X's Q & A

Q&A: Besides a vasectomy reversal, what other options do we have for having a baby together?

Dear Renee: There is a sperm aspiration process you may use to retrieve sperm from testicular tissue, then inject the sperm into the cytoplasm of your eggs. This would require doing an IVF cycle. You would need to check with your husband's urologist for statistics regarding vas reversal. Pregnacy rates for you doing IVF with testicular biopsy would be close to fifty percent, but again check with an IVF center in your area for more detailed pregnancy rates and prices. Good Luck. Sincerely, Eric Silverstein, M.D.

Q&A: What are our options to having a baby if my husband had a vasectomy 18 months ago?

Dear Renee The other option would be to undergo an IVF/ICSI cycle, and have sperm aspirated from the testicles (an area called the epididemis). That obviously involves during an IVF cycle with the costs involved. I would recommend freezing the extra embryos if you go that route. If your husband has a successful vasectomy reversal and you get pregnant on your own, the issue of birth control will need to be discussed (not an issue if you go with IVF). Good luck

Q&A: Should I see a urologist if I have a bulge in one testicle?

You absolutely must see a Urologist. What if it's not a varicocele??? After the Urologist diagnoses your "bulge", you can then discuss options with him as to whether or not a varicocele repair is warranted at this time (if it indeed is a varicocele). Dr. Roseff

Q&A: What temperature should sperm be frozen to and what temperature should it be at for insertion?

Sperm is frozen to -321 F, but cryoprotectants are added to it and sperm is processed prior to freezing (you can't just freeze the sperm alone). The thawing procedure depends upon several factors regarding what cryoprotectants were used and how the sperm was processed prior to freezing. None of this should be attempted at home.... Dr. Roseff, Director WECARE Visit us at

Q&A: Are there side effects with the use of Lupron and Gonal F, and how long have they been in use?

Hi Franca, Lupron has been used an an adjunct for assisted reproduction since at least some time in the early 1990's. Gonal-f received US marketing approval in 1997 (although it was used before that in Europe). There are potential side effects with both of these drugs, and this is not the appropriate forum to go into all of those possible issues. EVERY reproductive endocrinologist should discuss the possible side-effects with their patients BEFORE giving you prescriptions for these meds. It takes me between 10-20 minutes to discuss the possible risks/implications of these meds in a face-to-face discussion with my patients. If you would like to come here and discuss these meds in depth, please feel free to let me know. Thanks for your questions! Dr. Roseff, Director W.E. C.A.R.E. Visit us on the web at: =================================================== Since I don't know your entire history and haven't examined you, any medical information given to you may be incomplete or inaccurate. Therefore, Dr. Roseff and the W.E. C.A.R.E. staff can not be responsible for any actions taken or not due to the information contained within these communications. These communications are for educational and informational purposes only, and should never be used to replace the information and care rendered by your own doctor. ===================================================

Q&A: What can I do to start a family (ie get pregnant) if I have a lot of health issues?

Hi, The best tip I can give you, considering your problems with endometriosis and cervical problems, is to see a Board Certified Reproductive Endocrinologist. If you need help finding one in your area, please let me know.

Q&A: Where do I get information on the various artificial insemination options?

Dear Elle A good source is Good luck Fady I. Sharara, M.D VA Ctr for Reprod Med

Q&A: What do I need to do to have children again after having a tubal ligation?

Hi, It sounds like you probably need in vitro fertilization (IVF). IVF totally bypasses your tubes, and may be your best option for achieving a pregnancy. There are many qualified IVF centers in CA, so you should be able to find one nearby. Thanks for your inquiry! Scott Roseff, MD, FACOG - Director of W.E. C.A.R.E. Visit us on the web at: -------------------------------------------------------------------------------- Since I may not know your entire medical history, and I may not have examined you, Dr. Roseff (W.E. C.A.R.E.) can't be held liable for any consequences of your actions taken (or not) as a result of the medical information conveyed in this message. This communication is for your general information, only, and should never be used as a substitute for the medical advice/care of your own physician. --------------------------------------------------------------------------------

Q&A: What is the risk of artificial insemination from an HIV+ male and an HIV- female?

Hi, Thanks for your inquiry! I've copied some information for you, below (without the references). It comes from the following website, and you can view the entire website if you wish: ================== HIV TRANSMISSION BY ARTIFICIAL INSEMINATION Unprocessed Donor Semen Currently, 14 women are known to have been infected with HIV via artificial insemination from anonymous donors: 2 in Italy,(53) 4 in Australia,(54)2 in Canada,(55) and 6 in the United States.(5556) All of these cases of insemination-related infection occurred before the availability of HIV antibody testing. Another woman was HIV infected after insemination of processed sperm from her HIV-seropositive hemophiliac husband.(57) These reports demonstrate that HIV transmission can occur after the use of fresh, cryopreserved or processed sperm. Both intrauterine insemination and cervical insemination result in HIV transmission. Other generalizations about the efficiency of HIV transmission via this route are limited by the retrospective nature of the follow-up, the limited number of infected recipients, and absence of information as to the HIV viral load of the seropositive donors or other host factors in either donor or recipient at the time of insemination. It can be concluded that, before availability of HIV testing, HIV transmission from unrelated semen donors was an infrequent event given the approximate 75,000 women artificially inseminated annually in the United States.(58) Further, these reports demonstrate that heterosexual transmission of HIV can occur in the absence of cervical or vaginal lesions or trauma and in sexual partners free of sexually transmitted disease. Processed Semen from HIV-Positive Males The CDC recommends against insemination from HIV-positive men, but some HIV discordant couples are highly motivated to bear their own children and have used processed semen to reduce the risk of HIV transmission. In a case report from the United States, processing fresh ejaculate by centrifugation to remove cells failed to prevent HIV transmission in that the women seroconverted after artificial insemination.(57) A modification of this technique in Italy, however, appeared successful in preventing transmission.(61) The researchers reported that 29 women were inseminated and none seroconverted. Ten babies born to these women have remained HIV-negative. The processing method involved centrifugation, repeated washing, and an incubation period that allowed spermatozoa to swim up to the upper layer of the culture medium. They concluded that this procedure may offer highly motivated HIV discordant couples a way to achieve artificial insemination with reduced risk of HIV transmission, although it involves some risk. These results also provide evidence against the controversial claim that HIV is transmitted by spermatozoa as opposed to infected leukocytes and free virus in seminal fluid.(62,63) ================= Hope this helps! Dr. Roseff Visit us at

Q&A: How do I get pregnant by artificial insemination and I am not ovulating?

By following what he/she told you you need. You cannot get pregnant unless you ovulate an egg. good luck Fady I. Sharara, M.D VA Ctr for REprod Med

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