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Dr Malpani,
Malpani Infertility Clinic.
Jamuna Sagar,
Shahid Bhagat Singh Road,
Colaba, Bombay 400 005.
Tel: 91-22-22151065,
91-22-22151066
Fax (India): 91-22-2215 0223

Email: info@drmalpani.com

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How to Have a Baby -- Overcoming Infertility
Getting Pregnant -- A guide for the infertile couple

Dr Aniruddha Malpani, MD and Dr Anjali Malpani, MD
Malpani Infertility Clinic, Bombay, India.

This entire book is available free online right here to help you start your family

The book is now also available online, free, in Hindi, Gujarati and Marathi at www.infertilityfriends.org !

You can buy a print copy of this book at http://issuu.com/malpani/docs/howtohaveababy.



Table of Contents

Preface
  • Why a new edition for the new millennium?


  • Chapter 1b: Do you have an infertility problem? When to start worrying!
  • What can you do to improve your own fertility ?
  • How often should you have sex ?
  • How can you time baby-making sex ?
  • Does sexual position matter ?
  • How can the older woman check her fertility potential ?
  • What about herbal medicines which claim to improve your fertility ?
  • How can you balance your career and fertility ?
  • Which is the "right time" to plan a baby?
  • Has the fertility of couples declined in modern times ?
  • Where can I get help ?

  • Chapter 2a: How Babies are Made - The Basics
  • How does a woman's reproductive system function ?
  • Can you explain the menstrual cycle and its role in fertility ?

  • Chapter 2b: How Babies are Made - The Basics
  • How do a woman's hormones control her fertility ?
  • How does a man's reproductive system work ?

  • Chapter 2c: How Babies are Made - The Basics
  • What happens during ejaculation ?
  • How does testosterone affect male fertility ?

  • Chapter 2d: How Babies are Made - The Basics
  • What happens to the sperm once they enter the woman's vagina ?
  • What happens to the egg when conception occurs ?
  • What happens when the egg and sperm meet ?

  • Chapter 3: Finding Out What’s Wrong -- The Basic Medical Tests
  • What are the basic medical tests needed to assess fertility ?
  • How are these basic infertility tests done ?

  • Chapter 4a:Testing the Man - Semen Analysis
  • Why should the man be tested first ?
  • Where should the semen analysis be done ?
  • How do I provide a sample for semen analysis ?
  • How does the lab analyse the semen ?
  • What do sperm look like ?

  • Chapter 4b: Testing the Man - Semen Analysis
  • What is a normal sperm count ?
  • What is normal sperm motility ?
  • What is normal sperm morphology ?
  • What does the presence of  pus cells in the semen signify ?
  • What does a normal semen analysis report mean ?
  • What are the reasons for a poor semen analysis report
  • What if my sperm count is zero (azoospermia) ?

  • Chapter 5a: Beyond the Semen Analysis

    Chapter 5b: Beyond the Semen Analysis 
  • What blood tests can be done for infertile men ?
  • Of what use is an ultrasound exam in evaluating an infertile man ?
    Of what use is a testicular biopsy ?


    Chapter 6a: Diagnosis and Treatment for Male Infertility -- More Confusion!
  • What is a varicocele ?
  • How is a varicocele diagnosed?
  • Is surgery for varicocele repair useful ?
  • How is a varicocele surgically repaired ?


  •  

    Chapter 6b: Diagnosis and Treatment for Male Infertility -- More Confusion!
  • What is obstructive azoospermia ?
  • What surgery can be done to treat obstructive azoospermia ?
  • What about men with an absent vas ( CBAVD, congenital bilateral absence of the vas deferens) ?
  • What can a man who has had a vasectomy do if he wants more children ?
  • Do sperm antibodies cause male infertility ?
    Can hormone imbalance cause male infertility ?
  • How does substance abuse affect male fertility ?

  • Chapter 6c: Diagnosis and Treatment for Male Infertility -- More Confusion!
  • How do undescended testes cause male infertility ?
  • How does testicular torsion cause male infertility ?
  • Which infections cause male infertility ?
    Which medications can cause male infertility ?
    Does heat cause male infertility ?
  • What ejaculatory problems can cause male infertility ?
  • What is retrograde ejaculation ?
  • What is anejaculation ?
  • What is electroejaculation ?

  • Chapter 7: The Man with a Low Sperm Count
  • Why is treatment of a low sperm count so confusing ?
  • What can the man with a low sperm count do ?
  • Why do I have a low sperm count ?
  • Is there any connection between a low sperm count and sexual performance ?

    Chapter 8a: Microinjection: The Latest Advance in Treating the Infertile Man
  • What is ICSI ?
  • How is ICSI performed ?
  • How can ICSI be used to treat men with a zero sperm count ( azoospermia) ?
  • What is TESE ( testicular sperm extraction) ICSI ?

  • Chapter 8b: Microinjection: The Latest Advance in Treating the Infertile Man
  • How is a single sperm injected into the egg for ICSI in the IVF laboratory ?
  • What are the risks of doing ICSI ?
  • What recent advances have taken place in ICSI ?

  • Chapter 9a: Ultrasound - Seeing with Sound
  • How is ultrasound ( sonography) used for treating
    infertility ?
  • How is ultrasound used for follicular scanning to monitor ovulation ?
  • What if an ovarian cyst is found on ultrasound scans ?
  • Who should do the ultrasound scans ?

    Chapter 9b: Ultrasound - Seeing with Sound
  • What recent advances have occurred in ultrasound ?
  • How can ultrasound guided procedures be used to treat infertility ?

  • Chapter 10a: Laparoscopy -- The Kinder Cut
  • What is laparoscopy ?
  • When is laparoscopy done?
  • What precautions need to be taken before laparoscopic surgery ?
  • How is the laparoscopy performed ?
  • What is an operative laparoscopy ?
  • What is a "second-look laparoscopy"?

  • Chapter 10b: Laparoscopy -- The Kinder Cut
  • What can you expect to feel after the laparoscopy ?
  • What are the complications of laparoscopy ?
  • How can I be sure my doctor will perform the laparoscopy properly ?
  • Which is better - a laparoscopy or a HSG ?
  • What happens after the laparoscopy ?

  • Chapter 11a: Hysteroscopy
  • What is hysteroscopy ?
  • How is hysteroscopy performed ?
  • What is operative hysteroscopy ?
  • What is hysteroscopic tubal cannulation ?
  • What are the complications of hysteroscopy ?

  • Chapter 11b: Hysteroscopy
  • What are uterine( endometrial) polyps ?
  • How do fibroids ( myomas) affect fertility ?
  • What are the new techniques for studying the role of the endometrium in infertility ?

  • Chapter 12a: The Tubal Connection
  • What are the fallopian tubes ?
  • How do tubal diseases cause infertility ?
  • How is tubal disease diagnosed ?
  • What are the limitations of diagnosing tubal disease ?
  • What are the recent innovations for tubal factor diagnosis and treatment ?

  • Chapter 12b: The Tubal Connection
  • What is the role of surgery in opening a blocked tube ?
  • How is tubal microsurgery performed ?
  • What are the options for treating proximal tubal occlusion ?
  • What are the risks of tubal surgery ?
  • How can a tubal ligation be reversed ?
  •  

    Chapter 13a: Ovulation -- Normal and Abnormal
  • How does ovulation occur normally ?
  • How can I find out if I am ovulating ?
  • Is BBT charting of any use ?
  • What about using fertility software programs ?
  • Of what use is an endometrial biopsy ?
    Of what use is a D&C ( curettage) ?
  • How does testing for progesterone help ?
  • How can I find out when I am ovulating and use this information to track my fertile time ?
  • How can I use cervical mucus monitoring to monitor my ovulation ?

  • Chapter 13b: Ovulation -- Normal and Abnormal
  • How is ultrasound used to monitor ovulation ?
  • How do I use ovulation prediction kits ( OPK) ?
  • How can I use the new pocket microscopes to track
    ovulation ?
  • What blood tests can be used to predict ovulation ?
  • What happens when ovulation is abnormal ?
  • What are the blood tests which are used to diagnose problems with ovulation ?
  • What is ovarian failure ?
  • What are the treatments are available for inducing ovulation?

  • Chapter 14a: The Older Woman
  • How does age affect fertility in the woman  ?
  • What are the tests for measuring ovarian reserve ?
  • What is the relationship between infertility and the midlife crisis ?

  • Chapter 14b: The Older Woman
  • What are the fertility issues unique to older women ?
  • How can donor eggs help the older infertile woman ?


  • Chapter 15: Polycystic Ovarian Disease (PCOD)
  • What is PCOD ( polycystic ovarian disease) ?
  • How is PCOD diagnosed ?
  • What is the cause of PCOD ?
  • What is occult PCOD ?
  • How is PCOD treated ?
  • How can ovulation be induced in patients with PCOD ?
  • How is surgery used to treat patients with PCOD ?
  • How is IVF used for treating patients with PCOD ?

  • Chapter 16: The Cervical Factor
  • What is cervical mucus ?
  • How can you track your mucus ?
  • How can problems with cervical mucus affect fertility ?
  • How does the doctor test your cervical mucus ?
  • What is the postcoital test ( PCT) ?
  • What is the in vitro sperm mucus penetration test ?
  • How can poor cervical mucus be treated ?

  • Chapter 17: Hirsutism -- Excess Facial and Body Hair
  • What is hirsutism ?
  • What causes hirsutism?
  • How is the cause of hirsutism diagnosed ?
  • How is hirsutism treated ?

  • Chapter 18: Endometriosis -- The Silent Invader
  • What is endometriosis ?
  • What causes endometriosis?
  • What does endometriosis look like ?
  • What are the symptoms of endometriosis ?
  • How does endometriosis cause infertility ?
  • How does the doctor diagnosis endometriosis ?
  • What medications are used for treating endometriosis ?
  • How is surgery used for treating endometriosis ?
  • How is IVF used for treating endometriosis ?

  • Chapter 19: Ectopic Pregnancy – The Time Bomb in the Tube
  • What is an ectopic pregnancy ?
  • How is ectopic pregnancy diagnosed ?
  • How is ectopic pregnancy treated ?
  • How does an ectopic pregnancy affect future fertility ?

  • Chapter 20: Unexplained Infertility
  • What is unexplained infertility ?
  • How is unexplained infertility diagnosed ?
  • What are the causes of unexplained infertility ?
  • How is unexplained infertility treated ?

  • Chapter 21: Secondary Infertility -- Caught Between Fertile And Infertile Worlds

    Chapter 22: Empty Arms -- The Lonely Trauma of Miscarriage
  • How are abortions classified medically ?
  • How often do abortions occur ?
  • What are some of the myths about abortions ?
  • What are the causes of repeated abortions ?
  • How do chromosomal abnormalities cause miscarriages ?
  • How do hormonal imbalances cause miscarriages ?
  • Which illnesses can cause repeated abortions ?
  • How does PCOD cause repeated miscarriages ?
  • How do immune problems cause repeated abortions ?
  • How do antiphospholipid antibodies cause repeated abortions ?
  • How do uterine problems cause repeated abortions ?
  • Can lifestyle factors cause repeated abortions ?
  • What about the emotional aspects of dealing with repeated abortions ?
  • What should you know about planning your next pregnancy after you have had an abortion ?
  • What are the treatment options for women who have had repeated abortions ?
  • What are the chances of having a healthy baby after repeated abortions ?

  • Chapter 23: Understanding Your Medicines
  • What medicines are used for treating infertility ?
  • How is bromocriptine used for treating infertility ?
  • How is danazol used for treating infertility ?
  • How are steroids used for treating  infertility ?
  • How is clomiphene ( clomid) used for treating infertility ?
  • How are gonadotropin injections used for treating infertility ?

  • What are HMG injections and how are they used in infertility treatment ?

  • How is HMG therapy monitored
  • How are FSH injections used for treating  infertility ?

  • How are HCG injections used for treating infertility ?

  • How is GnRH used for treating infertility ?

  • How are GnRH analogs used for treating infertility ?
  • How is metformin used for treating infertility ?

  • What medicines are useful for treating male infertility ?

  • Why is medical treatment of low sperm counts ineffective ?
  •  

    Chapter 24: IUI - Intrauterine Insemination
    What is intrauterine insemination ( IUI) ?
    When is IUI used for treating infertility ?
    How is artificial insemination performed ?
    How is IUI performed ?
    How is the IUI timed ?
    How are the sperm processed in the laboratory for IUI ?
    What recent advances have occurred in IUI treatment ?
    What is the success rate of IUI treatment?
    What are the risks of IUI treatment ?
    How much does IUI treatment cost ?

     

    Chapter 25a: Test Tube Babies - IVF & GIFT
  • What are the assisted reproductive technologies ( ARTs ) ?
  • What tests need to be done prior to doing IVF treatment ?
  • What are the 5 basic steps of an IVF treatment cycle ?
  • How is superovulation performed ?
  • How is superovulation monitored ?
  • When may an IVF cycle be cancelled ?

  • Chapter 25b: Test Tube Babies - IVF & GIFT
  • How is egg retrieval performed ?
  • How are the eggs inseminated in the IVF laboratory ?
  • How is fertilisation checked in the IVF lab ?
  • How are embryos cultured in the IVF lab ?

  • Chapter 25c: Test Tube Babies - IVF & GIFT
  • How is embryo transfer performed ?
  • What happens after the embryo transfer ?
  • Why doesn’t every embryo become a baby?
  • How can you maximise your chances of success after IVF ?
  • How much does IVF cost ?

  • Chapter 25d: Test Tube Babies - IVF & GIFT
  • What is embryo freezing ?
  • What happens if the IVF cycle fails ?
  • What about your next IVF cycle ?

  • Chapter 25e: Test Tube Babies - IVF & GIFT
  • What is GIFT ( gamete intrafallopian transfer) ?
  • What are the basic steps of GIFT ?
  • How do GIFT and IVF compare ?
  • What is ZIFT ?

  • Chapter 25f: Test Tube Babies - IVF & GIFT
  • How can you make sense of IVF success rates ?
  • What games do some IVF clinics play with their pregnancy rates ?
  • What is assisted hatching ?
  • What is blastocyst transfer ?
  • How can we simplify IVF ?

  • Chapter 25g: Test Tube Babies - IVF & GIFT

    Chapter 25h: Test Tube Babies - IVF & GIFT
  • What are the risks and complications of IVF ?
  • What is OHSS ( ovarian hyperstimulation syndrome) ?
  • What about the risk of a multiple pregnancy after IVF ?
  • What about the dangers of overtreatment and
    undertreatment ?
  • How can you support each other during your IVF cycle ?
  • How can you select the best IVF clinic for yourself ?
  • What questions should you ask when selecting an IVF
     clinic ?
  •  

    Chapter 26: Preimplantation Genetic Diagnosis - the newest ART
  • What is PGD ( preimplantation genetic diagnosis) ?
  • How is PGD done ?
  • What are the controversies regarding the use of PGD ?

  • Chapter 27: Using Donor Sperm
  • What is donor insemination ( TID) ?
  • What are the psychological issues raised by donor insemination treatment ?
  • Who are the sperm donors ?
  • How is the sperm frozen and stored in a sperm bank ?
  • How is donor insemination treatment performed ?
  • Why is it safer to use frozen sperm samples for donor insemination ?
  • What is sperm banking ?


  • Chapter 28: Surrogate Mothering
  • What is surrogacy ?
  • Who needs surrogacy treatment ?
  • What are the complex issues raised by surrogacy ?
  •  

    Chapter 29: When Enough is Enough - The Decision to End Treatment
  • When should you consider stopping infertility treatment ?
  • How does one decide to stop infertility treatment ?

  • Chapter 30: Adoption - Yours by Choice
  • When should you consider adoption ?
  • What is involved in the adoption process?
  • When is adoption not the right answer ?
  • What are some of the myths about adoption ?
  •  
    Chapter 31: Childfree living - Life without children
  • What is childfree living ?
  • How can you adapt to the decision to live childfree ?

  • Chapter 32: Stress And Infertility
  • What is the relationship between stress and infertility ?
  • How does infertility cause stress ?
  • Why is infertility stressful ?
  • What can you do to reduce your stress ?

  • Chapter 33: The Emotional Crisis of Infertility

    Chapter 34: How to Cope with Infertility
  • How can you cope with the stress of infertility ?
  • How can you share your feelings about infertility ?
  • How can you cope with your infertility in your daily life ?
  • How can you cope with your friends and relatives ?
  • What times can be especially difficult ?
  • How does infertility affect your marriage ?
  • What is the relationship between stress and infertility ?
  • When should you seek professional help to cope with your stress ?

  • Chapter 35: Infertility and Sexuality
  • How does infertility affect your sexuality ?
  • Which are the times when sexuality is particularly affected ?

    Chapter 36: Support Groups-Self-Help is the Best Help

    Chapter 37: Myths and Misconceptions

    Chapter 38: Helping Hands - How Friends and Relatives can Help

    Chapter 39: Rights of the Infertile Couple - and What Society Needs to do About Them


    Chapter 40: Alternative Medicine: Exploring Your Treatment Options
  • Why are some couples unhappy with modern infertility treatment ?
  • What can alternative medicine offer infertile couples ?
  • How can you protect yourself from quacks ?
  • How can you use alternative medicine intelligently ?

  • Chapter 41: Making Decisions about Treatment
  • How can you be sure you are making the right decisions about your treatment ?
  • How can you identify your fertility goals ?
  • What kinds of infertility treatment are Available?
  • What questions should you ask your infertility doctor ?
  • What are the issues which will affect your final decision
  • What tools can you use to make better decisions about your options ?
  • How can you prepare yourself ?

  • Chapter 42: How to Find the Best Doctor
  • How do you go about finding the right infertility doctor ?
  • What criteria can you use to assess your doctor ?
  • What are the risks of going to a general gynecologist for your infertility treatment ?
  • Which is the best way of getting a second opinion ?
  • What can you expect during your first consultation with an infertility doctor ?
  • When should you change your doctor ?
  • How should you select an IVF clinic ?
  • Whys do you need to be an active participant in your infertility treatment ?
  • What are your rights as a patient ?
  • What are your responsibilities as a patient ?
  • What emotional support can you expect from your doctor ?
  • What questions should you ask your doctor ?

  • Chapter 43: How to Make the Most of Your Doctor
  • How can you improve your relationship with your doctor ?
  • What do you need to do before you go to your doctor ?
  • How should you talk to your doctor ?
  • What should you do when you need to phone your doctor ?
  • What tools can you use to make the most of your doctor's visit ?

  • Chapter 44: Let the reader beware - making sense of medical stories in the news
  • What are the problems with newspaper reports on infertility treatment ?
  • How can you intelligently read newspaper reports about infertility ?
  • What can you do to protect yourself from the inappropriate use of technology in your infertility treatment ?

  • Chapter 45: The Infertile Patient's Guide to the Internet
  • How can you use the internet intelligently to get the right treatment ?
  • How can you get a second opinion on the internet ?
  • What are some of the other useful websites for infertile patients ?

  • Chapter 46: The Ethical Issues - Right or Wrong?
  • What are some of the ethical issues surrounding the new reproductive technologies ?
  • How do the different religions look upon infertility
    treatment ?

  • Chapter 47: How Much Does Treatment Cost?
  • How much does infertility treatment cost ?
  • Do insurance companies cover infertility treatment ?

    Chapter 48: Pregnant - At Last !
  • How do you find out if you are pregnant ?
  • What is the beta HCG test for pregnancy ?
  • What are "biochemical pregnancies" ?
  • How is ultrasound used for monitoring pregnancy ?
  • What precautions do you need to take once you get
    pregnant ?
  • How do you cope if you miscarry after your infertility treatment ?
  • How can you make the most of your precious pregnancy ?
  • Is parenting different after infertility treatment ?

    Chapter 49: Preventing Infertility

    Chapter 50: The Infertile Patient's Prayer and Infertility "Defined"

    Chapter 51: Making IVF affordable
  • How can we make IVF more affordable ?
  • What is natural cycle IVF ?
  • What is transport IVF ?
  • What is intravaginal culture ?
  • How can we simplify IVF ?

  • Chapter 52: Why are women scared of IVF?

    Chapter 53: Infertility Record Sheet

    Chapter 54: Self-Insemination
  • What is self insemination ?
  • How is self insemination done ?

  • Chapter 55: Interpreting the lab test results
  • What is a normal semen analysis report ?
  • What are the normal hormone values for men ?
  • What are the normal hormone values for women ?
  • What are normal beta HCG levels during pregnancy?

  • Glossary
     
    Fertility Basics

    Making Babies

    Are you infertile

    Basic medical tests

    Ultrasound

    Wasteful Infertility Tests

    Finding the Right Doctor

    Making the Most of your Doctor

    How to use the internet


    The Infertile Man

    Male Infertility

    Low sperm count

    Semen analysis

    ICSI

    Donor Insemination
    The Infertile Woman

    Female Infertility

    The older woman

    PCOD

    Endometriosis

    Recurrent miscarriages

    Ectopic pregnancy

    TORCH infections

    TB and infertility

    Fibroids

    Ovarian cysts

    Ovulation

    Irregular periods

    Hirsutism

    Secondary Infertility
    Treatments

    Laparoscopy

    Hysteroscopy

    Medications

    IUI ( Insemination)

    Alternative Medicine
    IVF

    IVF

    ICSI

    PGD

    Failed IVF

    OHSS

    Beta HCG

    Egg Donor

    Embryo Adoption

    Surrogacy

    Free IVF videos
    Coping with infertility

    Coping with Infertility

    Stress and Infertility

    Making the right Decisions

    Ethical issues

    Cost of treatment

    Adoption

    Sexuality and Infertility

    Support Groups

    Infertility Myths
    Free infertility resources

    Free Fertility Calculator

    Free IVF calendar

    Free Second Opinion

    Infertility Store

    Free Online Book

    Free IVF videos

    What to Expect when you aren't quite expecting

    IVF E-learning course

    IVF Comic Book