Table of Contents
In February 2009, “The Infertility Blog” celebrated 3 years of production. I have been very pleased with the response. At least once per week someone tells me how valuable they find the information and how much they appreciate the effort.
Not only is it an effort to produce, I am finding it’s a lot of work for patients to read the 121 entries to date. Sometimes patients ask me to write on a certain topic, and I have to say, “I already did, go back and check.”
So to make it easier, here is the table of contents of Blogs so far. These are the “topic blogs”. They are not all of the blogs as there are many “Answers to Questions” sprinkled in between. Hopefully this will give you easier access to the information from earlier chapters. You can also print it to keep as a reference.
In addition, you can search the blog. In the upper left next to the orange e sign, is a box for you to type in your search words. If you type in a word such as FSH or SART, blogs containing those words will be listed.
Here you have it. Feel free to share it with others needing help.
2/05/06: A Woman Who Thought Her Hysterogram was normal. A classic story of a woman being surprised when I told her the radiologist read her hysterogram incorrectly.
2/07/06: From No Sperm, to a Few Sperm, to Twins. A classic story about a couple who was told by one doctor they had no sperm, but who saw another who said they had sperm.
2/15/06: No More Happy Birthdays. Birthdays and infertility can mix.
2/22/06: The Dreaded Biochemical Pregnancy. Explains the diagnosis and meaning of a biochemical pregnancy.
3/05/06: The First of a Few about FSH levels. Day 3 FSH levels explained.
3/09/06: FSH Levels: An Excuse to Send Patients Away. In some cases pregnancy is possible with elevated FSH levels.
3/12/06: FSH and Estradiol (Estrogen). Discusses day 2/3 estrogen levels and their relationship to FSH levels and pregnancy rates.
3/21/06: But Doc, What Went Wrong? Maybe Nothing. Your doctor can’t always explain why cycles are not successful.
3/27/06: Endometriosis: It’s Everywhere, but in Small Amounts. An introduction to endometriosis and its effect on fertility.
4/02/06: Endometriosis: What Are you Waiting For. Endometriosis is both over-diagnosed and under-diagnosed.
4/07/06: Why Do We Do IUI? Insemination can be more successful than intercourse.
4/12/06: Is There Enough Sperm for IUI? IUI can help with low, but not very low counts.
4/18/06: What are Your Odds? Don’t start treatments until you know your odds with each procedure.
4/22/06: This is Your Brain, This is Your Brain on Clomid. Clomid had some unique side effects.
4/27/06: The Clomid Death Sentence: Too many months on Clomid can kill your chances.
5/4/06: Sperm Morphology Mythology. Morphology may not be that important.
5/11/06: Abnormal Sperm Can Fertilize Eggs and Make Babies. More on morphology.
5/17/06The Disclaimer: Medical advice must come from your doctor.
5/19/06: Hysterograms: Let’s Not Forget the Uterus. Focusing on the tubes can miss important information about the uterus.
5/31/06: Who is Reading Your HSG? Reading the report without looking at the films doesn’t cut it.
6/04/06: Pregnancy Rates Matter. The pregnancy rates from each program are published by SART and the CDC. You should read the reports.
6/16/09: Your Doctor’s IVF Pregnancy Rates are Available to You. More of the same.
6/22/06: Ovarian Cysts Part One: Normal Ovulation. The term “Ovarian Cyst” can have many meanings.
7/01/06: The doctor said I can’t start because I have a cyst. What it means to have a cyst on day 2/3.
7/06/06: PCO: Pretty Cute Ovaries? What is PCO?
7/13/06: You Can't Have a Baby Unless you are Pregnant. The positive pregnancy test can be the start of a good thing.
7/20/06: How to subscribe to this blog. Get the blog sent to you.
7/21/06: Uterine Scar Tissue After a D&C. D &C, and the potential for scarring.
8/03/06: Abnormal Bleeding? Don’t have a D and C without a Hysteroscopy (and have an ultrasound first). “Blind” scraping doesn’t help much.
8/20/06: The Boxes of Pregnancy and Miscarriage. Especially when infertile, miscarriage really hits home.
8/28/06: Diagnostic Laparoscopy. Becoming a less-important infertility treatment.
9/11/06: Psychologists are Available: Consider Using Them. Why go it alone.
9/19/06: Hysteroscopy 101. An explanation of Hysteroscopy.
9/25/06: Is LH Important for IVF Success? There is little controversy; LH is not so magic.
10/05/06: Blocked Tubes: 2 Cases of Proximal Tubal Occlusion. Blocked tubes can mean different things.
10/17/06: I called and an embryo picked up the phone. Embryos do grow up.
10/27/06: What About Tubes that are Blocked at the Other End, Near the Ovary? More discussion about tubal blockage.
11/09/06: How Many Embryos are You Putting Back? Fewer is usually better.
11/20/06: How Can the Pregnancy be Bad But Still Growing? A few details about early pregnancy loss.
11/30/06 What’s a Hormone? Definition and examples of reproductive hormones.
12/09/06: What is Lupron and Why Are Only Some People Using It? Insight into different stimulation protocols.
12/12/06: More On Lupron and Why We Don’t use it as Much. More of the same.
1/08/07L Microdose or Microflare or Flare Lupron. More of the same.
1/20/07: Sperm Deficient Females Can Be Quite Fertile. Many donor sperm patients get pregnant quickly.
1/28/07: So Your Uterus is Bicornuate? Check Again, and Again. It may really be a septum, and it’s very important to know.
2/06/07: Bicornuate or Septate? What’s difference and why it matters.
2/26/07: Last One About Septums. How and why they are corrected.
3/10/07: When and How to time the IUI. Home and office monitoring.
3/16/07: A Little More about IUI. Inseminate one day or 2?
3/15/07: More on PCO. The basics workup, cysts and treatment.
4/02/07: Polycystic Ovaries and Insulin Resistance. What PCO can mean for your health.
4/04/07: Even More about Polycystic Ovaries. Is Metformin useful?
4/23/07: The Last Word on PCO, For Now. Modifying fertility the work-up for PCO patients.
5/06/07: The PGD Paradox: On paper, PGD for aneuploidy sounds great, but so far it has not lived up to expectations.
5/15/07: 3 Good Stories About 2 Opinions. Why wouldn’t you get a second opinion?
5/23/07: More About PGD. The pros and cons of PGD for aneupliody.
5/31/07: Ectopic Pregnancy. One woman’s story of a tubal pregnancy.
6/09/07: Ectopic Pregnancy FAQ’s. Some basics about ectopic pregnancies.
6/19/07: More questions About Ectopic Pregnancies. Treatment with Methotrexate.
6/29/07: Miscarriage and the Immune System (antibodies). Testing of the immune system.
7/12/07: Miscarriage, Infertility, Antibodies and the Immune System. More evidence would be helpful.
7/22/07: Meeting Your Doctor: What are You Thinking, What is the Doctor Thinking? Your doctor should make your first visit a positive experience.
7/30/07: A Bit More on Seeing Your New Doctor. Don’t let pre-conceived notions keep you from seeing a fertility doctor.
8/17/07: The Follicular Phase and the Luteal Phase. A basic understanding of the menstrual cycle.
8/25/07: Luteal Phase Defect. What are we looking for in the biopsy?
9/05/07: Luteal Phase Defect 3. More about how we make the diagnosis.
9/11/07: Four Simple Clicks Will Help You Have a Baby. You owe it to yourself to check the pregnancy rates of your clinic. It’s all at SART.org.
9/28/07: More About Pregnancy Rates: How to decipher the pregnancy statistics.
10/06/07: Why is Progesterone Used for IVF? The sources and actions of progesterone.
11/06/07: Are You Sure You Need Donor Eggs? Some women are pushed into Donor Egg.
11/19/07: What’s a Fibroid? What they are, how they start and the problems they cause.
12/01/07: Myomectomy. How it’s done.
12/06/07: Fertility and Diet. Mostly involves losing excess weight to improve ovulation.
12/17/07: Exercise. Please exercise.
1/03/08: Your Fibroid: Should it Stay or Should it Go? Which fibroids require removal.
1/12/08: More About Fibroid Surgery. Complications of the myomectomy procedure.
1/21/08: Minimal Stimulation. Less may not be more.
2/01/08: If You Live in the State of New York, the Government May Help Pay for Your IVF. It’s called the New York State Demonstration Project.
2/19/08: Fertility Questions: SCSA. Sperm DNA tests are unproven.
3/11/08: Fertility Preservation. Authoritative information about egg freezing.
4/13/08: Varicocele. A controversial operation.
6/10/08: The Endometrium. The essentials about the uterine lining.
6/22/08: The Endometrium Part II. The thin lining and scar tissue.
7/21/08: Improving Endometrial Thickness. Tricks of the trade to make the lining thicker; limited success.
8/02/08: The Endometrium Part III. Less conventional therapies.
9/01/08: Polyps. The significance of these benign growths inside the uterus.
11/26/08: Stories of Persistence. Women who succeeded by not listening to the doctor.
12/14/08: The Road to Blastocyst: Eggs and Embryos. Understanding the embryology part one.
1/12/09: More About Embryos. Developing embryos and embryo morphology.
1/27/09: Just Before Blastocyst: The Morlula. Day 4 embryos.
4/08/09: Meet the Blastocyst: Photos and descriptions of blastocysts.
4/27/09: What Can Blastocyst Do For You? A good blastocyst program can help you get pregnant with fewer embryos.
Not only is it an effort to produce, I am finding it’s a lot of work for patients to read the 121 entries to date. Sometimes patients ask me to write on a certain topic, and I have to say, “I already did, go back and check.”
So to make it easier, here is the table of contents of Blogs so far. These are the “topic blogs”. They are not all of the blogs as there are many “Answers to Questions” sprinkled in between. Hopefully this will give you easier access to the information from earlier chapters. You can also print it to keep as a reference.
In addition, you can search the blog. In the upper left next to the orange e sign, is a box for you to type in your search words. If you type in a word such as FSH or SART, blogs containing those words will be listed.
Here you have it. Feel free to share it with others needing help.
2/05/06: A Woman Who Thought Her Hysterogram was normal. A classic story of a woman being surprised when I told her the radiologist read her hysterogram incorrectly.
2/07/06: From No Sperm, to a Few Sperm, to Twins. A classic story about a couple who was told by one doctor they had no sperm, but who saw another who said they had sperm.
2/15/06: No More Happy Birthdays. Birthdays and infertility can mix.
2/22/06: The Dreaded Biochemical Pregnancy. Explains the diagnosis and meaning of a biochemical pregnancy.
3/05/06: The First of a Few about FSH levels. Day 3 FSH levels explained.
3/09/06: FSH Levels: An Excuse to Send Patients Away. In some cases pregnancy is possible with elevated FSH levels.
3/12/06: FSH and Estradiol (Estrogen). Discusses day 2/3 estrogen levels and their relationship to FSH levels and pregnancy rates.
3/21/06: But Doc, What Went Wrong? Maybe Nothing. Your doctor can’t always explain why cycles are not successful.
3/27/06: Endometriosis: It’s Everywhere, but in Small Amounts. An introduction to endometriosis and its effect on fertility.
4/02/06: Endometriosis: What Are you Waiting For. Endometriosis is both over-diagnosed and under-diagnosed.
4/07/06: Why Do We Do IUI? Insemination can be more successful than intercourse.
4/12/06: Is There Enough Sperm for IUI? IUI can help with low, but not very low counts.
4/18/06: What are Your Odds? Don’t start treatments until you know your odds with each procedure.
4/22/06: This is Your Brain, This is Your Brain on Clomid. Clomid had some unique side effects.
4/27/06: The Clomid Death Sentence: Too many months on Clomid can kill your chances.
5/4/06: Sperm Morphology Mythology. Morphology may not be that important.
5/11/06: Abnormal Sperm Can Fertilize Eggs and Make Babies. More on morphology.
5/17/06The Disclaimer: Medical advice must come from your doctor.
5/19/06: Hysterograms: Let’s Not Forget the Uterus. Focusing on the tubes can miss important information about the uterus.
5/31/06: Who is Reading Your HSG? Reading the report without looking at the films doesn’t cut it.
6/04/06: Pregnancy Rates Matter. The pregnancy rates from each program are published by SART and the CDC. You should read the reports.
6/16/09: Your Doctor’s IVF Pregnancy Rates are Available to You. More of the same.
6/22/06: Ovarian Cysts Part One: Normal Ovulation. The term “Ovarian Cyst” can have many meanings.
7/01/06: The doctor said I can’t start because I have a cyst. What it means to have a cyst on day 2/3.
7/06/06: PCO: Pretty Cute Ovaries? What is PCO?
7/13/06: You Can't Have a Baby Unless you are Pregnant. The positive pregnancy test can be the start of a good thing.
7/20/06: How to subscribe to this blog. Get the blog sent to you.
7/21/06: Uterine Scar Tissue After a D&C. D &C, and the potential for scarring.
8/03/06: Abnormal Bleeding? Don’t have a D and C without a Hysteroscopy (and have an ultrasound first). “Blind” scraping doesn’t help much.
8/20/06: The Boxes of Pregnancy and Miscarriage. Especially when infertile, miscarriage really hits home.
8/28/06: Diagnostic Laparoscopy. Becoming a less-important infertility treatment.
9/11/06: Psychologists are Available: Consider Using Them. Why go it alone.
9/19/06: Hysteroscopy 101. An explanation of Hysteroscopy.
9/25/06: Is LH Important for IVF Success? There is little controversy; LH is not so magic.
10/05/06: Blocked Tubes: 2 Cases of Proximal Tubal Occlusion. Blocked tubes can mean different things.
10/17/06: I called and an embryo picked up the phone. Embryos do grow up.
10/27/06: What About Tubes that are Blocked at the Other End, Near the Ovary? More discussion about tubal blockage.
11/09/06: How Many Embryos are You Putting Back? Fewer is usually better.
11/20/06: How Can the Pregnancy be Bad But Still Growing? A few details about early pregnancy loss.
11/30/06 What’s a Hormone? Definition and examples of reproductive hormones.
12/09/06: What is Lupron and Why Are Only Some People Using It? Insight into different stimulation protocols.
12/12/06: More On Lupron and Why We Don’t use it as Much. More of the same.
1/08/07L Microdose or Microflare or Flare Lupron. More of the same.
1/20/07: Sperm Deficient Females Can Be Quite Fertile. Many donor sperm patients get pregnant quickly.
1/28/07: So Your Uterus is Bicornuate? Check Again, and Again. It may really be a septum, and it’s very important to know.
2/06/07: Bicornuate or Septate? What’s difference and why it matters.
2/26/07: Last One About Septums. How and why they are corrected.
3/10/07: When and How to time the IUI. Home and office monitoring.
3/16/07: A Little More about IUI. Inseminate one day or 2?
3/15/07: More on PCO. The basics workup, cysts and treatment.
4/02/07: Polycystic Ovaries and Insulin Resistance. What PCO can mean for your health.
4/04/07: Even More about Polycystic Ovaries. Is Metformin useful?
4/23/07: The Last Word on PCO, For Now. Modifying fertility the work-up for PCO patients.
5/06/07: The PGD Paradox: On paper, PGD for aneuploidy sounds great, but so far it has not lived up to expectations.
5/15/07: 3 Good Stories About 2 Opinions. Why wouldn’t you get a second opinion?
5/23/07: More About PGD. The pros and cons of PGD for aneupliody.
5/31/07: Ectopic Pregnancy. One woman’s story of a tubal pregnancy.
6/09/07: Ectopic Pregnancy FAQ’s. Some basics about ectopic pregnancies.
6/19/07: More questions About Ectopic Pregnancies. Treatment with Methotrexate.
6/29/07: Miscarriage and the Immune System (antibodies). Testing of the immune system.
7/12/07: Miscarriage, Infertility, Antibodies and the Immune System. More evidence would be helpful.
7/22/07: Meeting Your Doctor: What are You Thinking, What is the Doctor Thinking? Your doctor should make your first visit a positive experience.
7/30/07: A Bit More on Seeing Your New Doctor. Don’t let pre-conceived notions keep you from seeing a fertility doctor.
8/17/07: The Follicular Phase and the Luteal Phase. A basic understanding of the menstrual cycle.
8/25/07: Luteal Phase Defect. What are we looking for in the biopsy?
9/05/07: Luteal Phase Defect 3. More about how we make the diagnosis.
9/11/07: Four Simple Clicks Will Help You Have a Baby. You owe it to yourself to check the pregnancy rates of your clinic. It’s all at SART.org.
9/28/07: More About Pregnancy Rates: How to decipher the pregnancy statistics.
10/06/07: Why is Progesterone Used for IVF? The sources and actions of progesterone.
11/06/07: Are You Sure You Need Donor Eggs? Some women are pushed into Donor Egg.
11/19/07: What’s a Fibroid? What they are, how they start and the problems they cause.
12/01/07: Myomectomy. How it’s done.
12/06/07: Fertility and Diet. Mostly involves losing excess weight to improve ovulation.
12/17/07: Exercise. Please exercise.
1/03/08: Your Fibroid: Should it Stay or Should it Go? Which fibroids require removal.
1/12/08: More About Fibroid Surgery. Complications of the myomectomy procedure.
1/21/08: Minimal Stimulation. Less may not be more.
2/01/08: If You Live in the State of New York, the Government May Help Pay for Your IVF. It’s called the New York State Demonstration Project.
2/19/08: Fertility Questions: SCSA. Sperm DNA tests are unproven.
3/11/08: Fertility Preservation. Authoritative information about egg freezing.
4/13/08: Varicocele. A controversial operation.
6/10/08: The Endometrium. The essentials about the uterine lining.
6/22/08: The Endometrium Part II. The thin lining and scar tissue.
7/21/08: Improving Endometrial Thickness. Tricks of the trade to make the lining thicker; limited success.
8/02/08: The Endometrium Part III. Less conventional therapies.
9/01/08: Polyps. The significance of these benign growths inside the uterus.
11/26/08: Stories of Persistence. Women who succeeded by not listening to the doctor.
12/14/08: The Road to Blastocyst: Eggs and Embryos. Understanding the embryology part one.
1/12/09: More About Embryos. Developing embryos and embryo morphology.
1/27/09: Just Before Blastocyst: The Morlula. Day 4 embryos.
4/08/09: Meet the Blastocyst: Photos and descriptions of blastocysts.
4/27/09: What Can Blastocyst Do For You? A good blastocyst program can help you get pregnant with fewer embryos.
posted by Dr. Licciardi at 8:57 AM
17 Comments:
Wow. That must have taken some time archive hunting to organise. Good work, and you blog is always interesting to read.
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Wow... I can't believe you did that!!!! Thank you so much for all your time and effort, Dr.! By the way, you can create tags for your posts and they will show up as topics on your blog.
For example, when you write about SART, you can create a tag for that post that says "fertility clinics"; so every post about SART or other tips on how to find a good clinic etc can have that tag. You will then have a list of tags you can choose to display and users can click them to see all posts related to that topic. I hope that helps :)
Doctor,
You are really doing a great job.
Pls write about Depo Provera and whether or not it has lasting effects on fertility which are damaging.
This comment has been removed by a blog administrator.
I am 34 and was diagnosed with DOR last year. Two miscarriages, multiple IUIs and one failed IVF and failed FET later, still no baby. Can you please give some details about DOR - causes, how it develops in someone so young (me), what you have found works in these patients.
Some stories of hope of women with DOR would be so nice to read.(if there are any)
Thank you for all you do for women struggling with infertility.
I'd love to hear what you think about the use of Naltrexone for infertility treatment. A OBGYN in my area has been treating women from my Resolve group with the drug for several years now-some of which have had success, others are still TTC.
Thank-you for taking the time to catalogue your posts.
I have a question re: Elevated FSH (I have read your posts on it). I have had a few chemical pregnancies and it seems that the month following a chemical my FSH is elevated. Is there a connection?
Thank you for your blog. As I'm about to undergo my second IVF attempt, I would be interested to know what the long-term ramifications, if any, there are due to taking so many medications.
thank you for taking the time to maintain this blog. I have found it to be an amazingly helpful information source.
I do have a question about luteal phase defects and I read your post on them. I don't believe that I normally have one, but ever since starting my FSH injections for IUI's have (inconsistently) a 10 day luteal phase. Is this common?
Thank you for organizing this blog so well :) I am a new reader and have a question. My husband and I transferred one great blast for our fresh cycle (IVF #1) and it was negative, however we transferred 2 frozen blasts of the same quality a few months later(FET #1) and one resulted in our wonderful baby boy. Our doctor believes the other frozen blast implanted, but stopped growing.
Background:
Me: 25, no fertility issues
DH:40, 2-5 % morphology and 95-100 % anti-sperm anti-bodies head/tail due to hernia operation with mesh
My question is, for another child, do we proceed with our one "good" frozen blast (which I believe you said is a 10% or less success rate), or proceed with another fresh cycle and transfer 2, instead of the one we transferred the first time? Also, my husband had a SA before we were married after a varicocele repair and we never "tried" on our own...we proceeded straight to IVF, which worked for us. What are the chances of us conceiving on our own for child #2?
Thank you.
Great information. I have been TTC now for 2 years and recently started blogging about it and trying to find the humor in infertility so I don't cry anymore.
http://999reasonstolaughatinfertility.blogspot.com/
This is an amazing blog. Thx for all your excellent information it helps so many.
I do have a question: I am 38 I have done 5iui's, 2ivfs and 2 FETs with no success, all with blastocysts. I make lots of eggs, in the 20's, and both times overstimulated. The first time I had 3 blasts, the second cycle 12. We still have 8 blasts frozen. I have had one biochemical pregnancy when I transferred a single blast. Here's my question do you think I have an implantation problem. My doctor thinks this is just bad luck could this be the truth? Is it normal to have transfered 7 blasts with no success so far. Could high estrogen cause failure on fresh cycles? Any insight would be great.
Thank-You for all your posts and information. I am a new reader and have read most of 121 posts. It made me realize that a) I’m not alone out there and b) there are so many different type of infertility problems and that what I have wouldn't be considered a major impediment to conceiving one day.
My question: I'm 27 and was diagnosed as PCOS. I’m just starting my second round of clomid and was wondering about the time it takes for me to get to my next cycle. After my first failed round, my doctor had me abstain from intercourse for 2 weeks, do a pregnancy test and then take Provera. Do I really need to wait the 2 weeks if my day 23 showed that I did not ovulate? I just think it would speed things along and 2 weeks is an awfully long time to a newly married couple. Any thoughts?
Thanks
Dear Dr. Licciardi,
I am 40 and just had a failed first IVF cycle that resulted in all immature eggs (7 retrieved) after only 5 days of stims (follistim/menopur + ganirelix days 4 & 5) before the HcG shot.
The doctors were very surprised that by day 5 I had 7 follies 12 - 19 (more <10) and they said I had to trigger, my final E2 was only around 700. I had a good HcG level after the trigger.
I have never heard of anyone only stimming for 5 days.
I am curious what your experience has been with people who are fast responders and what you recommend in terms of changing protocols? Do you believe that follicle size alone determines egg maturity or can a short follicular phase be a problem even with larger follicles?
Previously I had a failed IUI with follistim for 8 days that produced 3-4 large follies with E2 @ 600, which they said was a good response (my FSH is in the upper normal range 6.5 -9).
Could this have been a fluke IVF cycle? Maybe I haven't been at this long enough to know. The adjustments suggested for a 2nd try are starting with an estrogen primer to suppress any premature follicles and obviously stim me longer to let follicles get even bigger.
Your blog has been an amazing resource for me as we are in the middle of our IF journey. Thank you for your wonderful insights.
many thanks,
- a Brooklynite
I was treated for stage 1 endo in January 2008. I just completed 3 months of Lupron therapy in preparation for IVF. During my pre-IVF testing, a cyst was found on my ovary that my RE believes is likely an endometrioma. During my last IUI cycle in January, there was absolutely no sign of a cyst. How could I have developed an endometrioma during 3 months of Lupron therapy? Doesn't that suggest it made my endo worse rather than better? I am baffled and desperate for answers. My RE has none. Please help. Thanks!
as an infertile woman your blog helps me to understand my situation so I encourage you to continue with this blog
Thank you Dr Licciardi! I really appreciate your blog and all the info you're publishing. It's very useful. I actually went to NYU as well, so I have even more respect for you!
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