.org/toc.html User Contributions:Comment about this article, ask questions, or add new information about this topic: |
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