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- From: Bec <bec@fertilityplus.org>
- Newsgroups: alt.infertility,misc.health.infertility,alt.answers,misc.answers,news.answers
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- Subject: Infertility FAQ (part 1/4)
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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
-
- 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
-