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banthony - January 1st, 2009 7:40 PM

My wife and I have been pursuing infertility treatments for too many years. We have been diagnosed with "Unexplained Infertility."

We have completed all the diagnostic tests.

All these tests say we are normal.

My testing says I'm normal (normal sperm court, normal motility, normal morphology, no infections, no genetic defects, no exposure to radiations/medications/chemicals and no hormonal imbalances) I turned 43 this year.

The same is true for my wife (normal eggs, normal egg reserve, no endometriosis, no ovulatory disorders, no ovary sydromes, no genetic defects, no exposure to radiations/medications/chemicals and no hormonal imbalances) My wife turned 42 this year.

We also tried the IUI treatment multiple times with no success.

We are very frustrated with our lack of success at finding the root cause for our infertility and a treatment for our infertility.

In order to not waste more of our time/money, what questions should we ask in our search for a new MD/Practice?

B. Jacobs, M. D. - January 1st, 2009 10:12 PM

First, it has been about 20 years since I have not been able to find an explanation for a couple's infertility after they enter my practice. If you are not seein a Reproductive Endocrinologist, go see one. OB-GYN generalist are great for managing general OB-GYN but do not have adequate tools to evaluate and treat infertile couples. For information about my evaluation and treatment processe, please see our web page. This board will not permit me to provide the URL, but you can find it by Googling my name. I'm sorry.
Goodl luck.

banthony - January 2nd, 2009 5:18 AM

Perhaps I was not clear. We have been seeing a board certified Reproductive Endocrinologist for more than 5 years. This is after seeing an OB-GYN generalist for more than 2 years.

I will also google your name and see if it can provide more information.

B. Jacobs, M. D. - January 3rd, 2009 2:13 PM

Good luck. At least you have the right to seek other opinions, if you so desire.

banthony - January 3rd, 2009 7:14 PM

So do you have any suggestions/advise on how to "seek out other opinions?"

B. Jacobs, M. D. - January 4th, 2009 9:01 AM

There are a number of Reproductive Endocrinologists. I do not know who is in yor area. You might go on line and do a search for your city.
Good luck.

banthony - January 4th, 2009 10:11 AM

So is there a procedure/tips to figure out which RE is the real deal?

Since we are now 42/43 and have wasted 7+ years with the first RE, it is my understanding we don't have a great deal of time to mess around with picking a second RE.

And I'm guessing getting recommendations from our insurance company or letting our fingers do the walking in the yellow pages isn't the smartest way to pick a RE. There are no local support groups, our church does not have any recommendations, etc. And while we are located in the southeast, we are not located in Texas.

B. Jacobs, M. D. - January 4th, 2009 9:29 PM

NOw that I know your ages, I know at least 1 problem. After the age of 40, a woman's fertile potential declines dramaicly. Please consider using an egg donor.
Good luck.

banthony - January 5th, 2009 11:35 AM

This is not helpful. I'm not interested in starting a harem. Our ages were listed in the very first post. It would be helpful if you could response to this question.

"
So is there a procedure/tips to figure out which RE is the real deal?

Since we are now 42/43 and have wasted 7+ years with the first RE, it is my understanding we don't have a great deal of time to mess around with picking a second RE.

Thank You

B. Jacobs, M. D. - January 5th, 2009 5:00 PM

Actually, it is not as bad as it may sound. It is the age of your wife's eggs which is the age-related problem. If there really are no other problems, using the eggs of a donor between the ages of 20 and 30 will provide you with a much better chance of a pregnancy.I know nothing of her uterine cavity or your semen parameters. Unfortunately, very few labs perform an adequate semen analysis. I use a specialty lab for that purpose.

banthony - January 6th, 2009 7:10 AM

Unfortunately, the courts don't seem to be in agreement with your assessment on using "donor eggs." In a 30 second review of case law, the RE industry has a few problems with informed consent, writing proper releases, etc. I'm also sure you don't want to know what my wife thought of your idea.

All of my 100+ semen analysis were normal. What is the value of continued testings? Isn't a semen analysis done for every IUI/IVF? Also might check the very first post again to see all the factors that they checked.

There also this outstanding question:

Is there a procedure/tips to figure out which RE is the real deal?

Since we are now 42/43 and have wasted 7+ years with the first RE, it is my understanding we don't have a great deal of time to mess around with picking a second RE.

B. Jacobs, M. D. - January 6th, 2009 5:02 PM

I do not know how to advise you. If you lived near Dalals, I would be happy to work with you. I do not know anything of the courts in your juristiction, but donor egg and gestational carrier protocols are part of the RE processes recognised as legitimate medical treatments. In Texas the law even allows for couple using a gestational carrier to have the court declare the pregnancy theirs the wife's name is on the birth certificate as Mom - not the gestational carrier.
Good luck.

banthony - January 6th, 2009 5:57 PM

I don't live in TX. Perhaps TX laws are more evolved than laws in our states.

Here is the reality/legal situation I have to deal with:

In my judicial district, it is my understanding that we had a family court judge rule that:

a. The donor egg was the sole property of the biological mother, not the female that underwent the ART treatment.
b. The biological father was financially required to support the child he created, even if he was not married to the biological mother.

The judge based everything on DNA, not who wanted to get pregnant or who carried the child.

Your comments may be applicable for your state, but this is the law of the land in my state until overturned by an appeals court.

So without moving to TX, this does not appear to be an option.

There also this outstanding question:

Is there a procedure/tips to figure out which RE is the real deal?

Since we are now 42/43 and have wasted 7+ years with the first RE, it is my understanding we don't have a great deal of time to mess around with picking a second RE.

Thanks for your timely response.

B. Jacobs, m. d. - January 7th, 2009 6:48 AM

I have no way of knowing which RE's in your area are going to be optimal choices for you. You and others in your state have my sympathy regarding the ruling of the family court judge. It seems to be contrary to the rest of the country.
Good luck.

banthony - January 7th, 2009 7:08 AM

Isn't that great! So I guess we randomly pick an RE and hope for the best.

B. Jacobs, M. D. - January 7th, 2009 5:02 PM

Just provide copies of all the laboratory data generated and copies of the HSG films. They should be available where the X-rays were performed. every RE in the countrry should be aware of the SART report on embryo implantation rates based on age of the patient. Again, from a purely medical perspective, I have to recommend donor egg.
Good luck.

banthony - January 8th, 2009 8:38 AM

I just don't see how that is going to help us. We don't have the finicial means to fund both an legal appeal and ART treatments. We will be very fortunate to fund one cycle of IVF after all the wasted years with RE#1.

Also, what is the best way to get your records away from RE#1? He is very upset that we are leaving his practice.

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