Gerard M Honoré - Overcoming Infertility: A Womans Guide to Getting Pregnant

An Addicus Nonfiction Book

Copyright 2010 by Gerard M. Honor, Ph.D., M.D., and Jay S. Nemiro, M.D. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopied, recorded, or otherwise, without the prior written permission of the publisher. For information, write Addicus Books, Inc., P.O. Box 45327, Omaha, Nebraska 68145.

ISBN 978-1-886039-16-2

Cover design and illustrations by Jack Kusler
Photo of human sperm by Jason Burns/Dr. Ryder/Phototake USA

This book is not intended to serve as a substitute for a physician. Nor is it the authors intent to give medical advice contrary to that of an attending physician.

Library of Congress Cataloging-in-Publication Data

Honor, Gerard M., 1957
Overcoming infertility: a womans guide to getting pregnant /
Gerard M. Honor, Jay S. Nemiro.
p. Cm.
Includes index.
ISBN 978-1-886039-16-2 (alk. Paper)
1. InfertilityPopular works. 2. InfertilityTreatmentPopular works. I.
Nemiro, Jay S., 1950- II. Title.
RC889.H53 2010
618.178dc22 2010021381

Addicus Books, Inc.
P.O. Box 45327
Omaha, Nebraska 68145
www.AddicusBooks.com

Printed in the United States of America
10 9 8 7 6 5 4 3 2 1

To my wife, Erika, and my children, Jossie and Wolf,
for putting sunshine in every single day;
and to the memory of my mother, Ellen Stone Honor Ryan,
for her unfailing love, generosity,
and the riches of opportunity she gave me.

Gerard M. Honor, Ph.D., M.D.

To my wonderful wife, Ginamy life partner;
to my six children, whom I thank for their love, patience,
and understanding; to my entire staff, for their loyalty
and commitment to excellence; and to all our patients,
past and present, whose courage, grace,
and strength I continue to admire.

Jay S. Nemiro, M.D.

I wish to extend my sincerest thanks to Bob Schenken, M.D., and Jeff Deaton, M.D., for not only being unmatched as teachers, mentors, and friends, but for also being models of personal and professional excellence. They set standards few of us will achieve, but to which we should all aspire.

I also acknowledge Alisa Zinsmeyer Young, M.A., for her invaluable original contributions to this book in the fields of infertility counseling and coping. I am grateful for her professional expertise and for sharing so generously with us and with our readers.

Finally, though no less important, I wish to thank Chris Hinz and Rod Colvin of Addicus Books for their enthusiasm, professional editorial guidance, and lots of plain hard work in every phase of bringing this book to life.

Gerard M. Honor, Ph.D., M.D.

I want to thank a number of people who, directly or indirectly, have helped make this book possible. I would like to acknowledge my professors and teachers throughout college and medical school; they guided me through challenging years of hard work and motivated me to stay the course. I thank Richard Falk, M.D., a superb mentor who had enough faith in me to recommend me as Georgetown Universitys first fellow in reproductive endocrinology and infertility. I acknowledge all the OB/GYN residents who continually challenged me to be a better teacher. I also thank Robert W. McGaughey, Ph.D., whose twenty-four-year partnership as our IVF lab director has helped thousands of our patients to become parents.

I would like to acknowledge my wife, Gina, who has been an ongoing source of inspiration and who continues to be supportive of me in my work, which often requires long days and nights. I am grateful to my six children, Aria, Shane, Talia, Judd, Ashley, and Chad, who are a daily reminder of why I do what I do. I thank my staff, without whom I could not practice the quality of medicine our patients deserve. I extend a very special thank you to all our patients, past and present, who are now the parents of nearly 10,000 babiesmiracles of love and science.

Finally, I would like to thank Chris Hinz for her excellent editorial support and Rod Colvin of Addicus Books for his encouragement and for publishing this book on such an important topic.

Jay S. Nemiro, M.D.

I n my practice as a reproductive endocrinologist, Ive met thousands of women who have tried, without success, to have a baby of their own. I have seen firsthand the emotional distress these women endure, and I understand how these feelings can cast dark shadows on every part of their lives. My goal is to help these women become mothers. First, we must find the road to take to accomplish that goal. I begin by asking questions in effort to discover why she is not getting pregnant. Once I have more information, we can start drawing out the mapthe plan for reaching a diagnosis and the plan for treatment.

When I first meet a woman in my office, we begin the first of many important conversations. I always try to listen carefully to her concerns and share with her as much information as she seeks. I believe real knowledge can give peace of mind, and that knowledge along with emotional support brings inner strength. It is the treatment plan and this strength that takes these women and their partners to eventual success.

I hope this book serves as a resource that gives these many brave women the answers to their important questions. My goal with the book is provide readers with the knowledge, strength, and hope they need to take their journeys toward families of their own.

Gerard M. Honor, Ph.D., M.D.

M y intention in writing this book is to make the journey a little less stressful for women who are trying to have a child. I hope this book will empower you and your partner by giving you useful information. Having had the privilege of working with thousands of couples who have faced infertility, Ive found that knowledge leads to understanding, and understanding leads to empowerment.

By knowing how infertility can occur and the challenges it can pose for both you and your partner, youll be better equipped to make informed decisions about issues ranging from diagnostic tests to treatment. Youll also be ready to handle the emotional and psychological roller coaster that often accompanies each development and decision throughout fertility treatment.

I encourage you to find a physician with whom you can develop a true partnershipa doctor who is committed to providing competent, compassionate care and who also understands the fears and feelings a woman may experience in attempting to achieve her dream of becoming a mother. Remember, even if you are successful in getting pregnant, your emotional journey continues. Youll want the continued support of your physician.

It is my hope that, once you have a healthy baby in your arms, you will be able to relax and enjoy motherhood, and you will look back and say it was all worth it.

Jay S. Nemiro, M.D.

N ot being able to have a baby can be heartbreaking. You no doubt know the frustration. Perhaps you grew up believing that one day youd be a mother. Now youre not so certain. Youre also not alone. Its estimated that as many as 10 percent of reproductive-age females are grappling with infertility