by Sharon Perkins,RN and Jackie Meyers-Thompson Infertility FOR DUMmIES ‰ 01_115183 ffirs.qxp 1/30/07 7:40 PM Page i 01_115183 ffirs.qxp 1/30/07 7:40 PM Page ii by Sharon Perkins,RN and Jackie Meyers-Thompson Infertility FOR DUMmIES ‰ 01_115183 ffirs.qxp 1/30/07 7:40 PM Page i Infertility For Dummies® Published by Wiley Publishing, Inc. 111 River St. Hoboken, NJ 07030-5774 www.wiley.com Copyright © 2007 by Wiley Publishing, Inc., Indianapolis, Indiana Published simultaneously in Canada No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permit- ted under Sections 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600. 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Library of Congress Control Number: 2006939496 ISBN: 978-0-470-11518-3 Manufactured in the United States of America 10 9 8 7 6 5 4 3 2 1 01_115183 ffirs.qxp 1/30/07 7:40 PM Page ii About the Authors Sharon Perkins has spent the last twenty years working as an RN, raising five children and spoiling two grandchildren. Following her Air Force pilot hus- band from state to state, she’s lived from Arizona to South Carolina, and still enjoys traveling from Arizona to Texas to Michigan to Virginia to visit kids, grandkids, and mom. Sharon’s ambition to be a writer dates back to grade school, if not earlier, and her desire to be a nurse (okay, she originally thought it would be nice to be a doctor but changed her mind) goes back at least that far. Amazingly enough, she found a way to combine nursing and writing in a way she would never have dreamed possible, thanks to a patient (Jackie) with the persistence and drive to make it happen. Jackie Meyers-Thompson is managing partner of Coppock-Meyers Public Relations/JD Thompson Communications Inc. and a “professional” fertility patient (seeking “early retirement” however!) It’s been said that we make plans . . . and the gods laugh. Jackie has heard that laughter often. It took her longer than she expected, and yielded more than a few laughs, and tears, before she met her husband-to-be, Darren Thompson. But by 35, she was newly married and deliriously happy and felt that the rest of the story would soon fall into place . . . Jackie can be a slow learner. Nonetheless, she can also be an industrious worker. She loved writing and, as a result, carved her path in marketing and public relations. She had a loving husband and a successful business, so the only things left to add were a few cherubic children and her own Great American Novel. Three years and a slew of physicians later, Jackie had more than a few doubts whether her future would ever include children. But her persistence and focus paid off. Infertility For Dummies is, in part, Jackie’s story of the journey that landed her a book and her beautiful baby daughter Ava Rose, who at 31/2, doesn’t want to be called a baby anymore. When not writing, working, or watching her daughter grow, Jackie spends her time making plans. Some things never change. 01_115183 ffirs.qxp 1/30/07 7:40 PM Page iii Dedication From Sharon: To my father, who always thought I could do anything, and my mother, who kept all our dreams alive. From Jackie: This book is dedicated to my still wonderful and Darling Husband (DH!), Darren Thompson, who has now added DF (Darling Father) to his ‘resume’ as well! And to Ava Rose Thompson, our long awaited child, who reminds me daily of the miracles in life that so often come when you least expect them. Authors’ Acknowledgments From Sharon: It’s hard to say thank you to everyone in the world, and yet I feel I would have to thank everyone from third grade teachers to babies I cared for in the NICU, because every one has taught me something useful and helped me become who I am today--both a nurse and a writer! So I’ll settle for thanking my family, including children, husband, in-laws, sis- ters, brothers, nieces, nephews and of course my grandchildren. I can’t leave out my friends, work buddies, and every patient I’ve ever cared for, as well as my church family and various writing groups who have been supportive and encouraging over the years. And, last but not least, Jackie — for having the vision and optimism to see that we really could accomplish this, even when we hardly knew each other outside of the nurse-patient relationship. Without her, I never would have tried this, and we’ve long since left the nurse-patient thing behind for genuine friendship. To quote St. Paul, “I thank God for all of you.” From Jackie: I don’t believe I would have gotten to this point had it not been for the wonderful care and treatment that I received through Dr. Jerome Check and the Cooper Center for In Vitro Fertilization in Marlton, New Jersey. It was also at the Cooper Clinic that I met Sharon Perkins. Her humor, caring, and expertise make her as great a nurse as they do a writer and most importantly a friend. I have so much to be grateful for in the support of family and friends. Cousin Sandy searched and researched and learned as much about fertility as his own field of medicine in helping us through the maze of doctors and proto- cols. My mother Larissa Meyers who helped us through the highs and lows in every way she knew how along with the rest of our families, the Thompsons, the Jaffes, the Cicecklis, and the Perlsteins. To my friends Melissa, Camille, 01_115183 ffirs.qxp 1/30/07 7:40 PM Page iv Courtenay, Susan, Leslie, Irene, Erin, Liz, Judy, Donna, Patty, Angie, Cheron, Leora, Margaret and Maureen, who were there for me during some of the most difficult and glorious times, unfailing in their encouragement and always providing a shoulder to cry on or a voice to laugh with. In the writing of this book, a number of professionals became friends as well. Jennifer R. Bloome, founder and president of Anji, Inc. and The Anji Connection, provided me with great insight into the power of mind and body when trying to conceive. To Rachel Glasser who listened and helped me learn. To Lisa, Evan, Dan and all the great folks at Follas Laboratories who celebrated every good result with me. And a special thanks to Dr. Garry Cutting and his staff at Johns Hopkins University who gave their time and expertise when we hit another brick in the wall during our efforts to conceive. Thanks as well to Dr. Martin Schwarz, who became a friend and great source of information on the ‘other side of the pond’ and Steven Keiles and Dr. Luke Padwick, who helped provide us with some crucial pieces to our puzzle. From both of us: Wiley took a chance on us six years ago, and we thank you all for your faith in us and your support. Our acquisitions editor Lindsay Lefever’s enthusiasm for this book was infectious; our project editor, Jen Connolly, has been a pleasure to work with. Immense thanks to Dr. Richard Paulson, who has been a marvelous source of information and guidance for this book; he kept our hyperbole under control and made sure we had our facts straight! 01_115183 ffirs.qxp 1/30/07 7:40 PM Page v Publisher’s Acknowledgments We’re proud of this book; please send us your comments through our Dummies online registration form located at www.dummies.com/register/. Some of the people who helped bring this book to market include the following: Acquisitions, Editorial, and Media Development Project Editor: Jennifer Connolly Acquisitions Editor: Lindsay Lefevere Copy Editor: Jennifer Connolly Technical Editor: Richard Paulson, MD Editorial Manager: Michelle Hacker Editorial Supervisor: Carmen Krikorian Media Development Manager: Laura VanWinkle Editorial Assistants: Erin Calligan Mooney, Joe Niesen, Leeann Harney Cover Photos: © Matthias Kulka/Corbis Cartoons: Rich Tennant (www.the5thwave.com) Composition Services Project Coordinator: Heather Kolter Layout and Graphics: Claudia Bell, Carl Byers, Laura Pence, Alicia B. South Anniversary Logo Design: Richard Pacifico Proofreaders: Jessica Kramer, Susan Sims Indexer: Techbooks Publishing and Editorial for Consumer Dummies Diane Graves Steele, Vice President and Publisher, Consumer Dummies Joyce Pepple, Acquisitions Director, Consumer Dummies Kristin A. Cocks, Product Development Director, Consumer Dummies Michael Spring, Vice President and Publisher, Travel Kelly Regan, Editorial Director, Travel Publishing for Technology Dummies Andy Cummings, Vice President and Publisher, Dummies Technology/General User Composition Services Gerry Fahey, Vice President of Production Services Debbie Stailey, Director of Composition Services 01_115183 ffirs.qxp 1/30/07 7:40 PM Page vi Contents at a Glance Introduction .................................................................1 Part I: Are We There Yet? Wondering Why You’re Not Pregnant..............................................7 Chapter 1: Where, Oh Where, Can My Baby Be? ...........................................................9 Chapter 2: Understanding Your Anatomy .....................................................................21 Chapter 3: Practicing Positive Behaviors — Before Conception ...............................41 Chapter 4: Struggling with Secondary Infertility..........................................................55 Part II: Stepping Up Your Efforts .................................65 Chapter 5: Trying Simple Techniques in Not-So-Simple Situations............................67 Chapter 6: Considering Special Circumstances ...........................................................89 Chapter 7: Seeing a Doctor — and Keeping Your Cool..............................................103 Chapter 8: Taking Supplemental Steps on the Road to Baby ...................................117 Chapter 9: Are We Having Fun Yet? Trying to Conceive and Your Relationship ...........................................................................139 Part III: Asking for Directions: Finding the Problem..................................................147 Chapter 10: Finding the Problem: Testing 1, 2, 3........................................................149 Chapter 11: All About the Boys ....................................................................................169 Chapter 12: When the Beginning Is the End: Early Pregnancy Loss ........................183 Part IV: Moving Up to High-Tech Conception ..............195 Chapter 13: A Little Help from Dr. Specialist: Intrauterine Insemination and Fertility Injections.........................................................................197 Chapter 14: Welcome to the Big Time: In Vitro Fertilization.....................................213 Chapter 15: Let the IVF Cycle Begin!............................................................................233 Chapter 16: The Care and Feeding of an Embryo: Amazing Teamwork in the Lab...................................................................................251 Chapter 17: Waiting, Waiting: Surviving the Two-Week Wait after an IVF Cycle..............................................................................269 02_115183 ftoc.qxp 1/30/07 7:34 PM Page vii Part V: The Road Less Traveled . . . So Far! ................285 Chapter 18: Challenges of Third-Party Reproduction................................................287 Chapter 19: Moving On..................................................................................................307 Chapter 20: Hello, Dolly! New Advances, New Concerns in Fertility .......................315 Part VI: The Part of Tens ...........................................331 Chapter 21: The Ten-Plus Most Annoying Things to Hear When You’re Trying to Get Pregnant...........................................................333 Chapter 22: Ten (Okay, Seven) Groups of Fertility Medications and Where to Find Them......................................................................337 Index .......................................................................345 02_115183 ftoc.qxp 1/30/07 7:34 PM Page viii