A Baby at Last! A Couple's Complete Guide to Getting Pregnant

A Baby at Last by Zev Rosenwaks, M.D. and Marc Goldstein, M.D.

Fertility experts Dr. Zev Rosenwaks and Dr. Marc Goldstein of NewYork-Presbyterian Hospital/Weill Cornell Medical Center offer advice to men and women confronting infertility in their new book "A Baby at Last! The Couple's Complete Guide to Getting Pregnant--from cutting-edge treatments to common sense wisdom."

Rosenwaks is the director of the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at NewYork-Presbyterian Hospital/Weill Cornell Medical. Goldstein is the director ofthe Center for Male Reproductive Medicine and Microsurgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

Read an excerpt of the book below, and then head to the "GMA" Library to find more good reads.

Chapter 1

VIDEO: Drs. Zev Rosenwaks and Marc Goldstein offer couples fertility advice.
A Couple's Guide to Getting Pregnant

You Are Not Alone: When to Seek Help

Claire, a thirty-seven-year-old designer, had tried unsuccessfully to have a baby for a year and a half before she went to see her gynecologist. Her doctor found she had an incompetent cervix, which he corrected surgically. Six months later, her husband, Jeff, a thirty-eight-year-old salesman, went to a urologist, who found Jeff had a very low sperm count and a cyst on one testicle. Claire did some research on the Internet into hospitals and doctors. An oncologist friend suggested they go to Weill Cornell, where a radiologist told them that Jeff's cyst was benign, but Dr. Goldstein found that Jeff had varicoceles (varicose veins in the scrotum) affecting both testicles. Microsurgery repaired the varicoceles, but Jeff's sperm count remained very low, so they decided to try an in vitro fertilization (IVF) procedure with Dr. Rosenwaks.

For the first IVF attempt, three of Claire's eggs were fertilized with Jeff's sperm and transferred into her uterus, but none progressed to a pregnancy. A few months later, Jeff had better-quality sperm surgically removed from his testicles, and those sperm were used to fertilize ten of Claire's eggs. Dr. Rosenwaks transferred four healthy embryos.

"I had prepared myself for the possibility that it wouldn't work," says Claire.

"Jeff and I talked a lot during the two-week wait about what we would do if we got bad news. We also met with a counselor at Weill Cornell, who made the process easier to deal with." When they received word that Claire was pregnant, "I couldn't believe it," says Jeff. "I'll never forget that call." Their daughter, Connie, is now eighteen months old.

Fertility is, on the face of things, a very simple process. It's a matter of getting the sperm and egg together. But the variables are plentiful, and as many couples find, it's easy for something to go wrong. You need a good quality egg and properly functioning sperm. You need enough sperm to be deposited where it's supposed to be. The sperm has to be strong enough to swim up the female reproductive tract through the fallopian tube to reach the egg to fertilize it. The fallopian tube has to be normal to be able to pick up the fertilized egg and deliver it to the uterus so it can develop fully. The woman's brain also needs to function properly, so that the pituitary gland produces adequate amounts of hormones necessary to foster follicle and egg development in the ovary. In turn the ovary, under the influence of the pituitary gland, must produce the critical hormones—estrogen and progesterone—necessary to promote uterine lining development and support for the implantation of the fertilized egg.

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