Fertility and Infertility For Dummies, UK Edition E-Book

Gillian Lockwood

• Herausgeber: John Wiley & Sons
• Kategorie: Ratgeber
• Sprache: Englisch

Seitenzahl: 615

Veröffentlichungsjahr: 2011

Beschreibung

This friendly guide combines professional and personal advice on every aspect of fertility and infertility. From deciding when to seek help and what help to seek, to the emotional, fi nancial, and medical considerations of fertility treatments, you'll be reassured every step of the way with all the support and specialist advice you need to increase your chances of a healthy and happy pregnancy.

Leseprobe

Fertility and Infertility For Dummies, UK Edition

by Dr Gillian Lockwood, Jill Anthony-Ackery, Jackie Meyers-Thompson, and Sharon Perkins

Fertility and Infertility For Dummies, UK Edition®

Published byWiley Publishing, Inc.111 River St.Hoboken, NJ 07030-5774www.wiley.com

E-mail (for orders and customer service enquires): [email protected]

Visit our Home Page on www.wiley.com

Copyright © 2007 John Wiley & Sons, Ltd, Chichester, West Sussex, England

Published by John Wiley & Sons, Ltd, Chichester, West Sussex

All Rights Reserved. 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 under the terms of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London, W1T 4LP, UK, without the permission in writing of the Publisher. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, England, or emailed to [email protected], or faxed to (44) 1243 770620.

Trademarks: Wiley, the Wiley Publishing logo, For Dummies, the Dummies Man logo, A Reference for the Rest of Us!, The Dummies Way, Dummies Daily, The Fun and Easy Way, Dummies.com and related trade dress are trademarks or registered trademarks of John Wiley & Sons, Inc. and/or its affiliates in the United States and other countries, and may not be used without written permission. All other trademarks are the property of their respective owners. Wiley Publishing, Inc., is not associated with any product or vendor mentioned in this book.

LIMIT OF LIABILITY/DISCLAIMER OF WARRANTY: THE CONTENTS OF THIS WORK ARE INTENDED TO FURTHER GENERAL SCIENTIFIC RESEARCH, UNDERSTANDING, AND DISCUSSION ONLY AND ARE NOT INTENDED AND SHOULD NOT BE RELIED UPON AS RECOMMENDING OR PROMOTING A SPECIFIC METHOD, DIAGNOSIS, OR TREATMENT BY PHYSICIANS FOR ANY PARTICULAR PATIENT. THE PUBLISHER AND THE AUTHOR MAKE NO REPRESENTATIONS OR WARRANTIES WITH RESPECT TO THE ACCURACY OR COMPLETENESS OF THE CONTENTS OF THIS WORK AND SPECIFICALLY DISCLAIM ALL WARRANTIES, INCLUDING WITHOUT LIMITATION ANY IMPLIED WARRANTIES OF FITNESS FOR A PARTICULAR PURPOSE. IN VIEW OF ONGOING RESEARCH, EQUIPMENT MODIFICATIONS, CHANGES IN GOVERNMENTAL REGULATIONS, AND THE CONSTANT FLOW OF INFORMATION RELATING TO THE USE OF MEDICINES, EQUIPMENT, AND DEVICES, THE READER IS URGED TO REVIEW AND EVALUATE THE INFORMATION PROVIDED IN THE PACKAGE INSERT OR INSTRUCTIONS FOR EACH MEDICINE, EQUIPMENT, OR DEVICE FOR, AMONG OTHER THINGS, ANY CHANGES IN THE INSTRUCTIONS OR INDICATION OF USAGE AND FOR ADDED WARNINGS AND PRECAUTIONS. READERS SHOULD CONSULT WITH A SPECIALIST WHERE APPROPRIATE. THE FACT THAT AN ORGANISATION OR WEB SITE IS REFERRED TO IN THIS WORK AS A CITATION AND/OR A POTENTIAL SOURCE OF FURTHER INFORMATION DOES NOT MEAN THAT THE AUTHOR OR THE PUBLISHER ENDORSES THE INFORMATION THE ORGANISATION OR WEB SITE MAY PROVIDE OR RECOMMENDATIONS IT MAY MAKE. FURTHER, READERS SHOULD BE AWARE THAT INTERNET WEB SITES LISTED IN THIS WORK MAY HAVE CHANGED OR DISAPPEARED BETWEEN WHEN THIS WORK WAS WRITTEN AND WHEN IT IS READ. NO WARRANTY MAY BE CREATED OR EXTENDED BY ANY PROMOTIONAL STATEMENTS FOR THIS WORK. NEITHER THE PUBLISHER NOR THE AUTHOR SHALL BE LIABLE FOR ANY DAMAGES ARISING HEREFROM.

For general information on our other products and services, please contact our Customer Care Department within the U.S. at 800-762-2974, outside the U.S. at 317-572-3993, or fax [phone].

For technical support, please visit www.wiley.com/techsupport.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

British Library Cataloguing in Publication Data: A catalogue record for this book is available from the British Library.

ISBN: 978-0-470-05750-6

Printed and bound in Great Britain by Bell & Bain Ltd, Glasgow

10 9 8 7 6 5 4 3 2 1

About the Authors

Dr Gillian M. LockwoodBM BCh MA (Oxon) DPhil MRCOG is the Medical Director of Midland Fertility Services (www.midlandfertility.com). Gill was a late recruit to medicine. She read Philosophy, Politics and Economics at Oxford University and then worked as a Government Statistician. A television documentary encouraged her to change careers to Medicine and she qualified in 1986. A chance meeting with Professor Robert Edwards (the ‘test-tube’ baby pioneer) introduced her to the science of IVF and since 1990 she has specialised in Reproductive Medicine.

For 10 years Gill was Senior Clinical Research Fellow and Lead Clinician at the Oxford Fertility Unit, where her research interests included polycystic ovary syndrome, premature ovarian failure, and recurrent miscarriage.

She lectures and broadcasts on ethical and social issues in reproductive medicine, has chaired the British Fertility Society Ethics Sub-Committee, and is a member of the RCOG Ethics Committee. She is an Associate Editor of Human Reproduction and a member of the Editorial Board of Human Fertility. She has published over 30 ‘first author’ articles in international journals and has contributed to many text books and review publications.

Since 2000 Gill has been the Medical Director of Midland Fertility Services (MFS), in the West Midlands. MFS is a ‘nurse led’ fertility unit at which the nursing staff perform all procedures required for IVF including surgical sperm retrieval (TESA), egg retrieval, and embryo transfer. MFS recently announced the successful delivery of the UK’s first ‘frozen egg’ babies; a development that has given new hope of becoming ‘genetic mothers’ to the thousands of young women who each year have to undergo sterilising chemotherapy or radiotherapy.

Jill Anthony-Ackery BA (Hons) is the Communications Manager at Midland Fertility Services. Jill is a relatively recent entrant to the world of fertility treatment, with responsibility for the communications and marketing of MFS since 2003, initially as a consultant public relations director and then as a member of the clinic staff since 2004.

Her qualifications for such a role? A degree in art and film history (!) and 18 years’ experience managing the reputations of client companies from a small UK trade association to international cosmetics, steel, and photographic equipment manufacturers. Oh! and also two years of ICSI treatment at MFS, during which she and her husband Gwyn conceived twins, suffered a miscarriage at around 12 weeks, then had an unsuccessful frozen embryo transfer, followed by a second full cycle, resulting in the birth of their daughter Connie in 2002.

When she returned to work in 2003, she combined her almost evangelical zeal about those miracle workers at MFS with her professional experience and patient perspective – and got paid for doing so! It’s a dream job where she continues to be inspired daily by the team and patients.

Jill has written countless articles in a range of newspapers, consumer magazines, and trade publications from many industry sectors. She was also the original editor and a contributor to Beyond the Lens, the business bible for professional photographers. In 2006, her work at MFS won a gold award from the Chartered Institute of Public Relations and she works closely with national and regional press, television, and radio to satisfy the unquenchable media interest in assisted conception.

Jackie Meyers-Thompson is managing partner of Coppock-Meyers Public Relations/For Your Information Communications, and a ‘professional’ fertility patient.

Sharon Perkins is the nurse coordinator for the Cooper Center for In Vitro Fertilization in Marlton, New Jersey, one of the largest infertility centres in the United States. She previously worked in labour and delivery and neonatal intensive care.

Dedication

From Gill: This book is dedicated to my family. To my husband, Michael, who made it possible for me to study medicine; to my three sons, Nick, Jamie, and Sam, who remind me every day what a blessing children are; to my mother, Ivy, who makes it possible for me to work, travel, do research, give lectures, and still know my boys will be well fed and have their homework completed on time.

From Jill: This book is dedicated to my husband Gwyn who let me reveal so candidly some of the personal stories about our fertility treatment, and to our darling daughter Constance Lydia, who is the reason for my being able to contribute to this book.

From Jackie: This book is dedicated to my Darling Husband (DH!), Darren Thompson, who has loved me and believed in us, through it all. And to my mother, Larissa Meyers, and my father, the late Leonard Meyers, who taught me early and well that I could climb any mountain.

From Sharon: This book is dedicated to my father, who always believed I could do anything.

Authors’ Acknowledgements

From Gill: This book is written with thanks to all the colleagues with whom I have worked since my first day as a clinical medical student in 1983. From the kind nurses who showed me how to take a blood sample without making a mess of the patient, to the patient professors who encouraged me to study for a PhD in Oxford when I’d discovered that reproductive medicine was the most exciting, rewarding, and interesting job ever.

My thanks also go to the patients. Being a fertility patient is tough but I have been fortunate to have the privilege of caring for a group of people who, almost without exception, have met the challenges of fertility treatment with patience, warmth, courage, and humour. And some got babies too!

From Jill: Gill and I have worked together at Midland Fertility Services since 2004 and while I learn something new/interesting/amazing/funny from her during every conversation, I thank her for the huge privilege of working together on this project.

My route to writing such a book was unplanned and a wonderful outcome to the dark moment, back in 1999, of being told ‘you need fertility treatment’. Of course, our daughter Connie was the greatest result of that time and as the fertility experts at MFS are now my colleagues, I need to thank them all – mainly for helping us to have Connie, but also for the continuous learning process I enjoy from our work and which has helped me write this book – especially Su Barlow, Judith Baron, Heidi Birch, Jo Johnson, Anna Kavanagh, Vicki Robinson, and Linda Tanner.

Thanks to my parents David and Sheila Anthony (the oracles!) who made me believe I could achieve whatever I set my heart on. I hope to pass the same mind-set on to Connie, as unstinting belief in your child is a wonderful and lasting gift. They know how huge my thanks are.

While I have incorporated Gwyn’s and my own personal stories into the book, I have also remembered the experiences of some of the MFS patients who have shared their stories with me over the last few years to re-tell through the media, including Vivian Barnes, Michelle Brookes, Shara Brookes, Elaine Eades, Julie Griffiths, ‘Lucy’, and Tom and Li McLoughlin-Yip. While their stories aren’t explicitly included in the book, they have helped shape some of the content, so that readers in similar circumstances may find the best advice and a possible way ahead.

Also thanks to Mrs (Isobel) Watts – your influence continues!

Finally, to Samantha Clapp and Rachael Chilvers at Wiley – we took it to the wire, but we did it! Many thanks.

From Jackie: Thanks toDr Jerome Check, Dr Jung Choe, and the Cooper Center for In Vitro Fertilization in Marlton, New Jersey. It was at the Cooper Clinic that I met my writing partner and friend, Sharon Perkins. Her humor, caring, and expertise make her as great of a nurse as it does a writer.

Thanks to Cousin Sandy, the Thompsons, the Jaffes, the Cicecklis, the Perlsteins, Melissa, Camille, Suzanne, Courtenay, Susan, Leslie, Sharon, and Nancy. Thanks too to Stephanie Smart and Jennifer R. Bloome.

From Sharon: Thanks to Jackie Meyers-Thompson; my husband, John; my children, John, Matt, Kim, Greg, Cindy, Ben, and Molly; Matthew Ryan, the most wonderful grandson in the world; my mother, Lois Orchard; my sister, Sue Collins; and my sister-in-law, Louise Kalmouni. My father, father-in-law, and mother-in-law would all have loved to see this book become a reality. As my mother says, they’re having a book party in heaven!

Thanks to Dr Check, Dr Choe, Dr Nazari, Dr Krotec, and Carol. And to all the wonderful patients I’ve met over the years, this book is really for – and because of – you.

Publisher’s Acknowledgements

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: Rachael Chilvers

Development Editor: Tracy Barr

Copy Editor: Anne O’Rorke

Proofreader: Juliet Booker

Content Editor: Steve Edwards

Technical Editor: Dr Christian Becker, University of Oxford

Executive Editor: Jason Dunne

Executive Project Editor: Martin Tribe

Cover Photos: © GettyImages/ DAJ

Cartoons: Ed McLachlan

Composition Services

Project Coordinator: Jennifer Theriot

Layout and Graphics: Joyce Haughey, Stephanie D. Jumper, Barbara Moore, Laura Pence, Heather Ryan

Proofreaders: David Faust

Indexer: Aptara

Brand Reviewer: Jennifer Bingham

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

Contents

Title

Introduction

About This Book

How This Book Is Organised

Icons Used in This Book

Part I : Making Babies as Nature Intended

Chapter 1: In the Beginning

Making Babies: An Inefficient Process at Best

How Aging Affects Fertility

Things to Think About Before You Conceive

Timing Your Baby: The Big Picture

Understanding the Long-Term Effects of Birth Control

Gene Genie: Looking at the Family Tree

Getting Pregnant: Was It Easier for Grandma?

Chapter 2: Taking Baby Steps

Biology for Baby Makers: Reviewing Male and Female Anatomy

Putting Male and Female Parts Together: Having Sex (At the Right Time)

Conceiving a Baby: How Sex Should Work

Making Sure That You’re Healthy – Before Conception

Behaving Yourself When Trying to Conceive

Finding Information

Part II : Planning a Pregnancy

Chapter 3: We’re Trying! We’re Trying! (to Get Pregnant)

Predicting Ovulation: Kits, Sticks, and Software

Practice Makes Perfect

Positive Thinking – Home Pregnancy Tests

Coping with That Time of the Month Again: The Pain of Not Getting Pregnant

Looking at Your Lifestyle

Eating for Two? Sampling a Fertility Diet

Looking at Supplements – Vitamins, Minerals, Herbs, and More

Turning to Complementary Therapies

Chapter 4: You, Your Fertility, and Your GP

Deciding When the Time is Right to See Dr G Practitioner

Thinking About FAQs for Your First Visit

Carrying Out Tests on Your First Visit

Choosing Over-the-counter Remedies: Placeboes or Simple Solutions?

Chapter 5: Great Expectations . . . But: Early Pregnancy Loss

Getting ‘a Little Bit’ Pregnant – It’s Possible

Suffering a Miscarriage

Ectopic Pregnancy: When the Embryo Is Developing in the Wrong Place

Picking Yourself Up after a Loss

Part III : Tests and Investigations

Chapter 6: Moving on Up: Seeing a Specialist

Seeking Dr Specialist

Working with Dr Specialist

Facing the Stranger in Your Sex Life

Understanding What Dr Specialist Says

Chapter 7: Finding the Female Problem: Testing, Testing, 1, 2, 3

Cataloguing the Common Tests: ABCD HSG

Understanding Female Infertility Problems

Reversing Sterilisation

Understanding Diseases That Affect Fertility

Chapter 8: It’s a Man Thing: When Tests Reveal Sperm Problems

Sounding Out Semen Analysis

Interpreting Your Partner’s Test Results

Reversing a Vasectomy

Overcoming Cancer and Male Fertility: The News Is Cautiously Optimistic

Part IV : Eureka! Possible Solutions

Chapter 9: Doing Your Homework: Researching Fertility Clinics and Funding Treatment

Dealing with First Reactions

Researching Fertility Clinics

Footing the Bill: Who Will Pay?

Chapter 10: All The ‘I’s: Introducing IUI, IVF, and ICSI

Doing the Groundwork

Deciding How Much Treatment You Need

Discovering IUI, IVF, and ICSI – the Basics

Deciding How Long to Keep Trying

Thinking Ahead: Health Effects of Fertility Treatment

Chapter 11: Giving Mother Nature a Helping Hand: Intrauterine Insemination (IUI)

Deciding How Much Treatment You Need

Treating Luteal Phase Defects

Acquiring Help through AI

Moving Up to Controlled Ovarian Hyperstimulation

Boosting Progesterone

Chapter 12: Making Test-Tube Babies: IVF

Starting an IVF Cycle: A Roller Coaster Ride of Emotions

Taking a Shot in the Dark: Time for hCG

Going for the Gold: The Egg Retrieval

Doing His Duty: Your Partner Is Busy, Too

Answering Common Egg Retrieval Questions

Chapter 13: ICSI: It Only Takes One Good Sperm!

Understanding How ICSI Works

Knowing Who Can Benefit from ICSI

Recognising a Good Sperm When You See One

Thinking Ahead: Things to Know about ICSI

Chapter 14: ‘Babies on Ice’: Egg Freezing and Fertility Treatment

Freezing Eggs: Coming In from the Cold

Reaping the Benefits of Egg Freezing

Completing the Job: Thawing, Fertilisation, and Transfer

Creating a Storm in a Test Tube – The Controversy over Freezing Eggs

Chapter 15: Giving, Receiving, and Sharing: Egg Donor Treatments

Using Donor Eggs: The Whys and Wherefores

Finding an Egg Donor

Taking Steps to Egg Donation

Getting Support

Chapter 16: Creating an Embryo: Amazing Teamwork in the Lab

Recognising a Good Egg

Sorting Suitable Sperm

IVF: Making an Embryo ‘in Glass’

Taking the Call from Embryology

Grading an Embryo

Looking at Your Uterine Lining

Hatching Embryos – Come on Out, Guys

Blast Off! Considering a Blastocyst Transfer

‘One Embryo or Two?’

Transferring Your Embryo

Keeping Your Feet and Your Spirits Up after the Transfer

Do’s and Don’ts for the Two-Week Wait

Part V : Post-First Cycle: How You May Feel and What You Can Do

Chapter 17: Waiting and Hoping: Surviving the Two-Week Wait after Embryo Transfer

Technically, You’re Pregnant – Waiting for the Proof

Sensing Every Little Twinge: The Truth about Pregnancy Symptoms

Preparing for ‘But What If?’ – Having a Plan B

Saying ‘No’ to Home Pregnancy Tests

Responding to Positive News

Considering the Next Step If IVF Doesn’t Work

Chapter 18: What’s in Your Freezer? Frozen Embryo Transfers

Facing a Few Facts about Frozen Embryos

Discovering Why Embryos Are Frozen

Understanding the Process of Cryopreservation

Dealing with the Ethical Issues of Embryo Freezing

Chapter 19: If at First You Don’t Succeed: Trying IVF More than Once

Calculating the Odds: Success Rates per IVF Cycle

Going Back for Seconds? Considering Your Options

I’m Okay, You’re Okay – Checking On the State of Your Union

Exploring Some Controversial Fertility Treatments

Gearing Up for More Cycles

Giving Up on Fertility Treatments? Considering When to Let Go

Part VI : Different Strokes for Different Folks: Options for Non-Traditional Families

Chapter 20: Third-Party Reproduction: You and You and Me and Baby Make . . . Four!

Preparing Yourselves for Using a Donor

Borrowing from the Sperm Bank

Using Donor Eggs

Receiving Donor Embryos – Embryo Adoption

Surrogacy: Borrowing a Uterus for Nine Months

Traditional Surrogacy – The Road Less Travelled

Telling the Family or Keeping It to Yourself

Chapter 21: Safe Options for Same-Sex Couples and Single Mums

Examining the Issues That You May Face as a Same-Sex Couple

Adoption in the Gay and Lesbian Community

Going It Alone: Fertility Issues for the Single Parent

Chapter 22: Ready-Made Families and Other Choices

Opting to Adopt

Trying Out Foster Parenting First

Deciding to Live Child Free

Working with Children

Chapter 23: New Advances and Ethical Dilemmas

Looking Down the Road: Long-Term Health Effects of Fertility Medication

Selecting the Sex: When You Absolutely, Positively, Want a Boy Or a Girl

Selective Reduction: Making the Hardest Choice

Dividing Up the Leftover Embryos

Putting Old Genes into New Skins: Cytoplasmic Transfer

Posthumous Conception: Legal and Ethical Issues

Cloning and Human Concerns

Saving Stem Cells for Research

‘Welfare of the Child’: Asking Clinics to Decide Who’s Fit to Parent

Making Mistakes in the Lab: When Saying You’re Sorry Isn’t Enough

Where Is All This Leading? New Fertility Frontiers

Part VII : The Part of Tens

Chapter 24: Ten Tips to Get You Through Treatment (and Keep You Sane!)

Give Yourself Time

Don’t Panic

Remember You’re Not Alone

Don’t Blame Yourself

Listen to Friends – Occasionally

Don’t Delay Treatment

Don’t Freak about the Financing

Don’t Get Needled about Needles

Share Your Treatment Experience

Coming to Terms with No Success

Chapter 25: Ten (Okay, Seven) Groups of Fertility Medications and Where to Find Them

Gonadotrophins

GnRH Agonists

GnRH Antagonists

hCG (Human Chorionic Gonadotrophin) Intramuscular

hCG Subcutaneous Recombinant

Progesterone

Clomiphene Citrate

Locating What You Need

: Further Reading

Introduction

Making babies is supposed to be fun and easy. Most people want to make babies, assume that they can, and for a long time the big priority is avoiding making babies in the wrong place at the wrong time. But if you’re part of the one in six couples who have problems making babies, then this is the book for you.

Infertility is a medical problem for about 3.5 million people in the United Kingdom. You are certainly not alone. But treatment is out of reach financially for some people and a tremendous personal strain on most. Many people (the ‘just relax and you’ll get pregnant’ crowd) misunderstand fertility, and a few (the ‘drink this vile potion and you’ll get pregnant, guaranteed!’ group) even exploit it. Clinical and scientific aspects of infertility continue to improve, yet the emotional considerations are often side-lined.

Fertility & Infertility For Dummies is the result of combining Sharon’s expertise as an infertility nurse; Jackie’s expertise as a patient; Gill’s wealth of information as a leading fertility consultant; and Jill’s experience of infertility as a patient and subsequently as the PR consultant for one of the UK’s biggest fertility clinics. We wrote this book so that people trying to conceive will know when to seek help, what sort of help to seek (and avoid!) and what the emotional, financial, and medical considerations of assisted conception can be. We hope this book finds its way to the bookshelves and bedsides of everyone who needs emotional support or specialist help to have the baby they want.

About This Book

You can’t pick up a magazine or turn on daytime television without hearing it: The great fertility debate over when women should have babies. But the quality of the information doesn’t match the quantity of the coverage, because much of it is inappropriate or just plain inaccurate.

Meanwhile, for the 30,000 infertility patients being treated in the United Kingdom alone (which doesn’t take into account the many people who haven’t sought or can’t afford fertility treatment), the question isn’t ‘when?’ but ‘if?’! Will they ever be able to conceive, carry, and deliver the child they are seeking, and will they be one of the fertility patients who sometimes pay up to £20,000 for the privilege of being told again, ‘Sorry, the pregnancy test was negative’?

This book is intended to help you walk into a GP’s or consultant’s office and feel in control of the questions, investigations, and treatments for infertility. Our aim is to provide fertility patients – both those at the starting line and those close to the finish – with comprehensive information about the options available to them. We discuss topics ranging from the scientific to the spiritual, from the empirically proven to the fantasist, quasi-voodoo, providing a thought, an idea, or just a giggle along the way.

You can read through this book from front to back and feel confident that you can find the answer to just about any fertility issue, from natural family planning to cloning. But if you’re like most people, you’ll probably look through the table of contents, home in on the chapters that affect you, and jump directly to them. This book is a resource, to go back to whenever a new issue or question arises, to find the answer you need without reading through everything that goes before. It’s good for people with every level of fertility expertise, from the novice to the jaded, been-there-done-that patient. The no-tech and low-tech fertility chapters come first, so you can skip them if you’re already a veteran and move right into high-tech and really high-tech stuff found in the second half of the book.

We intersperse personal stories throughout the book; these (hopefully!) make interesting reading from the viewpoint of ‘I did it, so you can too’ stories.

How This Book Is Organised

Fertility & Infertility For Dummies is divided into seven parts. If you’re just beginning to think about getting pregnant, you may want to start with the first couple of chapters. If you’re familiar with infertility treatment, you may want to skip to the sections that apply to your current treatments, or to those you may be moving up to in the future. If you want to read through the entire book, you’ll be well informed on all the latest infertility issues and the newest technological advances in the field.

The following sections explain the organisation of this book:

Part I: Making Babies as Nature Intended

If you’re a newcomer to the wonderful world of baby making, we suggest that you start reading here. In this part, we explain male and female anatomy (including everything you ever wanted to know about reproductive organs), look at the logistics and implications of getting pregnant, and review any habits and behaviour you could change – or not – before trying to get pregnant.

Part II: Planning a Pregnancy

This part helps you fine-tune your conception efforts using methods to predict ovulation, and helps you understand how complicated getting pregnant really is. We also assess the value of male and female fertility home-test kits, guide you through your first visits to your GP about possible infertility, and help you understand and deal with pregnancy loss. We also take a look at some alternative approaches to conception, from herbs to acupuncture.

Part III: Tests and Investigations

This part explains the tests you may be doing and those your GP may advise, to find out why you’re not yet pregnant; we explain what the tests are and what the results may mean. We also accompany you on your visits to a consultant, and help you decipher what the doctor tells you, including the investigations that he or she may recommend. We explain tests for male infertility and what fertility treatments your hospital consultant can offer. We also take a look at the choices you have if you’re told you need fertility treatment.

Part IV: Eureka! Possible Solutions

This part explains how to research and choose a fertility clinic and options for paying for your treatment, including possible NHS funding. We explain intrauterine insemination (IUI), in vitro fertilisation (IVF), and intracytoplasmic sperm injection (ICSI) and what each involves. We take you through the stimulation process, the egg retrieval, and look at how an embryo is created in a lab. We also look at embryo and egg freezing and at egg sharing treatments in this part.

Part V: Post-First Cycle: How You May Feel and What You Can Do

This part supports you through the two-week wait between IUI or embryo transfer before your pregnancy test and guides you through your options if the result is negative, including frozen embryo transfers, and considering another treatment cycle.

Part VI: Different Strokes for Different Folks: Options for Non-Traditional Families

This part considers third-party reproduction – the use of surrogacy or using donor eggs, sperm, or embryos to get pregnant. We also discuss parenting for ‘non-traditional’ families (gays, lesbians, and singles) and discuss fostering and adoption for every kind of family. Finally, we look at new – and sometimes controversial – treatments including fertility preservation and cloning.

Part VII: The Part of Tens

Want to read some tried and tested advice to keep you sane during your treatment? Want to know the difference between a gonadotrophin, an antagonist, and a recombinant? This is the part for you.

Icons Used in This Book

If either of us has a personal story that is funny, informative, inspirational, or otherwise interesting, we identify it with the Personal Story icon. These anecdotes are never essential reading, but they’re usually entertaining!

If something’s really important for you to keep in mind during your fertility treatment, we mark it with a Remember icon.

If something’s technically interesting but not really essential to know, you see the Technical Stuff icon.

The Tip icon highlights practical information that may make the road to baby somewhat smoother.

If you see the Warning icon, pay special attention. It tells you about potential problems or difficulties.

Part I

Making Babies as Nature Intended

In this part . . .

Y ou may not have given much thought to the difficulties of getting pregnant – more likely you’ve spent many years trying to avoid getting pregnant! However, after you make the decision to have a baby, you need to look at all the factors that go into having a successful pregnancy, from health issues to lifestyle changes. In this part we look at questions you need to ask before trying to get pregnant, and we give you some basic information on how human reproduction works – and how it will hopefully work for you.