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Infertility FAQ (part 3/4)

( Part1 - Part2 - Part3 - Part4 )
[ Usenet FAQs | Web FAQs | Documents | RFC Index | Forum archive ]
Archive-name: medicine/infertility-faq/part3
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 9 - TREATING INFERTILITY

Please note, information on drugs mentioned appears after the male and female
sections, as does methods of impregnation (IUI, IVF).

------------------------------------------------------------------------

9.1 - TREATING MALE FACTOR

Varicocele: The options are either surgery to close it off, or balloon insertion
to block the blood flow.

ICSI: Done in conjunction with IVF. After the eggs are retrieved, a single sperm
is injected into each mature egg. Stats on ICSI vary _widely_ from clinic to
clinic. It is a good idea to check out the clinic and the embryologist for their
ICSI statistics before doing ICSI. A fertilization rate of at least 50-60%
should be expected with a good clinic and currently the better clinics have a
35-45% ongoing pregnancy rate. (needle aspiration of sperm, inject in egg,
implant egg again, supposed to work even with quite low sperm counts).

For retrograde ejaculation: antihistamines and alpha-sympathomimetics.

For idiopathic oligospermia: Antiestrogens, such as clomiphene citrate (Clomid
and Serophene) and tamoxifen can increase sperm density and motility. Sporadic
success has been reported with testoractone. hCG has had some positive results,
but they aren't solidly reproducible. GnRH (in early stages of investigation).

Of questionable benefit or outmoded: testosterone, arginine, bromocryptine
(other than for hyperprolactemia), corticosteroids, thyroxin, oxytocin. (This
list from "Male Infertility," by Larry Lipshultz, MD, and Serono Syposium. There
seems to be a lot of controversy about which infertility treatments are
worthwhile, so some of these may still be being debated.) Note: Larry Lipshultz
is a highly regarded urologist who specializes in male infertility. He is
located at the Baylor College of Medicine in Houston, Texas.

Coffee and vitamin C are claimed to improve sperm motility. There is conflicting
evidence on whether caffeine is good or bad for sperm counts. Caffeine added to
washed sperm does help motility, but whether caffeine taken internally will help
is questionable. Vitamin C does have a tendency to help other vitamins absorb.

Vitamin E: May help sperm attach better to the egg. Recommended dose is 600 mg
per day. An improvement was shown in sperm function on the zona binding test,
which may help increases chances of pregnancy.

Vitamins and herbs: Rachel Browne has suggested the following formula which
seems to have helped her husband: multi vitamin (without iron but with zinc), 1
mg C, 1000 mg l-arginine, 200 IU E, Bee Pollen and Siberian Ginseng in 500 mg
pills, 100 mcg selenium, high potency B-complex, and 250 mg l-carnitine. His
multi vitamins have: 10000IU beta carotene, 400 IU D, 150 mg C, 100 IU E, 25 mg
B1, 25 mg B2, 25 mg B6, 100 mcg B12, 100 mcg niacinamide, 50 mg pantothenic
acid, 300 mcg biotin, 400 mcg folic acid, 25 mg PABA, 25 mg choline bitartate,
25 mg inositol, 25 mg calcium, 7.2 mg magnesium, 5 mg potassium, and 15 mg zinc.

Microsurgical epididymal sperm aspiration (MESA), testicular sperm aspiration or
extraction (TESA, TESE) and percutaneous epididymal sperm aspiration (PESA):
MESA, TESA,PESA and other forms of retrieving sperm are used when there is no
sperm in the ejaculate are used in conjunction with IVF and often with ICSI.
Depending on where this is done, it can be done with a needle, a microscopic
needle, or surgery. See http://www.ihr.com/bafertil/articles/azoosper.htm or
http://www.maleinfertility.org/new-retrieval2.html

Other treatments include surgery to remove blockage, vasectomy reversal (of
course), and some kind of gadget which men wear to cool the scrotum area.

------------------------------------------------------------------------

9.2 - TREATING FEMALE FACTOR INFERTILITY

Anovulation, irregular ovulation, and weak ovulation: All are treated with
clomiphene citrate, menotropins (Pergonal, Humegon), and urofollitropins
(Metrodin, Fertinex) to enhance follicle production. Some women also treat this
problem with accupuncture or herbs. Check
http://www.healthy.net/clinic/therapy/chinmed/specifics/fertility.htm for more
information.

Endometriosis: Some can be removed with laser during laparoscopy. Also treated
with Danazol, Lupron or birth control pills.

Polycystic ovaries (PCO): Can be treated by using superovulation drugs,
steroids, and ovarian surgeries mentioned below. Current studies are looking
into the use of GnRH.

Immune problems: Some autoimmune problems are treated with low-dose aspirin and
Heparin. Alloimmune problems are treated with paternal white blood cell
immunization and IVIg. See http://www.inciid.org for more information.

Adhesions and scarring: Treated with laparoscopy and hysteroscopy for laser
removal of scar tissue.

Infectious: STDs and PID are treated with antibiotics when possible. May also
require surgery for adhesions and scarring.

Recurrent miscarriage/pregnancy loss: If a cause can be found, it usually lies
within one of the above-mentioned fertility problems, such as an immune problem
or infectious disease. See http://www.fertilityplus.org/faq/miscarriage/rpl.html
for testing information.

------------------------------------------------------------------------

9.2a - Corrective Surgeries for Wowen

Laparoscopy: Often used to laser out endometriosis. Brief description and
personal experiences are posted at
http://www.fertilityplus.org/faq/itests.html#lap1

Hysteroscopy: used to remove fibroids and correct septums. Brief description and
personal experiences are posted at
http://www.fertilityplus.org/faq/itests.html#hyst1

Tuboplasty: Plastic or reconstructive surgery to correct abnormalities in the
fallopian tube.

Fimbrioplasty: Plastic surgery on the fimbria, finger-like projections at the
end of the fallopian tube that capture the egg from the ovary and deliver it
into the tube.

Ovarian drilling: Process of putting several holes in polycystic ovaries to
increase chances of ovulation.

Ovarian wedge resection: surgical removal of a portion of a polycystic ovary to
increase the chance of ovulation.

------------------------------------------------------------------------

9.3 Drugs Commonly Used in Infertility Treatment

Aspirin (low-dose or "baby" -- usually 81-82 mg): Used in treatment of immune
problems such as presence of anti-phospholipid antibodies or the lupus
anticoagulant -- mostly in conjunction with Heparin. Also used by some to
increase thickness of the uterine lining. Basically to prevent clotting in the
lining. Very few side effects are observed with low-dose aspirin. Full-strength
aspirin and NSAIDs such as Advil and Aleve should not be used as they may
interfere with ovulation and reduce the chance or pregnancy. Check
http://www.ivf.com/immune.html for information on aspirin therapy in pregnancy.
Check http://www.fertilityplus.org/faq/nsaids.html for more information on
ovulatory problems related to these drugs. 

Birth control pills: Commonly used for suppression of the ovaries prior to a
stimulated cycles. Common side effects include headaches, weight gain, light
periods, mid-cycle spotting, and elevated blood pressure.

Bromocriptine, brand Parlodel: Used for reduction of prolactin levels in both
men and women. Side effects include dizziness and drowsiness, as well as more
serious ones such as convulsions, black stool, nervousness, shortness of breath,
and more.

Clomiphene citrate, brands Clomid and Serophene: Used to induce or enhance
ovulation in women by stimulating the hypothalamus to release more GnRH and the
pituitary to produce more LH and FSH. Common side effects include drying of
cervical mucus, headaches, dizziness, cramping, hot flashes, moodiness, sore
breasts, stomach upset, bloating, vision problems, skin rash thinning of uterine
lining and formation of cysts. For men, it is used to lower estrogen and to
increase LH and FSH to increase sperm counts. See
http://www.fertilitext.org/clomid.htm and
http://www.serono-usa.com/fertility/serophene.html.

Conjugated estrogens, brands, Premarin, Premaril and many others: Given mostly
as hormone replacement. Side effects for men include muscle spasms, weakness,
numbness, shortness of breath, change in vision, and headache. In women it can
cause profuse bleeding. In both sexes it may cause increased chance of yeast
infection, hair loss, acne or rashes, gastrointestinal problems, nausea and
vomiting. Premarin info http://www.premarin.com/.

Danazol, brand Danocrine: Synthetic androgen used to treat endometriosis.
side effects include acne and oily skin, muscle cramps, weight gain, swelling of
feet or lower legs, tiredness and weakness.

Estradiol: Given often after IVF to keep E2 levels up. Side effects include
nausea and bloating.

Follitropins, alpha and beta,(recominant FSH, R-FSH, R-hFSH) brands Follistim,
Gonal-F, Puregon: Recombinant FSH (lab made, rather than made from urine of post
menopausal women), most often used for superovulation. Received through
subcutaneous injection, though Follistim is approved for intramuscular injection
in obese women. side effects include hyperstimulation, abdominal and pelvic pain
and bloating. Follistim info
http://www.organoninc.com/products/consumer/follistim/follistim_c.html, Gonal-F
info http://www.serono-usa.com/fertility/gonal_f.html.

GnRH-antagonist, ganirelix acetate, brand Antagon: Used to inhibit premature
luteinizing horomone (LH) surges in women undergoing controlled ovarian
hyperstimulation (COH). It's use is similar to Lupron, but it is newer on the
market and has the added benefit of shortening up the IVF cycle. Side effects
include abdominal pain, headache, ovarian hyperstimulation, vaginal bleeding,
injection site reaction, nausea, and gastrointestinal discomfort. More info:
http://www.organoninc.com/pi/antagon/antagon.html.

Glitazones, brands Actos (pioglitzone) and Avandia (rosiglitazone): These are
insulin-sensitizing meds used primarily for diabetics, but gaining popularity in
the treatment of insulin resistance in women with PCOS. These medications are
usually tolerated better than metformin, and may be more effective in improving
glucose tolerance. The downside is that they are less likely to assist weight
reduction (if desired) and they are both Pregnancy Category C medications and
most doctors will want to take patients off the medication once a pregnancy is
achieved. Liver function should be monitored quarterly while on these meds, and
patients should be aware of signs of liver troubles such as jaundice, dark
urine, vomiting and stomach pain. The most common side effect is headaches.
Check http://www.actos.com, http://www.avandia.com  and
http://www.inciid.org/faq/pcos.html for more information.

Gonadotropin releasing hormone (GnRH): Used in treating PCO and low sperm count.

Guaifenesin, brand Robitussin (many generics available): Used to thin cervical
mucus. Recommended dose is 2 teaspoons three times per day with a full glass of
water. Should be taken starting 5 days prior to ovulation and continued until
ovulation has occurred. Side effects include nausea and gastrointestinal
problems. Check http://www.fertilityplus.org/faq/cm.html.

Heparin: Used in treatment of immune problems -- to prevent blood clotting in
the uterine lining. This is an anticoagulant which may have side effects such as
nosebleeds, blood in urine or stool, and bruising. Recommended that you take
calcium supplements in addition to pre-natal vitamins since Heparin depletes the
supply.

Human chorionic gonadotropin (hCG), brands A.P.L, Profasi, Pregnyl, Chorigon,
Novarel, and recombinant brand Ovidrel: For women hCG is used to induce
ovulation, usually after taking clomiphene citrate, menotropins or
urofollitropins. Also used to support the corpus luteum and keep progesterone
levels elevated. Side effects include pregnancy symptoms such as nausea and
breast swelling. Interferes with the ability to take a pregnancy test. Used to
help a man's sperm count if the FSH, LH, and testosterone levels are low.
Sometimes used in conjunction with menotropins. Only for men with the rare
condition of hypogonadotropic hypogonadism. Side effects include moodiness and
tiredness. The new recominant hCG, Ovidrel, is supposed to cause less localized
reaction, and may help with empty follicle syndrome. Profasi info
http://www.serono-usa.com/fertility/profasi.html, Pregnyl info
http://www.organoninc.com/products/consumer/pregnyl/pregnyl_c.html.

Intravenous immunoglobulin (IVIg): Treatment for immune disorders. Side effects
are fast or pounding heart and trouble breathing.

Leuprolide acetate, brands Lupron and Decapeptil: used to treat Endometriosis,
uterine fibroid tumors, and to suppress women prior to IVF. Side effects include
moodiness, hot flashes, and irregular vaginal bleeding. Lupron info
http://www.lupron.com/.

LHRH antagonist, cetrorelix, brand Cetrotide: used to block LH surge/premature
ovulation. It blocks the effects of gonadotropin-releasing hormone (GnRH). The
GnRH controls the secretion of LH, the hormone that triggers ovulation. Like
Antagon, it allows for a shorter stimulation cycle for IVF or IUI. Side effects
include, reddening, itching, or swelling at injection site, nausea, and
headache.

Menotropins, brands Pergonal, Humegon, Repronex: FSH and LH, commonly used for
superovulation. Side effects in women may include hyperstimulation, soreness
around ovaries, bloating and rash. For men, side effects include dizziness, loss
of appetite, headache, irregular heartbeat, nosebleeds, and shortness of breath.
Pergonal info http://www.serono-usa.com/fertility/pergonal.html, Humegon info
http://www.organoninc.com/products/consumer/humegon/humegon_c.html,
Repronex/Menogon info http://www.ferringusa.com/rephome.htm.

Metformin, brands Glucophage and Glucophage XR: Metformin is a diabetes
medication used to to improve insulin utilization. For several years it has also
been used to treat insulin resistance that often accompanies PCOS. For some
women it will restore ovulation or improve response to ovulation stimulation
medications. Side effects are mostly gastroinstestinal and usually lessen with
continued use.It is a Pregnancy Category B medication that is sometimes
continued in all or part of pregnancy. For more info, check
http://www.glucophage.com,  http://www.inciid.org/faq/pcos.html and
http://www.fertilityplus.org/faq/metformin.html.

Paternal white blood cell immunization: White blood cells from the father are
injected into the mother as a way of fighting certain immune problems. Commonly
given when partners are very similar genetically because the woman's body may
fail to recognize the pregnancy and fight it.

Progestins, brand Provera: Used to induce a period when there is no natural
cycle. Side-effects, bloating, headaches, mood swings, swelling of face and
extremities, increased blood pressure, and weight gain.

Progesterone, brands Crinone, Prometrium, or compounded at pharmacy: Can be
given as suppositories, vaginal capsules, oral capsules/pills, lozenges/troches,
Crinone gel applicator, and injections. Used to keep progesterone levels
elevated in the luteal phase. Side effects include bloating, cramps,
constipation or diarrhea, dizziness, drowsiness, headache, effects that warrant
doctor consultation include pain, swelling or redness of an arm or leg,
one-sided muscle weakness, vision problems, trouble breathing, fainting,
itching, or skin rash. Crinone info
http://www.serono-usa.com/fertility/crinone.html.

Progynon C (Ethinylestradiol 0.02mg): used to increase thin uterine lining.

Steroids such as dexamethasone and prednisone: used to suppress androgens in
women with PCO and for certain immune problems. Side effects include weight
gain, blurred vision, and increased thirst.

Tamoxifen citrate, brand Nolvadex: Used to treat men with elevated estrogen
levels. It is also used for women who fail to ovulate. The typical starting dose
is 20mg on days 2-5 of the cycle. Women with irregular cycles can start it any
time, and the dose may be increased as needed. It is used in a similar manner as
clomiphene citrate, but may have less damaging effect on cervical mucus and
uterine lining. Side effects include nausea, hot flashes, weight gain, and
headache. Any vision changes, vomiting or skin rash require doctor consultation
This medication is used primarily for breast cancer. Nolvadex info
http://www.nolvadex.com/.

Urofollitropins, brands Metrodin and Fertinorm (discontinued): Pure FSH, most
often used for superovulation. Received through intra-muscular injection.
Side effects include hyperstimulation, abdominal and pelvic pain and bloating.

Urofollitropins, highly purified, brands Fertinex, Fertinorm HP and Metrodin HP:
Pure FSH, most often used for superovulation. Received 
through subcutaneous injection. Side effects include hyperstimulation, 
abdominal and pelvic pain and bloating. May not be as effective in those with a
body mass index over 26 (meaning higher dose may be needed). Fertinex info
http://www.serono-usa.com/fertility/fertinex.html.

------------------------------------------------------------------------

9.4 - ASSISTED REPRODUCTION TECHNIQUES

Timed intercourse: As the name implies, this involves timing intercourse for
ovulation. The use of ovulation predictor kits may make this more exact. The
greatest pregnancy rate is achieved in those who have sex the 5 days leading up
to ovulation and perhaps ovulation day (though some feel that is too late).
Couples with low sperm counts should have sex every other day, while daily
intercourse should be fine for those with normal and high counts.

Artificial insemination (AI): The insertion of sperm into the female
reproductive tract. Includes insemination at the cervix and intra-uterine
insemination (IUI).

At-home insemination (AHI): This can be done with donated sperm (though proper
testing is suggested before doing this) or with the husband/significant other's
sperm. Rather than using a turkey-baster, as some jokingly suggest, this is best
done with an oral medicine syringe. Semen is collected in a cup (or thawed from
donor), sucked into the syringe, and slowly injected into the woman's vagina as
close to the cervix as possible. For more information, check
http://www.fertilityplus.org/faq/homeinsem.html

Intra-uterine insemination (IUI): Semen is collected and "washed" or "spun." The
sperm is then injected through the cervix, into the uterus using a small
catheter. Check the IUI FAQ at http://www.fertilityplus.org/faq/iui.html.

Intra-tubal insemination (ITI): This is similar to IUI, but the catheter goes
beyond the cervical opening and deposits sperm in the fallopian tube. This is a
more uncomfortable procedure and may not greatly improve chances of success.

In vitro fertilization (IVF): Eggs and sperm are combined in a lab to fertilize
eggs outside the body. Embryos are transferred back 2-3 days after egg
retrieval.

Intra-cytoplasmic sperm injection (ICSI): Basically one sperm injected into one
egg. Used for men with very low sperm counts to try to increase the chance of
fertilization.

Assisted hatching (AZH): Assisted hatching is putting a small opening in the
embryo's outer layer called the zona pellucida. The embryo must break free of
the zona to hatch out prior to implantation in the uterine lining. AH is often
used for older women (38 or over), who often have more rigid zonas.

Non-surgical embryonic selective thinning (NEST): Similar to assisted hatching,
only the embryo is slightly shaved prior to implantation to thin the zona
pellucida rather than put a hole in it.

Gamete intra-fallopian transfer (GIFT): Combining eggs and sperm outside of the
body and immediately placing them into the fallopian tubes to achieve
fertilization.

Immature oocyte retrieval: Immature eggs are collected and grown in the lab
using fertility drugs. When mature, they are fertilized and replaced in the same
manner as IVF.

Zygote intra-fallopian transfer (ZIFT): IVF with the transfer of the zygote into
the fallopian tube -- a combination of IVF and GIFT.

Stimulated cycle oocyte retrieval in (office) fertilization (SCORIF): This is a
stimulated cycle, like IVF, where the eggs are retrieved and placed in a capsule
with sperm. The capsule is then inserted into the vaginal so that fertilization
takes place within the woman's body. After fertilization (2-3 days), the embryos
are transferred into the woman's uterus.

Non-stimulated (cycle) oocyte retrieval in (office) fertilization (NORIF):
Natural cycle where eggs are retrieved, placed in a capsule with sperm, and the
capsule is inserted into the woman's vagina for fertilization. In 2-3 days the
embryos are transferred in the uterus.

Donor egg: Use of another woman's egg to achieve pregnancy through IVF.

Donor sperm: Use of donated sperm for artificial insemination or IVF. List of
online cryobanks can be found at http://www.fertilityplus.org/faq/donor.html.
________________________________________________________________________
________________________________________________________________________


SECTION 10 - INFERTILITY INSURANCE

The best way to determine what kind of infertility insurance you have is to
check the details of your policy and/or call the company (and get any details in
writing if necessary). One often sees questions on the infertility newsgroups
about whether or not this or that insurance company covers infertility treatment
-- it isn't that easy a question to answer because the same company in the same
state can sell different policies to employers.

If you have coverage for prescriptions, you may need to check separately to see
what is covered. When calling about drugs, use specific names. Drugs that have
multiple purposes are usually covered (such as progesterone and estrogen). There
are cases where treatment is not covered, but medications are -- and vice versa.
There are also policies that cover testing but not treatment, and many cover
treatment at a different percentage than other services.

These are just some common sense suggestions . . . you can check the following
sites for more information: State Infertility Insurance Laws at
http://www.asrm.org/patient/insur.html; Infertility Insurance FAQ at
http://www.fertilethoughts.net/infertility/faq.html; and Insurance Coverage for
Infertility article at http://www.inciid.org/legal.html. The latter two sites
also have bulletin boards for discussion of insurance issues.

________________________________________________________________________
________________________________________________________________________

SECTION 11 - RECOMMENDED READING

------------------------------------------------------------------------

11.1 - BOOKS

The Ache for a Child
by Debra Bridwell
Victor Chariot Books, 1994, ISBN: 1564762483

And Hannah Wept: Infertility, Adoption, and the Jewish Couple
by Michael Gold
paper: Jewish Pubns Society, 1994, ISBN: 0827604424
cloth: Jewish Pubns Society, 1988, ISBN: 0827603061

The Couples Guide to Fertility: Techniques to Help You Have a Baby
by Gary Berger, Marc Goldstein, Mark Fuerst
Main Street Books (Doubleday), 1995, ISBN: 0385471246

Getting Pregnant and Staying Pregnant: Overcoming Infertility and Managing Your
High-Risk Pregnancy
by Diana Raab
Hunter House, 1991, ISBN: 0897930800

Getting Pregnant When You Thought You Couldn't: The Interactive Guide That Helps
You Up the Odds
by Helane S. Rosenberg, Yakov M. Epstein
Warner Books, 1993, ISBN: 0446393886

Having Your Baby by Donor Insemination: A Complete Resource Guide
by Elizabeth Noble
Houghton Mifflin, 1987, ISBN: 039545395X

Healing Mind, Healthy Woman: Using the Mind-Body Connection to Manage Stress and
Take Control of Your Life
by Alice D. Domar, Henry Dreher
Henry Holt, 1996, ISBN: 0805041346 (hardcover)
Audio cassette available, ISBN: 0694516988
Paperback to be released soon.

How to Be a Successful Fertility Patient: Your Guide to Getting the Best
Possible Medical Help to Have a Baby
by Peggy Robin
Quill, 1993, ISBN: 0688117325
How to Get Pregnant with the New Technology
by Sherman J. Silber
Warner Books, 1991, ISBN: 0446393223

Infertility: Your Questions Answered
by S. L. Tan, Howard S. Jacobs, MacHelle M. Seibel
Birch Lane Press, 1995, ISBN: 1559722940

In Pursuit of Fertility: 
A Fertility Expert Tells You How to Get Pregnant
by Robert R. Franklin, Dorothy Brockman
Henry Holt, 1996, ISBN: 0805041818

Listen to Your Body
by Eileen Stukane, Niels H. Lauersen
Berkley Pub Group, 1993, ISBN: 0425104931

Longing for a Child: Coping with Infertility
by Bobbie Reed
Augsburg Fortress Pub., 1994, ISBN: 0806626720

Miscarriage: A Man's Book
by Rick Wheat
Centering Corp., 1995, ISBN: 1561230820

Miscarriage: Women Sharing from the Heart
by Marie Allen, Shell Marks
John Wiley & Sons, 1993, ISBN: 0471548340

Overcoming Infertility Naturally
by Karen Bradstreet
Woodland Pub., 1994, ISBN: 0913923869

Preventing Miscarriage: The Good News
by Jonathan Scher,
HarperPerennial, 1990, ISBN: 0060920564

A Silent Sorrow: Pregnancy Loss Guidance and 
Support for You and Your Family
by Ingrid Kohn, Perry-Lynn Moffitt
Dell, 1992, ISBN: 0440507138

Sweet Grapes: How to Stop Being Infertile and Start Living Again
by Jean W. Carter
Perspectives Press, 1991, ISBN: 0944934013

Taking Charge of Infertility
by Patricia Irwin Johnston
Perspectives Press, 1994, ISBN: 0944934072

Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control
and Pregnancy Achievement
by Toni Weschler
Harperperennial Library, 1995, ISBN: 0060950536

Wanting Another Child: Coping With Secondary Infertility
by Harriet Fishman Simons
Lexington Books, 1995, ISBN: 0029289386

There is also a book section in the Fertility Information Resource List at
http://www.vais.net/~travis/firl.html.

More recommended reading regarding miscarriage is posted at
http://www.fertilityplus.org/faq/miscarriage/resources.html.

------------------------------------------------------------------------

11.1a - ONLINE SOURCES FOR ORDERING INFERTILITY BOOKS

Perspectives Press is a publisher specializing only in adoption and infertility
titles, for adults and children. Go to
http://www.perspectivespress.com/ourbooks.html for a listing of titles.
Purchasing information is included as well as an online order form for direct
sales. There is also a discount book page where you can get some deals.

Amazon books at http://www.amazon.com has a huge selection of infertility and
miscarriage books available for mail order at a small discount. It takes 2-3
days for most titles to be sent out, then add transport time. This resource also
allows you to sign up for notification whenever new books in your selected
subject area become available. Most books sold at a 20-30% discount off the
cover price, some at 40%.

Tapestry books at http://www.tapestrybooks.com has a large selection of
infertility and adoption titles. Amazon may have more available, but tapestry
offers a printed catalog of titles as well as its web site.

Barnes & Noble is now online at http://www.BarnesandNoble.com.  In-stock titles
are sold at 20-30% discount off the cover price.

------------------------------------------------------------------------

11.2  - PERIODICALS

Used with permission of Travis Low, Fertility Information Resource List (FIRL),
http://www.vais.net/~travis/firl.html

FerreFax, by the Ferre Institute, Inc.
258 Genesee Street, #302, Utica NY 13502 USA
Telephone: 315-724-4348 (vox), 315-724-1360 (fax)
http://members.aol.com/ferreinf/ferre.html
mailto:ferreinfo@aol.com

Fertility and Sterility
American Society of Reproductive Medicine
1209 Montgomery Highway, Birmingham, Alabama 35216-2809 USA
Telephone: 205-978-5000 (vox), 205-978-5005 (fax)
http://www.asrm.com/profession/fertility/fspage.html
mailto:asrm@asrm.com
A cutting-edge medical journal. A bit pricey, but it may be worth it for you.

Fertility Weekly
P.O. Box 43054, Atlanta, Georgia 30336 USA
Telephone: 800-705-7185 (vox) 770-949-2066 (fax)
http://www.homepage.holowww.com/1f.htm
mailto:kkey@hendersonnet.atl.ga.us
A weekly digest on fertility and human reproduction. Expensive, but sample
issues are available (and you get what you pay for). 

Hannah to Hannah
P.O. Box 5016, Auburn, CA 95604-5016 USA
Telephone: 916-444-4253 (24 hour voice mail)
http://www.hannah.org
mailto:hannahs@hannah.org
Published by Hannah's Prayer, a Christian infertility and pregnancy loss support
organization with a small but growing number of local support group chapters in
the US. 

The Infertility Experience (T.I.E.)
P.O. Box 10, St. John, IN 47373
mailto:inferex@aol.com
Bimonthly newsletter offering support and guidance to those going through the
infertility process. Includes reader response and book reviews. The cost is
$18.00 for a one year subscription.

INCIID Insights
P.O. Box 91363, Tucson, AZ 85752-1363 USA
Telephone: 520-544-9548 (vox), 520-509-5251 (fax)
http://www.inciid.org
mailto:INCIIDinfo@aol.com

Infertility Awareness
A membership benefit from Infertility Awareness 
Association of Canada (IAAC)
396 Cooper Street #201, Ottawa, ON K2P 2H7 Canada.
National office: 613-234-8585 or 800-263-2929 (vox), 
613-234-7718 (fax)
mailto:iaac@fox.nstn.ca

The Infertility Experience (T.I.E.)
P.O. Box 10, St. John, IN 47373
mailto:inferex@aol.com
Bimonthly newsletter offering support and guidance to those going
through the infertility process. Includes reader response and book
reviews. The cost is $18.00 for a one year subscription.

Infertility Helper
36 Norwood Road, Toronto, Ontario M4E 2S2 Canada.
Telephone: 416-690-9593 (vox).
http://www.helping.com/family/iy/iy.html
mailto:helper@helping.com
They also publish the Adoption Helper. 

Newsletter of Resolve National
1310 Broadway, Somerville MA 02144-1731 USA
Telephone: 617-623-0744 (vox), 617-623-0252 (fax)
http://www.resolve.org
mailto:resolveinc@aol.com

Roots & Wings Adoption Magazine
PO Box 577, Hackettstown, NJ 07840 USA
http://www.adopting.org/rw.html
mailto:76262.354@compuserve.com 

TASCFORCE
A free email newsletter concerning surrogacy issues.
http://www.surrogacy.com
mailto:TASC@surrogacy.com


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continued in Infertility FAQ (part 4/4)
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mailto:bec@fertilityplus.org
Fertility FAQs and Info - by patients, for patients
http://www.fertilityplus.org/toc.html

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Last Update March 27 2014 @ 02:11 PM