Getting Pregnant Now

The Pregnancy Miracle Ebook

Pregnancy Miracle by Lisa Olson is an in-depth guidebook showing readers the comprehensive information and tips about pregnancy. It begins with approximately 100 pages of informative content on the biological reproductive system, general methods to help conceiving, analysis of popular fertility treatments in West, and an introduction to less known ancient Chinese fertility techniques. Lisa outlines a three day juice cleansing following by a seven day parasite cleanse, plus a heavy metal cleanse and liver detoxification protocol. Cleansing your body of these harmful substances is important for a variety of reasons, as outlined in the book. When these toxins collect in your body, your digestive system becomes sluggish, which leads to blood intoxication which eventually results in a sluggish liver. Lisa Olson spent years developing the Pregnancy Miracle book so that people like her who are experiencing difficulties conceiving can have a chance to have their dreams of a new family member. Her program has helped thousands of women solve their fertility problems, but the program is designed to help men as well. More here...

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Author: Lisa Olson
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Male infertility and b12 deficiency

In about 40 percent of cases, a couple's inability to conceive is due to male infertility. Here again, vitamin B12 plays a significant role and, again, that role is generally overlooked by doctors. The link between male infertility and insufficient B12 levels first became commonly known in the 1980s, when researchers reported a study in which 27 percent of men with sperm counts less than 20 million were able to increase these counts to more than 100 million after receiving 1,000 mcg per day of vitamin B12.8 This research was pursued by scientists in Japan, who published a series of clinical and laboratory studies showing B12S beneficial effects on sperm counts. Here's what they found A different research group tested the effects of B12, Clomid (a fertility drug generally used to treat women, but also used in some cases to treat men), and B12 plus Clomid on infertile men. They found that for infertile men with sperm counts higher than 10 million ml, the combination of B12 and Clomid...

Jumping the hurdles of IVF

You come across a range of health-care professionals on your way through IVF treatment and in Chapter 4 I introduce you to the many members of your IVF team. It's very important that you feel you receive the best possible care, so I also discuss how you can ensure that the members of your IVF team respond to your needs and what you can do if they don't. IVF is like a set of hurdles that you have to jump in order to get to the finishing line hopefully with a baby in your arms In Chapter 5 I describe the obstacle course, what it takes to get over those hurdles and what may go wrong along the way. IVF is often likened to an emotional roller-coaster ride. In Chapter 9 I explain how the ups and downs you go through during an IVF treatment cycle can throw you off course and how you can get back on track again. If you're interested in technical details, I explain the actions and possible side effects of the drugs you take for IVF in Chapter 6, what happens in the IVF lab in Chapter 7 and how...

Cant Conceive How B12 Deficiency Contributes to Male and Female Infertility

Vitamin B deficiency is associated with infertility Pregnancy may occur in the presence of B deficiency, but may be associated with recurrent early fetal loss. hematologist Michael Bennett, M.D.1 For infertile couples, life often becomes an endless round of expensive (and often unsuccessful) fertility treatments. For couples who conceive babies but suffer miscarriages, trying again to become pregnant can be frightening, turning what should be a happy life experience into an anxiety-ridden ordeal that often ends, once again, in failure. There are dozens of common causes of male and female infertility, ranging from endometriosis, pelvic inflammatory disease, and polycystic ovary disease in women to structural or hormonal problems in males, and to anti-sperm antibodies in either partner. But there is another risk factor for both male and female infertility that is often overlooked, even by infertility specialists. That problem is vitamin B12 deficiency. One miscarriage is sad enough, but...

Choosing a family planning method

On the following pages we describe different family planning methods. Before recommending a method, find out about the woman's needs. Does she want to be sure she will not get pregnant using this method Is the woman's partner willing to cooperate in using family planning How much can this woman spend on family planning Does the woman want a method that she can stop using if she wants to become pregnant or one that is permanent When thinking about family planning it is important to also think about HIV and other STIs. Sexual intercourse, which causes pregnancy, is also how STIs are passed. Some family planning methods, like condoms, help prevent pregnancy and protect against STIs. Some, like birth control pills and intrauterine devices (IUDs), only prevent pregnancy. When you are helping a woman choose a family planning method, you must help her think about her risk of STIs including HIV. See Chapter 18 to learn more about STIs. FAMiLY PLANNiNG METHOD Birth control pills, injections,...

Accessing IVF treatment

Various state laws cover who can access IVF, what you need to do before having IVF treatment and what happens when couples or individuals use donor sperm, eggs or embryos (see Chapter 13 for more detailed information on this process). All states and territories allow heterosexual married or de facto couples to access IVF treatment (although in South Australia you have to have lived together for at least five years to qualify ), but the situation isn't as clear cut for single women and State IVF laws The following states have their own laws regulating IVF clinics For single women and lesbian couples the rules for accessing IVF vary between the states. Some states distinguish between medical and social infertility and allow single women and lesbian couples who can't have babies because of a medical problem to access IVF, but don't allow access to women who don't have or don't want a male partner. Reproductive tourism is a term coined to describe women who cross state borders to access...

Artificial Insemination

Artificial insemination is a procedure in which sperm obtained by masturbation or other methods of mechanical stimulation are deposited in the vagina, cervix, or uterus of the female by means other than natural intercourse, with the specific intent to achieve pregnancy. Artificial insemination is a brief office procedure that may be performed using the fresh sperm of the male partner or the frozen thawed sperm of an anonymous sperm donor, and involves injection of the sperm into the female through a thin tube. Intrauterine insemination requires preliminary processing of the semen sample to isolate the sperm for insemination since seminal plasma cannot be directly injected into the uterus. To be effective, insemination must be performed in close proximity to the time of ovulation (release of an egg) in the female as both sperm and eggs have a relatively short lifespan. Situations in which artificial insemination may be a recommended procedure include (1) anatomical problems that...

Taking IVF One Step at a Time

Understanding the various technical terms Preparing for IVF treatment Taking drugs to stimulate your ovaries Collecting the eggs and sperm and making embryos Waiting for your pregnancy test results Using frozen embryos m VF treatment follows the stages of the menstrual cycle. That's why C you hear people referring to a 'treatment cycle' or an 'IVF cycle' or sometimes just a 'cycle' when they describe the steps involved in an IVF attempt. You also hear clinic staff use weird acronyms for different types of treatment instead of the often very long and technical real names of these treatments. An IVF cycle is like a series of hurdles that you have to jump over without falling. After you make it over one hurdle, another one is ahead of you. If you miss a hurdle, you go back to square one. In this chapter, I explain all the strange acronyms involved in IVF. I also give you a detailed description of what you can expect in each step of a treatment cycle, why treatment sometimes doesn't go...

Fluking it by getting pregnant without help

Some couples unexpectedly conceive another baby spontaneously even though they needed IVF to have their first baby. This can come as a bit of a shock, particularly if you get pregnant within a few months of giving birth. After the long hard road to having your first child, you may have trouble comprehending how you can possibly conceive without any help from the lab. Unless you know that you definitely can't conceive without IVF, there's always a chance that the stars will align and you'll conceive spontaneously. So, if you don't want a surprise pregnancy, talk to your doctor about contraception. But if you want more children and don't mind when, who knows you may just get lucky

One egg one sperm ICSI

If you're undergoing ICSI, the embryologist gives the sperm a helping hand to enter the egg. Since it takes only one sperm to fertilise an egg, the embryologist catches a single sperm and injects it directly into the centre of an egg. If you have several eggs, the embryologist repeats the process. ICSI sounds simple but is actually a very technically advanced procedure that requires complex equipment and a highly skilled operator. To perform the procedure, the embryologist uses a specialised piece of equipment called a micromanipulator, which has two 'arms' one arm has a specially designed holding pipette (which has a slight suction applied to it) to hold onto the egg and the other arm has an extremely thin, sharp and hollow needle attached to it to pick up and inject the sperm into the egg. The embryologist delicately steers the 'arms' using knobs and levers.

Ten Tips for New IVF Parents

M ongratulations You've cleared all the IVF hurdles and you're pregnant As you close the door on your IVF treatment and enter the world of antenatal care, you can start to count the days until you finally meet your baby. The transition to parenthood is an amazing and joyous period that starts in pregnancy. But becoming a parent for the first time can be pretty daunting and unsettling, even if you've endured a long hard road to get there. One of the difficulties that some IVF parents face is that their expectations of themselves as parents, their baby and life with a newborn are somewhat romantic and idealised, and don't match the real-life experience of caring for a little one. Added to this, friends and family expect IVF parents to be blissfully happy and find parenting a breeze. The truth is, kissing goodbye to your life as you knew it and getting on with your new role as a parent with responsibility for the care and survival of a newborn baby is a mammoth task for all new parents,...

Ten Tips for Surviving IVF

M VF is a very high-tech way of getting pregnant and you have to get your head around all sorts of medical jargon and complicated instructions, not to mention putting up with the inconvenience of numerous clinic visits and all that poking, probing and prodding of your body along the way. But that's the easy part The trickiest aspect of IVF for any couple is hanging on to each other and your sanity during the ups and downs of treatment. In this chapter, I give you ten survival tips to help you through IVF. Before undergoing IVF treatment you need to gather as much information as you can, so that you have an idea of what to expect and can make informed decisions about your treatment options. Most importantly, knowing how IVF can affect your emotional health and finding out about strategies to help you cope with treatment make you better equipped for the IVF journey. Refer to Chapters 9 and 11 for more information about the emotional aspects of IVF.

Table 135 Questions about Intimacy and Infertility to Ask Your Doctor

Regardless of where you are in terms of your treatment, improving intimacy with your partner is an important goal. Physical intimacy is a significant part of most adult couples' relationships, despite age and illness. But cancer can and does get in the way. As psychologist Leslie Schover writes in Sexuality and Infertility after Cancer, Sex and cancer are two words that do not seem to belong in the same sentence. We think of sexuality as a force for joy and new life, whereas cancer is a death force. Increasingly, however, men and women survive their cancers. . . . Being able to enjoy sex is one important battle in winning the war against cancer.

Cutting the Ties With Your IVF Team

When you undergo IVF treatment you're in constant contact with the members of your IVF team. But after your six-week scan confirms your pregnancy, you have to say goodbye to your team and move onto the obstetric team for antenatal care. However, the obstetric team members usually don't want to see you until several weeks after your first scan and during this wait some couples describe feeling a bit abandoned, unsure who to turn to with questions they have. If you're worried about something before you have your first antenatal visit, contact your IVF nurse The IVF nurses are always willing to help, and if they can't answer your queries, they'll point you in the direction of someone who can.

Offering Lowcost IVF in Developing Countries

IVF and other assisted reproductive technologies are very high-tech and expensive forms of treatment that are available almost exclusively in developed countries. However, the personal tragedy of childlessness is no different for men and women in developing countries. In fact, in some cultures women who can't have children may risk public humiliation, divorce, abandonment or withdrawal of food and financial support even if their infertility is due to a sperm problem. As a result, the Low Cost IVF Foundation has developed a very simplified IVF protocol that's being trialled in some African countries. The idea is that one IVF cycle shouldn't cost more than 300. To keep costs down, the protocol If this protocol produces reasonable rates of success, in the future IVF could become a feasible option for infertile couples in poorer countries. You can follow the progress of this initiative on the Low Cost IVF Foundation's website (www.lowcost-ivf.org).

Natural family planning methods

Natural family planning methods, which are also called rhythm methods, involve determining the days during your monthly cycle that you're fertile Calendar method. Using certain calculations, you determine the first and last days during which you can become pregnant in your cycle. The effectiveness of natural family planning methods depends on your diligence. Used perfectly, effectiveness ratings could reach 90 percent, which means that 10 out of 100 women who use natural family planning as birth control for a year will become pregnant. Few couples use natural family planning perfectly, so they experience slightly lower effectiveness rates. your cycles and observe physical signs of ovulation. Some research has shown that the timing of a woman's fertility window can be highly unpredictable, even if her cycles are regular. That means you may have the potential for becoming pregnant even when calculations suggest you're not ovulating.

Moving On When IVF Doesnt Work

Closing the IVF door Managing your disappointment Getting back into life A lthough the chances of having a baby with IVF have increased dramatically over recent years, the sad fact is that treatment still doesn't work for everyone. IVF clinics provide plenty of information about their 'success' rates, but you need to remember on the flip side that they also have a 'no success' rate.

Family planning programs that work

Midwives help individual women and men decide about family planning methods. In this work, they may find that family planning is difficult to get in their communities. Midwives may then get involved in making family planning programs work better. What makes a family planning program work to improve a woman's health, her knowledge, and her control over her body Health services that include family planning along with care before, during, and after birth, support for breastfeeding, treatment for infertility, and treatment and prevention of STIs. Respect for local health providers and safe traditional practices, including traditional methods of regulating monthly bleeding and family planning. Midwives often have good experience combining traditional methods with modern methods of care. Freedom from pressure and coercion. Coercion means a health worker or someone else pushes a woman to use family planning or a certain method when she does not want to. This happens when programs limit the...

Men must also be responsible for family planning

When men and women choose family planning together, it is much easier to use family planning successfully. Because men do not get pregnant, they do not always take the responsibility that women do for pregnancy and family planning. Many men think of family planning as the woman's problem. Some men do not want their partners to use family planning. They may want lots of children, or they believe family planning is wrong, or they may feel that family planning is expensive or inconvenient to use and do not see any benefits to using it. When men support the right of women to decide when and if they want to be pregnant, women can make the choice to use family planning if they want to. Then women and men can both have sex with less worry if they do not want a child. As a midwife, you may be able to influence men in your community to take more responsibility for family planning. The number Making family planning work for the community support their partners in whatever family planning method...

Infertility treatment first things first

Americans spend millions of dollars each year on fertility drugs, artificial insemination, and in vitro fertilization. There is a place for these drugs and interventions, but only when simple, safe, inexpensive measures are exhausted. High on the list of such measures is getting tested for B12 status. This testing must include a serum B12 level, a urinary MMA test, and a homocysteine test (see chapters 1, 10, and 11). These simple tests, if provided routinely to infertile couples, might spare thousands of men and women the suffering caused by infertility, miscarriages, and stillbirths. Professor Ralph Gr sbeck and Olga Imerslund (noted discoverers of hereditary cubilin failure with cobalamin deficiency) have written about how vitamin B12 and folate deficiencies can cause infertility. Gr sbeck suggests, Every case of infertility in primary health care should initially be managed by test treatment with micronutrients, before reproduction specialists are consulted.i5

Understanding How IVF Knocks You About Emotionally

Of course, people are different and the way you feel about being infertile and having IVF treatment depends on several factors, such as 1 Your relationship If you and your partner support each other and talk openly about how you feel, chances are you'll have fewer emotional problems than if you have trouble communicating with your partner and don't feel loved and cared for. I give you some tips for working together with your partner throughout your IVF journey in Chapter 2. You may sail through IVF without any difficulties and, if you do, good for you. But if you're like most people, you'll experience some negative feelings from time to time during treatment and when you do it may help you to know that these feelings are normal and that you're not the only one feeling this way. How you cope emotionally with IVF depends largely on your personal circumstances. It goes without saying that if you're young, start IVF as soon as you find out you have a fertility problem and fall pregnant...

Realising How IVF Can Affect Your Mental Health

Realising how IVF plays havoc with your emotions Being there for your partner Coping with pregnancy loss Avoiding letting treatment run your life Healing over time A lthough IVF doesn't pose a great risk to your physical health (see Chapter 10), the possible risks to your mental health and general wellbeing from IVF are probably greater than from most other medical procedures. As well as your immediate reactions to the ups and downs of each step in the treatment process (which I describe in Chapter 9), IVF impacts on the way you feel about yourself, your partner and your life in general especially when the treatment doesn't work. In the last few years numerous researchers have studied the ways in which infertility and infertility treatments affect people's feelings and functioning. Evidence shows that such unexpected and unwelcome life events can shake you up in all sorts of ways. In this chapter, I draw on what's known from the research literature to explain how infertility and...

B12 Deficiency and Miscarriage Far More Common than Doctors Think

A recurring theme in the medical literature is that B12 deficiency is a fairly rare cause of miscarriage or stillbirth. The evidence, however, suggests otherwise. levels .in every patient investigated for infertility or recurrent abortion. This is particularly critical, they say, now that women of childbearing age receive large amounts of folic acid from supplements or fortified foods, because high folic acid levels can mask B12 deficiency. Such testing will help many women to become pregnant, and in addition, it will protect many children against the devastating effects of B12 deficiency in utero. As we've noted elsewhere, insufficient B12 in the developing infant is linked to serious and potentially fatal problems, including neural tube defects (see Chapter 6) and neurological abnormalities that can lead to mental retardation or autism (see chapters 6 and 12). In 2010, we heard from a woman who underwent gastric bypass surgery for weight loss in March 2003. She became pregnant in...

Understanding the Risks of IVF to Your Physical Health

Weighing up the risks involved for the female partner Checking out the risks involved for the male partner Considering the health of IVF children A s with all medical procedures, IVF involves some potential risks that you should be aware of before you decide to embark on treatment. You need to consider firstly the risks that relate directly to the IVF procedure and secondly health problems that may develop down the track because you've undergone IVF. But the most burning question for couples who have IVF is whether their child children will have more medical problems than children conceived spontaneously. In this chapter, I outline what's known about the possible short- and long-term risks of IVF treatment to the female and male partners, and to the baby. It's not always possible to say with certainty whether adverse health outcomes found in couples who've undergone IVF are caused by the IVF technique itself, the underlying cause of the infertility or the fact that, on average,...

Understanding the Risks of IVF

Rn n the hands of experts, IVF procedures are safe and medical complications are rare. But your emotional health can take a beating when you have IVF and sometimes, no matter how hard you try, the treatment doesn't work. In this part, I explain the potential risks involved with IVF to your physical and mental health and discuss how you can move on and get your life back on track if IVF doesn't work for you.

Riding the Emotional Roller Coaster of the IVF Cycle

A n IVF cycle is often described as an emotional roller-coaster ride during which you sometimes feel hopeful and optimistic and at other times sad and low-spirited. In this chapter, I describe the events that can make your emotions swing during an IVF cycle and give you some strategies for dealing with your feelings and staying in control while you're having treatment. In Chapter 11, I talk more about how the whole infertility and IVF experience can affect your life and sometimes almost drive you round the bend.

Type of fertility problem

Your chance of having a baby varies slightly depending on the type of infertility you have. Male factor infertility Couples with male factor infertility have the best odds of having a baby with IVF technology and in 2006 had a live birth rate of almost 22 per cent per started stimulated cycle and almost 17 per cent per frozen embryo transfer. Female factor infertility Couples with female factor infertility have slightly lower odds of having a baby with IVF technology and in 2006 had a live birth rate of just over 17 per cent per started stimulated cycle and just over 14 per cent per frozen embryo transfer.

Finding out exactly what happens in an IVF cycle

At most clinics, the nurses make sure that you know what to do throughout the course of your IVF cycle. So, before you start your cycle, you have a scheduled appointment with a nurse to find out what to expect and what you need to do at each step. This meeting is likely to cover

Coming to Grips with All the IVF Acronyms and What They Mean

Several forms of treatment have evolved from the original IVF technique developed in the late 1970s. These treatments all go by their short names, 1 IVF, in-vitro fertilisation In-vitro fertilisation literally means 1 ICSI, intracytoplasmic sperm injection IVF works only when the male partner has a normal or next-to-normal sperm count. (I tell you what's considered a normal sperm count in Chapter 1.) Scientists tried for a long time to work out how to help couples with male factor infertility and finally, in the early 1990s, they succeeded. ICSI helps many couples with male fertility problems. Instead of a sperm having to fight its way into the egg to fertilise it, the embryologist gives the sperm a helping hand. Using a so-called micro manipulator, the embryologist holds an egg still with a fine glass pipette called you guessed it a holding pipette. She or he then 'catches' a single sperm and injects it into the centre of the egg (the cytoplasm) using an extremely fine needle. The...

Legally Speaking Understanding How IVF Services Are Regulated

In Australia, assisted reproductive technologies such as IVF are heavily regulated by federal and state government legislation as well as professional bodies. Overall, such regulation is beneficial for couples seeking IVF treatment because you can be sure that clinics have high standards of care. All IVF programs have to abide by the following rules and regulations I The National Health and Medical Research Council (NHMRC) Ethical Guidelines on the Use of Assisted Reproductive Technology in Clinical Practice and Research 2004, which cover the ethical side of providing IVF services. I The Fertility Society of Australia's Reproductive Technology Accreditation Committee (RTAC) Code of Practice for Assisted Reproductive Technology Units, which describes in detail how clinics should be run. The RTAC audits IVF clinics every year to make sure that clinics offer the highest possible standards of care. Only clinics that meet the terms of the code are certified.

Choosing an IVF Clinic

About 75 clinics around Australia provide IVF services. Your family doctor or the doctor looking after your infertility investigation may routinely refer his or her patients to a particular clinic, but you may prefer to choose the clinic yourself. If you live in a city you may have several IVF clinics within a ten-kilometre radius of your home or workplace. So how do you know which clinic's right for you Researching the clinics helps you make an informed decision. Start by gathering as much information as you can.

Improving Your Chances of IVF Success

The success rate for IVF treatment has greatly improved since the late 1970s when the technique was first introduced. Although your chance of having a baby with IVF depends largely on factors beyond your control such as how many eggs you produce in response to your drug protocol and whether your eggs and sperm turn into healthy embryos recent research shows that getting into shape before starting IVF treatment can influence the odds in your favour. This mostly involves things you should be doing anyway to stay healthy there's no rocket science to it

Has she had any miscarriages or abortions

Miscarriage A miscarriage (spontaneous abortion) is when a pregnancy ends before the woman is 6 months pregnant, while the baby is still too small to live outside the mother. This is common and often happens before the woman even knows she is pregnant It is usually difficult to know why a miscarriage happens, but some causes of miscarriage are preventable. Malaria, sexually transmitted infections, injury, Sometimes miscarriages happen because a woman has been near poisons or toxic chemicals. For example, women who work on farms often breathe or handle pesticides which can cause miscarriage. These women have more miscarriages than other women. Some miscarriages can be prevented by treating women for illness and infection and by helping them avoid chemical poisons and violence. But some women have one miscarriage after another, and you may not know why. Get medical advice to find the cause and to help her carry this pregnancy all the way through . Women who work with pesticides or other...

Reacting to Your Infertility Diagnosis

Even if you've long suspected that you have an infertility problem, the actual diagnosis of infertility can come as a shock. Like many people, your initial reaction to the news may be disbelief 'There must be a mistake here Maybe the test results are wrong, or they've been mixed up ' After it all sinks in you may feel angry 'Why us What have we done to deserve this This is so unfair ' You may also feel guilty, blaming your infertility on something you did in the past 'It's probably because I had that termination when I was 16', 'If only I'd been more careful when I went backpacking 20 years ago I wouldn't have been infected with Chlamydia '' Over time, you may also experience all or some of the following Feelings of isolation, because infertility can be difficult to talk about Sadness and grief about not being able to do what's 'only natural' Worry about whether you'll ever have a baby

Who can have IVF in Australia

There are laws and regulations governing IVF in many Australian states relating to who can access IVF treatment, what kinds of records clinics need to keep, what clinics need to do to make sure that couples can make an informed decision, how long eggs sperm embryos can be frozen, the rules for donation of eggs sperm embryos and other matters. These laws and regulations change from time to time and vary between the states. For example, in the past only legally married heterosexual couples were able to access IVF in some states, but today married and de facto couples can access IVF in all states and in some states same-sex couples and single women are also eligible for IVF. In addition, some states require identifying information about egg sperm embryo donors and recipients to I explain the legal and regulatory aspects of IVF in Chapter 4 and in Chapter 13 I outline the laws and regulations governing donor conception.

Moving On to IVF The Hightech Way to Get Pregnant

Whether you've already tried other forms of infertility treatment or are told that IVF is the only way for you to have a baby, making the decision to start IVF treatment is a big one. Nonetheless, many couples at this stage also feel a sense of relief that they're finally going to be actively doing something that gives them a chance of having a family. To help make your decision, you need to find out as much as you can about IVF before you start treatment. This includes what the law says about who can have IVF, what happens in an IVF cycle, what your chances are of the treatment working and what the risks of treatment are.

Finding an infertility specialist

There are several types of specialist that you may see for an infertility problem 1 Infertility specialists are gynaecologists who specialise in the treatment of infertility. If such a specialist practises in the area where you live, ask your family doctor for a referral straight to the top If you live in an urban area, you may have several infertility specialists to choose from. Rather than your family doctor simply referring you to one particular specialist, you may want to think about what's important to you and ask to be referred to the specialist who best fits your preferences in terms of the following issues 1 Distance to travel You're likely to need to see the infertility specialist a number of times, so not travelling too far may be an important consideration. 1 IVF expertise Not all gynaecologists perform IVF, so if you think you may need IVF ask about this before choosing a specialist. 1 IVF treatment location Infertility specialists sometimes practise in different...

Finding Out Why You Dont Get Pregnant

As soon as you suspect that you have a fertility problem, you need to confirm your suspicions and find out what sort of problem you have, because this determines your treatment. Some detective work is needed here and you may have to see several doctors before you discover the cause of your infertility. A fertility problem is a challenge that you and your partner should tackle together. Whenever possible, make sure that you can both attend the required medical appointments. Don't waste precious time doing nothing. Your chances of having a baby, with or without IVF, depend a great deal on the female partner's age (I give you statistics about this in Chapter 3). So, if you've been trying unsuccessfully for a year or more, don't get talked into waiting just a little longer especially if you're aged in your mid-thirties or above.

Getting Ready for IVF

Perhaps you've been trying for a baby for many months and nothing has happened. If you think you've waited long enough and want to start doing something to help you conceive, I suggest that you start reading here. In this part, I talk about the steps you can take to find out why you can't conceive and the possible treatment options. I devote a whole chapter to discussing how you may feel when you discover that you're infertile and how to handle the emotional aspects of infertility. I also talk about what you can do to improve your chances of IVF working and how to find an IVF clinic.

Realising How IVF Can Affect Your Mental Health 143

Understanding How IVF Knocks You About Chapter 12 Moving On When IVF Doesn't Work 153 Offering Low-cost IVF in Developing Part V Beyond 199 Cutting the Ties With Your IVF 203 Starting IVF 248 Fluking it by getting pregnant without help 249 Chapter 22 Ten Tips for Surviving IVF 253 Chapter 23 Ten Tips for New IVF Parents 259

Miscarriage

Miscarriage is a synonym for ''spontaneous abortion'' or ''spontaneous pregnancy loss.'' A miscarriage occurs because of an abnormal fetus (usually within the first twelve weeks) or disruption of the uterus as a safe environment (more prevalent after thirteen weeks). Miscarriages are common, occurring in up to 19 percent of pregnancies. Miscarriage usually leads to vaginal bleeding, abdominal cramping, and occasionally severe pelvic Miscarriages are unanticipated and occur early during a time of frequent maternal ambivalence regarding the pregnancy. Grief is often prolonged, with self-reproach as to the cause of the miscarriage. Siblings usually experience turmoil due to various combinations of previous jealousy of the pregnancy, lack of parental emotional availability, and processing the reality of death.

Beyond IVF

Congratulations IVF treatment worked for you and you're pregnant Beyond IVF is a whole new world, one you've wanted to be part of for a long time. But you may find that the blissful state of pregnancy isn't so blissful after all and that caring for a baby can in fact be a bit of a nightmare. In this part, I talk about pregnancy, birth and parenting after IVF, and how you can prepare yourself for this new phase of your life.

Family planning

Having the number of children you want, when you want them, is called family planning. It is also sometimes called child spacing. There are many methods, both traditional and modern, that can be used for family planning. Family planning methods are sometimes called birth control or contraception. Why might a woman and a man want to use family planning by learning about family planning and sharing the information. by working with others to give couples more choices of family planning methods. by working with the community to get men more involved in using family planning.

Starting IVF again

If you know that you have to undergo IVF to conceive again, you need to bite the bullet and get on with it. Ask your family doctor for a new referral to your infertility clinic and then make an appointment to see the IVF doctor. Your IVF doctor will arrange for you to have any tests that need updating, then you can see the IVF nurse and get your instructions to start another IVF cycle (refer to Chapter 5 for a refresher on what the cycle entails). Having been there and done that already, you won't find the IVF experience as daunting as when you started your first cycle. Going back to IVF for baby number two can be easier in some ways because you know the ropes and what to expect. But the disappointment you feel if the treatment doesn't work isn't easier to take the second time around. And don't listen to people who say you should be grateful that you've been successful already If you want another baby, you're entitled to feel sad if the treatment doesn't work.

Male Infertility

According to three of four studies, oral vitamin E supplementation can effectively treat some forms of male infertility (Geva et al 1996, Kessopoulou et al 1995, Rolf et al 1999, Suleiman et al 1996). Doses used varied from 200 mg day to 800 mg day. As with many other conditions, treatment may be best suited to those individuals with elevated oxidative stress levels, although this requires further investigation.

Infertility

The ability to conceive a child is an issue with many different types of cancer, may affect both men and women, and can result from both adult and childhood cancers and treatments. Infertility can also be seen as a tragic consequence (a double whammy) of surviving a life-threatening disease. For some people infertility is a source of terrific loss and may bring about intense feelings of sadness, shame, worry, and anger. Just the possibility of future infertility can interfere with relationships. As one of my patients who had Hodgkin's lymphoma as a child says, At what point do you tell someone you are dating that you might not be able to have children The inability to have the family you always Infertility may come as a surprise or may be an expected outcome of the cancer treatment. It may also be temporary, for example, when a young woman with breast cancer goes into menopause during chemotherapy treatment and then several weeks or months after the end of treatment resumes ovulation...

Age and IVF success

A common misconception (no pun intended ) is that IVF can help you have a baby if you put off starting a family until later in life. After all, movie stars seem to have no problems having babies in their forties. Well, in many cases these women use eggs donated by younger women to conceive, although such a fact isn't usually publicised. (I cover donor conception in Chapter 13.) Age is one of the most important factors in determining your chance of having a baby with IVF. In Chapter 8 I show you exactly how age affects your IVF treatment, but the long and the short of it is that your odds of having a successful pregnancy decrease dramatically as you approach age 40. The average age of women who have IVF is 35 years. Women under the age of 30 have a 26 per cent chance of having a baby after one IVF cycle. Women over the age of 40 have only a 6 per cent chance of having a baby after one IVF cycle. Taken together, the best advice if you're contemplating IVF is to get started now. In a...

Fplus

More complex forms of treatment have evolved from the 'original' IVF treatment, some of which you may need in your quest to start a family i Third-party reproduction Today, some 10 per cent of IVF treatment cycles involve using donor gametes (eggs and sperm) or embryos to have a baby. The big question that arises in such cases is whether a child born as a result of the donation should be able to find out who the donor is. I discuss the arguments for and against in Chapter 13.

Folliclestimulating hormone

After menopause women still produce FSH, but since they have no follicles or eggs in their ovaries the hormone is simply excreted in their urine. Originally, drug companies used to produce FSH for fertility treatment by extracting the hormone from postmenopausal women's urine. The hormone was purified and turned into powdered form. The quality of this drug varied between batches and there was an element of uncertainty about its purity and FSH for IVF is provided for free under Medicare's Pharmaceutical Benefits Scheme (PBS) which is great, because this drug is very expensive. Refer to Chapter 3 for more about the PBS.

Interpreting the NPSU report

When you're trying to get your head around the NPSU's IVF statistics, it's important to remember that the data reflect the average of what happens to all couples undergoing IVF treatment. The data include the young and the old, couples on their first treatment cycle and those on their tenth cycle, couples who have lots of eggs and those who have only a few and so on. The report thus provides a global view of the workings of IVF. Miscarriages Understanding Your Chances of IVF Success So, what are your odds of having a baby with IVF The answer is It depends. i Factors relating to you as a couple, such as your age, the cause of your infertility and lifestyle factors such as being overweight and smoking In this section I show how some of these factors play out in the big IVF

Completing your first treatment cycle

Every time you try to conceive with IVF there's a chance the treatment will work. If you're lucky, it may work the very first time for you. In one study of 200 women who were pregnant as a result of IVF, 26 per cent were fortunate enough to conceive on their first go. If it's bingo for you first time, you'll think IVF is pretty easy and that all the talk about how hard it can be to conceive with IVF is nonsense You have a 100 per cent personal success rate. If you're unsuccessful on your first attempt to conceive with IVF, you may be encouraged to know that in the same study of 200 women, 68 per cent conceived within 12 months of treatment and on average they had 3.5 transfers, including transfers of frozen embryos, before hitting the jackpot.

Feeling on top of the World

IVF is a numbers game and as you play the game you always look at the crucial numbers. These are Such reports would make anyone on IVF feel on top of the world. But if you're over 38 years of age or have had a previous unsuccessful cycle with very few follicles and eggs and poor-quality embryos, your expectations will probably be pretty low when you try again. In that case, the following progress reports may make you feel very happy It's fair to say that news about the progress of your IVF cycle is always good if it matches or is better than what you expect.

Discovering that things dont always go to plan

In IVF, bad news can come out of the blue Sometimes a progress report is much worse than you expect and your dream of a baby seems to float out of reach. The kind of news you hope never to get includes Receiving bad news about your IVF treatment when you don't have your partner with you adds to the injury. Whenever practically possible, make sure that your partner's with you at the clinic if you know you're getting a progress report. If your partner can't be with you, ask someone else you feel close to and trust to attend the clinic with you for moral support. The language used to describe infertility and bad IVF outcomes can make you feel even worse than you already feel, because the terms imply that you had something to do with the failure. For example 1 Couples who have babies after IVF treatment are referred to as 'successful' which implies that those who don't have babies are failed couples. Whether IVF works or not is beyond your control and the fact that treatment fails is no...

Supporting each other

Your greatest supporter is your partner. The two of you have the same goal and have decided to give it your all to have a baby together. However, at times you may both be feeling down and have trouble giving each other support. If that's the case it may be better to turn to someone else for support and focus on nurturing your relationship with your partner instead Have fun together, go to the movies, eat out, see your friends, go for walks, do anything you like to take a break from the 'IVF job' and to remind yourselves that there's more to your relationship than surviving IVF.

During pregnancy and childbirth

Generally speaking, pregnancy and childbirth are very safe events in countries like Australia with a good healthcare system and most babies are born healthy. But, irrespective of how you conceive, you may have unexpected complications during pregnancy or at the time of birth. Some of these complications are more common with IVF than with spontaneous conception. This is because 1 Women who have IVF are generally older when they give birth and this increases the risk of pregnancy complications. Compared with pregnant women in general, women who fall pregnant with IVF are more likely to When you're considering the risks of pregnancy as a result of IVF treatment, you need to compare these risks with how often complications happen in spontaneously conceived pregnancies. The Australian Institute of Health and Welfare publishes an annual report on Australian mothers and babies. Here are some points to ponder from its latest report 1 1 in every 6 pregnancies miscarry (1 in 5 after IVF) 1 1 in...

Realising you may be sad but youre not mad

Many studies use measures of mood and anxiety to gauge how infertile couples feel throughout their IVF journey. The research clearly shows that keeping your spirits up through the turmoil of IVF is very hard, and couples commonly feel sad and worried while they're on the IVF program. When you feel really sad about something, it's very hard to enjoy anything in life. If you have trouble getting pleasure out of things you normally enjoy, you need to spend time dealing with your feelings and trying to get joy back into your life. Symptoms of depression and anxiety are perfectly normal reactions to the extraordinary circumstances of requiring complex, demanding and invasive medical procedures to help you to have a baby. So, if you feel down, helpless, miserable, powerless, gloomy, unhappy or distressed or all of the above while you're on the IVF program, you're not crazy you're just trying to get through a massive life challenge. But watch out for the chronic sadness that sometimes sets...

Feeling good for nothing

When you try really hard to achieve something and are unsuccessful, you understandably get frustrated. And if you keep trying and are still unsuccessful, you may start to wonder whether you're doing something wrong or are just no good at whatever you're trying to achieve. This can be the case when you don't get pregnant with IVF. If you try over and over again and the treatment doesn't work, your self-confidence and self-esteem take a beating. If you're running low on self-confidence and self-esteem, you may start to feel useless and a failure in all sorts of ways, which in turn makes you depressed and feeling even worse. If you get into this vicious cycle where you feel ever more down in the dumps, you need to seek help, because breaking this cycle on your own can be very difficult. Make time to see an IVF counsellor. The counsellors have seen and heard it all before and can help you get back on top of things.

Coping when lifes not as fun as it used to be

Enjoying life as much as you normally do can be hard when you're undergoing IVF treatment, especially when the treatment isn't working. The physical and emotional demands of treatment tend to be a bit of a dampener on your spirits. You may feel that your life has lost its gloss and become bleak and gloomy. As far as possible, try to keep doing the activities you really enjoy while you're on the IVF program such as playing a sport, reading, seeing friends or going to the movies. These activities give you a sense of normality and are a chance for you to take a break from the strain of life with IVF. The big life challenges really put relationships to the test. The way you and your partner deal with the stress of your infertility and IVF treatment can make or break your relationship. i Gaining strength from each other Most couples who go down the IVF path have a strong commitment to each other and to their goal of having children together. Studies show that these couples often have...

Talking about your feelings often helps her hinders him

Studies show that among couples who go through IVF treatment, both women and men get the majority of their emotional support from their partner. Mostly this works well, because there's give and take on both sides of the relationship and when one partner feels down the other steps up to the plate, and vice versa. But what happens when both partners feel down and have trouble coping with the demands of IVF As a general rule and it's certainly not true for everyone women feel better having a good talk about what's troubling them and men feel better if they don't talk about things. 1 Avoidance-oriented People who tend to use the avoidance-oriented coping style prefer to dodge the stressful situation altogether. If this is you, you feel better if you don't talk about your failed IVF cycle. You do all sorts of things not to think about it, like immersing yourself in work, playing sport or spending time with people who don't know you're having IVF treatment. 1 Emotion-oriented People who...

Dodging the blame game

When things go wrong you may look for someone to blame. The blaming that sometimes happens when IVF fails includes The fertile partner in a couple blames the partner with the fertility problem Blaming is counterproductive, because you feel worse and the person you blame feels bad. Truth is, most failed IVF cycles are due to either bad luck or biological factors out of your (and everyone else's) control.

Deciding to stop treatment

Most couples find that being on the IVF program has some negative effects on their sex life, job, career and financial situation. In spite of this many couples keep trying, sometimes over a period of years. Others find the process of IVF too demanding and decide to not pursue treatment if they experience treatment failure. The most common reason why couples stop treatment is that they're pregnant a very good reason to stop But for those who aren't so fortunate, the emotional demands of IVF are a much more common reason for discontinuing treatment than the physical burden of treatment. I talk more about the process of arriving at a decision to stop IVF treatment in Chapter 12.

Seeing Further Down the Track

Several studies have followed couples who had IVF for a period of time after their treatment. The good news is that within a few years of ending treatment, there are very few differences in terms of emotional wellbeing between those who had a baby as a result of treatment and those who didn't. Here are a few more results from these studies i Infertility doesn't go away, even if you have a baby Interestingly, despite having a baby with IVF, many couples still think of themselves as infertile It seems hard to shake off the experience of having fertility problems. That said, most couples who have an IVF baby know that they have to go through IVF again if they want more children, so it's understandable that they continue to think of themselves as infertile. i Life goes on, even if you don't have a baby The majority of couples whose IVF treatment doesn't work are able to move on and live satisfying lives. For many, in fact, it's a great relief when IVF is over because they can get on with...

Getting off the merrygoround

Deciding to stop IVF treatment can be difficult, because it may mean giving up on your dreams of becoming parents or having another child. That's why some couples just keep going with IVF, even if the chance of the treatment working is virtually zero. If this happens to you, you need someone to stop the merry-go-round so that you can both get off. Interestingly, in one study about IVF experience a whopping 79 per cent of women thought that couples should be counselled about the option to stop treatment. There's no right or wrong time to call it quits The only important thing is to find the right time for you. Some couples make plans in advance about how many times to try IVF and stick to their plans others need time to feel that they're ready to close the IVF door. Take the time you need, because this gives you a better chance to feel that you made the right decision. Susan and Andrew joined their IVF program full of enthusiasm and optimism. However, unfortunately they weren't lucky...

Dealing With Dashed Hopes

Part of the process of coming to terms with the fact that IVF hasn't worked for you is dealing with your disappointment and the disappointment of those close to you. IVF isn't just about hoping to have a baby it's about hoping to experience parenthood and sharing this unique experience with your partner, hoping to extend the family tree and give your parents grandchildren, hoping to enjoy raising children together with your friends (who all already have children, of course) and looking forward to having your own grandchildren in the future.

Managing your disappointment

When IVF comes to nothing, you may have overwhelming feelings of disappointment. This is to be expected after all, you've invested a lot of time, money, and physical and emotional capital without any return. It can take time to get over the disappointment and come to terms with not having a child or having fewer children than you want. Over time, some of these negative feelings fade. In one study of women's IVF experience several years after treatment, only 12 per cent of the women who didn't have a baby agreed that their life had been negatively affected by IVF, while 91 per cent said that they were glad they'd tried IVF. But it can be difficult to totally give up hope of having a baby 74 per cent of the women who didn't have a baby were still hoping to become pregnant and 68 per cent said that they would always be sad that they didn't have children. Deep disappointment can sometimes feel like anger inside. If you're angry with your clinic, your doctor or your lack of success, for...

Recognising your families disappointment

Many of the people close to you will be disappointed that IVF hasn't worked for you. They've been keeping their fingers crossed hoping that your extraordinary effort would pay off and feel sad for you that it didn't. But they may also feel a bit sorry for themselves for example, your mother may be disappointed that she won't become a grandparent or your sister may be sad that she won't be an aunt. If you already have children who were looking forward to having a sibling, they may feel that they've missed out on something they were looking forward to.

Needing a sperm donor

Azoospermia Very few sperm are needed for the embryologist to be able to create embryos with the intracytoplasmic sperm injection (ICSI) procedure (see Chapter 7), but if you have azoospermia and so have no sperm at all, you need donor sperm. Some IVF clinics have developed specialised protocols for couples where the male partner is HIV-positive that allow his sperm to be used without risking passing on the infection to his partner or their baby. However, for the procedure to be safe the male partner has to have an undetectable or extremely low viral load. Previously failed ICSI treatment If you have a low sperm count or a high proportion of abnormal sperm (see Chapter 1), you can usually conceive with the ICSI procedure, but if this procedure doesn't work you need donor sperm.

Understanding What the Law Says About Donor Conception

1 Australian Capital Territory, Queensland and Tasmania The National Health and Medical Research Council's Ethical Guidelines on the Use of Assisted Reproductive Technology in Clinical Practice and Research guide clinics in these states regarding the information about donors, recipients and offspring that IVF clinics need to keep on record. The guidelines stipulate that clinics mustn't use gametes from donors who don't consent to identifying information about them being released because donor-conceived children have the right to know their genetic parents. 1 New South Wales, Victoria and Western Australia These states have central registers with information that IVF clinics are obliged to provide about the identity of donors, recipients and children born from donor procedures. The information can be accessed by a child once he or she turns 18.

Putting Things on

A growing number of couples are completing their families as a result of IVF treatment but still have embryos in the freezer. That's why the number of embryos being stored in IVF clinics around Australia and indeed, around the world is increasing steadily. At some point couples with extra frozen embryos known as supernumerary embryos have to make the sometimes difficult decision about what to do with these embryos.

Deciding What to Do With Your Surplus Embryos

Tens of thousands of embryos are stored in freezers in IVF labs around Australia. Initially you freeze your embryos to improve your chances of having a baby. After several years, however, you may have all the babies you want and don't need the rest of your frozen embryos. Occasionally there are sadder reasons why couples don't use their frozen embryos for example, separation or chronic illness may prevent you from having your embryos transferred. Irrespective of why you don't use all your frozen embryos, at some point you need to make a decision about what to do with those that are left in storage.

Looking at Future Possibilities

Undergoing IVF without all the injections Pinpointing the most viable embryos to transfer Helping embryos to implant Freezing your eggs when you're young Moving IVF technologies to developing countries Examining IVF spin-offs rom humble beginnings, assisted reproductive technologies have come W a long way. The birth of the first IVF baby, Louise Brown, in the United Kingdom in 1978 was the culmination of many years of research. In those days no fertility drugs were used doctors simply waited round the clock for the right time to retrieve the one and only egg that a woman releases every month, even if this meant performing surgery (that's how eggs were retrieved then) in the middle of the night. And, if doctors did manage to catch a woman's elusive egg, getting it to fertilise and divide was another major hurdle because lab culture systems were less than perfect. So, in the early days of IVF women went through an awful lot for only a microscopic chance of having a baby. Since then,...

Getting Eggs Without Stimulating the Ovaries

Hormone stimulation is one of the cornerstones of modern IVF, but for women with polycystic ovaries or polycystic ovarian syndrome who have many tiny follicles in their ovaries, the stimulation protocol can be difficult to manage and they risk over-responding to the drugs and developing ovarian hyperstimulation syndrome (OHSS) (see Chapter 10). Embryologists are currently perfecting a technique known as in-vitro maturation (IVM) to allow such women to have IVF without hormone stimulation. Using IVM, the doctor retrieves immature eggs from tiny follicles in the woman's ovaries and then the embryologist places these eggs in a special culture medium for a few days to allow them to mature before introducing them to the partner's sperm. So, no need for injections and no risk of OHSS sounds perfect. Although some predict that IVM will become the IVF treatment of choice in the future, for women who don't have a large number of tiny follicles in their ovaries, hormone stimulation is likely to...

Identifying the Most Viable Embryos

The majority of embryos created in IVF labs and indeed many of the embryos that come into being as a result of good old-fashioned sex don't survive to develop into babies. Embryologists grade embryos based on their appearance (see Chapter 7) and good-looking embryos have a greater chance of developing into babies than not so good-looking embryos. But there's more to it than looks alone because even the best looking embryos don't always result in pregnancies and sometimes embryos that don't look so flash continue to develop into healthy babies.

Making the Embryos Stick

Some couples undergo embryo transfer after embryo transfer without getting pregnant. This implantation failure means that, for some couples, IVF just doesn't seem to work. Implantation failure is a devastating event for these couples and is therefore the focus of much research. Scientists are exploring several possible reasons for implantation failure, including In addition, scientists have identified certain gene patterns among women who experience implantation failure and are working on isolating these patterns as a predictor of IVF success. So, in the future, it may be possible to look at your gene pattern before you start IVF treatment in order to get a good estimate of your chances of having a baby with IVF. If your odds are really bad, you may decide not to go ahead with the treatment.

Curing Chronic Diseases

Many years of IVF-related research led to the discovery of embryonic stem cells about a decade ago. Embryonic stem cells, which are produced by embryos, have the potential to develop into any type of cell in the body for example liver, brain or skin and scientists all over the world are working very hard to find ways of using these cells to repair and regenerate tissue that's affected by chronic disease. Many believe that in time diseases like diabetes, Parkinson's and Alzheimer's will be cured using stem cell technology. Apart from relieving human suffering, if stem cell therapy proves successful the health-care cost savings would be enormous. However, the issue is extremely controversial and debates about the ethics of using embryonic stem cells are ongoing worldwide.

Jumping For Joy Baby On the

A fter all the trials and tribulations of infertility and IVF treatment you've W finally reached your goal You're pregnant The end of your infertility journey marks the beginning of a new and exciting phase in your life. The transition to parenthood begins with pregnancy, and you have a lot of work to do to get ready for the birth and your new life as a parent. Research shows that there are many similarities, but also important differences, between women who conceive with the help of IVF and those who conceive the 'old-fashioned' way in how they experience pregnancy, childbirth and mothering. In this chapter, I outline what's special about being pregnant after IVF and give you a few tips about what you can do to prepare for parenthood.

Finding Your Pregnancy Hard to Believe

When you conceive with the help of IVF you find out about your pregnancy much sooner than do couples who conceive spontaneously. So at first you may find it hard to believe that you're finally pregnant, especially if you don't have any pregnancy symptoms. However, after you've actually seen the little foetus on your six-week ultrasound examination, your pregnancy starts to feel more real. That's when you may find that your worrying about the outcome of every step in the IVF process becomes worrying about the outcome of your pregnancy

Wondering whether your baby will be okay

From time to time every woman thinks about the wellbeing of her unborn baby and hopes that her baby will be born healthy. After IVF treatment, you may be even more preoccupied thinking about whether your baby is developing normally and will be okay. For some women who conceive with IVF, worry about the welfare of their baby stops them from fully enjoying the fact that they're pregnant especially in the first few weeks of their pregnancy. However, these feelings don't usually last and in the second half of pregnancy, when they feel the baby moving, most women worry less and often feel quite blissful.

Getting Prodded and Probed

Antenatal care is all about monitoring the health of mother and baby so that any problems with the pregnancy are detected early and managed effectively. Women who conceive with the help of IVF often have more antenatal visits than women who conceive spontaneously. Partly this is because IVF mums are older and therefore are more likely to have pregnancy complications (see Chapter 10), to carry twins and to be first-time mums.

Having more than one baby

The number of couples who have a multiple birth after IVF treatment has been steadily decreasing over the last few years, mainly because more and more women are having only one embryo transferred. But twins are still more common among IVF parents In 2007, about 10 per cent of IVF parents had twins compared with a rate of 1.7 per cent for parents in general.

Thinking About Your Baby

As they approach the birth, most pregnant women become more and more emotionally attached to their unborn baby and spend increasing amounts of time thinking about their baby. While pregnant women in general form an emotional attachment to their baby that increases substantially when they can feel the baby moving inside them, IVF mothers form a very strong and

Planning the birth Have your say

About 50 per cent of women who conceive as a result of IVF have a caesarean birth, which is about twice the rate for women in general. Some of the reasons for this high rate are 1 About 70 per cent of twin pregnancies are delivered by caesarean section and since IVF mums are more likely to have twins than other mums, this adds to the high proportion of babies delivered by caesarean section after IVF. 1 More caesarean sections are performed in private than public hospitals, and most IVF mums have private health insurance. 1 Women who are older than age 35 when they have their first baby are more likely to have a caesarean birth than younger women, and IVF mums are usually older and more likely to be first-time mothers than mums in general.

Having a birthing experience that isnt quite what you expected

Several years ago some colleagues and I undertook a study of women's experiences post-IVF (see Chapter 18). About one-third of the IVF mums in our study weren't so thrilled with their childbirth experience but were very happy with the baby, of course These were predominantly the 1 When you have trouble conceiving and need IVF to have a baby, you may want to at least be able to have a 'natural' birth. If that doesn't happen, you may feel cheated and disappointed with the way things turn out. Table 19-1 IVF Mums' Satisfaction with Childbirth Table 19-1 IVF Mums' Satisfaction with Childbirth IVF mums and childbirth As part of our study, my colleagues and I examined how IVF mums regard their childbirth experience and stay in hospital afterwards. We compared the women who took part in our study with all Australian women who gave birth in the same year and found some interesting differences. For example, IVF mothers were Giving birth is a special moment in any woman's life, but for women...

Feeling ready to take your baby home

Initially, IVF parents may worry more about baby care than new parents in general. This is probably because infertility and IVF treatment can rock your beliefs about your ability to look after your baby and keep your baby safe. But, of course, you're as competent as anyone else and over time you get back your trust in yourself and feel more confident about caring for your baby.

Busting Some Motherhood Myths

The birth of a baby is usually a joyful event and after you give birth to a healthy baby (especially post-IVF) you're expected to be extremely happy. But being happy about having a healthy baby doesn't make caring for him any easier. The ideas that women just know how to look after a baby, that motherhood is the most rewarding job a woman can ever do and that being a stay-at-home mum is easy are myths about mothering or fathering, if dad's the primary carer that I hereby declare busted. You're not born with special genes for parenting the only thing you know by instinct is that a new baby needs to be fed, cared for and protected. But how do you do this People may presume that because you're an IVF mum you know what to do, since you've been looking forward to mothering for such a long time. But new IVF mums are as much novices to the job of mothering as other new mums, and it's normal to feel uncertain, hesitant, insecure and unconfident when you're new in a job.

Having So Much to Worry About

As part of the study my colleagues and I carried out about mothering post-IVF (see Chapter 18), we were interested to know whether we could predict which women may struggle to feel confident in their new mothering roles. We found that women who check one or more of the following statements have lower maternal confidence I Did you experience a lot of difficulty trying to conceive (for example, you were infertile for a very long time, experienced pregnancy loss and had several failed IVF cycles) More than half the IVF mums admitted to being anxious about taking their babies home from hospital. When we asked them about their confidence three months later, we found that more than half were very confident about caring for their babies and the rest mostly first-time mums were still a bit worried. So, even after three months' practice, you may still feel a bit tentative about baby care.

Feeling out of your depth

As a competent adult who managed a demanding job, travelled the world and successfully negotiated plenty of life challenges, you may be totally surprised that a tiny baby can make you feel so out of your depth. Many new parents feel this way, but the feeling can hit even harder when you've had IVF. After you've experienced a lot of trouble having a baby, your confidence in yourself can take a dive, and this dip can cause you to doubt your ability to keep your precious baby alive.

Wondering whether youre producing enough milk

We asked the IVF mums in our study how they I Compared with other mums, at three months fewer of the IVF mums were either fully breastfeeding (45 per cent versus 62 per cent) or partly breastfeeding (64 per cent versus 72 per cent) I Over half the IVF mums continued to breastfeed their baby for more than six months (54 per cent) I Compared with other mums, the IVF mums were more likely to breastfeed their baby Based on these figures and comments that the women shared with us, most IVF mums hope to breastfeed their babies and do indeed start.

Feeding can be tricky

Whether you breastfeed or bottle-feed your baby, feeding can be difficult and problems are common with newborns. Almost half of the IVF mums in our study reported having feeding problems such as not producing enough breast milk, producing too much milk and the baby refusing to take the breast or bottle.

Graduating from sleep school

In our study about mothering after IVF we discovered that many IVF mums use mother-baby programs by three months, 40 per cent had used one program or another most attended day-stay programs but 8 per cent were admitted to a residential program. And by 18 months 17 per cent had been admitted to residential mother-baby programs, compared with a rate of 5 per cent for new mums in general in Victoria, where we conducted our study. Some of the many reasons why IVF mums may struggle with baby care and face the kind of difficulties that mother-baby programs can help with include 1 IVF mums are older and are more likely to be first-time mums, have a caesarean section and a multiple birth. 1 IVF babies are born slightly earlier and generally weigh less so can be a bit trickier to care for at first. 1 Your infertility and IVF experiences can dint your maternal confidence and this can cause you to 1 You (and others around you) may expect that, now you have the baby you've always wanted, you'll...

Sleeping through the night sometimes

From the IVF mums in our study (see Chapter 18) we found that When the babies of the IVF mums in our study reached 18 months old, we asked the mums to answer a number of questions about their overall experience of motherhood to date. The results showed that many were more satisfied with their lives as mothers than most other mums, and most found motherhood very enjoyable and rewarding. However, some of the mums were still struggling with their feelings, as these examples show I 'I think it's important that women who become pregnant after assisted conception (especially those with multiples) understand that once they are a mother, they are entitled to feel like any other mother. By this I mean that they are

Taking the rough with the smooth

You may find some downsides of being an IVF parent. One is that your friends may be a few steps ahead of you You're still at home with a new baby while they're sending their kids off to school. Because a lot of parents' daily activities are tied in with the life stages of their children, you may no longer see so much of your 'old' friends when you become a new parent. Another slight drawback, related to being an 'older' parent, is that your own and your partner's parents may be less able to help you because they're too old. They may even be in poor health and need your help at times when you need a helping hand. Several of the IVF mums in our study mentioned missing the help of grandparents and coping with the additional responsibility of caring for frail parents and parents-in-law.

Finding Virtual Support

You'll find an array of websites dedicated to infertility and IVF treatment, and many have facilities for people to chat and share their experiences. From the comfort of your home you can connect with people who really understand what you're going through because they've had similar experiences to yours even though you don't know them or live on the same continent. If you like the idea of talking about your feelings and sharing your experiences of infertility and IVF while remaining anonymous, the internet is perfect for you. If you enter 'infertility support' into your favourite search engine, you're likely to get more than ten million results You can narrow your search down by adding 'Australia', but you'll still get more than two million results. So you may need to spend a bit of time figuring out which sites you find useful. In Appendix C, I list some Australian online support groups.

Turning to a Counsellor

IVF clinics in Australia and New Zealand are required to make counselling services available to couples who attend their programs. Infertility counsellors are experts on the emotional aspects of infertility and infertility treatment and can help couples to make informed decisions about their treatment options. You can benefit from a counsellor's experience and expertise at any stage of your treatment. For example, you may want to talk to a counsellor if you Receive bad news about your treatment and need to talk to someone who understands IVF about what this means for your future chances of having a baby with IVF Suddenly feel overwhelmed by everything and unable to manage the strain of the infertility and the rigours of treatment

Knowing When to Stop Treatment

There's no right or wrong time to stop treatment, but you and your partner need to think carefully at what point you'll bring your efforts to have a baby to a close and move on with your lives. Talking to your IVF doctor or a counsellor can be helpful in reaching your decision about when to stop IVF. Although the outcome of IVF is out of your control, you still have control over how many treatment cycles you have and can decide to stop when you've had enough.

Reaping the Rewards of Parenthood

Even if your confidence about caring for your baby is a bit shaky at first, rest assured that you're not alone and very soon you'll be an expert on looking after your baby. Research shows that confidence about caring for the baby grows over time and most IVF mums and dads find parenthood enormously rewarding and fulfilling. Perhaps the long and winding IVF journey, during which you realise that you can't take parenthood for granted, makes you appreciate and value parenting even more than if you'd had a baby the quick and easy way.

What Does This Mean A Glossary of Terms

Artificial insemination Placing washed sperm in the uterus to help a woman to conceive. ultrasound-guided procedure whereby eggs are removed from the ovaries for the purpose of IVF treatment. female factor infertility Couple infertility due to a female problem. A hormone produced by a growing pregnancy that is used in IVF to mature eggs because it has the same effect as luteinising hormone, which initiates oocyte (or egg) maturation and ovulation in the menstrual cycle. hysteroscopy Examination of the inside of the uterus. idiopathic infertility Infertility that has no apparent cause. infertility The inability to conceive after one year of unprotected intercourse. intracytoplasmic sperm injection (ICSI) A procedure used for male factor infertility where a single sperm is injected into an in-vitro fertilisation (IVF) Literally 'fertilisation in glass' refers to fertilisation occurring in a lab rather than in the body. in-vitro maturation (TVM) Immature eggs maturing in the lab. IVF...

Freezing Gametes and Embryos

Cryopreservation is really handy in many different situations, such as wanting to preserve some of your eggs or sperm before undergoing cancer treatment or when you have more than one or two really good-quality embryos after a stimulated IVF cycle. Although different methods are used for freezing gametes and embryos, after they're frozen they're stored in tanks of liquid nitrogen at a temperature of -196 degrees Centigrade. Material frozen at such a low temperature has no bioactivity, meaning that it can be frozen indefinitely without 'going off'. As a back-up during IVF treatment When you undergo IVF treatment, you're asked to produce sperm 'on demand', which can be pretty nerve-racking. If you suffer from performance anxiety, you may be reassured by having some back-up frozen sperm, in case you can't produce the sperm sample when it's needed. After undergoing testicular biopsy If you have very severe male factor infertility, sperm or small pieces of testicle can be removed...

Who looks after you now

A few years ago some colleagues and I carried out a large study of almost 200 women's experiences of pregnancy, childbirth and mothering post-IVF. We followed the women from early in their pregnancies until their children were 18 months old. These women very kindly shared their experiences by completing questionnaires in early and late pregnancy, and three, eight and eighteen months after childbirth. I Nina, who was 34 and fell pregnant with her first baby after two IVF cycles, said 'All I want is to feel normal again. The whole deal with getting pregnant with IVF I Sylvia, who was 39 and had experienced two miscarriages before finally having an ongoing pregnancy on her fifth IVF cycle, stated 'I feel so reassured every time I see my doctor, and best of all is to have a scan where I can see for myself that the baby is alive and growing. After my visits I feel relaxed and happy knowing that all is going well but after a week or so I start to worry about the baby again and count the...

What the Law Says About Surrogacy

The story of the first Australian baby born as a result of IVF and surrogacy made big headlines. Alice Kirkman was born in Melbourne in 1988. Her mother Maggie didn't have a uterus and her father Zev didn't have sperm, so Alice was conceived from one of her mother's eggs and donor sperm, and her aunt Linda carried the pregnancy and gave birth. After Alice's birth, surrogacy became illegal in Victoria, in spite of intense lobbying to allow altruistic surrogacy arrangements by Dr John Leeton, the doctor who made Alice's birth possible. So,

Undertaking Preimplantation Genetic Diagnosis

To avoid this dilemma, you can opt for your embryos to be tested in the lab before you fall pregnant. To do this, you undergo an IVF treatment cycle (I explain the cycle in Chapter 5) and then have the resultant embryos tested, to make sure that only those that aren't affected by the condition tested for and have the right number of chromosomes are transferred. This is called pre-implantation genetic diagnosis or PGD for short. If you've experienced several miscarriages, your doctor may suggest that you and your partner have a blood test to determine whether the miscarriages were the result of a balanced translocation (where a piece of chromosome breaks off and attaches to another chromosome). People with a balanced translocation don't normally have health problems as a result of the translocation because they have the full complement of genetic material but their sperm or eggs may have some missing or extra genetic material, which can lead to miscarriage. If your miscarriages were...

Get Pregnant - Cure Infertility Naturally

Get Pregnant - Cure Infertility Naturally

Far too many people struggle to fall pregnant and conceive a child naturally. This book looks at the reasons for infertility and how using a natural, holistic approach can greatly improve your chances of conceiving a child of your own without surgery and without drugs!

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