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Advice about Fertility

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Partner's zero sperm count

April 2010

My partner has a zero sperm count, not low count, a zero count. According to his lab tests it's not genetic, there are no blockages, but he has for years taken hot hot baths, saunas, etc, so we don't know yet whether he's done permanent damage or not. The urologist has said we could wait a few months avoiding hot baths to see if the sperm production goes up unless we do a needle biopsy to check. What about others things, foods, herbs, acupuncture that we can do to foster sperm production? Anyone have experience with this? anonymous


I urge you to get a needle biopsy. It is minimally invasive and it can answer your question quickly. Then you will be able to move on with that information. In my situation, my husband had zero sperm count and the needle biopsy showed he was producing sperm. We opted for ICSI and IVF and have a gorgeous child as a result! My experience is--don't fret but don't waste time either. I wish you my very best!!! MLV
If someone has a zero sperm count they should be evaluated for other disorders as well. If there is no sperm in the ejaculate but sperm in the testicle, it is being blocked from coming out. The most common cause would be absence of the vas defferans. This is genetic. Also, I have seen people who had no other symptoms except a zero sperm count and had cystic fibrosis. Most urologists will automatically refer all men with a zero sperm count for a sweat test. seen it many times

Dermoid cysts and fertility

June 2009

I am 41 and have been trying to conceive for 1 year. All tests have been ok, but large dermoid cysts (over 6cm diameter) were found on both ovaries. These were removed in February using key hole surgery. After a recent scan two more small cysts (2cm diameter) were show on both ovaries again. These are causing me occasional stabbing pains, especially during exercise. I have been advised to have surgery again. I do not know if these cysts were missed during surgery, or have grown in the past 3 months. Has anyone had experience of this problem? Are the cysts affecting fertility? Should I have surgery again? What alternative techniques should I consider? Anon


The first thing I would say is go to a reproductive endocrinologist NOT an OB GYN for advice and surgery. The reproductive endocrinologist will be much more concerned to conserve ovarian tissue. My guess is that they will say that you don't need to operate on a 2 cm cyst, that you should try to conceive first because every time you disturb the ovary, you don't know whether it will resume function. I also think based on my experience of dermoid cysts that they will say that a 2 cm cyst will not prevent you from conceiving, but I'm not an MD. Go to Pacific Fertility in SF and see Dr. Eldon Shriock if you possibly can. And lastly, if you can stand acupuncture, Dr. Jingchun Ou at 3901 Grand Ave (547-3986) can help you conceive and also possibly delay the growth of the cysts. There are 3 Doctor Ou's at that address; Jingchun Ou is the fertility specialist.

Before I had my first child, I was in a similar position to you -- 2 cm cyst that was being watched (but I just had one ovary since I had already lost the other to a dermoid). The operation was delayed for several years because my doctors, Eldon Shriock and Robert Jaffe at UCSF, were giving me every chance to conceive. Finally the cyst was too big (I think 6 cm?) and they had to operate. In the meantime, Dr. Shriock had moved to Pacific Fertility and my health care plan would not pay for him to do the surgery. I did very extensive research to try to find someone else and was told over and over again by doctors at Stanford, UCSF and Kaiser that Dr. Shriock was the gold standard when it comes to ovarian surgery. An ob-gyn at Kaiser who had trained with him told me that I should just offer to pay him out of pocket -- that since I only had one ovary left, I should spare no expense. When I asked Dr. Shriock if I could pay for it myself, he just laughed. But then he arranged for his partner to perform the surgery so that my health plan would pay for the operation, and came in to perform the surgery with his partner for free. I still choke up when I think of it.

I've had two kids since. The first was born nearly a year to the day after the surgery. It is possible to have two children with just one not-quite-intact ovary left. I credit Dr. Shriock and Dr. Ou with both of my kids. I don't think I would have had the opportunity to have them were it not for them. If you possibly can, get yourself over to see them.

good luck -- been there


I am so sorry to hear that the cysts have formed again. I don't know how my story will help but I think it's good to hear from others who have had to deal with fibroid cysts and fertility. I found out that I had a 10cm fibroid cyst on my right ovary during my first ultrasound when I was 12 weeks pregnant. I was advised by my doctor to have the cyst removed before my 14th week. She said the risk of the cyst rupturing was far greater than the risk of surgery harming the baby at that stage of my pregnancy. In the end, I had the cyst removed (they were 2 cysts on one stem) under general anesthesia. During an ultrasound before my surgery I was told that the egg that was fertilized was from my left ovary. I think you should have the cysts removed. Even under general anesthesia and while I was 14 weeks pregnant, it took just 2 weeks for me to recover and I now have a very healthy toddler. Just think, 2 weeks and you'll be cyst-free and can try for a baby without worrying about cysts. Even though my surgery was a success, I wouldn't want anyone to have to undergo surgery while pregnant. Good luck to you. Former cyst suffer
I had dermoid cyst taken out of L ovary,and another kind takenout of R. The R. one grew back and they took my R ovary out 10 months later. I was 28. With a part of L and no R ovary, I conceived at age 40. (husband with low sperm count, too) So -- it can be done. Pain can be scar tissue, sometimes. Some second and third opinions are warranted, I think, but don't give up hope on conceiving. Miracles happen! Nancy

Surgery for husband's Varicocele?

May 2009

Hello, My husband and I have been trying to conceive for the last 8 months without success. His doctor recently informed him that he has Varicocele. From what I've read online I'm not convinced that having a surgery done will increase our chances. Has anyone had experience with this? Hoping to conceive one day
anon


Hi, Infertility, for any reason, is very stressful to go thru. Fortunately, a varicocele is common and easy to fix. My husband had a procedure done to correct his and now we have 2 happy, healthy, wonderful children. Get the procedure done and get pregnant! Happy Mama

Infertility Treatments - what to do next?

Sept 2008

We are blessed w/ a 2.5 year old and have been trying 6+ mos. for a second child naturally (to no avail). Getting preg. w/ our first was pretty easy, so I feel very lucky. I am 38 and am starting to get nervous (but know anxiety is not what I need w/ fertility!). We are about to make an appt with Dr. Willman in Orinda. I suppose what I'm looking for are some lessons learned, tips and advice on what ''treatment'' to do next (chlomid, insemination, etc.) I have a family history of hormone positive breast cancer, so I'm not open to doing IVF and the injections at this point. So, the least ''intrusive'' treatments would be preferable. Also, were there side effects of taking chlomid and doing artificial insemination? Thank you! anon


My husband & I got got pregnant unexpectedly at age 35 w/ a first time mistake. When I started trying for No. 2 I thought it would be super easy and it ended up taking 18 months. I had to get help to eventually get pregnant. Luckily for me it was something that required a very simple fix. I wish I had been a little more aggressive getting help earlier. The first step I took was reading Taking Charge of Your Fertility (TCOYF) which I think is great for any woman, regardless of age, to better understand their body cycles. What I highly recommend is joining some infertility Boards. I was on one w/ Mothering.com & another on a Yahoo group. There are a number of different Yahoo groups to choose from depending on what issue you might be experiencing as well as some general boards. I learned a ton of medical details on the Yahoo group, it helped me ask the right questions and be prepared once I saw a Fertility doc. Once you see a Dr. you will get a bunch of tests that will steer you and the Dr. in the right direction. Until those results are in I would just start educating yourself w/ these message boards and/or books. The one drawback in the testing is many of these have to be done at certain times in your cycle so I think it can easily take 2-3 months to get all the necessary testing done. Being well aware of your cycle by reading TCOYF will help you avoid any delays in getting your testing started. Wish you the best of luck!!! - Due in 3 Weeks!
I went to Dr. Willman but changed doctors later because I was 38 almost 39 and I thought she wasn't aggressive enough doing 4 IUIs with NO results. I also switched doctors to switch up the mojo and went for IVF immediately. Bingo. Had success.

My advice is that the IUIs can be a waste of time. It's not much better than just sex sex sex all the time. I also have a maternal history of breast cancer and I don't see why you're so hesitant to take the IVF route - the drugs are the same in IUI and IVF (they were for me; I took Menopur).

I wasted a lot of time, money and heartache doing the less invasive stuff (Clomid was a waste of time, but side effects not too bad) and IUI (side effects same as IVF - bloating and lots of weight gain...but it went ON FOREVER because Willman kept wanting to try that route...ended up we spent more on IUIs than the IVF all tolled).

So that's my advice. --It's a hard time, I know.


I highly recommend reading ''Taking Charge of Your Fertility'', by Toni Weschler to assist you on your journey. There was also a recent study done regarding use of clomid or IUI and the limitations of these interventions which may help you with your decision: http://www.webmd.com/infertility-and-reproduction/news/20080807/study-in fertility-treatments-no-help good luck
Have you had your hormone levels tested? Have you considered ''alternative'' medicines like acupuncture/chinese herbals? I suggest these two things. The first may provide some clues as to the difficulty. The second may do that as well as provide some solutions.

At 40, I had my levels tested and was given a very poor prognosis for getting pregnant. After three months of work with my acupuncturist, my levels were ''perfect'', and within three months I was pregnant with my son. Over the course of the past year I have had some horrendous headache/perimenopause issues. I again had the levels tested (this time saliva testing, not bloodwork). Things were wacked out. Following the dietary and lifestyle change recommendations of my acupuncturist, in addition to some supplementation and chinese herbs, I am currently (at 45) 14+ wks pregnant with a daughter.

My acupuncturist is my hero. For me, she has practically worked miracles. She is really great at helping identify the problem(s) and providing some solutions as well as helping guide you to others. It requires work and flexibility and dedication on your part. She is located in Berkeley and her name is Abigail Surasky. I would HIGHLY recommend her to you. Wishing you the best! anon


Sorry you have to go this route. We've done pretty much every infertility treatment that exists, so heres some thoughts. IUI's and clomid are pretty non invasive procedures......the IUI itself is not much more than a PAP type experience and requires no 'aftercare' as such. Its pretty cheap too (relative to ivf anyway). Most Dr's will prescribe clomid alongside an IUI and I never had anything much more than a pmt type feeling with it. You would be doing exactly the right thing to see an RE (reproductive endocrinologist) rather than a regular OB for this kind of stuff. Theres absolutely no point in taking clomid and doing IUI's if your tubes have become compromised for whatever reason, or there are male factors present (things can change over time and may have done since your previous pregnancy). Checking both these things out is fairly quick and simple (an HSG for you and a semen analysis for your partner) and at least then if you go ahead with an IUI you will know the basic requirements for a pregnancy are in place. There is also the concept of 'ovarian reserve' to consider (ie the quality of your eggs), and a basic infertility workup should include FSH and LH measurements on day 3, and maybe something called the 'clomid challenge test' which can give further indication of your egg quality. Good luck to you! information is power
I'd suggest accupuncture with Leslie Oldershaw with herbs for 4 - 6 months while you research IVF programs. Then I would either pick ''big guns'' - IVF -- or stop. When you look at odds, trying clomid/IUI/injectables really does not do nearly as much as IVF. And if you do IVF consider Portland OR and Colorado. If you are going to go for it, go to the best place you can. Stanford was a great place for me and because of your family history you may consider Dr Milki there - he is first a scientist, then an IVF doctor. Although I did not get pregnant, I highly reccomend thier program and him in particular. You are not as ''old'' as some, although at 37 there is a big drop in fertility. Next one comes around 40-41. been there
I was in the same boat as you - quickly getting pregnant with my first at 35, but after over a year of trying for the second starting at age 37-38 we reverted to fertility treatments. There's a whole bunch of tests you'll have to go through first before they even begin to talk about what treatment to start with and those tests usually take months to complete. There's hormone level monitoring at different points in your cycle, making sure you don't have any cysts or other uterine issues that might have developed after your last pregnancy, checking your husbands sperm, etc. So once you get through all of that your doctor will present you with your options.

In my case everything was fine except my follicle stimulating hormone (FSH) levels started to go up, which means that there is a low estrogen environment and more FSH was being released from the pituitary gland in attempt to stimulate the ovaries enough to produce a good follicle and estrogen. Basically higher levels usually mean a diminishing egg supply and also possibility a reduced egg quality. So it's a time gamble to try just insemination first before moving onto Clomid (you also do artificial insemination with Clomid to increase your chances), as your FSH levels may be going up in the meantime. After 35 FSH levels can jump, and at one point I saw a big jump just over a 3 month spread.

I did one round of Clomid, and then my doctor thought it would best because of my age and hormone levels not to waste time and try injections next. One round of injections resulted in a twin pregnancy. Through the local twin parents support group I have met many women who were in the same fertility boat and were able to get pregnant on one round of Clomid so it's worth a shot. Out of all the women I know, I've only met one woman who had a bad reaction (bad mood swings, anxiety, etc.) on Clomid. For others it wasn't much different than PMS. I had no side effects. There's no side effect to artificial insemination that I know of.

So in a nutshell, my advice would be not to risk having your FSH levels go up and to go for the Clomid if that's an option given your test results. If you do get a reaction, then you can always revert to just trying insemination on its own. anon


Well, you have an appointment with Susan Willman. She got me pregnant twice and I have 2 ''perfect'' children thanks to her. She wasn't all cheery, didn't smile a lot...no false hope from her! She'd say 'well, you have a 5% chance of success here'' stuff like that. I had un-talented doctors feeding me clomid & this & that perscription and after 7 years of nothing working, I somehow found myself with her. She is incredibly talentedand hard working. She got in there and corrected 5 things, any one of which would prevent reproduction. Luck plays a huge part in it of course. But, yeah, she took care of me! I also took Chinese herbs, accupuncture, reflexology, quit a stressful job... whatever it took. It probably all added up. Dr. Willman is great. Like I said, I have 2 healthy kids so, can't argue with that. She did several laproscopic surgeries on me....and I had lots of medical innovation / interventions. Nothing compared to actual motherhood though! No words for how tired I am...
I don't know where you are in the process, but having had infertility myself and going from IUI to IVF, I can tell you that there is a lot to keep track of. A good friend of mine, a pediatrician and fellow infertility traveler, has put out a book to help record critical information along the way. http://www.infertilityassistant.com/The_Infertility_Assistant.html This might be of use. Anon
Hi, Good luck with your decision. I just wanted to mention that chlomid in older women (yes, over 37) can lead to a thin uterine lining. So you could make more eggs but have a less friendly implantation environment. It's possible that the person doing the iui will not tell you this. My case. So I did an additional chlomid cycle I would not have done had I known. You must find this out w/ any chlomid cycle. older with 20/20 hindsight

Considering IVF after repeated miscarriage

August 2008

We are considering doing IVF. I have a chromosomal translocation that means 50% of my pregnancies will end in miscarriages... this far 4 of 5 have ended in miscarriage. I get pregnant crazy easily, apparently I have the follicles/ovaries of a teenager (I am almost 38), and it seems the only reason I am miscarrying is the genetic problem. I already carried one baby to term (now almost 3) Two questions.

1. The success rate percentages for 38-40 are GRIM... but it seems like I don't/won't have a lot of issues most women have (I make a lot of eggs, etc) Why does IVF fail for women?

2. There is a place in Colorado that has a 41% live birth rate for my age group. No other place in the country touches their rates. It is hard to say no to that rate. Is it worth flying out there to do this or just any IVF place with a decent live birth rate? Anon


I would seriously consider consulting with Reproductive Science Center http://www.rscbayarea.com/ regarding IVF. They at one time had the highest success rate in the area (I am not sure if this is still true). The doctors are exceptional, compassionate and truly experts. I have nothing but praise for both Dr. Wilman and Dr. Hinckley in the Orinda office. Keep in mind that the CDC data on success rates includes those with a wide range of issues and I suspect you may get a more positive prognosis in person. RSC has info. seminars fairly regularly where they pass out coupons for half priced initial consultations. Dr. Wilman helped me with my first pregnancy and hope she will help me with a second- at age 38. Best of luck to you and your family! -Erika
First off, I'm sorry you find yourselves having to tread this ugly IVF journey. Its a tough road to travel. Your post is very upbeat, but the reality of IVF is that it is an emotionally and financially grueling journey. Its been an part of our lives for the past 4 years, so we're pretty familiar with all the positives and negatives it can bring.

As an IVF 'veteran' your first question makes me nervous. IVF isn't an exact science. Not everyone comes away with a baby, even when their infertility is 'unexplained', they produce many embryos and everything goes seemingly perfectly. There are many junctions along the way where the number of decent quality embryos you produce as a couple is reduced (last time we only retrieved 8 eggs, of which 5 fertilised, of which 3 made it beyond day 2 and of which only 2 were of reasonable quality......) Quality is key with IVF, so its not the number of eggs you can/may produce that is of relavance but rather the quality of those eggs, and the unfortunate reality is that with increased age, goes reduced egg quality, hence those 'grim' stats. The reality is that sometimes (often actually) it just doesn't work, for whatever reason.....and the why is largely unknown.

Wrt your second question I would be interested to know what the patient group is like that this clinic accepts? It certainly seems like a high success rate - what do they attribute it to? Unless you are very sure your chances are better then I would at least check out PFC and/or UCSF in SF (we preferred PFC incidently). I'm sure their opinions would be worth seeking as part of your decision making process? A couple of hundred dollars for a consult will fade into insignificance once you get stuck into an IVF cycle or two.

The process of IVF is pretty intense and involves a lot of fairly unpredictable appointments once you are in the stimulation phase. You probably need to be in Colorado for a couple of weeks at least, unless you could arrange your monitoring visits here in the Bay area, and just head to Colorado for the retrieval and transfer?

I hope I don't sound too negative. We have visited both the extreme lows and the ultimate high that IVF can bring, and it truely can work miracles, but please, please, don't assume you are immune to the lows, despite your history..... Its a long long way to fall when things don't go so well. Much much luck to you on your journey, IVF vet


If you have a chromosomal issue to get pregnant, but willing to go through IVF process, there is PGD (Pre-implantation Genetic Diagnosis) to find out which embryos may carry your affected chromosome with trans location.

We did ICSI (similar to IVF) with PGD for different reason at UCSF. I was like you, at the age of 41, I had ovaries of 20's. Still, my first two ICSI failed due to the quality of embryos, but on the third trial I was successfully pregnant (with multiples. Added bonus.)

I think IVF fails, just like natural pregnancy. I heard that many natural pregnancies fail due to various and probably still unknown reasons, so this medical technology is not certainly 100% guaranteed. That being said, success does happen too. When I was trying with ICSI, my doctor told me that my pregnancy rate would be only 10%, but we tried anyway. I am glad that I did at least try. ICSI and PGD suggestor


Hi, We've been doing IVF with Reproductive Science Center of the Bay area, and we have had a good experience (plain old unexplained fertility over here!) However, I have been reading a blog called here be hippogriffs http://julia.typepad.com/ and her husband has roberstons traslocation (13 pregnancies, 2 live births).

Anyhow,it seems like you might want to look at the PGD programs really throughly--the woman at the blog I referred you to had an erroneous PGD done at Shady Grove outside of DC, and then decided to go with a clinic that was local and convenient and had a successful twin pregnancy. From my extensive blog reading, and attending Google U, I'd say you have a pretty high chance of getting pregnant, and staying pregnant, as long as the PGD is accurate. You have a sense of what the anomaly is, unlike most of us who miscarry, so the PGD is really the most important thing.

If you do decide to stay local, I highly recommend Dr Susan Willman at Reproductive Science Center in Orinda/San Ramon. She is very smart, caring and honest about the likelihood of success. I think she is also the director of PGD at RSC. Best of luck to you--M/c's are awful. Sarah


Hello: I want to recommend CCRM in Colorado. Their success rates are excellent, and I am now pregnant. One thing that they offer which might be great for you is a type of pre-genetic testing (CGH) that tests all 46 of the chromosomes on 5 day blasts, so you know that you are only transferring normal embryos. The CGH rate for pregnancy is 80% for women of all ages! You might consider doing a phone consult with one of the doctors to see what they think. The downside is that you have to go there for a one day workup and do all of their tests, even ones you may have just done at your local clinic, and of ocurse, you have to be in CO for a couple of weeks, which makes it more expensive. Still, I think it is worth it. Their lab is excellent, and I think that is the big difference, in that they are able to get more 5 days blasts, which increses outcome. If you go to IVFconnections.com and go to IVF in the USA, then Colorado, you will see many threads, including a large one about CGH. Good luck, I know how hard the process is! Anon
I want to very enthusiastically recommend the IVF program at UCSF. We had Dr. Paolo Rinaudo and he was terrific. The other docs are great too, as are all their staff. They do a really good job of informing you about all of the considerations, risks, success rates, etc at every step of the way. I think that it would be wise for you to at least speak with them or attend their information session (once a month I think?) before you decide you need to go to Colorado.

As everyone else has said, there are a variety of reasons that IVF can fail. While producing enough eggs is important, the quality and size of the eggs is also important, the timing of everything is vital, what happens whether or not embryos are created and their quality, etc. etc. We learned that the lab folks are really the most imporant staff of an IVF Center, not the docs. The lab is the place where the magic merging of egg and sperm happens and it's a very specialized skill, especially with ICSI.

A couple of things to look at with success rate statistics: age of the women in the group, whether the group includes anyone who is ''high risk'' (part of that classification is age), and incidence of multiples. Some places get lots of live births because they implant lots of embryos. But having a pregnancy with multiples is high risk as well and not something to take lightly. anon


Young and infertile - anyone else relate?

June 2008

A few weeks ago, there was a parent here who wrote about the challenges they face for being the “youngest parent on the blog”. My situation is similar in some ways – I feel a lot of isolation for being young (29) and infertile. I have been dealing with my infertility for almost eight years with some breaks in-between) and having been in support groups where the average age is 38 can leave me feeling awkward so say the least. In terms of relating to the other members on matters having to do with life in general, it’s not a problem and I have made many friends – the fertility aspect is a problem (for me) though. The fact that I’m not the stereotypical young woman who can get pregnancy easily is downright humiliating.

I hope I am not alone in this though I can understand if I am especially in this area. Any words of wisdom or advice? Young and Infertile


I don't have any great advice, but did want to let you know I went through being young and infertile, too. I started TTC at age 26, and finally had a baby at 30. At least the positive in that was that I started relatively young and had time to deal with the infertility before my clock really started ticking. I don't remember ever really thinking about the youth factor at the time, just how sad I was that I wasn't having a baby. It was frustrating to have friends my age who got pregnant at the drop of a wine cooler, but I found that connecting with other women dealing with infertility, regardless of age, was a great outlet. It sounds like you're already doing that. Just Wanted You to Know You're Not Alone
I'm 43 now but dealt w/ infertility beginning at age 30. By the time I joined a group most of us were 35. Open Path offers facilitated groups for a fee. You would probably have to wait for facilator to assemble a group of 20s early 30s women, but could make that request, or use open path to create your own member-facilitated group (someone did that for secondary infertility). Perhaps pbn-ers in your situation will respond!

From my own experience, I wish for you the strength and self knowledge to figure out how you would like to resolve and take action and to move forward on that 'open path.' Infertility treatment works best w/ young women. If you want to go big guns, go big guns for best results. If you want to go holistic/chinese medicine, your body will respond slowly over time to new diet and changing energy...give it time to do so by starting now. If you want to adopt, it takes 3-6 mos to get the search going domestically, longer to get a placement, and international has waits as well. And if you are going to be childfree, take that trip around the world and embrace your independence/heal with joy. I'm not advocating rushing into decisions prematurely. But I am thinking of how my 30s and early 40s have been marked by yearning and slow moving. patience did pay off in that I did eventually conceive one child by a combo of accupuncture and iui and some chemical assistance. Best wishes! anon


I am so sorry for the struggle you've had for eight years. I struggled with infertiliy for 7 years. I began trying at 30, but if I had started younger I would have had the same issues. In terms of connecting with the other women about infertility, please don't let age be a barrier. Please don't blame yourself for your infertility just because you're younger. At the same time be careful to not assume that the other women only have fertility problems because they are ''old''--or think they are at fault for starting ''too late''. There are so many misconceptions about infertility for women of all ages. I think so many of us feel ''humiliated'' because as a country we don't educate our selves about fertility or provide women with the health services and information we need. So people not in the know assume getting pregnant is so easy, and if you can't do it, it is your fault--you waited too long, you're too uptight, etc. I have many friends who were very understanding of my pain. And I appreciated their support, however only other women who have experienced it truly understand. So I think its so great that you have a support group. Share with them your feelings and concerns about the age difference. One final note, we now have a beautiful child through adoption and can't believe how fortunate we are to have this baby in our lives and family. All the frustration and saddness with miscarriage and infertility have washed away. I wish you the best of luck. anon
Yup, I can relate. I was 30 when I found out the chance of having kids was less than 5%. After being on the pill for my entire adult life, this was quite a shock. It was hard to take, but I think hearing the truth was a lot better than wondering why I wasn't getting pregnant every month. We immediately went into adoption mode and tried to adopt an infant via open adoption for long while before trying egg donation via IVF. Now at 38 and a mom of three (all from the same cycle), I know that the years of frustration, anxiety, sadness, and hopelessness were for a reason. I never would have had *these* kids had it happened any other way. As I tell all my friends with fertility issues (and there are many), you will have a family. I can't tell you how or when, but if you want one, you will get one. And it will be the perfect one for you. Tired, but happy mom.
I can relate! I'm 30 and my husband is 34. Started trying to conceive at 27 and 31, and adopted our son 2 years ago when things weren't going as smoothly as we hoped (we planned to adopt, anyway). Found out shortly thereafter that we both have issues contributing to our infertility.

I'm sure there are plenty of us out there. I think the apparent lack of ''young infertiles'' in the Bay Area goes hand-in-hand with the fact that people tend to start families a bit later in life here (therefore, experience more infertility OR just discovery fertility problems later). Hang in there! Feel free to ask for my e-mail! Me, too!


Dear Young friend,

I understand the feelings this provokes in a woman. I am 26 yrs. old and have been diagnosed with Polycystic Ovarian Syndrome- which is more than a ovarian cyst because of hormonal imbalance. I have a very severe case where I hemorrhage for up to 9 months among other side effects. My case is pretty extreme, but I do know many young women that are diagnosed (who have less severe cases) and who suffer tremendously because of their concern with infertility. “Know you are not alone- we are many”

I on the other hand worry about making it through another day and am happy by just being alive whether or not I'm infertile is not my biggest concern. Although I know my family, friends, and different social structures sometimes make me question my decision. However, I have learned to be happy with what I do have and not feel in any way humiliated. I invite you to really explore and deconstruct why infertility has such a profound effect and if this experiences symbolizes more than just infertile.

I make it point to look and learn from women who never had children and live fulfilled lives. I ask what makes them be content. A very wise woman told me- they stop searching with anxiety that which they cannot control or change. They live now and love now and learn to value themselves for everything they are without defining themselves by the ''stereotype model'' (for at the end none of are stereotypes- we are individuals).

I'm not sure what your health situation is but give a look at the PCOS online support group. You will find teen girls who have PCOS and know they are infertile and so forth. They have a yearly conference. I think you will find a lot of inspiration.

In general- I consciously correct my self whenever I feel this experience lowers my spirit. I do not allow others to influence me with their views, and most importantly I do not allow my self to let stereotypes of women to invade my mind, body, and soul.

I wish you the best in this journey and please feel free to contact me if you have any questions. Roxana


Fertility Issues w/ #2, Clomid?

May 2008

Hi Everyone, I am 33, and have been trying to get pregnant with child #2 for 15 months. I know I am ovulating (ovulation sticks + Fertility Awareness). First rounds of tests including semen analysis were all normal, except progesterone in the low-normal range. My OB is leaning toward trying Clomid, but that doesn't make much sense to me as I know I am ovulating. I have another appt in a few weeks, and I'm not sure whether I should look for a fertility specialist or not... I don't have the desire, nor the funds for lots of invasive procedures since I already have one wonderful child (who BTW was conceived the first month of trying!). Any advice? Tired of storing baby clothes for ''Someday''


It's my understanding that Clomid causes more eggs to be ripened and ready to be fertilized at ovulation, so it increases your chance of getting pregnant. Good luck! anon
I worked at The Sperm Bank of California for a few years and heard similar concerns from women contemplating assisted reproduction. Though I began the job with a worried perspective about fertility medications, my view shifted as I saw frustrated women who had been trying to conceive for many months having success after using clomid.

I reviewed the possible and proven side effects and decided that the risks seemed worth it compared to not getting pregnant or trying for too long.

When I changed jobs and a year later became a client of The Sperm Bank of California, I had my own hormone levels tested, to find out my progesterone was low, though I was also ovulating. After a couple of tries without meds, I used clomid for a few cycles and got pregnant. Now I'm pregnant with our second child, this time using a different fertility medication. The Sperm Bank of California has some good fertility information and links to resources. thespermbankofca.org --a mama of one and pregnant with #2


I had a friend who had gotten pregnant easily the first time, but went through EVERYTHING trying to get pregnant a second time. Finally, they eventually figured out she had developed an immune reaction against her husband's sperm. There is a simple way to test for this. I'd ask for the test, just in case. R's friend
I had some indication that my progesterone was low, but apparently the tests don't always show that this is the case. Perhaps that is what is preventing your egg from implanting or staying put. That was my situation. I took progesterone suppositories and got pregnant and stayed pregnant on the first try with progesterone, and for my second baby, on the second try after starting progesterone. So, you never know for sure, but it seemed that that did the trick for me. My MD suggested I take clomid along with the progesterone the second time around, since I was 38 (although I was ovulating fine) and I didn't think that made sense, at least before trying a few rounds with progesterone. So, it seemed I was right. Good luck finding the right approach, whatever that is for you.
I used Clomid for 6 months. The advantage is that it creates more viable follicles available for fertilization. Your chances of having twins doubles, but no, or very little increase in multiples beyond twins.

I do not want to make you nervous - but there is something about Clomid that you should know. It messes with your mind while you're on it - it messes with your mind, A LOT.

For example, I felt, and ''saw'' myself crushing my partner's skull with a giant rock and ''watched'' the blood leak onto the bed. When I talked to my fertility specialist about this, she was aware that some people had these feelings - but that I should just make sure not to act on them, DUH, as my 8 year old would say.

But that's just my point, I did get pregnant. I have a beautiful, talented, bright, loving daughter . . . and It was worth the Clomid


Don't pursue any fertility treatment, including clomid, with an OB. It will be a frustrating waste of time. I know you said you don't want to do anything dramatic to have another child, but I suggest that you see a reproductive endocrinologist to find out what's wrong (could be all sorts of explanations that your OB has not looked into). If you do decide to try clomid, at least an RE will follow your cycle closely and let you know if they don't think it will help. Susan Willman at RSC is a good RE. hope this helps
I, too, got pregnant with my first child during the first month of trying and then had difficulty with getting pregnant with my second. It sounds like you are using ovulation predictor sticks aleady, but what really helped me was the Clear Plan Fertility Monitor. It tracks your cycle over the whole month and lets you know when the best days are for trying to conceive. It helped me discover that while I was having regular cycles, I was ovulating too late in the cycle to sustain a pregnancy or, in other words, I had a luteal phase defect. Not saying you have this specifically, but the monitor helped me diagnose myself essentially and when I brought this information to the attention of my OB, I was put on progesterone and got pregnant with my son shortly thereafter. I have other friends with similar stories. It may be worth a shot. Good luck! Trouble Trying for #2 Too
I had my kids at age 39 and 41. We started trying right after I got married when I was 36. At 38, I went on Clomid (and ultimately for both pregancies) and wondered why if I was detecting my surge and ovulating was I not getting pregnant. Everything checked out. So, we went on Clomid and both times it took us five tries. We also did IUI as extra insurance each time because I heard that Clomid can sometimes make your cervical muccus too thick for the sperm to travel. So, both times it took FIVE tries. And we now have two kids as a result. It's definitely better than going to the next level and much cheaper. Word to the wise, tho, when you're on the clomid you SUPER ovulate so it's can be uncomfortable. I kinda liked it because I KNEW something was going on. clomid mama
I had low progesterone issues and Clomid did the trick for me. I don't know why, it just did.

To answer the second part of your question, here is my experience: with my first son, I responded right away to clomid, got pregnant on my first cycle with clomid+ IUI after 15 months of TTC naturally. When we tried to get pregnant again a couple of years later, I wasn't as responsive to the clomid, so my regular OB kept ramping up the dosage until I was taking 200 mg. (which is a lot) After several cycles with IUI at the highest dosage, he finally referred me to the IVF clinic at UCSF to discuss hormone injections. After my consultation, the specialist I saw there recommended going back to a lower dosage of clomid plus progesterone suppositories, which my OB could have prescribed if he had actually known what he was doing. I got pregnant on the first cycle. Another advantage of the specialist was that she really monitored my cycle with ultrasounds so we knew how many eggs were being produced. Even though my insurance company only paid for part of the procedures, with the in-network negotiated rates we only ended up paying a few hundred dollars for everything. Even though everything finally worked out and I have 2 wonderful boys, at the time I kind of wished that I had gone to a specialist from the get-go and perhaps they wouldn't have been spaced so far apart. Go for the specialist


Dieting while trying to get pregnant?

April 2008

I had a miscarriage in December and gained 7 pounds during the pregnancy. I am dying to lose the weight, but also trying to get pregnant. Does anyone know of any reason I couldn't calorie restrict and exercise while in fertility mode?


Luckily for you, women with the highest fertility diet scores ate less trans fat and sugar from carbohydrates, consumed more protein from vegetables than from animals, ate more fiber and iron, took more multivitamins, had a lower BMI, exercised for longer periods of time each day, and, surprisingly, consumed more high-fat dairy products and less low-fat dairy products. www.news-medical.net/?id=32024 So, you can lose weight and simultaneously increase your chance of getting pregnant. Just eat less trans fat, less sugar, more vegetable protein, more fiber, more iron, and more cheese. Exercise more and take a multi-vitamin. Health Nut
Exercise and mild calorie restriction should not affect your fertility, provided you go back to a higher-calorie diet once you test positive for pregnancy. If you drastically reduce your calories, you might dip in fertility. Try to cut out about 200 calories a day or so and exercise, but don't go overboard. Anon
From a Chinese Medicine perspective: eating a well balanced diet, full of fresh fruit and (mostly cooked) vegetables, some whole grains and enough protien is the best way to get your body ready for carrying a baby. Eliminating junk food, sugar, juice, soda etc while eating this balanced diet should be enough to get your body to an ideal weight also. Exercise is very important, it gets the circulation going and improves the health of every system. However, too much can be detrimental especially while preparing for a baby. If you feel energized after you work out - that's enough, but if you feel exhausted, then you are using up your energy not replensishing it. G., Licensed Acupuncturist
Unless you are underweight I wouldn't think losing a few pounds would hurt. If you are more on the overweight side it could only help. I struggled for a long time to get pregnant w/ No. 2. I am on the heavy side. Someone recommended to me a book called ''Fertility Foods''. I got it and read it. It is based on eating foods that are low in the Glycemic Index. This is similar to South Beach of maybe a Diabetic type diet. So, think doing any of these might be helpful as long as they aren't drastic. I ended up having to get extra help but was taking medication that made me very carb sensitive so basically ate low in the Glycemic Index. Now that I'm pregnant I can say that it was good for me to eat this way for +1 month. It's sort of balanced me out and is still keeping me away from excess (non-complex) carbs. - Good Luck to You!!!
Well, you don't want to calorie restrict too much. Eat at least 1500 calories a day, for sure. Eat healthy foods--fruits, veggies, lean meats, whole grains, plenty of water, nuts, seeds-you get the picture. There is no reason you can't do moderate exercise. A couple of studies suggest that there is a boost in fertility when a few pounds are lost, on those of us that need to lose a few. From my own experience, I got pregnant two months after I joined the Y and lost about 5-7 pounds. Getting in better shape is also just great preparation for pregnancy. You want to be in the best possible shape and stay there! been there
Personally, I don't think weight loss mode is especially conducive to fertility. It can affect your hormonal balance. I had fertility problems for a couple of years before I had my daughter, and it turned out the reason was related to low body fat and too much exercise. I was still ovulating regularly but was not able to maintain the hormones needed to allow a pregnancy to implant. A little more fat and the problem went away. Unless your baseline is very heavy, I'd recommend keeping your seven. Worry about your weight after your baby is born, or better yet, when he or she is ready to wean. anon
The only recommendation I would have is that if you have some misgivings about your ''fertility diet'' then don't do it. Your OB would probably tell you not to diet while you're trying to get pregnant, and you will feel like the worst kind of self-centered, inadequate fertility problem woman if you have another miscarriage. Not that you caused it, but you might feel like it was your fault, and that is not worth it. I know this from my experience, and the fear of another miscarriage (or lack of pregnancy, as my age continued to march on) grew ever larger. 7 pounds won't kill you, honest. Even if you come out just looking like a tired mom as opposed to Ms. Gorgeous, you'll be fine. I know this too. I'd love to have a few extra pounds off me, (and I have no more babies along the way), but it's not really that important if you really, really want to get pregnant. It's actually not really that important anyway you look at it. In fact, I used to be accused of being anorexic (I wasn't), so I know what it's like to be skinny, lithe, and fit, and at this point I would love to say that I only had 7 lbs to lose, but the worst thing is just coming to terms with my new body image being different than my old body image. But really, big deal. I'm a good person, my daughter loves me, could care less what I look like, and honestly, from the previous generation's perspective, I'm still gorgeous.

Trying to conceive again

Nov 2007

I am a 34 year old mama to a 2 year old girl and have been trying to conceive baby #2 since June (6 months). I charted my temperature and used opk's with my daughter and we conceived her on the second month of trying--it happened very fast. I figured conceiving #2 would be just about as quick and am feeling very discouraged and depressed as it is now 6 months later. I have been charting and using opk's and have a regular cycle (I know when I ovulate and have no reproductive issues--that I know of--I had an uncomplicated pregnancy with my daughter and a natural, unmedicated vaginal birth). My husband had his semen analyzed last month and all is normal. I know many people struggle for months and even years with infertility but I never thought of myself as one of them given my history. All my friends and playgroup moms are having kids 2 years apart and now I'm worrying about my kids being far apart in age. Any support, advice, words of encouragement and success stories welcome. Discourged Mama


i totally understand what you are going through. the frustration, heartache and unfairness can seem unbearable at times. we tried to conceive for a year before undergoing fertility testing to find out i had a very slight hormonal imbalance. i was prescribed medication for it, but that was not what i wanted to do so i went to acupuncture instead. after the first visit my hormones changed quite noticeably. 3 months later we were pregnant! maybe you dont even have anything 'officially' wrong but i still think acupuncture can help just to balance everything out, send extra blood and energy to your uterus, relieve stress, etc. just hang in there! knowing the intricate details of how conception takes place its a surprise any of us get pregnant at all! it can take time, and that doesn't mean anything is wrong with you. try not to focus on it so much (i know that can be impossible) because that just adds to the stress. i can highly recommend marti kennedy at the ashby center for complimentary medicine in berkeley. she specializes in fertility and womens health. www.martileekennedy.com GOOD LUCK!! i sympathize
I am sorry you are going through this. I know how frustrating and depressing it can be, among other things. I would recommend you get your hormone levels tested first of all. Even at 34, things can begin to change in a way that makes conception more difficult. Once having obtained that info, I would take it to my favorite acupuncturist, Abigail Surasky, in Berkeley. One of her specialties is women's issues, including infertility. She is responsible for getting my body able to have my third child. Her number is 845-8017. Been there
You'll be happy to hear that a recent study quoted in the New York Times recommends five years as the ideal spacing for both mother and children: ''A spacing of about five years is apparently optimal,'' Dr. Kidwell said. ''It frees the parent from having to meet the demands and pressures of two children close together in age, thus allowing parents and children more time in one-to-one interaction for a more supportive and relaxed relationship.'' Children born about two years apart, Dr. Kidwell points out, are likely to have the most intense competition for parental attention throughout their lives. Been there
I know what you're going through and I sympathize. It's so hard to expect to get pregnant right away and not have it happen. My only advice is to be patient and try not to worry(yeah right, huh?). It took my husband and I a full year to get pregnant with our first (and only at this point). In the meantime, 2 friends got pregnant within the first 3 months of trying. It seemed like everyone around me was pregnant and we just couldn't do it. Then my birthday month hit at the 12th month of trying and I said screw it, I'm not thinking about it this month and took a mental break. I partied for the first time in months, went camping, did all kinds of fun stuff and boom, I got pregnant. Maybe a nice vacation or a month break from the temperature taking, etc might help get your mind off of it (although I know that never truly happens). I also told myself that the baby I was meant to have would come when it was ready, and she did. Take care and have some fun. Been there

Fertility at age 39

Oct 2007

I have two children, both pregnancies achieved easily between ages 32 and 35. Now I’ve just turned 39 and we are trying for a third. We’ve been working at it for nine months, I have gotten pregnant twice, both ending in miscarriage at 6-8 weeks. In the event of another pregnancy, my OB has said to call him immediately and he will put me on both baby aspirin and progesterone. Still waiting for that to happen…

I’m not willing to go to extreme and expensive lengths for a third child, but are there easy things I can do to maintain a pregnancy? And in the event of a third miscarriage, what kinds of testing should I have done (bearing in mind the fact that I will not do IVF and probably won’t do Clomid)?

I am completely new to this world of fertility issues…don’t even know where to start. Am I even asking the right questions? Family Not Quite Complete


I'm 38 and trying for No. 2. I was clueless w/ No. 1. I've been trying for 15 months now. Someone recommended a book called Taking Charge of Your Own Fertility. I highly recommend it for ALL women. It is extremely informative. So, take a look at that and use the info. I also belong to a Yahoo Group for people TTC & monitor some of the fertility boards at Mothering.com/Discussions. I've learned a ton monitoring those two sites. (Frankly, I'm suprised that there is not more discussion on this board). Good luck, I've seen many people locally have a lot of success at your similar age. - Anon
Like you, I wasn't having problems getting pregnant but staying pregnant. When I started trying to have a baby, I miscarried twice (8 weeks & 5 weeks). Not getting much support or answers from my doctor, I switched and was told by the new doc to call as soon as I learned I was pregnant again to start progesteron. She also tested my FSH levels. Progesterone was easy & inexpensive--a suppository. I will never know if my body could have sustained this third pregnancy on its own. My doctor's opinion was that progesterone can only help. If I didn't need the ''support'' it wouldn't hurt. I do remember my fears at 15 weeks when my doc told me it was time to stop the progesterone. She assured me the placenta had ''taken over'' at that point. I was 42 at the time of conception and the birth of girtl/boy twins. FSH tests showed my levels were ''normal.'' The twins were a big surprise (perhaps due to advanced maternal age). I wish for you all you hope for!
I, too, had multiple miscarriages before age 40. 2 were from aneuploidy and one was from retained products of conception from an incomplete D&C.

Aneuploidy is the number one cause of miscarriages but there are other causes, so it can be worthwhile seeing a reproductive endocrinologist to be sure you've had the whole workup. In my experience OB's don't know the whole recurrent miscarriage workup but RE's do.

Aneuploidy increases with age, so if the other tests come out normal (hysteroscopy to check for retained products is reasonable, since you could have scarring from one of your deliveries), you could either keep trying till you ''get the good egg,'' or do IUI's with injectable gonadotropins to increase the number of eggs per try. You would ''hope'' for twins, and the euploid one would keep growing while the aneuploid one disappeared.

BTW, Clomid is not an option over 35 because it thickens the cervical mucous and thins the uterine lining, so letting a general OB give you the stuff could lead to more miscarriages from thin lining. Please, please, please don't let a general OB manage your infertility. I've watched in pain as several friends have lost a year or more doing just that. Fertility drops like a stone starting now, so time is of the essence in getting the best care possible.

Congratulations on your two live children!!!!! During my recent fertility woes, my toddler and husband have been a great source of comfort that my life is good no matter what. G7P1


It's so painful to be ''surprised'' by difficulty getting pregnant. (I never succeeded, and I have just adopted a delightful baby.) My advice is go see a fertility specialist right away. I'm sure your doctor is great, but fertility specialists can explore and pursue with you the wide range of options (not just IVF and Clomid), depending on what's going on with you, and your husband (could be him, ya know). (BTW I found injectible FSH drugs much easier than what I've heard about Clomid.) There are lots of simple tests, including hormone levels (I imagine you've done this), make sure your tubes are not blocked, and, perhaps, do a (simple) biopsy to check your endometrial lining to see your actual progesterone levels in the tissue where it matters.

Also, I'd highly recommend the book: Taking Charge of Your Fertility, rev. (Toni Weschler) Great for people trying to get pregnant, or trying not to. It should be required reading in high school Health Educ.!!

Many blessings on your fertility journey. May your 3rd child come soon. lisa k


I completely understand your reluctance to go to extreme and expensive lengths to get pregnant...At 39 my husband and I decided we wanted children, but then I had trouble getting pregnant and went through the medical establishment for help. I found the process demoralizing, in that I was ''diagnosed'' with low ovarian reserve (which they said also meant poor egg quality) and told I should go straight to IVF. My husband and I decided we weren't going to do that, but that I would try acupuncture and herbs as a last resort...Well, I found a wonderful acupuncturist and herbalist and I became pregnant within three months of treatment. I had had a miscarriage before, so I was concerned about ''holding'' the baby. She prescribed herbs, which apparently worked, and I had a healthy baby girl...We decided to try for another, and at 42 am pregnant with my second child! Anyway, there are many wonderful acupuncturists out there, and I personally recommend Anca Sira in San Rafael. You can google her name and look at her website. Her email address is ancasira@ancasira.com. She is incredibly responsive and caring, and will work with you to address whatever your concerns are for getting pregnant and for maintaining a healthy pregnancy. Jenny in Oakland
I had a similar situation -- an easy pregnancy and then a great deal of difficulty getting pregnant, including a miscarriage, with my second at age 39. It turned out that I had hypothyroidism and this greatly affects fertilty. My doctor thought that I had developed this during my first pregnancy, which is common. As soon as I was on medication, I got pregnant and had a easy pregnancy and a healthy baby at age 41. I also went on to have another baby at 43 -- again, an easy pregnancy. If you haven't already done so, I would suggest that your doctor run a simple blood test to check your thyroid. Good luck! mom of 3
I suggest you try the acupuncture and Chinese herbs route. I had great success at the age of 41 using that. I hope you get that third baby! anonymous
There are several things you can look into without having to resort to Clomid or injectibles.

First, I would suggest you get your hands on Toni Weschler (sp?) book Taking Charge (Control) of your Fertility. It helps explain your cycle, which helps in figuring out optimal timing for your attempts to get pregnant. I would also suggest you go to the web site associated with the book: www.ovusoft.com There is a great support community there that you can tap into regarding your attempts to get pregnant and keep pregnant. I would also suggest buying the software Toni has to help you calculate your optimum time of the month to get pregnant.

I would also suggest you get a copy of an herb book geared towards women (I loaned my copy out; so, I can't tell you the name of it). The one I had had an herbal recipe that naturally helped with fertility.

I would also suggest springing for an ovulation monitor. I think I used Clear Blue Easy Ovulation monitor that cost around $200. You can probably get a used one for half that amount.

I used all of these techniques, and was able to get pregnant at age 42. This isn't to say that what worked for me will work for you, but just to say that there are less invasive ways to get pregnant than resorting to Clomid or injectibles, if you don't have any organic reasons for not getting pregnant. With regard to using progesterone after getting pregnant, I know plenty of women in their late 30s and early 40s who had healthy babies while using progesterone to protect the pregnancy; so, you shouldn't sweat about using that once you get pregnant next time. found success short of fertility meds


If I were you, I would beg your MD for a referral to an RE (e.g., Susan Willman). You'll probably have another miscarriage by the time he gets around to granting your request, but by the time you have three you should be DEMANDING it. Every miscarriage is very painful, and it's awful that you have to go through it so many times before you can be seen by a real specialist. The specialist will go through a number of tests that are fairly simple, ruling out the obvious problems that can be easily corrected. Note that most specialists have a 6-8 week waiting list to see them. And you can tell the specialist that you're not really inclined toward IVF or Clomid.

And wouldn't you be better off knowing that you'd eliminated the things that can be easily corrected? (Hopefully you will be that lucky). Oh, and don't give up yet. If you've already had a couple of kids, your chances of conceiving are much higher than mine were. It just takes time when you're older. Only about a third of pregnancies take anyway, and chances are lower when you're older. Plus, if you see a specialist, you'll find out if you're having sex at the right time or just wasting your energy. (You can combine ovulation kit with watching your other signs, a la ''taking charge of your fertility'' by Toni Weschler, and document things further by taking your temperature. But keep in mind that once your temp has risen, you've already ovulated. So too late...) Good luck.


Try taking B12, I know three women who got pregnant and had trouble sustaining it, then did the B12 therapy and got successfully pregnant very soon afterwards. It has something to do with progesterone levels? Can't recall exactly. Check on the web for information on the right amount, I can't recall that offhand either. anon
Hi, You're asking all the right questions. I suggest you buy the book Taking Charge of Your Fertility. That book answers all the questions you are asking. I'm also 39 and it's pretty normal for women to have miscarriages and it gets more normal as we age. However, there are some MDs who are really good at finding out why the miscarriages are happening even though that can't always be determined. It sounds to me like your MD is giving you two remedies for miscarriage without having found the possible causes. Susan
Speaking from someone having gone through fertility treatments unsuccessfully in my early 40s (which were worth the effort and expense nevertheless), if I were you I would not hesitate to see a reproductive endocrinologist who could fully advise you on the testing that could be done and what your options are for you specifically, given your threshold for intervention, and based on your individual test results. And by the way my understanding is that you need to take the baby aspirin every day in preparation for getting pregnant and the progesterone as soon as you ovulate. So you may actually be too late if you wait until you find out you're pregnant to take these things. But don't take my word for it! Consult the experts! anon
I noticed someone recommended Susan Willman to you and I want to add my 2 cents:

She is great. I went through what you are now experiencing. I tried everything and crying, begging, many times with my HMO to change Doctors, I somehow finaly got with Susan Willman.

I don't want to bore you with what I had to live through to get there, and it was worth it. She did quite a lot of ''plastic surgery'' on my uterus, removing non-oxygen producing areas, making room, etc.....pronounced it ''beautiful'' and did IVF. I will say that she never gave me a ray of false hope and sometimes I wished she would not make it sound like such a long shot. I did 4 rounds before I got my son. He is perfect.

The second (IVF) pregnancy came & went easily and I have 2 perfect boys; 5 & 8 years old thanks to her.

I can not say enough good things about her. I have heard people get mad about this and that, the office / business end / her manner..... I can only praise her. Because when all is said and done, I have 2 perfect children after 7 years of trying everything and a lot of demoralizing incompetence from other Drs who have good local reputations.

I feel disloyal mentioning that there even was a negative side, but, we are so pumped up on hormones and hope and fear, frustration, sadness,....so much.....! How could there not be something? And what we have to do to pay for it? Another whole subject! But anyway, I just wanted to chime in and say that Susan Willman is a saint in my heart and I am eternally gratefull to her. She is a very talented reproductive endocrinologist as well as a uterus sculptor. She is great!


Most miscarriages are from chromosomal abnormalities, and the rate of these abnormalities increases with age. I would run away from any physician who recommends empirically treating with progesterone instead of doing a miscarriage workup. Please go to a good, ehical RE and get the full recurrent miscarriage workup, and don't let an OB manage this anymore. Also, send the products of conception for chromosomes on any subsequent miscarriages.

Since you didn't mention any miscarriages when you were younger, I'll assume you didn't have any. If you have always miscarried, you and your partner should have your full chromosomes run to check for balanced translocations, etc. If you have a new partner since the birth of your live children, he'll need to have his chromosomes tested.

Since you are getting pregnant, I assume you know when you are ovulating, either b/c your menstrual cycles are perfectly regular and you try to conceive 14 days before your expected menses, you are using LH (ovulation predictor) kits, are doing cervical mucous or temperature testing. If you do know when you are ovulating, if you consistently get your period 14 days later, you do not have a luteal phase defect and are not likely to need progesterone supplementation.

Time is passing fast, and if a third child is very important to you, it will make a difference that you are being aggressive about this.

Some post-ers mentioned Chinese herbs and acupuncture. I used acupuncture for a thin uterine lining, and it had absolutely no effect, in fact the next cycle when I tried without acupuncture, my lining was thicker.

Good luck. Learned the hard way


Fertility at 38.5

Sept 2007

Hi, I am 38.5 and have been trying to get pregnant for ~18 months. I started with timed intercourse with BBTs. I got basic infertility tests (everything was unremarkable for me and my partner) and I had an FSH of 8.6 in 2/2007. My OB/ gyn who gave me clomid for 2 months-- no luck. I insisted on seeing an RE and we started injections with IUI-- still no success twice. I had my FSH retested (6 months later) and now it's 11.1! Needless to say, I am starting to panic. I've had absolutely no success all these months-- not even late by 1 day. My next step is IVF but this seems so invasive and I'm struggling to remain positive. I wasn't particularly pleased with my last RE (lab tests got lost, phone calls dropped and there are delays b/c she's out of the office-- which I realize isn't her fault) but I feel like I'm taking a huge step, I'm very anxious and I'm not in a good state to critically evaluate REs or other alternative therapies. Does anyone have any suggestions? anon


I went through a similar process. I did try the IVF once and it was very intense. I then tried accupunctire to no avail. I didn't get pregnant but we instead opted for adoption. We did domestic adoption and brought our daughter home when she was 4 days old. It was a great decision. We have a fantastic 14 month old who I wouldn't trade for the world.

The main problem I had was that although all of my levels were fine I just wasn't getting more than 2 or 3 eggs maturing (usually women get 5 or more per cycle with fetility interventions) You don't say what might be reducing your chances of pregnancy but if its the egg issue IFV may not have any better effects.

Just remember there are many options for having a family! happy mom


Hi, I went thru something similar in trying to get pregnant for 3 years from the time I was 32 until I succeeded at 35. The docs could find nothing really wrong with me. I has a lot of work- ups and tried clomid and IUI. The next step was exploratory surgery and IVF. I wasn't ready to jump on that train, so we decided to take a break from trying. During this break, I started exercising regularly - riding my bike 3x week. I was pregnant within 2 weeks! I have friends who also had fertility issues and exercise turned out to be the deciding factor for them too. You don't say if you're exercising or not, but if not, I highly recommend it. I know everybody's experience is different, but I can not emphasize enough how important exercise is for wellbeing - including fertility. Get fit and get pregnant!
I've heard that a couples vacation timed to coincide with your fertile days can sometimes help, because of relaxation and stress reduction. Not one of those whirwind have-to-see-as-much-as-possible vacations, but the relax and kick back and get away from it all blissful kind of vacation -- whatever that means to you. Don't know if you've tried this, but if nothing else, it's great reason to take a vacation! L
I am a little older than you and have been trying for 2 years now. We tried on our own, did the usual fertility work-up at my OBGYN after 6 months and like you, nothing remarkable. I tried an RE and did a clomid cycle which was negative. I also tried accupuncture for 6 months and have been taking heavy duty prenatal vitamins for almost a year now. Nothing has really helped though I do feel a lot healthy on the vits. I finally decided, because of my age to try IVF. I did a bunch of research and actually travelled to do the treatment - I wanted to go for the best since I was probably only going to be able to afford to try once. Before I did IVF the RE ordered a bunch of alloimmune and autoimmune tests as well as other tests and it turned out that I had an immune problem with my husband. I also had raised natural killer cell activation which can affect implantation. We will be doing IVIG to counteract these issues. So I would advise that you get these sorts of tests done too as this might be your problem too and can be corrected. Even if your FSH is over 9, you can find RE's who can give you an individualized drug protocol for IVF, which can give you a good shot of producing decent eggs even at our age. Also the self-injections are not as bad as I had expected and I had almost no side-effects.

I also found out recently that I had endo. which can affect fertility, so in hindsight I'm not surprised that I couldn't succeed on my own. If you want to know more about the tests and treatment and which RE I chose and why, you can ask for my email. Anon


Have you considered acupuncture to help? I haven't experienced infertility issues, however I have been successfully treated by this wonderful SF acupuncturist, Dr. Lifang Liang, for other female related disorders (i.e., Endometriosis). While her website and book specifically mention acupuncture with IVF, I am sure she has a range of treatments to help infertility hormones levels, etc. She's a super nice lady. She has studied and practiced both Western and Eastern medicines. My friend's daughter also went to her for some teenage hormone imbalances, and had positive results. I know if I ever had trouble conceiving, I would go to her. Her website is http://www.lifangliang.com BTW: I've always had a fear of needles, however getting stuck with acunpunture needles was not difficult at all. The Chinese herbs can sometimes be quite strong tasting and have pungent odors, however I knew they were doing me good. kc
I realize every situation is different, but I conceived my first at 38 and my second at 40, both through using clomid and both times it took five tries. So, I'd stick it out a little longer. I remember getting frustrated by try #2, too and the fertility doc told us that most people get pregnant after five rounds. Good luck! mom of 2
Firstly, Don't Panic--stay calm. I have had friends deal with this issue. I highly recommend you visit Donna Parker, L.Ac a licensed 5 elements acupuncturist who specializes in infertility. She has a wonderful manner and she comes recommended by women who are dealing with your issue. You can contact her at donna@donnaacupuncture.com and visit her website at donnaacupuncture.com and read about the fertility treatment. Again, she is amazing-- good luck! Michelle
I will say I pretty much followed a similar path to you. Nothing seemed to be ''wrong'' with me or my husband in lab tests, but still, after timing sex for 2 years, then 3 clomid cycles, then 3 injectible IUIs, we had no success (except I did have a ''biochemical'' pregnancy that never took with one IUI). Then I moved on to IVF and was successful the first time with twins - but then they found no heartbeat at 7 weeks. Then I tried a frozen IVF cycle and I am now in my 7th month of pregnancy with a singleton. I was 39 when I got pregnant; I'll be 40 on my due date.

An obvious ''problem'' getting to this point would seem to be my age when we started trying - I was about 35 or 36 I suppose, even though follicle scans at age 39 said I had the ovaries of a 21 year old (a direct quote from my fertility doctor).

With that - I don't think IVF is really all that more invasive than an IUI, and the success rates are higher. You will do the injections just like you did before. The only difference is they will try to create more follicles and they will ''harvest'' them. It's not that bad a process. It's just more expensive. But with the higher rates of success (an IUI I think has at max a 25-30 percent success rate depending on age, of course, and IVF is higher - you can talk to your doctor about your specific numbers).

I'd say because you're not happy with your current doctor - get a new one. There are plenty around here and it's a competitive business (hear all the ads on the radio for them?). I ended up not being too happy with the doctor that did the IUIs - I felt she wasn't aggressive enough and it seemed I could never see HER when it came to D- Day- the day we put the turkey baster in and bathed my eggs with my husband's ''boys - so I switched doctors when I ''graduated'' to IVF. I was SO happy. And being happy and comfortable with your doctor is half the battle, I swear.

It's hard not to get discouraged - but perhaps if you take some control of the situation - get a new doctor, for example - you will feel like you DO have more control over what's happening, or not happening, to your body.

In terms of alternative therapies - I wouldn't scrap the path you're on just yet. You can do both IVF and doctor-approved other stuff at the same time. I did acupuncture for the second IVF. Did that put me over the top? Who knows? I thought I'd try it for what it was worth. If anything it's a relaxing 30 minutes, and at this point, you need all the relaxing time you can get.

Good luck. It's hard, and I know it doesn't help to hear other people's success stories right now. But don't be scared to take that next step. It may just be the one you need to take. --A friend, even though you don't know me


My partner and I tried to get pregnant for forever. After trying without any ''help'', we ended up doing 10 IUIs over about 18 months. We finally got pregnant the first time we did IVF. All I can say about it is that I wish we had done it so much sooner. It was so stressful to try month after month with NOTHING--I kept putting off IVF thinking it was so invasive, or such a big thing, or the end of the road--not to mention expensive. In the end though, we spent more on all the IUIs than we did on the IVF! It actually wasn't that big of a deal--it was so much LESS stressful than all of the other procedures where we had so much less of a chance of getting pregnant. If I had to do it over again, I wouldn't have waited so long--I would've skipped right to IVF in the beginning. We started all of the fertility treatments with an OBGyn, then switched to an RE that we loved. He said that the clomid + IUIs will work in the first 4 mos (generally) if it is going to work. We should've done IVF right after that and saved ourselves a lot of heartache. (We used Dr. Fujimoto at UCSF by the way and LOVED him!)

All I can say is--first, you have to completely trust the RE you are working with. If you don't, please find someone else. Second, don't be scared of the IVF. It wasn't bad at all, and it gave us the best chance of getting pregnant--and I wish in retrospect we hadn't wasted all that time thinking it was too big of a jump! -FINALLY a mom


I tried all of the things you did when I was trying to conceive our second child. Finally what worked for us was having sex earlier in the month and having a chiropractic adjustment. I really believe that making sure my lower back and pelvis was in allignment helped to relax all of the nerves in my pelvis allowing me to become pregnant. In addition having sex before ovulation worked for us, or maybe I was ovulating earlier in the month than I thought? Best of luck! Jeanne
First off, I appreciate that it must be very hard to deal with all the issues that you're facing. I went through 3.5 years of trying to conceive before I finally got pregnant with IVF last year. Admittedly, I was in my early 30s when we started, but like you there was clinically ''nothing wrong'' with either me or my husband, which left us feeling like there was nothing we could do other than keep trying. We partly took so long because we were utterly clueless where to begin and didn't know anyone else who was in our situation. What I think finally gave us our best chances was finding our ''dream team'' of specialists. They weren't necessarily the most popular or most expensive, but they were all very competent and quick to respond, and really helped with the emotional sides of going through infertility treatments. In fact, we tended to find that the more expensive and popular practitioners we tried gave us the least personal attention and we often wound up missing cycles and being frustrated. In the end, our awesome RE was Dr. Mary Hinckley at the RSC in Orinda (you can get there by BART if necessary), and our accupuncturist was Christina Martin who is now at 4th street. Also, you will find many wonderful people who are going through infertility at a variety of ages through the Resolve website (www.resolve.org). It's a great place to connect with other people that understand what an upcoming round of treatments means for you and offer advice.

Misc. points: If you haven't done accupuncture, I'd definitely recommend it. I couldn't believe how quickly my body responded to it - after just a couple of treatments, I no longer felt menstrual cramps from my periods. This may seem irrelevant, but when you're already upset about seeing your period and a failed cycle, it helps to have this bit of comfort. Also, it can help with FSH levels. Although we had a good experience with the RSC, I will mention that the person who organizes our cases was a bit disorganized. She did give us a calendar, but we found that we often had to call her to remind her to place a prescription in to the pharmacy, etc. Once we realized this, everything went smoothly. As for going through IVF, we wish in retrospect that we had done it earlier. It is indeed invasive and expensive, but it gives you information that you can't get any other way about the quality of your eggs, the fertilization process, etc. Our first embryo transfer didn't work, but we had embryos left to transfer that finally resulted in our daughter. If you can afford IVF, it could really help clarify what you need to do to move forward towards having a child. Anon


Hi I got pregnant @ 45 and delivered a healthy 8 lbs baby boy @ 46. things I did prior too... tried for 18 months, then started to get serious so thats when I went to acupuncture. Did that for about 5 months, then stopped and went to ob-gyn and she put me on Femara, like clomide but not exactly, got pregnant the first month! Also I had quit work and just tried to relax and enjoy life. I have no idea why or how but I just tried to stay in the moment, lots of yoga, lots of laughing oh ya we said oh well maybe we should adopt and then I got pregnant! ann
sounds like you've tried all the non-invasive options. i recommend that you find a RE doc or clinic that you really like who doesn't waste your precious time and money by losing labs and not call ing you and go for invitro. NOW.at 38.5 with a fsh of 11+ you need to skip the ''alternative options'' . every cycle that passes decreases the chances that you'll be able to use one of your own eggs, and your increasing FSH is an objective measure of that fact. isn't an FSH of 10 related to menopause? look this up but i think it's so.

a RE doc i work with (i'm a certified nurse midwife) recently told me that the average 40 year old only has 20 percent of her eggs that are still healthy. yikes. he said that the most important factor in conception is the age of the woman. he said that about 5 times to make sure i really got it because i'm almost 41 and want a second child.

your post is a good reminder that ''modern'' women have started to take fertility for granted (not you i'm speaking in general terms).we (including me) have made our lives more well rounded with career, recreation, travel, and just enjoying life, but forgeting that after 35 fertility starts to decrease and does so dramatically at 40. we're not all going to be on the cover of People magazine with our twins at 40, and in fact most of us can't even get pregnant at 40 and those twins probablly cost $50K.

good luck to you and remind every woman you know not to wait to have those babies. we can do lots of thing after we have babies, but if we wait too long doing other stuff that other stuff is all we'll ever have. i'm going to light a candle and think of you tonight with your baby. wishing you well


It may or may not help, but have you read Taking Charge of your Fertility? Many people don't need IVF (you might, I don't know), and can manage this with more info than doctor's offices usually have/accept/share. Good luck
I had a similar story/fsh/age. After 3 years of failed injectible and clomid cycles and every test in the book, I finally opted to have a laparoscopy (we couldn't afford IVF or adoption). It turned out I had mild endometriosis, and it was removed with a laser during the surgury. It took a week or two to recover enough to go back to work, but I conceived the first inj. cycle afterwards. After weaning that child I conceived naturally twice (ending in early miscarriages). I did another inj. cycle and am now in the second trimester. Endometriosis can have no symptoms other than infertility, or you can have some symptoms. I had shockingly bad menstrual cramps, which have never returned in the 4 years since the surgery. I'm pretty certain that for me the endometriosis was the main problem. Once we got rid of it, I just needed a little hormonal boost to get pregnant with a ''good'' egg. I hope you find your solution soon. Check out Dr. Susan Willman at RSC in Orinda. best of luck to you
I was in the same spot you're in now and my advice is to do IVF immediately and do as many cycles as you can endure emotionally, physically and financially. It was hard for me to become pregnant but I did by doing ICSI and IVF with my own eggs. And I feel strongly that it would have been worth going through IVF even if I had NOT gotten pregnant because I needed to do everything possible before giving up. I realize that may not be your style but it sounds like you are really upset about the amount of time you are spending trying other methods. It sounds like not trying IVF will only add to your anxiety and panic unless you are ready to stop medical intervention and let nature decide for you.

Time is not on your side and, unless there is been a huge medical breakthrough I am unaware of, IVF is the way to go - don't waste your time with IUI's and researching alternative therapies. The FSH number is useful but we don't know everything about infertility so try not to focus on that. I was lucky to find a doctor that didn't mess around and helped me through four IVFs as quickly and as comfortably as possible. He didn't focus on the FSH and mine was 18 at conception. Another patient conceived with an FSH of 21.

But the first doctor I saw was not helpful - wasted precious time with Chlomid and IUI's and then told me it was impossible and to try donor eggs. I am a little puzzled that your doctor has been continuing with less aggressive procedures for 18 months. Do you feel this doctor is a good match for you? If you are really committed to pursuing IVF you need a doctor who will support you completely. Obviously a doctor should be realistic with you about your chances but he or she should also rally for you and help you move on to the next step.

I am so sorry you are feeling so pressured but you do need to jump in and take charge and push yourself through this. IVF's are somewhat invasive but it is an outpatient procedure and I was not incapacitated by it. But it is a physcial strain and it is important to take really good care of yourself. Once I got through the first cycle it all became so familiar that the medications and procedures became less scary and confusing.

IVF's are stressful and expensive so it is hard to remain optimistic. I hope that you have the support of friends and family and the money to pursue this. If you try IVF and decide you don't want to continue with it then at least you tried and made a very informed decision. If you decide to not pursue IVF at all, for whatever reason, that is OK too. But I feel very strongly that IVF is the best option for those of us struggling to conceive at an older age. so sympathetic to your struggle


Given your history, and if you really want to have a biological offspring, I would waste no time in starting IVF. IVF is actually less ''invasive'' than having the baby, especially if you need a C-section. And, you can save some of the harvested eggs for a second baby later. If the IVF doesn't work out, and if you would like a wonderful baby girl, there are 60,000 girls in Chinese orphanages waiting for parents. My coworkers have adopted three of them, and all of the girls are delightful and perfect in every way. - ''Auntie''
I am pregnant now at the age of 38 and would like to recommend my obstetrician and fertility specialist Doctor Hank Streitfeld on Colby Street in Berkeley. He is a brilliant doctor who has helped many, many women to treat their infertility and become pregnant. Rebecca
Wow...I could have written your post! Same age & time frame for ''trying'', slight variations in procedures & test results, etc, but i'm in your boat. Wish I could lend advice, but can offer a shoulder to lean on. Can't wait to hear the responses. You're not alone! ab
You have my sympathy! I assume you've read ''Taking Charge of Your Fertility''? If not, give it a try. I know you said you took your temperature to time intercourse, but maybe there's something useful you could learn about your cycle's length and the timing of ovulation. Or maybe you've got an issue with unwelcoming cervical fluid? My fingers are crossed for you! anon
After reading the responses to your post, I wanted to add my 2 cents as I too faced fertility challenges. I got pregnant in 5 months with our first child. But after over a year of trying on our own with ovulation kits and basal temperature for the second, nothing happened. I couldn't believe I could get pregnant so easily and then not be able to the second time. In the end I did 2 rounds of Clomid, then one round of injectables which worked. I'm now thrilled to be the mama of twin girls. The injections scared me at first, but after doing it the first time it was fine. As one post said, any fertility treatment compared to actual childbirth is a piece of cake.

Some people will tell you to just relax and it will happen. Getting told that would really upset me. It's like there's something wrong with your attitude so it's your fault your not getting pregnant. Those sort of comments just added to my stress and were counterproductive. So don't let them get to you, and have faith in yourself that you can get through this and that whatever path you chose to take is the right one for you.

As for accupuncture, I found it was very relaxing but stressful to be spending so much money. In the end I decided to stop as I felt that stress was counterproductive. If you can afford it, I say do it. But if you can't, don't stress about it. One thing I appreciated learning from my accupuncturist is the importance of nutrition and how it impacts fertility; it's especially important to eat a lot of protein.

Someone else mentioned excersise. In my case that did help. I was overweight when we were trying to get pregnant. I couldn't even do Clomid at Kaiser until my BMI was lower. So I ate healthier and excersised (there was an option to take medication to loose weight, but I wanted to do it on my own). I lost 20 pounds and my numbers improved. Excess weight can significantly impact your fertility.

Good luck. I wish you all the best. anon


My husband and I started trying to get pregnant when I was 36. I spent 5 years undergoing tests and procedures. Was dx'd with ''unexplained infertility''. Did 5 IVF's, got pregant once, then miscarried in my 4th month. We decided to pursue adoption. At 43 I became a mother via adoption. ''If I had known then, what I know now...'' I would have forgone all the treatments (which were heartbreaking, extremely stressful on my marriage, and, expensive) ....and gone directly to adoption. We attended an all day symposium put on by Resolve of Northern California (http://www.resolvenc.org/) and left saying ''yes, we can do this''.

We have an open adoption with my son's birthparents (who live about 500 miles away) and I have to say it's a pretty amazing relationship. We truly love them and respect the difficult decision they faced and they will forever be a part of our extended family. (BTW, my son is now 11 years old!)


GOOGLE ''Marcelle Cedars, MD'', Director of Reproductive Endocrinology and Fertility @ UCSF and see all the good information she has available. - GOOD LUCK TO YOU & get busy because TIME FLIES
I understand your fear, going from a normal FSH into the borderline zone. Time is of the essence now.

You will hear many heresay opinions about RE's and how to select an RE, but the only verifiable way is by their outcome statistics.

Checking the SART or CDC websites for outcomes and comparing very carefully (I printed them out and went over them carefully side by side) can help prevent hiring an RE who is sloppy because their outcomes will not be good.

Look up the RE's stats on www.SART.org and compare their outcomes with The Colorado Center for Reproductive Medicine in Englewood Colorado (Denver suburb), ''CCRM''.

It's hard to say this delicately, but California doesn't really have any earth-shatteringly great RE's. Look at the confidence intervals for live births for your age and the next older age group, and always compare to CCRM. If there is no confidence interval and outcomes are expressed as fractions, they are not statistically significant.

After two frustrating cycles with one of the ''two best'' RE's in the area, I switched to CCRM, and achieved pregnancy. They have over 40% out of town patients who failed elsewhere, and still have by far the most successful outcomes in the country. Even just the phone consultation could be enormously helpful for you. They accept women with borderline and high FSH.

Here are the steps:

1) call and get appt for 1-hour telephone consultation with the next MD available.

2) send your entire fertility medical record, nicely organized, with tabs and an index, in a a little binder

3) one hour phone consultation is $200 or $250. They will evaluate all your results to date, the outcomes of what you have tried, etc., and give some preliminary advice

4) One day workup: fly to Denver in the evening, spend one night in a cheap Hotwire hotel for $29, and spend the next day from 8am to 3pm at CCRM for full testing and re-testing of everything. It's like the Mayo Clinic of fertility clinics. They even do a hysteroscopy that day, and the doctor meets with you last, to summarize everything and set a preliminary plan.

5) protocol is chosen and cycle begins. Start meds in Bay Area, first ultrasound monitoring in Bay Area, then fly to Denver for 4-14 days depending on your plan.

They have remarkable results, whatever they say, I would trust.

As for alternative, etc., ask CCRM which alternative interventions have statistical evidence to help. The only ones they advocate are acupuncture if uterine blood flow is low, and pre- and post- embryo transfer acupuncture.

I went through 1 IUI and 2 IVF's locally before I finally went the extra mile to the best in the country. I wish you all the best and please feel free to write. Lay fertility expert, former Resolve leader


First, buy a book called: ''The Infertility Cure'', by Randine Lewis If I knew your address I would send it to you, as I have all my friends in a similar situation. At 37 I had an FSH level of 16. I tried IVF and got four eggs (I have one ovary) two perfect ovvums and no babies.

Then at 39 I met my now husband, and tried IUI. I went to Dr. Lifang Liang at Dr. Lewis's recommendation, and at 40 1/2 conceived naturally. I had been to three other acupuncturists including, Dr Angela Wu who has a clinic specializing in infertility. Dr Liang is the most knowlegable that I found. She was also an OB in China. I am still seeing her, and love her!

But first buy the book, it was what gave me hope and a good outlook about it all.

I bought the book for a friend, she called Dr. Lewis, got a recommendation for an acupuncturist, and at 43 after being told her FSH levels were way too high, got pregnant, a month later. Here's wishing for a good outcome for you.


do you have a male partner? if yes, have you checked his fertility? my husband had slow/low functioning sperm and we got pregnant the first time we used Pre-Seed, a sperm-friendly lubricant. (my hormone levels were fine but i was low on cervical fluid.)
I want to second the person who recommended CCRM (Colorado Center for Reproductive Medicine) for older women. We were also undecided what to do and where to go and thought of many local centers, some who have very loyal patients - who never get pregnant! For older women, if you want to succeed, CCRM is the place, the numbers are clear. The centers in the BayArea, no matter how prestigious Stanford or UCSF sounds, they don't have the success rates at your age group that can compete.

The other post gave a great summary of steps involved, I would only add that you can choose who your dr is at CCRM, Dr Schoolcraft is the primary Dr but he's very quiet, I'd recommend Dr Surrey - he's very friendly and nice and I found easier to talk with, you end up seeing all of them but for the consultation, I'd recommend Dr Surry.

It seems like a big deal to do it in Colorado, but it's not. We'd fly Frontier Airlines and stay at the TownPlace Suites by Marriott for $49 per night (this was 3 years ago) - their studio suites have a full kitchen so you don't have to eat out and the rooms are nicer than the regular Marriott hotel down the street.

Another bit of advice - look up www.ivfconnections.net - go to ALL BULLETIN BOARDS - there is more info on their forums than anywhere else on getting pregnant, not just on IVFs. anon


I originally posted about CCRM and a follow-up post mentioned Dr. Surrey. I would unequivocally use him as my RE for my next cycle at CCRM. He has Dr. Schoolcraft's clarity and incisiveness without his testiness. Dr. Minjarez is very smart and loving but makes things more complicated than they have to be. Dr. Surrey will pick the most streamlined protocol that will actually work to get you pregnant, AND he's smart, nice, and funny, and he's at the main office. He's perfect.

You'll also see how your chances of a live birth fall like a stone over 35, so time is of the essence, but you can do this! I'm afraid I'll have to suggest you ignore advice from people who got pregnant on their own and don't know a thing about rising FSH levels. You haven't been pregnant at all after 18 months of trying, even with Clomid. It's time to get advice from the best RE's in the country. Going to Colorado will save you time, money, and heartache in the end.

CCRM is the best in the country. Shown below are live birth rates for women age 38-40 years for 2004 (the latest year with a downloadable spreadsheet to play with the data). Centers are listed in order of decreasing outcomes for age 35 (not shown). Character limits prevented me from showing confidence intervals, which are more important and even more persuasive.

COLORADO CENTER FOR REPRODUCTIVE MEDICINE ENGLEWOOD COLORADO 41.9
ADVANCED FERTILITY ASSOCIATES MEDICAL GROUP GREENBRAE CALIFORNIA 23.2
UCSF CENTER FOR REPRODUCTIVE HEALTH SAN FRANCISCO CALIFORNIA 33.3
ZOUVES FERTILITY CENTER DALY CITY CALIFORNIA 22.9
NORTHERN CALIFORNIA FERTILITY MEDICAL CENTER ROSEVILLE CALIFORNIA 21.6
REPRODUCTIVE SCIENCE CENTER OF THE SAN FRANCISCO BAY AREA SAN RAMON CALIFORNIA 22.7
STANFORD UNIVERSITY IVF/ART PROGRAMPALO ALTO CALIFORNIA 13.2
FERTILITY PHYSICIANS OF NORTHERN CALIFORNIA SAN JOSE CALIFORNIA 16.2
PACIFIC FERTILITY CENTER SAN FRANCISCO CALIFORNIA 25.8
If this data comes out garbled in the newsletter, you can look it up for yourself on www.sart.org or download an excel spreadsheet to play with from http://www.cdc.gov/art/ Then you can also see the ''live birth confidence interval.''

Once you've had your consultation with Dr. Surrey, do whatever alternative stuff you want, except herbs. Herbs are real drugs and interfere with the medications, AND with China's pollution levels, more and more often are found to be contaminated. --Former Resolve group leader, pregnant at 44 with own eggs at CCRM


Ob Gyn is pushing Clomid for irregular periods

March 2007

Hi, I am a bit puzzled by my OB/GYN's response to a problem. I am trying to get pregnant, but it's difficult because of my irregular periods. When I went to see my OB/GYN, I wasn't even given an exam, he simply wrote me a prescription for clomid to stimulate ovulation. Not that I have anything against clomid, but is it really necessary to immediately resort to medication?! I'd really like to try something more natural first, and would be grateful for any suggestions. Recommendations for more holistic OB/GYN's in the Walnut Creek area who take PacifiCare (the Alta Bates medical group) would be appreciated as well. Thanks! anon.


If you have irregular periods, any sort of exam by your ob-gyn isn't going to reveal anything. Even a vaginal ultrasound won't really reveal much UNLESS you go in for a bunch of them after you actually have a period, then your doctor follows the growth of any follicles to see if you are actually ovulating. Anyway - You have irregular periods, you're trying to get pregnant, and the common first step to even the playing field for you with other fertile women is to give you Clomid. It doesn't always work though - I have irregular periods and very long cycles, and Clomid taken 3 or 4 times only gave me a shorter cycle once. Irregular periods are often an indicator of PCOS, so do some research of your own on that, and talk to your ob-gyn about that. As for non-Western medicine you can look into: Maybe try acupuncture. There have been testimonials from BPN users that acupuncture regulated their menstrual cycles. But it's not cheap and you'll be doing it a long time. Don't freak out about the Clomid though. It's better to start trying with that now rather than to wait to use it a year, then realize two years down the road as you near 40 that you actually have fertility problems - like I did. -Clomid is not the anti-Christ
Hey, Clomid-is-not-the-anti-Christ here again: One thing your doctor CAN do is make you get a bunch of blood tests to see if all sorts of hormones and other baby-making essentials you never knew you had are in proper balance. Like if you once had an eating disorder, that can permanently affect your thyroid and can affect your ability to get pregnant. All this will be revealed in blood tests. These tests are usually done around the time you resort to Clomid, or after you take Clomid and it doesn't work for you, or if you end up going to a reproductive endocrinologist. There's also a 3-day Clomid test to test your fertility that you can ask your doctor about. At any rate - it's not a small deal that your periods are irregular. You need to make them regular to ensure you have 12 chances a year to get pregnant rather than 9 or whatever it is for you. -CINTAC
You're very wise to question your OB/GYN's treatment. If you've been trying to conceive for a while, it's important to get some diagnostic testing done so you at least will know if a natural, holistic approach stands a chance. Don't waste any more time with your current OB/GYN. Like you, I had an irregular cycle. I wasted over a year being treated by a doc who took the same approach as yours. He never ordered a single diagnostic -- just prescribed Clomid and OTC ovulation predicting kits, then Clomid plus intrauterine insemination. I'd been following a temperature cycle routine. (I was far too busy at work to research alternatives and too trusting that the doc I saw was competent because his partner had a good reputation. Plus I had a GP who had her 1st child at 40 and told me there was no rush, just be relaxed about it all!) I left that practice with a lot of anger and frustration and headed straight for a fertility specialist, Dr. Chetokowski. I had to wait 6 months for the first appointment, but he was superb -- very ethical, straightforward -- and had a great staff. One of the first diagnostics showed I had a lot of uterine polyps, the likely cause of my irregular cycle, which were surgically removed. We also learned we had male factor issues. No amount of Clomid or intrauterine insemination would have worked for our situation. My hormone levels were fine, but by that time I was 39. My eggs were getting old even though I felt 10 years younger. ICSI was the solution for us. It was expensive, but we've a lovely daughter now. I wish you much luck, AS
Some OBs will push Clomid because that's all they have experience for. I personally wouldn't go with Clomid first, because there are a number of tests that are easy to start with. I personally had started with Hank Streitfeld as an OB/GYN, and he called himself a fertility specialist, but all he really did was offer Clomid. He was NOT a fertility specialist, just an ob who tends to prescribe Clomid for ''fertility problems''. You probably want an appointment with a REAL fertility specialist. There are some fertility/irregular bleeding problems that can be fixed easily (and some lack of pregnancy can be related to semen problems). Clomid is a powerful drug, and probably one of the reasons we've got more twins around. Just remember that it messes with your cycle andyour chances of having twins increases (and twin pregnancies are more risky). Call up a real fertility specialist (an RE or someone who only specializes in fertility issues), and at the very least, get their list of standard tests that they start with, and ask your ob/gyn about them. In fact, if I were you, I'd probably get a new OB/GYN. Also, you can spend a little time on the web, with sites like resolve.org, that may lead you to some of the info that you'll need to start. Just don't get too wound up about it-it's worrisome. (Many OB/GYN's are frightently uninformed about some of these fertility issues.) Also keep in mind that most docs won't recommend you to a fertility specialist until you've had 3 miscarriages or have been unsuccessful for a year (the 3 miscarriages rule is in my opinion, needlessly cruel, having been down that route). Plus, once you get the recommendation, it will probalby be 6-12 weeks before you can get an appt, so you might want to get the tests that you can now.

Getting discouraged w/fertility treatments - continue?

Feb 2007

Hi, we have one great 5 year old boy and have been trying for over a year and a half for another one. We recently started fertility treatments at Kaiser and after just a month, I'm feeling discouraged and not sure if I want to continue. We've discussed IUI with our doctor and I wonder if others have had success with it? I'm feeling a little scared of it but would do it if I felt it could work. Also wondering how long others have pursued fertility treatment and how many months did it take to work. Trying to decide if we should continue and if so for how long... Thanks, Anonymous


Speaking from experience around infertility my heart goes out to you. Try not to feel too discouraged but don't feel guilty if you do either. My sister had great luck with infertility treatments at Kaiser, as did I (although I ended up going IVF route with Alta Bates ultimately). Kaiser was very supportive and a month is not long to spend on infertility, especially depending on what is causing the errr, hold up. I had to try a bunch of different avenues to get it right, and sometimes it's a little hit and miss. Hang in there, there are a lot more of us out there than you know. There are tons of great books on the market know for ''owning'' your fertility and I'm sure youw ill get a million responses about them. Good Luck. Happy mama
I was struck by your message. You say after one month of fertility treatment you are feeling discouraged and uncertain whether or not you should continue. One month is not very long.

I wonder if you were given a medication that is affecting your mood, OR if there are other issues at play. Were you hoping for a miracle cure and feeling depressed by the effort involved in fertility treatment? Are you unsure how much effort you want to put into having a second child? Do you need to talk with your husband about the point at which you'd like to stop trying? It might be helpful for you to hook up with a support group of women going through the same thing via Kaiser or the organization Resolve. I can tell you that I have done IUI at Kaiser a number of times(unsuccessfully, as it happens) and the process itself is nothing to be afraid of (no more discomfort than a getting a pap smear). If you reach the point where you are giving yourself injections to prepare for the IUI, that is a little harder to get used to. If you had one child without fertility treatment, I can imagine it must be hard for you adjust to this, the way it doesn't come naturally, all the scheduling that is involved (when you take which medication, when you ovulate,when the sperm is collected, when the IUI is performed, etc). Good luck to you as you make your way through the process. By the way, Berkeley author Peggy Orenstein just published a book about her own experience with fertility treatments called ''Waiting for Daisy'': might be an interesting read for you.


I have a gorgeous tolddler son who was conceived through IUI. When I started investigating fertility treatment I felt the same as you - very tentative and even suspicious. After I started looking into it and talking to people about it though, I found out that fertility treatment is incredibly common. Each person is different as to what could be the cause of their delay in getting pregnant. If you are tentative about treatment, perhaps you might feel more comfortable being aggressive about diagnosis - i.e. doing all the tests to figure out if there is something specific going on with you. This will give you a better indication of your own chances at IUI or IVF being successful for you, or if waiting it out is the way to go. I would recommend you sign up for an online discussion board and get support and advice from some of the bazillion people who've been through it. anon
Upon reading your post and thinking back three years ago, I am reminded of the pain and anquish I experienced with every menstrual cycle over the course of 4 years. I went through not getting pregnant on my own, giving up, trying again, miscarriage, giving up, fertility tests, treatments, giving up, surgery, and finally SUCCESS with one IVF attempt!! I now have happy, healthy 2 year old twins! I have never regretted all that I went through and I WOULD DO IT AGAIN!!

I know that treatments do not work for everyone, all the time. I feel the pain of the women for whom it does not work. I would have regretted NOT trying, though and would always have wondered if that one last thing would work. No one can say for anyone else, however, how much of the trying one can take. Month by month or year by year your feelings and resolve change. I swore in the beginning that I would NEVER go so far as to go through IVF - HA!

Practically speaking, the fertility doctors that I worked with at Kaiser and Dr. Chetkowski (Alta Bates) were honest and forthcoming with my chances (as much as they could be). I had ''unexplained'' fertility issues and was told I would probably have success with IVF... they were right from the beginning, although it took me two years to choose to do that. I did many IUI attempts that did not work, but my current thought is that there were problems with the egg and sperm finding each other -- nothing they would ever have been able to determine. However, if eggs and sperm are all in good condition and clomid or other drugs are working to boost it all, you may have great success with IUI! (and the process is really is not that big of an ordeal- kind of like a long annual exam...bring your partner to hang out with you so you can laugh at how silly it all seems YOU MUST LAUGH!! --)

The fertility drugs were not easy (especially during the IVF time period), so you need to have a partner that will really BE there for you. My husband was there for every appointment, educated himself, gave me shots, reminded me about taking pills and treated me like a queen during the rough times of the month. We cried together often and BOY did we celebrate together when it worked!

I wish you great success and the confidence to make the correct decision for yourself! I'm happy to answer any questions you may have. Its a tough time -- be strong! nancy marwoo99@yahoo.com


If you're considering IUI, I'd say go for it. You didn't say what your issues were or your age, but if your doctor recommends it, you probably have unexplained infertility issues. In-utero insemination is the least invasive and least expensive infertility treatment (roughtly $300 a try plus the cost of the drugs). Both my pregnancies were from a combination of chlomid and IUI treatments. Both times I got pregnant on the fifth try. Happy with the results. We decided we were not going to go further than IUI because we couldn't see spending $20,000 for one chance, so we felt very lucky that it happened. tired and happy mom of 2
My partner and I (we're both women) used IUI to get pregnant. While I can't address the question about ongoing fertility treatment, I can tell you that IUI was very straightforward and no big deal for us. Of course, we never had the expectation that we'd have sex to get pregnant, which is different than if you are in a heterosexual relationship. But I can certainly assure you that IUI is not painful or scary in any way. We actually had the procedure done in our home, so I can't speak to what it would be like in a doctor office setting. As you probably know the semen is spun down to remove all prostaglandins and other proteins so that only sperm (and possibly a preservative is added?) remain. A very very thin catheter is inserted into your uterus through your cervix and a very tiny amt (about 1/2 cc I believe) of sperm is slowly inserted (can't be more b/c uterus can only hold a tiny bit). I believe that sometimes they use a tool called a tenaculum in a doctor's office, which grips the cervix to hold it straight. That was NOT used in our home insemination and we each got pregnant the first time we tried it. Either way, whatever you decide, good luck. different mama
First of all: whatever your decision will be, you do not have to defend it or justify it to anybody. I was in your shoes a few years ago, I met many women/couples online and in person; and I realized that everybody makes a very personal choice and that's exactly what it is and how it should be. No mother or mother-in-law, or even your best friend should EVER question it. You and your SO will make the right choice, maybe our responses will help you to getting there!

This is what happened to me: we ''tried'' for at least 8 years, three rounds of AI, and one round of IVF with major complications (8 days in the hospital due to hyper-stimulation), a mere 2 fertilized eggs, which got frozen and later unsuccessfully transferred. Eventually, I hated every step of it. The constant monitoring, the shots, I blew up like balloon, I felt like a science project - eventually I hated my body and was very unhappy.

What made me happy again was our wonderful (despite very long) adoption from Russia. Everything was such a wonderful experience, the trip to Russia and Moscow were a blast as well as huge lesson in mankind and history. Now we have a son (and hopefully soon a 2nd one) and I am the happiest person in world :-) In hindsight I wish I had NOT stepped on the fertility path, but hindsight is 20-20. Good Luck! A Happy Mommy


We had no problem getting pregnant with our first child but after 6 months of problems trying for #2, we started with clomid, then moved to 3 straight months of IUI, followed by IVF. We were successful with the IVF and I am glad we went through with everything but I do have to say that I was depressed a lot and the drugs really drove me crazy. We were so determined to get pregnant with #2 that I was willing to to try anything so kept going on each month with something but there were times I went crazy and the drugs really did affect so much of who I was. Once I fully was able to go off all the shots and drugs finally I realized how messed up I had been BUT it was worth it and we got what we want. So my advice is to keep going but talk openly with your partner as well as people you trust, and even therapists if you need to. You need a support system and something will work, but just realize it is not an easy process and there are a lot of tough times. I also heard every story in the book and you will see it's not the same for everyone. Good luck! I feel your pain and know what you are going through. It took us over a year to get what we wanted but we are so happy now. finally got pregnant
I was in the Santa Clara Kaiser infertility program for about 1.5 yrs before I got pregnant. It is Kaiser's largest infertility program and I had to get transferred there from the Redwood City Kaiser after I tried for 1 yrs with no results.

Our history:

1-1.5 yrs, just tried natural conception using temperature and ovulation sticks

1.5 yrs at Kaiser Santa Clara. Continued doing temperature and ovulation sticks but also started with IUI only for about 4 times. Then did IUI + Clomid for about 2 times. Then did IUI and Repronex injections for about 3 times. When you do the drugs, you sometimes get cysts so you need to skip a month. We were in a skip month when we conceived. While we did IUI that month, it was considered ''natural'' because there were no drugs involved.

IUI alone (with no drugs) is considered the least invasive of the fertility treatments and I think this method is OK. It can be hard to plan all the logistics of last minute appts and bringing in the sperm but after awhile you get the hang of it. However, looking back, I am sorry I did all those drugs. I got pregnant without them and in my desperation to conceive, I never properly researched what they were.

Good luck! Anne


Progesterone Cream for Fertility?

Oct 2006

I'm currently trying to get pregnant with my second after a very easy conception (first month) and pregnancy two years ago. After four months, I'm still not pregnant, and while I know it's still way too soon to be worried, I'm trying to rule out all possible problems. I'm charting temp, cervical fluid, and cervical position, and if I'm nailing my ovulation right, my luteal phase (post-ovulation) seems to be a bit on the short side (8-10 days, usually 10). Apparently one remedy is to apply progesterone cream from ovulation through week 10 of pregnancy (if successful), and I'm wondering if anyone's tried this, and if so, what your experience was. (More details about me: I'm 33, I'm consulting the Toni Weschler book, and I'm using one of those fancy ovulation predictor kits starting with my current cycle to make sure that I really am ovulating when I think I am.) Hoping for another... soon!


I don't have any insight on progesterone cream, but just wanted to add a voice to suggest that everything might be fine without. After trying 2 months to get pregnant, I temped and charted for another 3 months and found I had a short luteal phase, from 7-10 days. Just when I was looking into options like Progesterone Cream and Vitamin B and compulsively searching for stories about conceiving with a short LP on-line, I got pregnant (with twins!). So it may just be a matter of time. Hope that's encouraging. I know it's stressful and I certainly felt a lot of pressure to be proactive anon

Clomid and trying for 2nd child

April 2006

We are trying for our 2nd child and I have been having problems this time around. I conceived quickly with our 1st child several years ago. It seems I am not ovulating now(even though the ovulation tests I have been using have shown that I am, or at least an increased LH surge). My Dr. has given me clomid and is now upping the dosage since I still did not ovulate for the first cycle I was on and wants to try it for a few cycles before we go to the next steps.

I just want to hear if there were others that have been through this and if you had a successful outcome. My husband and I never thought I would have any problems this time around since it was so easy for our first child, and we were wrong. I have also been seeing an accupuncturist to try to help my body chemistry but I have not seen any changes from that either. Every month gets harder and harder to go through and I am trying to stay positive. It is also hard to watch all my friends get pregnant so quickly with their 2nds and 3rds. Any advice would be welcomed. trying for #2


Hello, I needed Clomid while trying for my 3rd child at age 33 (the first two were conceived naturally). I was told that I didn't ovulate irregularly, although I think it was due to infrequent sex. Clomid worked quickly for me (got pregnant on third cycle)and have a beautiful, healthy girl. They used a fairly high dosage of Clomid by 3rd cycle. It was an annoying process but something you forget about once it's over. Definitely worth it. Here's the irony. I thought I had a real fertility problem (per the fertility experts - they told me that Clomid doesn't work as well over 35, which was fine b/c I wasn't planning on more kids). Well surprise...I stopped using protection about 9 months ago b/c I didn't think it was necessary and guess what happened...here I am 4 years later, pregnant again by accident (active sex life, lots of orgasms, ovulated naturally) - no Clomid! Go figure. I don't think I truly had a fertilty problem at all. If you really want to get pregnant fast, use the Clomid. An alternative is to TRY to forget about trying to get pregnant (I know easier said than done, I've been there believe me, when you want to get pregant you want it NOW!) and focus on having a fabulous sex life with lots of orgasms, and see what happens naturally (you may be surprised). Our bodies are intelligent and amazing. Good luck!
Hi, We recently discovered that we are pregnant with our first child after receiving fertiity treatment from Pacific Fertility in San Francisco. From my experience, the doctor will only have you on Clomid for 3-4 months and if there isn't any success, will move you to another drug. I wasn't ovulating naturally, so my doctor prescribed Clomid and an HCG injection. The HCG injection was given after an ultrasound was done to monitor my ovaries to see if a follicle had developed. My husband learned how to give the HCG injection and would give me one in the tush approx.48 hours prior to our IUI appointment. We ended up getting switched off of Clomid because it was thinning my uterine lining and was placed on Famara. In both cases, after ovulation, I used Prometrium (progesterone) as a suppository for 2 weeks. At the end of two weeks, we would take a pregnancy test. If negative, I would stop taking Prometrium and if it was positive, I was to continue. We were successful once we switched to Famara and IUI's. My heart goes out to you. The process is painful and heartbreaking regardless of whether you have a child already or not. My friends began to deliver their first born as my husband and I were beginning our fertility process. I remember going to friends houses to see their babies (and being happy for them), but coming home and crying because we didn't have a child. Friends who haven't gone through the process are helpful and supportive, but not to the same degree of someone who has been through the process. I found such a person and she was wonderful! Best of luck to you. anon
Is the doctor a fertility specialist? My regular OB prescribed clomid for 3 monts and it did nothing. Then we went to a specialist and she said clomid for my age 37 was not so effective and recommended Repronax (sp?) and IUI which worked the first month. We're expecting our second child in July. Although I was reluctant to spend the money I'm very glad we didn't keep waiting and hoping as age really is a major factor. We did this through Kaiser and with all the tests and treatment it was only about $2000. Good luck
I too had an easy time getting pregnant with my first. Then when trying for the 2nd we finally went to a fertility specialist at Kaiser after trying for a year. You didn't mention your age, but if you're over 40 like me, just a few years plummets fertility drastically. It helped me to break down the whole process mentally into different steps, and not think that the current treatment was the end all. First, we did the in-home fertility monitor. That didn't work we got on the program at Kaiser and the first thing they had me do was loose weight which can help fertility and then made me eligible for Clomid. That didn't work so then it was on to Clomid. That didn't work after 2 cycles, so given my age the doctor decided we needed to get more aggressive rather than try another Clomid cylce. So then it was on to Repronex (the injectable hormones). That worked for us on the first try, but while we were in that limbo stage of not knowing if it was going to work or not, it was reassuring to me to know that I still had a couple of more tries on the Repronex, and then after that IVF. Everything you read says stress is bad for fertility, but yet it's so stressful to be diagnosed as having a problem. I was worried about having to the hormone injections, but it was remarkably easy after the first couple of times. Don't get discouraged! anon
I was on Clomid on and off for almost 2 years when we tried to get pregnant the first time around, eventually at a dosage so high the pharmacist filled the prescription wrong because she couldn't believe anyone was taking that much. And it never once made me ovulate. My advice, based solely on my own experience and nothing medical, is if you've done a few cycles with Clomid and aren't ovulating, don't waste any time before stepping up to injectables. They're more expensive (and not covered by my insurance), but once I switched I got pregnant on my first cycle of Follistim. You just have to find the right drug for you. In the meantime, try to remember that your body has done this successfully once; you'll get there again. Good luck! Been there
Sometimes Clomid has the effect of drying up the slippery fertile ervical fluid which is necessary for helping to transport the sperm to your egg. I'd suggest trying a sperm-friendly lube such as Pre-Seed (available online) to help foster the right conditions so that you can get pregnant! Best of luck to you... - Pregnant thanks to Pre-Seed!

Trying to get pregnant with #2

March 2006

My husband and I have been trying for a little while to get pregnant with #2. We did not have very much trouble with our first child so I thought it would be easy again but it seems to be much harder this time around. I am in my early 30s and in pretty good health. I havn't touched alcohol or caffeine in over 6 months (and even lost weight to try and help conceive). It just seems like everyone around me is pregnant with #2 and #3 and from what I keep hearing no one has any diffuclty stories 2nd time around and even said it happened quicker than they thought. I try not to get too focused on it but it is hard when you keep hearing everyone around you is pregnant and you want to be there yourself (and most of the women I keep hearing about are older than me). Is there anything that has worked? any suggestions? I will try anything. When I talked to my OB she did not seem concerned at this time and just told me to keep trying and relax. Hoping for #2 soon


''Taking Charge of Your Fertility'' by Toni Weschler is a fantastic book which helped me and a number of friends and family get pregnant. It's tremendously informative about your body and how it works and really teaches you how to work w/your cycles so you can get pregnant. If I hadn't read it, I would still be assuming I ovulate every 14 days instead of 10 and might not have our two boys. I highly recommend it! CV
Have you read the book ''Taking Charge of Your Fertility'' by Toni Weschler? It tells you how to get in touch with your reproductive system, chart your cycles and basal temperature, and know when you are ovulating. It is much more accurate than over-the-counter ovulation indicators. All you need is a basal thermometer. I found it very helpful when trying to get pregnant. In fact, I knew I was pregnant way before the pregnancy test came back positive. It is also a highly educational book and taught me lots of things about my reproductive system that I wished I had learned as a teenager (e.g. I never understood the significance of vaginal discharge and how the different colors and consistencies of it indicate where you are in your cycle). C.L.
I know what you mean about seeing everyone else pregnant with #2! Maybe you could really pay attention to your body's fertile times. About two weeks after the start of your last period, you may notice a slick mucus (maybe even a long strand you can pull out) when you wipe after going on the toilet. Within the next couple of days is the best time to have sex, because that mucus creates a supportive environment for the sperm. I would guess that you shouldn't have sex for a while prior to this to make sure your husband has a lot of sperm when you need it most. I've also heard that eating wheat germ helps! (I don't know about the validity of the last two statements, though...) best of luck to you
We've been having the same problem trying for #2 after getting pregnant with the first very easily. I'm a little older than you which might affect my situation. We got checked out with various tests and everything looks normal which makes it harder to deal with. I've been taking lots of vitamin and mineral supplements based on reading the Foresight website where a scientific study was done on a group of women trying to get pregnant and they found that correcting deficiencies in various minerals and vitamins made a huge difference in being able to conceive. Your body might still be recovering from #1 which is exacerbated from running around after #1. I work part time and take care of a energetic toddler and often feel exhausted and stressed which also might affect us being able to concieve. I have done lots of research on-line and there are lots of resources out there on secondary infertility. I am also trying accupuncture which I've heard can really help balance your bodys energies out and reduce stress levels. There are others out there like you, so hang in there. I am still hopeful despite my age. If you'd like to comiserate further or want to share information, you can ask BPN for my email address. Also having trouble getting pregnant with #2
I think that it is pretty common to have trouble conceiving the second child. I have many friends who have had miscarriages after their first healthy child as well as those who could not conceive. If your doctor is not worried, I suppose you should not be either. Start having sex every other day for the last two weeks of your cycle. Good Luck to you. anonymous
I don't think your experience is uncommon (i.e. trouble getting pregnant a second time). I would recommend you visit with an acupunturist who specializes in women's issues. I would highly recommend Leslie Oldershaw (piedmont) who helped me get pregnant. anon
It took me longer to get pg with #2 also... but just when I was starting to feel like it would never happen, it did. You don't say how long you've been trying, but it may help to take a month off from trying (don't use birth control, just don't actively try) to get a relief from the stress of it. Stress really does make a difference. anon
I want to recommend the book ''Taking Charge of your Fertility'' by Toni Weschler. It was really helpful for me in getting pregnant for both of my pregnancies in terms of knowing when (or if) I was ovulating and when I am most fertile. I think it's a great starting point for fertility issues. Good Luck. Kim
I agree that just relaxing about it may do the trick. But in the interim, you may want to try the lubricant Preseed. It creates an environment/medium that sperm thrive in I guess. I'm sure there's info about it online. Also, sounds silly, but try being upsideown after sex and see if you can get things going in the right direction. Good Luck! anon
I got pregnant with my first child very easily but when we started trying for #2 it took a while. I think it is just a matter of timing and with one child already timing can be more difficult. I got the pee on the stick kind of ovulation predictor kit and got pregnant the first time I used it. Good luck and try not to worry about it too much. been there.
Hi, so sorry to hear about your frustration! Our #1 was also relatively easy to conceive and we are only about to embark on trying for #2, so I can't speak from experience yet. But I did notice after my son was born that my menstrual cycle is different from before my pregnancy -- a bit shorter with what seems to be a different ovulation point. I say this b/c I've just started charting temperatures and mucus and so on again, something I found incredibly helpful in understanding my cycle when we were trying for #1. This time around I've realized we'll need to ''try'' earlier in my cycle.

Have you taken a look at Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control and Pregnancy Achievement by Toni Weschler? It's an amazing guide to understanding your body and your personal cycle. I'm convinced it helped us get pregnant faster the first time around. Good luck! anon


Trying to get pregnant (IUI, donor sperm)

March 2006

My female partner and I have been trying to get pregnant for 11 months now and I need some wisdom and guidance. I am 34 and have been seeing Dr. Breneman at Kaiser Oakland...luckily, since I am a lesbian, I recieve full benefit of the Fertility Clinic. Yes, I am grateful for this, but it IS Kaiser and I feel like just a number most of the time.

I am taking letrozol and getting ultrasound assisted IUI's every month (usually 1 IU and 1 at-home insemination). We would love to do more, but at $380 per vial of sperm, our budget only allows 2.

I also have seen an acupuncturist several times and am taking suppliments. Mostly, I feel that all of the professionals I see just want us to wait it out. I know this is probably true, but it feels dismissive most of the time.

When should we begin to worry? I would love to hear any experiences/advice/wisdom about this. Has anyone gone through this with a midwife doing the IUI's? Thank you! Ready


My partner and I have two children and I got pregnant using donor sperm, IUI, both times. The 2nd baby was conceived while I was a patient of the same doctor you are seeing. My situation was slightly different because after several miscarriages, I was put on Clomid to help maintain my pregnancy.

I'm sorry the process at Kaiser feels dismissive to you. Dealing with an HMO is no fun because the doctors are under so much pressure to see a large caseload of patients so they are sometimes rude or abrupt because they are so rushed. I recall one doctor being especially rude but I always found Dr. B to be helpful and very sympathetic. She is highly competent and Kaiser is an excellent facility.

I read an article somewhere that they tested the stress levels of women unable to conceive and those undergoing cancer treatment and found them to be similar. At one point, I was so discouraged about multiple miscarriages that I began seeing a counselor. This helped me during that difficult time.

Hang in there and try to be patient. You are doing everything humanly possible. Sometimes it just takes time. anon


If you haven't already had the sperm checked to be sure the vials have live sperm when you get insemminated, do that now. Generally when a person has tried for a year testing is done to see if there is a problem. Since it takes so long to get appointments with Kaiser, I'd speak with your doctor about getting those scheduled for sometime in the next 2 or 3 months. Then relax the best that you can knowing you have moved on the next step. Good luck. My baby is now a teen
Dear Ready, I'm a lesbian who got pregnant on my second try with frozen sperm. Please email me directly for some advice I can pass along -- I can also highly, highly recommend having a consult with Stephanie Brill of Maia Midwifery and Preconception Services in Orinda -- www.maiamidwifery.com
I would suggest you contact Stephanie Brill at Maia Midwifery located in Orinda. She is absolutely amazing. Good luck. anon
Our first pregnancy took almost 1.5 years, trying every cycle. Things we learned (in our opinion) for the second pregnancy: IUI only. Decided not to ''waste'' the money on at home inseminations. Have fertility level checked- simple blood test. Not be so connected to one particular donor and ask sperm bank for highest count and highest motility donors. Our second prgnancy took 3 tries and cost us a lot less than the first. Most of all, trying to not worry seemed to be a key element. l.
Getting pregnant is a random process. For the average 35-year- old woman who is trying to get pregnant, there is about a 1 in 5.5 chance of getting pregnant in any cycle, and then a 1 in 4 chance of miscarrying. Overall this makes for a 1 in 7 chance each cycle of initiating a pregnancy that results in a baby 9 months later. About 4 out of 5 35-year-olds who try for a year will have this kind of ''successful pregnancy''. About 1 in 5 will not.

Sometimes it's just bad luck that keeps these women from getting pregnant - and sometimes it's a medical issue. Have you asked your doctor about this? If not, I suggest you do so. There are some simple diagnostic tests that can detect the presence or absence of several common barriers to getting pregnant.

There are also some powerful mind-body programs that can help improve the odds. Here are two examples: http://www.resolvenc.org/rnc_mindbody.html; http://www.infertilitydoctor.com/support/relax_workshop.htm. Look for a program led by someone who follows Alice Domar's approach. Good luck! Dave


Your story sounds a little bit like ours. I tried to get pregnant for 10 months. I tried a few times when living in Seattle just doing the OPK, then inseminating in the drs office. We then moved to the Bay Area, found Reproductive Science Center (Orinda, San Ramon, & Fremont) tried four more times, switched donors, then got pregnant right away. We were much more aggressive in CA. This is the procedure we used: OPK positive or day 14/15 (depending on your cycle), ultrasound day of positive OPK to confirm egg, if looks good then shot of hCG to trigger egg release, then insemination the next day. I opted for 2 inseminations, one the next day then another the following day. Two inseminations using the above methods is overkill for those just starting out, but we felt it was worth it after trying for so long. Also, I had my FSH tested and it was either low or high can't remember which, but regardless, the results indicated that my eggs may be older than they should be. I tried clomid for two cycles and got cysts and stopped. Was about to start FSH injectable cycle, but thought we'd try natural cycle with new donor first (good thing!). Hope this is helpful...good luck.
I am not a fertility specialist or a medical person, but I worked for many years interviewing couples who had difficulty conceiving and after hearing their stories, this is what I would do in your situation: first, I think there is a strong likelihood that you will get pregnant soon and in general you are supposed to have a full year without getting pregnant before seeking treatment. However, I would ask Kaiser to give you a full fertility ''work-up'' if you haven't all ready. I would also consult a fertility specialist outside of Kaiser if you aren't pregnant after a year. The reason I would do this is because I have talked to so many women who wished they had gotten a consultation sooner. There are a lot of decisions that need to be made that are best made if you have time (which at 34 you still do). I don't know a lot about Kaiser Oakland, but I do know that many women who ''waited it out'' when there was a diagnosable problem ended up really frustrated. My very best of luck to you. I know how painful it is to not get pregnant each month. holly

Infertility due to sperm motility

June 2005

I was wondering if anyone out there has ever dealt with infertility due to low/no sperm motility. I have spoken with plenty of women who have been faced with fertility issues due to female factors but haven't yet found anyone to speak with who is unable to conceive due to lack of sperm motility. My husband has little to no sperm motility due to anti-sperm antibodies. His blood and semen are mixing and the sperm are being attacked, which causes them to end up with no tail and are too damaged to swim. The doctor tried putting him on Prednisone but he quickly developed diabetes due to the steroid so he had to stop the medication. I am feeling very discouraged and also frustrated because I haven't been able to talk to anyone who has gone through this situation. Has anyone successfully conceived in a similar situation? The doctors are saying that in-vitro may not even work because the sperm are so damaged. Has in-vitro been successful for anyone who has gone through this? I would appreciate any comments or advice. anon


Hi. While my husband and I do not have sperm motility issues, we have an extremely low sperm count, I think the process we are going through would be applicible to you. We are dealing with a specilist at the UCSF Male Reproductive Health Clinic, Dr. Turek. The procedure is called ICSI where they inject the sperm direcctly into the egg, so as I understand it motility would not be an issue. If you can go to UCSF for a consultation, we found they were great at explaining what was going on and what our chances were to concieve. It is a multi step process with the chance of failure at each point, but definitely worth checking out. J
We didn't have quite as specific an issue - ours was a complete lack of sperm. Our only option was sperm donation, and having no other option, that is what we did. Now, many years later, I wouldn't change a thing. I have 2 lovely children, who favor us both, surprisingly. I highly recommend using donor sperm - it is very affordable, when compared with ICSI, or IVF, or many of the other options. You still get to be pregnant, and your husband will be able to be involved in all aspects of your pregnancy and birth. counting my blessings
Acupuncture and Chinese herbs can help with infertility due to low sperm motility. It helps the quality and quantity of the sperm in addition to helping the overall quality of the semen. Also, eat more fish (but nowadays be careful of eating fish high in heavy metals). Sara
We are facing infertility issues as well. Although it isn't due to sperm motility so I don't know much about that issue, I would strongly suggest seeing the accupuncurist Leslie Oldershaw. Her office is on Grand AVe and there are plenty of recommendations about her on the Parents Network - that's how I found her. She specializes in fertility issues and I remember her mentioning that she has treated men for sperm issues. She has a great holistic approach and will also look at diet and other issues to make sure that toxins, etc. aren't making things worse. Since medication is an issue for your husband, I can't recommend enough that you explore this approach. You have nothing to loose! anon

Infertility with attempt at second child

Sept 2004

I had my first child 4 years ago (at age 35). We conceived quickly. We've tried to get pregnant for the last 2 years with no success. Tests showed that my partner's sperm count is very low, with low motility and poor shape. We've tried 3 rounds of intrauterine insemination and one round of IVF with no success. During the IVF my doctor determined that I had poor quality eggs. Anyone else who has experienced this and overcome it getting pregnant at 39? ''Feeling Hopeless''


Your situation sounds painfully familiar to mine. We did finally conceive our second baby through IVF/ICSI after finally finding a reproductive endocrinologist who specialized in treating women with poor egg quality. (My husband had low motility as well.) The doctor was Dr. William Schoolcraft of Denver. We had failed IVF with another RE (no eggs fertilized), and he pretty much gave us no hope. At that time (6 years ago), most clinics were achieving about a 30% IVF success rate, but Dr. Schoolcraft was achieving over 60%, with the majority of his patients being couples who had already failed at IVF. We were very confident that Dr. Schoolcraft was one of the only REs in the country who could help us, so we were willing to travel. ; Also, his clinic works with many patients who come from out of state, so they have worked out the logistical details. I would be happy to correspond with you about the details of my treatment protocol with Dr. Schoolcraft. Please feel free to email me directly. m

Is a fertility specialist worth the money?

Sept 2004

My 34-year-old sister has had three miscarriages in the past two years -- all of them within six weeks of conception. She is seeing a Chinese herbalist who has succeeded in regulating her ovulation cycles. In addition, she is taking baby aspirin. However, she has not yet seen a fertility specialist and is unconvinced that this will do her any good. Her OB/GYN has performed a number of tests and says there is no reason why she should not be able to have a healthy pregnancy. What is the best course of action for her at this point? What would a fertility specialist do for her that an OB/GYN would not? Is it worth the time/money for a consultation at a fertility clinic? What kind of tests should she undergo? Concerned sister


Yes, a fertility doctor is worth it! Most are endocrinologists and have training way beyond what the ob/gyn does for both the female trying to get pregnant as well as the male partner. I think they should give it a try! saw fertility doctor and got pregnant
Has she had her progesterone levels checked? I had 3 early miscarriages at 6-7 weeks and it was found I had luteal phase defect. Once I went on the progesterone I carried my baby to term... progesterone lover
Sounds like your sister is doing a lot of things to help her fertility--but I wonder why the baby asprin? Has this been going on a long time and at a doctor's recommendation? I'm not a doctor, but that raised a lot of red flags. I was taught that asprin was not good for mothers in the first and third trimesters, and should probably be avoided during the pregnanacy as a whole. My dad used to take one asprin a day it as a blood thinner. And my accupuncturist always had me avoid even herbal blood thinners during pregnancy. Perhaps you could suggest a complete health screening for your sister first, taking into account all medications and even herbal suppliments. She could talk with that doctor about the value of seeing a fertility specialist. Wish her luck. Carolyn
YES! OB's are great at getting women through pregnancy but not necessarily getting them pregnant. A Reproductive Endocrinologist (RE) is who your sister should see. Her insurance *may* pay for it. Even if they don't pay for the doctor's visit, some of the blood work might ! be covered. There are many tests that an RE will order - and interpret - different than an OB. She has had enough pain & heartache with three miscarriages. All of the women I know who have been to RE's (and unfortunately I know many) wished they had gone sooner. good luck
Your sister could have a blood clotting disorder, which a reproductive endocrinologist (fertility specialist) would know to check for. After three miscarriages, most women are tested for them. If she does have it, baby aspirin wouldn't be enough -- she would need to be on a blood thinner, such as heparin. Or she could have the acupuncturist work on this if she prefers. She still needs a diagnosis. loved my reproductive endo
Baby aspirin is effective in some circumstances for preventing miscarriage but there is controversy amoung fertility doctors about who will benefit and who does not need it at all. Some say only those who have specific clotting disorders known to cause pregnancy, and I have heard of one doc who treats all IVF patients w/ baby aspirin, on the other hand some who never do. The expense of a fertility doctor will depend on who you see, whether your insurance covers it, what your diagnosis is, and how you decide to proceed. There are a myriad of ''treatments'' that depend on a number of variables (no different than if you have ''a stomach ache'' and are thinking of seeing a gastroenterologist). You could go to a specialist who might diagnose something very simple, for instance some underlying cause, and that will resolve in pregnancy. Things can get substantively more complicated from there, and the only answer that is valid is ''it depends'', on age, diagnosis, treatment, luck, etc.

The one thing that is important is to educate yourself about your body and situation. There are great books available in the library and online (Amazon has relevant ratings by previous readers), there are MANY on-line lists and resources to help you choose whether a specialist might be appropriate, what doctor will suit you, how much it might cost, and importantly- what questions to ask if you set up an appointment. Best wishes! anon


IVF or donor sperm for low motility?

May 2004

A friend of mine is looking at the possibility of undergoing IVF. They just found out her husband's motility is very low. One option at this time is using doner sperm with the IUI procedure. Their other option is to try IVF with her husbands sperm. She is wondering if anyone has gone through with the IVF procedures and looking back at it would have chosen the doner sperm as their 1st option instead.


My husband also has low motility and we pursued IVF. We had success on our first IVF attempt, so I would recommend going with your husband's sperm vs. a donor. However, you do not state what your husband's count and motility levels are and that could affect your decision. Speak to your IVF doctor and follow your heart. Good Luck!
My husband's sperm has very low motility (due to a spinal cord injury) and we chose IVF. We do not regret our choice. We were candidates for Intracytoplasmic Sperm Injection (ICSI) where they retrieve the sperm and the eggs and then inject a single sperm directly into each egg to increase the chances of fertilization. We conceived two healthy children this way (a now 6.5 year old from a fresh embryo and a now 3.5 year old from a frozen embryo). I know your friend was curious about negative IVF experiences, but I thought I would share our positive one anyway. She is welcome to contact me for more information if she wants.

Low sperm count - alternative to IVF?

Nov 2003

Well, it's finally been confirmed. The reason why my husband and I haven't gotten pregnant within the last year is because he has an extremely low sperm count. My GYN has referred us to the RSC, but we already know we can't (and honestly refuse) afford to pay that amount of money. We already have one son (conceived naturally) and feel that in spending thousands of dollars to try and have another is just taking away from him and our plans. However, we would be in awe if a miracle were to happen. So we have opted to weigh it out and give it some more time. I remember reading previous listing discussing how others had attempted alternatives to IVF or other infertily treatments. I was hoping I could get some input or referrals from people who have gone through this and made the decision to try non- traditional treatments. Anon


Sorry to hear about your diagnosis. Thankfully assuming your partner is willing there's a lot that can be done to improve sperm count. There is a daily supplement called Proxeed which is very expensive, but apparently quite effective in increasing motilty and count. Go here for more details. http://www.malefertility.co.uk/proxeed/page4.html There is also a lot to be said for acupuncture and Chinese herbs. I don't have specifics but can recommend Dr Angela Wu in SF. Best of luck, I hope this helps.
My wife and I had a similar problem, I was diagnosed with very low sperm count. We started various infertility treatments - hormones (depo testosterone) and artificial insemination, with no luck. We stopped all treatments (for a period of several months) and were considering IVF when to our surprise we conceived naturally. We also conceived our second child naturally (and unexpectedly)nearly a year after the first was born. My points are: (1) Don't give up yet. (2) Doctors'/scientists' understanding of fertility is incomplete at best. Statistically, it should have taken us ~10 years to concieve naturally (for each child) based on the measured sperm counts. anon
My husband and I are in a very similar situation. We have a 3 year old daughter and have been trying to conceive for more than a year. We finally did some tests and found out that my husband has a very low ( 8 million) sperm count, low motility and very bad morphology. I also thought that IVF was very expensive. My husband went to see an urologist who prescribed vitamin E, zinc and carnitine (Proxeed). There has been a study in the Netherlands showing that zinc + vitamin E can increase the sperm count by up to 50%. My husband tried for 3 months and his numbers went from 8 to 12 millions. Unfortunately this is still very low. The low motility is also a killer. If the numbers are low unfortunately it is very difficult to save the situation. The urologist also suggested to tie a varicocele but again this procedure is of questionable value if the numbres are very low. So for us IVF with ICSI is the only option left. Hope this helps still trying to have a second child
Check out www.onna.org for a list of vitamins and herbs as well as info for how to maximize your odds. Have you read Taking Charge of Your Fertility? A must-have and she goes into how to time intercourse when sperm count is a concern. Also www.inciid.org for their bulletin boards for their alternative therapy board, moderated by a MD who could help with ideas for male factor supplements.

When is it time to consider IVF?

January 2003

My husband and I have been trying for our second child for almost 2 years. After a miscarriage, we sought out a RE (reproductive endocrinologist) in San Francisco, Pacific Fertility Center. We have done 3 rounds of IUIs with injectible medications and they all failed. Our diagnosis is mild ovulatory dysfunction and borderline male factor. Help! Did you have success at other fertility clinics? When did you know you have to advance to IVF and was that the answer for you? Did you have insurance coverage? If yes, who? If no, how much was it and how did you afford it? Did you use alternative methods, ie acupuncture, vitamins/supplements, diet, exercise, etc. We don't have infertility coverage and would like to avoid IVF if possible. The procedure and the medications are so expensive. Any suggestions. Thank you for your help.


It seems to me that you need a Reproductive Endocrinologist that you can really work with. A good RE will answer questions about how likely you are to succeed with differing fertility techniques. (You should be comfortable enough with them that you value their advice over, say a mailing list ;-) I talked to several, and found one I liked.

I loved my RE, Dr. Susan Willman, who's in Orinda (925) 254-0444. I did try IUI's, but ended up with IVF, and now have two children. The decision to go from IUI to IVF depends on many factors, your diagnosis, but also your age, and what's important to you. The Center for Disease Control publishes the rates of IVF success by clinic, by the way. See http://www.cdc.gov/nccdphp/drh/ART00/index.htm

We paid for the IVF ourselves. None of the insurance offered us covered IVF. However, the insurance did cover many of the blood test before and medication (progesterone) after I got pregnant. If you're already using injectibles, you're already paying some of the costs of IVF. IVF Parent


I believe that it is important to pursue IVF as soon as it is feasible for you, since age factor is one thing that is always looming during infertility. You might want to have a second child, and you need the lead time.

We were lucky in that we had insurance to cover all of our attempts. My husband was employed by a company based in Massachusetts. When Dukakis was governor he mandated infertility insurance and we owe him a great debt of gratitude. There are a few other states that this is also the case for. He also worked for a California company that got infertility insurance and offered us a $25,000 cap, which paid for 2 tries.

I would join an online group called Fortility. They are incredibly knowledgeable about fertility issues and it is a great support group. You can reach them through surrogacy.org

Also, try looking into other clinics such as UCSF, Chetkowski, or other East Bay alternatives. Go for the doctor/practice that you like the best. It helps when your stress level goes up.

Dr. Wu in San Francisco is also amazing for fertility issues via acupuncture.

2 time IVF winner, 6 attempts anon


I'm sorry about your miscarriage. I too when through a number of miscarriages and many IUIs and drugs. Before you take the big (and expensive) step up to IVF I would recommend you try acupuncture and herbs. You may have already but you didn't mention it. There's a specialist in SF called Angela Wu who deals with fertility issues who has had tremendous successes. She'll get you to change your diet, take herbs and she's expensive but it worked for me and I now have a son. It won't hurt you and it can only do good.

Her phone number is (415)752-0170 and she has a website at: http://www.wushealingcenter.com/ Good luck! A very satisfied client


You don't mention your or your partner's ages, but they should be considered a factor when deciding your next options. In my case, my husband and I had been trying for more than five years, and we were both in our late 30s when we began fertility treatments.

My doctor's belief was that anything more than one year of trying without success constituted infertility. I believe the fertility clinic we had an IVF at used three years of trying as a baseline.

All our treatments were covered under Blue Cross PPO. But keep in mind that even the same carriers offer different coverage, depending on what the employer pays for. My husband's employer paid for very good benefits and covered fertility up to a set amount (I don't recall the amount); it didn't matter which type of medical fertility treatment was used. I don't know whether that included acupuncture and other alternative therapy.

My own OB/Gyn took us through six cycles of artificial insemination before he referred us to a fertility clinic in Palo Alto: Fertility Physicians of Northern California (http://www.fpnc.com/). It also has an office in San Jose. We live in the South Bay. The senior doctor there, G. David Adamson, is a pioneer in the fertility field.

Neither my doctor nor the clinic could find anything wrong with either of us, which in terms of pure statistics meant the odds were lower than other couples that we would conceive. That's because you can address a known cause of infertility. For instance, if the male partner has a low sperm count, ''cleaning'' or ''spinning'' the sperm combined with directly fertilizing the egg does wonders. Similarly, if a woman is not producing eggs, she can use donor eggs.

At the fertility clinic, we were offered the option of one cycle of artificial insemination with stronger fertility drugs (that I would inject myself) to increase my egg production or going right into in vitro. The difference was several thousand dollars in price. At this point I was 38, and it seems 37 is the magical cut-off point at which doctors tsk-tsk at you and say your odds of conceiving have plummeted. We figured that although IVF was more expensive, it would be even more costly to do another round of insemination FOLLOWED by IVF if the insemination didn't take.

So we opted for IVF. I'm happy to report that we were successful, and our son just turned 3. The funny thing is because no one could ever find anything wrong with either one of us, my doctor kept asking me about birth control, and I kept saying we were holding out hopes of having one more child. But by this time, we had exhausted our fertility coverage, and we were down to one income. So we just tried the old-fashioned way.

To put a coda on this, we're expecting our second child in March, and we did this one completely on our own. I believe a lack of stress from my being away from the working world may have a played a role. (On the other hand, I do have a toddler at home.) But go figure. Anonymous


I also went to Pacific Fertility Center in SF. We also did 3 medicated IUI's with them, and finally moved on to IVF. I think they are very conservative in that they suggest several IUI's before IVF--this is a testament to their honesty. If after several IUI's you haven't succeeded, then I think the choice is really yours (as it was ours) as to whether you want to make the financial and emotional investments that IVF requires. I have a 2 month old son thanks to IVF and the doctors at PFC. The most important thing is to trust your doctor and their advice--I was very pleased with everyone there and obviously, thrilled with the outcome.

One last comment--do consider seriously the payment options (''Plans'') they offer. We felt conflicted about our choice immediately after making it (basically one is ''insurance'', one is a one time shot, and one is a refund plan). We opted for the one time shot, but really felt as though we were gambling--not a nice feeling when you're dealing with something as unpredictable as conception... My two cents: Give it lots of thought so that you feel comfortable with your decision. Good luck to you! nina


Accupuncture & Chinese herbs regulated & shortened my cycle for the first time in my life, & I wasn't necessarily a ''believer''. Treatments can also be very soothing & relaxing. These can be expensive, but you might call Chinese medicine schools or Quan Yin in SF. Also, the idea that adoption leads to increased rates of conception due relaxing about having a baby & ''letting go'' may actually be better (or also) explained by changing hormones. I had started to miss periods for the few months before my (soon to be adopted) baby daughter moved in w/ me, but they quickly returned & became regulated, and I had clear signs of ovulaton. Research has shown hormonal changes in non-birth parents in reaction to babies. Is there a baby in your life you could bond with? (I'm sure the parents would be thrilled to have your help!).

Having said all this, you may want a 2nd opinion, especially depending on your FSH level, so as not to ''waste'' any more time-been there. I recommend Susan Wilman (RE) in Orinda.

I got a happy (different) ending, but dealing w/fertility can be so challenging. Good luck to you. Vicki


We did three IUI cycles before moving on to IVF. Unless there are identifiable reasons why the IUI's weren't working that could be addressed during future IUI's (like not enough follicles), it seems that IUI is not working for you. There is so much more control during an IVF cycle - they can really up your stim meds because there isn't the multiples risk (or as much of a risk) as with IUI. If you respond well, you may get enough embryos for more than one cycle, so the money you are putting into the stim meds goes further than with IUI. We got pregnant after our 2nd IVF. Have you talked thru IVF with your current RE team? THey should be able to help you understnad how IVF may improve your odds over IUI. Good luck!!! anon
I was in a similar situation and am so grateful I moved on to IVF. We were getting nickled and dimed doing IUI's, not to mention still spending a fortune on meds. (we did 1 clomid IUI, and 3 medicated). We did a shared risk IVF program through Dr. Susan Wilman in Orinda and got lucky the second time. We're still paying down the home equity loan, but its worth it.

If you want some onging support from very cool informed women, I recommend going to http://www.inciid.org/interinfertility.html There are two forums that could be useful: Infertilty waiting room and the IVF waiting room (see left column). These ladies saved my sanity. anon


You did not say your age, which is VERY important...2 years of trying at age 40 indicates you should run not walk to more advanced care. It sounds like you have tried the strategies pre IVF. IVF will cost about $10,000 for drugs, egg retrieval, and 1st round embryo transfer. If you have alot of good embryos, then 2nd and 3rd rounds should involve only the costs of frozen storage and embryo transfer (probably $1000). After all the failures with clomid, IUI, etc., I was happy to finally get to IVF, where I felt I had a better chance of success. We did get pregnant on the 1st round and went through UCSF (the docs have all moved on together to a new practice -don't know the name - the docs are Schriock, Givens, and Ryan). Again, if you are older, you should not waste any more time on unproven or less effective therapies. Anon
I tried for 3 years to have a baby, but was opposed to using fertility drugs. My sister in law recommended ''Eight Weeks to Optimum Health'' by Dr. Andrew Weil, as she had several miscarriages, did his program, and was able to carry her baby to term. I did this program and did also get pregnant and had a baby boy. I also had minor endometrial surgery which may have been the fix (hard to know as the doctor said that there wasn't much endometrius). I never had to try IVF, although I have two friends who did for their first child, and ended up having second children without planning them! Good luck! anon
It took me 4 years of medical intervention to get pregnant. I have Polycystic Ovary Syndrome. I spent about two years having a surgery and then using clomid and seeing bad doctors who weren't really paying attention. The second two years I was with a fantastic fertitlity specialist at Kaiser San Francisco, Dr. Seth Feigenbaum. I don't know how many cycles of Repronex injections we did but it took about two years so it was a lot. It was entirely free with my Kaiser coverage. Kaiser doesn't cover IVF so we were at the end of the line when Dr. Feigenbaum got a little more aggressive with my treatment and we have a beautiful 11 month old son now! Good luck! Danielle

Effects of Clomid on Menstrual Cycle

Dec 1999

Has anyone ever had experience with taking the drug Clomid (clomiphene citrate)? If so, was there ever an adverse reaction that showed up in your menstration? I recently took a test for my ovarium supply (to see if I still had any eggs left). I only took Clomid for five days. Two months later I suddenly had very heavy periods, like flooding, for two cycles. Since then my periods have resumed to normal but by OB-GYN wants to run a test (biopsy) and does not think the heavy bleeding could be due to the Clomid. I am trying to avoid the biopsy if possible, since it sounds pretty invasive (endometrial biopsy). I would love to hear feedback by anyone who has had a similar experience, or had this biopsy procedure.


The first advice I have is to discuss the side effects of Clomid with your doctor again. I am very shocked that the doctor thought that Clomid did not cause your heavy periods. Is it a commonly known side effect, from what I have read and experienced. In addition, there are several sites about Clomid on the Web. You can just search on the word "Clomid" in any search engine and get many sites. Check out http://www.parentsplace.com/fertility/infertility/qa/0,3105,11578,00.html for starters or search on infoseek.com. I took Clomid for about 4 months last spring and summer for infertility. It made my already bad PMS even worse, and did lead to heavier periods. Another side effect is ovarian cysts, and my OB/Gyn had my ovaries palpated before each new prescription. Perhaps your doctor is going one step further and doing a biopsy as well? I hope this information helps. Best of luck to you!

Using an ObGyn vs. Reproductive Endocrinologist

August 1998

Re infertility docs: I'd recommend you save yourself time and stress by seeking the expertise of a Reproductive Endocrinologist for infertility treatment (We have friends who have used UCSF, Chetkowski and Willman). You can obtain R.E. referrals from the organization Resolve, along with support and loads of information. If you haven't already done some extensive reading about infertility, you might want to obtain a book such as "Dr. Marr's Infertility Book" (I purchased at Stacey's Books in S.F.) which outlines causes, diagnostic procedures and treatments, costs, etc. There's definately different medical protocols out there and it's helpful to be knowledgeable about your options so you can fully participate in your care. We wish you much luck!


We used OMNI group which is in the building on the corner of Regent St...4th floor I think. Darcy Ketchum was our doctor, now moved, but we did see all of the doctors at one time or another. We actually used them once we were already pregnant...for the pre pregnancy testing, etc., I went to Dr. Margaret Cuthbert (now retired and writing her second novel.) We also saw Dr. Chetkowski, but maybe that is a step beyond where you are now. Can you ask to have appts with just one doctor...whichever one you feel most comfortable with? Seems like not so much to ask. Good luck.


I have not used the doctors you mentioned but have gone through
lots of treatments.
Round 1:  Used my gynecologist, Dr. Gore of SF.  He was not a specialist
          and how he treated me was inexcusable.  PLEASE continue to use 
          specialists.
Round 2:  Used Dr Kiltz, a partner of Dr. Chetkowski, in Berkeley.
          He and everybody in the group were wonderful.  However it
          wasn't a good test since I got pregnant the first round of
          Pergonal treatments.  Kiltz has since moved to New York.
Round 3:  One year after my son was born we went back to Chetkowski.
          I had run ins with one nurse, told Chetkowski about it, and 
          never had to deal with her again.  4-5 tries of Pergonal later
          we left that practice.  Chetkoski told me I couldn't have 
          childre and should give up but never gave me test results to 
          back that up.
Round 4:  Went to Dr. Eldon Schriock at UCSF.  He looked at my records, show
          showed me the test results that strongly suggest I couldn't have 
          children.  He suggested a psychologist to talk with (Dr. Ellie
          Schwartzmann of Oakland,  what a wonderfully helpful woman)
          We have tried a variety of treatments with him since then
          Although they haven't been successful, on the whole everybody
          has been nice and supportive.  One comment about Schriock,
          he has his nurses talking with you.  You have to force them to 
          have him call you and then it takes a couple of days.
Both of the practices have their pros and cons as do all of them The only suggestion I can make is that you make sure you are extremely comfortable with the practice, doctors nurses and receptionists alike. These treatments are unbelievably stressful and you need a lot of support.

If you need more information, try Resolve, the national fertility support group. They have a San Francisco office.


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