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Infertility FAQ (part 1/4)

( Part1 - Part2 - Part3 - Part4 )
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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

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