The transcript from our February 2002 infertility chat on America Online.

So how many times did you do ICSI before being successful and which birth was it? First or second? And your age?


We did ICSI only twice to have the first one. The age at the time we started was 28 and 30 and I had my first child when I was 36.




What's next on the horizon for treating infertility?


Kathy Hudson: There is an enormous amount of research going on now to understand the physiological and genetic causes of infertility and some of those will provide insights that will lead to new and hopefully more effective treatments.



Bill: In the past, historically, people have referred to it as a female problem. While the doctors can tell you almost every hormone that goes into a woman's cycle, they can tell you very little about how the sperm is created in the body and hopefully that attitude will change and more research will be undertaken to determine male infertility issues. It really is a joint problem.



Kathy: The experience that Bill and Susan had with being offered genetic screening of embryo's created in vitro, the number and variety of such tests are going to increase very steeply. And so, in addition to just being able to look at large scale alterations in chromosomes, physicians will be able to look at very small changes in DNA of individual genes that are confronting parents who are already in a situation rife with decisions and anxiety with even more choices about which embryo they wish to implant.



Rebecca: There is also increasing amounts of research being done to determine what might cause any birth defects seen with ART. Researchers are looking at developing cell culture media that is safer for growing embryos, they are looking to understand how, for example, freezing embryos might affect them genetically. Hopefully this will lead to safer and more effective treatments.




I had endometriosis in 98 and laser surgery. I conceived the same month with help from clomid (what a blessing). Does anyone know if it comes back and what are my chances of conceiving without assistance (surgery)?



We have read that it can come back but we don't know the statistics.



Bill: Being you already have a baby, you're in pretty good shape. Also, you can check at resolve.org, physicians usually host chats there.




Are any of you using a surrogate at this time?



Bill and Susan: No, we're finished at this time and very poor. :)




What information do couples need to know to help them make decisions about ART?


Kathy: Couples need to understand what's involved in the procedure, understand what the risks are of the procedure specifically for superovulation, they need to understand what the odds are of success, they need to understand what the long-term health consequences are for both parents and the resulting child and in many of these areas we have incomplete information and need to pursue research to provide the information to the patients.



Bill and Susan: Be as informed as possible about all of the aspects. Know what your insurance does and doesn't cover. Understand the statistics that are presented to you for success rates CAN BE manipulated. Look at things like pregnancy rates vs. "take home baby" rates to make sure you are comparing apples to apples. You are actually in this process actually purchasing a very expensive procedure so it's your responsibility to make sure you understand what's happening and that you are an active participant in the procedure. You need to make sure the doctors will be there not for just the medical procedures but for the emotional support needed during the process.



Rebecca: It might be important to know how are these things are regulated, what is known about them, what questions scientists have about them. For example, with co-culture, many questions had been raised before the FDA stepped in to regulate it. But few, if any, patients were told.

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