Infertility

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    AAnish Shah, MD, OBGYN (Obstetrics & Gynecology), answered on behalf of HCA Virginia
    How can acupuncture and Chinese medicine help treat infertility?
    Acupuncture and Chinese medicine can help treat infertility, according to Anish Shah, MD, a reproductive endocrinologist at Richmond Center for Fertility and Endocrinology. In this video, he explains how doctors can coordinate these treatments.
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    AHealthyWomen answered
    There is no way to prevent infertility because there are many factors that contribute to a woman's ability to ovulate, conceive and carry a pregnancy to term. Likewise, your male partner also has numerous factors -- natural and environmental -- that can contribute to infertility. The condition is not exclusively a woman's problem. About one-third of infertility cases involve male factor problems alone, and approximately one-third involve problems with both partners.

    For women, risk factors that could lead to infertility include:
    • being very overweight or very thin, either of which can affect ovulation and fertility
    • chronic, debilitating diseases, such as unregulated diabetes, lupus or thyroid problems that can interfere with normal ovarian function
    • medications such as high-dose steroids that can interrupt ovulation
    • polycystic ovarian syndrome (PCOS), with symptoms including irregular or infrequent periods, excessive facial hair and acne
    • surgeries on the cervix or abnormal Pap smears that result in cryosurgery or cone biopsy, which can affect the function of the cervix.
    • hormonal imbalances that cause abnormalities in your menstrual cycles
    • multiple miscarriages (two or more early pregnancy losses)
    • environmental factors, such as cigarette smoking, alcohol consumption, illegal drugs and exposure to workplace hazards or toxins
    • medication including herbal or natural medication
    • age
    • sexually transmitted diseases (STDs)
    • fallopian tube disease (accounts for about 22% of infertility cases)
    • endometriosis
    If you have a chronic health condition, be sure to discuss it with your healthcare professional. Most women with chronic conditions can become pregnant, have a healthy pregnancy and deliver a healthy baby.
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    AHealthyWomen answered
    Learning about different surrogacy agencies and deciding which one you would like to work with can be overwhelming. Every agency's approach is different, so it's important to choose a qualified agency that fits your personal requirements and expectations.

    Consider how the agency prescreens its potential surrogate mothers and whether its services and support offering is comprehensive. Understand how it will manage insurance coverage and financial transactions, facilitate legal representation and how much the agency will charge in fees.

    Your fertility clinic or a previous intended parent may be able to provide referrals for reputable agencies.
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    AHealthyWomen answered
    The medical process for gestational surrogacy varies by individual circumstances and the fertility clinic you ultimately choose to work with. However, all instances of gestational surrogacy involve in vitro fertilization (IVF), which is the fertilization of an egg by the sperm outside of the body and in a laboratory. If IVF is successful, then an embryo transfer procedure will take place, which involves manually placing the embryo in the surrogate's uterus. In some instances, the process may include a donor egg, donor sperm or donor embryo.
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    AHealthyWomen answered
    Your specific circumstances and that of your surrogate mother will determine the associated expenses of your gestational surrogacy journey. On average, the cost can range from $60,000 to $125,000 depending on the following factors: insurance coverage, if you are using a donor, the location of your surrogate and whether you are doing a fresh or frozen in vitro fertilization (IVF) cycle.

    The expenses incurred as part of the gestational surrogacy process, including your surrogate mother's compensation and out-of-pocket expenses, are the responsibility of the intended parents. This will be detailed as part of the surrogacy agreement prepared by qualified legal representation and signed with your surrogate mother before the medical process commences.  
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    AHealthyWomen answered
    During a surrogate pregnancy, it is critical for you and your surrogate mother to share similar viewpoints on a variety of  subjects and be in agreement about who will make these types of decisions throughout the pregnancy. You'll discuss important topics, such as prenatal testing, selective reduction and termination in detail with your surrogate mother before you move forward with the medical process. In addition, there is typically language addressing these subject areas in the surrogacy agreement you sign with your surrogate mother.
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    AHealthyWomen answered
    Every surrogacy relationship is wholly unique and can be characterized in many different ways. Some people go into the match knowing they want a close relationship with the surrogate mother, some develop organically or you may choose not to have a relationship at all. This all depends on your personal feelings and those of your surrogate mother.

    It is critical to discuss your relationship expectations with your surrogacy agency so it can match you with a surrogate who shares similar expectations. Important topics include regularity of communication, types of communication and the nature of your personal relationship. Of course, relationships evolve and change over time, so try to create a foundation with your surrogate mother on which a healthy relationship can develop.
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    AHealthyWomen answered
    If you are exploring gestational surrogacy as a means to build your family, it is recommended that you seek experienced advice to understand if surrogacy is right for you. There are numerous resources that exist to help intended parents understand all facets of the surrogacy process, including surrogacy agencies, fertility counselors and in vitro fertilization (IVF) clinic professionals. It is also beneficial to speak with a former intended parent or an experienced surrogate mother to help in your decision-making process.

    Gestational surrogacy is not right for everyone, and understanding all the aspects of the gestational surrogacy process, especially the financial and emotional impacts, is important before making the decision that is right for you. Talking with your doctor about your specific needs and the best way to achieve them is the first step. Remember you are never alone. Take advantage of support groups, counselors and your loved ones to help you through this process.
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    AHealthyWomen answered
    Having a purpose for sex beyond pleasure can definitely take the fun out of it, particularly if you're having fertility problems. Generally, it is recommended that you seek specialty care for fertility issues if you have not gotten pregnant after a year of trying.

    Infertility, whether or not you are undergoing treatment for it, places tremendous stress on a couple. The longer you go without conceiving, particularly once you and/or your partner begin treatment, the greater the stress. One study of 200 infertile couples found slightly more than half experienced a decline in sexual satisfaction after diagnosis.

    Here are two things you can do to help you start enjoying sex again:
    • Take a break from trying to get pregnant. Take two or three months off -- that won't make much difference in the long run, and it could do wonders for your marriage. During that time, schedule a vacation. If money is tight, that vacation could be to a friend's weekend house or even just a couple of days in a local hotel -- anything to get into a new environment with no reminders of fertility issues. Or, have a staycation -- take time off, stay at home and simply enjoy the time alone with your partner.
    • Try to bring some spontaneity to your sex life. That could mean having sex in a different room, at different times of the day or in different positions. Do not plan sex! Planning is invariably a major part of the problem. In fact, another option is to stop having sex at all for a week or more. Instead, return to the days of dating and kissing. But don't let anything lead to intercourse. You'll be amazed at how turned on you feel after a couple of make-out sessions.
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    AHealthyWomen answered
    Here are some tips on how to share your infertility with your loved ones:
    • Keep the details to a minimum. Your mother doesn't need to know how often you have sex.
    • Warn them that the hormonal treatments can lead to major mood swings.
    • Ask for their support when you need a ride to doctor appointments or help managing your life during exhausting tests and treatments.
    • Tell them what you don't want to hear.
    • Give them information about infertility. The websites of the American Society for Reproductive Medicine (ASRM) and RESOLVE provide excellent information.
    • Explain that you may not be able to attend baby showers, christenings, children's birthday parties and other such events for a while.
    • Consider setting up a blog or website your friends can visit for information so you aren't barraged by questions.
    Let them know when you're having a "fertility-free" day or month and want to take a vacation from talking about it.