At this moment an epidemic is sweeping the country. Your friends won't call you to find out if you've fallen victim. Charitable organizations won't be formed to rush to your aid. No. If you're having fertility problems, you probably feel that you're completely alone in your struggle. Your reaction may be, "Why me? Everyone else is having babies. It's not fair."

In my ten years of medical practice I have seen many infertile couples experience repeated disappointment, frustration, and disorientation. They cycle between guilt, anger, and despair, trapped in hope that with each new round of treatment they will conceive. When a course of therapy fails to produce a pregnancy, they experience all the stages of mourning as though they had actually lost an infant.

Over the years, however, I have seen many couples learn to deal with their trauma. They manage to get control of their lives and their feelings. They take an active part in their diagnosis and treatment. In fact, they seem to grow stronger and closer as a result of struggling with their fertility problem, It is because of these people that I decided to write this book.

I want to tell you not only how these couples coped but also how they resolved their fertility problems. I hope that by sharing their experiences, you will gain insight into your parenting needs and be able to design a course of treatment and therapy that will meet those goals. In addition, you will avoid unnecessary procedures, unwarranted disappointments, and excess costs. Above all, you will feel less like a victim and, I hope, much less alone.

I want to assure you that your fertility problems, your anger, your hypersensitivity, your feelings of inadequacy, and your eternal optimism aren't unique to just you. Fertility problems strike one in six American couples - 4.5 million people. Each year over I million people consult physicians for infertility evaluation and treatment.

The medical definition of infertility is "the inability to conceive after a year of unprotected intercourse or the inability to carry a pregnancy to term." However, if you already know or suspect that you have a fertility problem, you should seek an evaluation before waiting a year while trying to conceive. For example, a woman may suspect a problem if she suffers extreme pain with menstruation, has a history of pelvic inflammatory disease, or has few menstrual periods. A man may be concerned if he has ever contracted a sexually transmitted disease, has symptoms of genitourinary tract infection, or has an undescended or injured testicle. Infertility should not be confused with sterility, which is an irreversible condition. And it should not be referred to as subfertility, which connotes a borderline fertility problem that may not require treatment. All fertility problems, however, should be evaluated to determine their seriousness.

Recently I have witnessed astounding progress in the diagnosis and treatment of infertility. Only a few years ago most couples with fertility problems had to turn to adoption or remain childless. But now, with the advances in pharmaceuticals, microsurgery, in vitro fertilization, micromanipulation, and egg donation, many viable options have opened up to infertile couples—with the result that "miracle babies" are being born almost every day. There is every reason for hope.

I hope to help satisfy your thirst for medically sound information about your infertility—what may have caused it, what tests are available to diagnose the causes, what can be done to correct the problems, and most important, what your options are. Being informed of the most up-to-date medical technology will help you work with your physician to develop an effective, individualized course of treatment.

It is not uncommon to find fertility problems in both partners. However, even when only one of you must be medically treated, I find that the fertility problem affects both of you because the couple loses control of their destiny, the couple undergoes fertility treatment, and the couple shares the emotional strain of dealing with friends and family. Infertility does not affect just one person—it affects the couple.

Most people respond to infertility with disbelief and anger. As infertility becomes a reality, as they begin medical treatment, and if they experience repeated failures, their anxiety and frustration grow. All infertile couples suffer psychological trauma. All infertile couples feel cheated. All infertile couples feel that they've lost control of one of their most personal rights—the right to bear children. If you suffer from these symptoms, you are not alone.

In this book I will help you rethink the myths that may be haunting you and interfering with your self-esteem, your sexuality, and your progress toward conception. I want to help you stabilize your life so that you can deal with other important, related aspects of your life—your marriage, your family, your friends, and your career. You are entitled to have the freedom to be yourself and to consider new options apart from what others expect or demand. You may even want to give your family and friends a copy of this book so they can become more sensitive to your needs.

I will also inform you of the legal controversies surrounding the latest technologies for infertility treatment. You will learn why attorneys and lawmakers are concerned and even confused about parenting rights, fetal rights, and custody definitions when it comes to miracle baby making. With this information you will be able to sort through the moral and ethical decisions you may face regarding issues such as artificial insemination, in vitro fertilization, egg donation, surrogacy and genetic counseling. I believe that by reading this book, you will find encouragement, understanding, comfort, practical solutions, and the courage to keep trying for your own miracle baby.

Mark Perloe, M.D.
5445 Meridian Mark Road
Atlanta, GA 30342

Fellow of the American College of Obstetricians and Gynecologists, American Association of Gynecologic Laparoscopists, Diplomate of the American Board of Obstetrics and Gynecology, Member, Society of Reproductive Medicine

This book is not intended as a substitute for medical advice of physicians. The reader should regularly consult a physician in matters relating to his or her health and particularly with respect to any symptoms that may require diagnosis or medical attention.

The names, characters, places, dialogue, and events in this book either are the product of the authors' imagination or are composites of certain conversations and events, with names disguised.