Perhaps one of the most stressful times of life is when you've been trying to get pregnant, but nothing seems to work. At this stage in your efforts, the Pathways to Pregnancy program is a wonderful addition to your fertility team.

You've tried the basic steps, but perhaps there have been some evaluations that were overlooked, treatments not finished or techniques not pursued. The Pathways to Pregnancy will analyze where you stand as a couple today, and recommend a measured path forward.

At this stage, you need a firm and comprehensive approach to maximizing your time, resources and efforts to get you through to conception. The medical information analysis and guidance that is provided by the Pathways program is an excellent way to guide you in the months to come.

The beauty of the Pathways to Pregnancy program is that it removes much of the uncertainty in what's coming for you as a couple in the fertility process.

Once you've taken our survey and begin down the Pathways, you'll find (laid out clearly in front of you ) a state of the art Fertility Pathway designed for you and your partner to achieve pregnancy.

Even better, your Pathway can be adjusted if there is a change in your fertility health. Improvements or decreases in the results for either of you can quickly be identified so you can decide on a new path that is more effective for your needs. The choice will be up to you, but you will always be given clear options based on your timeline, treatments and costs.

And, since the Pathways to Pregnancy program is a self use free educational program, you're never tied to a any obligation. You choose if you want additional services!

The program is there when you need it, and when the joyous news comes and it's time to leave our program, we'll wish you the very best as new parents.

The Pathways to Pregnancy start with a free 5-minute, no-obligation survey you can begin now.

Many couples are concerned with approaching pregnancy from a healthy, natural and affordable approach. If you're in this camp and would like to try all of the natural techniques available in the most recent medical findings, then the Pathways to Pregnancy program is the right place for you.

The guiding principle behind the Pathways program is that unless you tell us differently, we'll recommend the most natural, non-invasive treatments and techniques first. And, we'll protect you from fads, old wives' tales and urban legends, so you're not wasting time or money on unproven myths. Our recommendations to you will be based on the latest medical findings for diet, treatment and technique that have a proven track record of success.

If, after sustained effort and time, your physicians recommend a course of more advanced medicines and testing procedures, you'll have the comfort of knowing that you've tried every option available before you move on to the more complex fertility treatments.

The Pathways to Pregnancy start with a free 5-minute, no-obligation survey you can begin now.

Total communication and collaboration is what Pathways to Pregnancy is all about. We believe it's vital that couples work together through the conception experience because it:

· reduces stress in both partners
· increases your joy in accomplishment
· helps you share the challenge of important issues and treatment
· keeps you both aware of the financial implications of treatment and timelines
· improves your feeling of contribution to each other's reproductive health

The Pathways to Pregnancy program is designed specifically for couples. Each of you will have your own recommendations and area to mark your improvement.

The whole Pathways system is designed from the ground up for male and female fertility enhancement. As you progress, your efforts as a couple are shared with each other, as well as available for your treating physicians, so they can optimize their care for you.

The program also recognizes that each couple will have a different approach to fertility based on their values, financial resources, and religious beliefs. Part of the Pathways filter is designed to exclude certain treatments or procedures you may not want to consider.

Even with your exclusions factored in, the Pathways to Pregnancy can guide you along the most likely path to conception. Your information creates your personalized Fertility Pathway.

The Pathways to Pregnancy start with free survey you can begin now.

It's rare that we run across a couple who isn't concerned about the expenses involved in fertility treatment. And you should be concerned! The Pathways to Pregnancy program is designed to factor in the current costs of treatments and techniques, as well as provide you with information that will allow you to plan for possible future expenses.

The Pathways take into account your age, fertility history and prior treatments, and combine those facts with your expressed desire for urgency in getting pregnant. This vitally affects the expense of treatment, because a 35 year-old woman who has already had years of fertility treatment has a different set of challenges than a 25 year-old woman who is just starting treatment.

Our core concern is to offer you a path forward-no matter where you begin-that balances your urgency to conceive with a progression from the least expensive and least invasive techniques to the more expensive and complex treatments.

The Fertility Pathway that will be generated from your survey will be your road map to focus on those things that you need to do to get pregnant, at you pace and desired cost.

The Pathways to Pregnancy start with a free 5-minute, no-obligation survey you can begin now.

Much of the pressure and stress of an extended effort at achieving pregnancy come from three areas: fear of the unknown, the cost of treatment and carrying the burden alone. In each case the Pathways to Pregnancy program is here to help reduce your stress.

We place you on a clear path forward, showing you where you are today and helping you and your partner plan for what may happen as you proceed down the path.

By providing you infromation so as to better understand your physicians, we help you get your questions answered sooner and keep the momentum of your treatment going. And when you have an idea of what treatments and techniques may be coming your way, you can plan for them financially, well ahead of time.

Every aspect of the Pathways to Pregnancy program is designed to increase your knowledge of where you are and where you're going. Our goal is to reduce your concerns by educating you on expenses, how to maximize your fertility dollar along your fertility pathway and how to shorten the time to conception and other nice tools!

The Pathways to Pregnancy start with a free 5-minute, no-obligation survey you can begin now.

Infertility is a disease of the reproductive system that impairs the body's ability to conceive children. Conception is a complicated process that depends upon many factors, including the production of healthy sperm by the man and healthy eggs by the woman; unblocked fallopian tubes that allow the sperm to reach the egg; the sperm's ability to fertilize the egg when they meet; the ability of the fertilized egg (embryo) to become implanted in the woman's uterus; and sufficient embryo quality. The Pathways to Pregnancy program was developed, in part, to help couples struggling with infertility. The program offers a guide to treatment through a wide spectrum of options from natural alternatives to the most technically advanced reproductive procedures. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy

About one-third of infertility cases can be attributed to male factors, and about one-third to factors that affect women. For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 percent of cases, is unexplained. The Pathways to Pregnancy program can assist you and your mate in discovering if you have infertility issues and, if so, what could be causing them. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

As with most diseases, there are numerous reasons an individual may struggle with infertility. There are several factors that tend to contribute to infertility, however. They include weight, age, sexually transmitted diseases, tubal disease, endometriosis, DES exposure, smoking and alcohol use. To increase the chance of conception, it helps to be in the best physical shape possible. It's also advisable to cut back on caffeine consumption.

The Pathways to Pregnancy program can help you determine if you are at risk for infertility and if making certain lifestyle changes could lessen your risk. The program can also give you valuable advice on how to find out if you are infertile, your level of fertility and what steps you can take to achieve conception. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

Lifestyle habits can markedly affect the quality of the semen. Alcohol, tobacco, drugs, recreational activities and exercise all can affect sperm production and ejaculation. Alcohol destroys sperm-producing tissue. Tobacco causes decreased sperm survival and function. Diet and vitamins have been shown in controlled studies to affect sperm production. Sexual practices can be modified to promote fertility. Abstinence periods of three to four days produce larger semen quantities and greater viability. Certain common lubricants such as KY jelly, lotions, and oils can kill sperm and decrease fertility

Most physicians advise you not to be concerned unless you have been trying to conceive for at least one year and are under 35. If you are over 35 and have been trying for 6 months or more, you should consult a physician. If you are a woman over 30 and have a history of pelvic inflammatory disease, painful periods, miscarriage, irregular cycles, or if you know that your partner has a low sperm count, consult your OB/GYN.

The Pathways to Pregnancy program is designed to help you determine what measures you should take in your efforts to conceive. Once you take our free fertility survey, you will immediately be placed in a path that's determined by several factors, such as how long you've been trying to get pregnant, your medical history and your age. When you sign up to become a member of the program, you will receive a timeline that outlines what steps you should take now, as well as those you may take in the future. For more information on the Pathways to Pregnancy program, click here.

The couple's doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Typically, both partners are interviewed about their sexual habits to determine whether intercourse is taking place properly for conception.

If no cause for infertility can be determined at that point, the doctor may recommend further tests. For women, these may include an analysis of body temperature and ovulation, x-ray of the fallopian tubes and uterus, and laparoscopy. For men, initial tests focus on semen analysis.

If you have already had a semen analysis done, you can use our Semen Analysis Calculator to assess where on the fertility scale you fall. Then you can join the Pathways to Pregnancy program for helpful advice, timelines and personalized fertility options. Your first step to joining the program is to take our free fertility survey. If you need a semen analysis performed please click here.

The day you start your menstrual period is "Day 1." Around "Day 14" you may ovulate and release an egg. The egg is viable for 24 hours; this is your most fertile time. However, not all women ovulate on "Day 14." Some ovulate earlier and some later. Some women do not ovulate at all. Your ovulation pattern can vary from month to month. Even if you are getting your period, it does not necessarily indicate that you are ovulating.

If you're having difficulty conceiving, the Pathways to Pregnancy program can help you determine why you are having difficulty and what you can do to achieve conception. It can also help you communicate with your partner and coordinate with your doctor(s) to get the information and support you need. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

One way a woman can determine when she ovulates is to take her basal body temperature every morning and record it on a chart. After recording for three to four months, she should share the chart with her doctor. Ovulation predictor kits are also available over the counter.

Timed intercourse is most effective when done the day before and the day after ovulation, if that day is known. It is ideal that a woman hoping to get pregnant monitors her ovulation closely and knows when her day of ovulation will be. If the date is unknown, having intercourse every other day around the time of ovulation (days 10, 12, 14 and 16) is a good alternative. To increase your chances of becoming pregnant, do not douche or use lubricants immediately before or after intercourse.

Healthy sperm can live for approximately 48 hours in the woman's reproductive tract, however vulnerable sperm resulting in decreased fertility and/or an abnormal semen analysis will live for a shorter period of time in the woman's reproductive tract. The chance of conception is highest when the fertility of both partners is maximized.

The Pathways to Pregnancy program is designed to help you determine what measures you should take in your efforts to conceive. Once you take our free fertility survey, you will immediately be placed in a path that's determined by several factors, such as how long you've been trying to get pregnant, your medical history and your age. When you sign up to become a member of the program, you will receive a timeline that outlines what steps you should take now, as well as those you may take in the future. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

Most infertility cases are treated with conventional therapies, such as drug treatment or surgical repair of reproductive organs.

Medical therapy for male infertility is successful in certain conditions. The most successful medical treatments for infertility are based on clearly defined abnormalities in the male reproductive tract. Drug therapy includes substances designed to improve sperm production such as hormone supplements for endocrine system disorders, antibiotics for fertility-impairing infections and immunologic agents, and medication to promote and control ejaculation.

Surgical therapy has been perhaps more successful than medication in restoring more normal quality to the semen analysis. Some surgical procedures like testes biopsy, vasogram (injection of dye into the genital duct), and cystoscopy of the bladder help to determine if an obstruction of genital duct system may be present. An ultrasound study of the prostate or testes is occasionally needed to evaluate infertility.

Surgical procedures that improve semen quality include varicocele (scrotal vericose veins) repair, vasectomy reversal, prostate resection, surgical sperm removal, and electroejaculation. Most of these procedures require general anesthesia and are day surgeries.

Our Pathways to Pregnancy program offers a variety of treatments from free to expensive, and from natural to invasive, so you can decide on the treatments, budget and timeline that are right for you. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

Vasoepididymostomoy is a microsurgical procedure that uses a microscopic camera and very small operative tools to correct obstructions in the genital tract. The procedure requires removal of the blockage in the epididymis (the coiled tube that extends the length of each testis and connects with a larger duct - the vas deferens) and re-attachment of the epididymis to the vas deferens. Vasoepididymostomy may improve pregnancy rates by up to one-third of all patients; however, the success of vasoepididymostomy is dependent upon the experience and technical expertise of the microsurgeon.

Varicocelectomy - the cutting away of a varicocele - is usually performed with regional or general anesthesia. The surgeon makes an incision into the groin, and the problematic venous system then is repaired. The venous channels are divided to prevent varicocele recurrence, and the external cremasteric vessels (the veins associated with the testis-elevating muscle) also are tied off and divided. Varicocele repair often dramatically increases semen quality and pregnancy rates in infertile couples. The major complications of varicocelectomy are varicocele recurrence and formation of hydrocele (collection of fluid in a contained area). However, newer microsurgical techniques have substantially limited these complications.

Vasovasostomy, otherwise known as vasectomy reversal, is the re-connection of the severed ends of the vas deferens. This procedure, like vasoepididymostomy, commonly is conducted using microsurgical methods. However, nonmicroscopic, "macrosurgical" techniques also are successfully employed. Most vasectomy reversal procedures are conducted on an outpatient basis.

The new forms of fertility treatment - collectively known as Assisted Reproductive Technologies (ART) - incorporate many methods of sperm retrieval and preparation. Once the sperm have been processed to ensure optimal fertilizing potential, they are used in a variety of procedures that aid the process of conception. These procedures include artificial insemination (AI), in vitro fertilization (IVF), and sperm microinjection techniques.

Sperm retrieval is not limited to ejaculated semen. With today's technology, sperm can be obtained from men with azoospermia (lack of sperm) that is caused by an obstructive lesion, failed vasectomy reversal, inherited absence of the vas deferens, or other uncorrectable blockage.

By applying microsurgical methods in a process known as micro epididymal sperm aspiration (MESA), sperm can be gathered close to the blocked portion of the epididymis, the elongated, coiled duct that provides for the maturation, storage, and passage of sperm from each testis. Similarly, percutaneous epididymal sperm aspiration (PESA) uses a small needle to penetrate the testicular skin and draw sperm from the area near the epididymal obstruction. Testicular sperm extraction (TESE), the removal of a small amount of testicular tissue under local anesthesia, also can be a source of sperm. Sperm retrieval methods usually are scheduled to coincide with the female partner's time of ovulation, so that they may be used for in vitro fertilization (IVF) of a retrieved egg.

Sperm washing is used extensively for the treatment of semen with low sperm counts, abnormal sperm forms, antibodies, and other fertility-impairing features. The "washing" is accomplished by adding culture medium (a fluid containing nutrients and buffers) to the semen and spinning the entire sample in a centrifuge (a machine that uses centrifugal force to separate heavier and lighter elements in a solution). The heavy sperm "pellet" is then rewashed in culture medium. The sperm that are gathered from such washing methods are used for artificial insemination and in vitro fertilization procedures.

In vitro fertilization (IVF) offers infertile couples, where women have blocked or absent fallopian tubes or where men have low sperm counts, a chance at parenthood. In IVF, eggs are surgically removed from the ovary and mixed with sperm outside the body in a Petri dish ("in vitro" is Latin for "in glass"). After about 40 hours, the eggs are examined to see if they have become fertilized by the sperm and are dividing into cells. These fertilized eggs (embryos) are then placed in the women's uterus, thus bypassing the need to pass through the inoperable fallopian tubes. IVF accounts for less than five percent of all infertility treatment in the United States.

Many couples are hesitant to undergo IVF and prefer to exhaust natural and less invasive treatments first. The Pathways to Pregnancy program was created to give couples a way to progressively increase their chances of conception by meeting them where they are in their efforts to conceive and making suggestions based on their personal preferences. The program always suggests the least invasive and least expensive procedures first and shows what options are available to you should you need to take further measures. The program will help you research the best IVF labs in your area, help you determine your insurance coverage and provide you with additional resources to assist you in making an informed decision about IVF. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

The average cost of an IVF cycle in the United States is $12,400. Like other extremely delicate medical procedures, IVF involves highly trained professionals with sophisticated laboratories and equipment, and the cycle may need to be repeated to be successful. While IVF and other assisted reproductive technologies are not inexpensive, they account for only three hundredths of one percent (0.03%) of U.S. health care costs. We suggest infertile couples explore lower cost alternatives before choosing IVF. Our Pathways to Pregnancy program offers low cost natural treatment plans for infertile couples. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

While an IVF cycle may have to be repeated several times before conception takes place, it is a successful treatment overall. It is estimated that more than 91,000 births occurred by IVF conception from 1985 to 1998. The average live delivery rate for IVF in 1998 was 29.1% per retrieval-a little better than the 20% chance in any given month that a reproductively healthy couple has of achieving a pregnancy and carrying it to term.

Artificial insemination is now more commonly referred to as Intrauterine Insemination (IUI). It is a procedure used for couples with unexplained infertility, minimal male factor infertility and women with cervical mucus problems. The procedure uses the sperm of the male (partner or donor), washing and treating the sperm and injecting it into the woman during her time of ovulation. IUI is less successful with poor quality sperm. Couples considering IUI should be sure the male partner has a semen analysis in which the results show him to have maximized quality sperm.

Many couples are hesitant to undergo IUI and prefer to exhaust natural and less invasive treatments first. The Pathways to Pregnancy program was created to give couples a way to progressively increase their chances of conception by meeting them where they are in their efforts to conceive and making suggestions based on their personal preferences. The program always suggests the least invasive and least expensive procedures first and shows what options are available to you should you need to take further measures. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

Intracytoplasmic sperm injection (ICSI) is an IVF procedure in which a single healthy sperm is injected directly into the egg. ICSI is useful when the man's sperm count is very low or many sperm are abnormal or immotile. A tiny injection pipette is used to pass the sperm through the zona pellucida (outside layer) of the egg into its ooplasm (central substance). In general, ICSI is performed on several eggs. Once they have been fertilized, they are replaced inside the woman's uterus after a period of about 48 hours.

Gamete intrafallopian transfer (GIFT) is an ART procedure in which the egg and sperm (gametes) are placed together within the fallopian tubes. GIFT requires prior, hormone-induced "super stimulation" of the woman's ovaries to produce mature eggs. The eggs then are retrieved from the woman by laparotomy, a surgical incision through the abdomen. After a number of mature eggs have been collected, they are combined with sperm which has been treated to concentrate the most healthy and active cells. Finally, the gametes are transferred back into the fallopian tubes, where fertilization should take place. Any embryos that result from this procedure will naturally descend into the uterus for implantation.

Electroejaculation - ejaculation that is stimulated by an electrode - is a successful form of therapy for men who have normal testes but who cannot emit semen or ejaculate because of a fault in the sympathetic nervous system. Candidates for electroejaculation include men who have undergone orchiectomy (testis removal for cancer) and retroperitoneal lymph node dissection (RPLND) or spinal cord injury. The technique of electroejaculation involves the placement of a probe in the rectum. Electrical current from the probe then causes the emission of semen due to direct stimulation of nerve fibers within the male reproductive tract. Forceful ejaculation generally does not occur during this procedure, and semen may be released through the urethra, or it may be released backward into the bladder. Because semen may need to be retrieved from the urine, the urine will be made alkaline (nonacidic) by having the patient take sodium bicarbonate tablets (600 mg) during the day before the procedure.

Some infertility treatments are typically covered at least partially by most insurance plans. Because insurance benefits are complicated and constantly changing, the Pathways to Pregnancy program facilitates working with your insurance company throughout your treatment with automatic integration of your insurance plan into the program.Our insurance experts have many years of experience learning how the medical industry decides what procedures will be covered and what will be denied. We are strong advocates for getting patients the maximum coverage possible from their plan. We sort out all of your insurance issues, from what procedures are covered to your out-of-pocket expenses, so you can focus on your treatment. To find out more about the Pathways to Pregnancy program and how it can help make your efforts to conceive less stressful and more productive, click here to begin our free fertility survey and discover where you are on the pathway to pregnancy.

The quality of the semen analysis is highly dependent on the method of collection. The ideal number of days to wait after sex to give a semen analysis is three to five days. Giving a semen analysis less than three days after an ejaculation produces a small volume, low count semen sample. Giving a semen sample more than five days after ejaculation can cause the sperm to have decreased motility.

If you need a semen analysis performed please click here. After you receive the results, you can enter the information into our Semen Analysis Calculator, which determines where you fall on the fertility scale. The results of your semen analysis can be used when you join the Pathways to Pregnancy program. The program offers guidance from a renowned male fertility doctor, a helpful timeline and personalized advice to help you in your efforts to conceive. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

Testosterone
A low testosterone causes low sperm production and can cause problems with erections and ejaculation. Testosterone replacement is very important because it restores sperm production and significantly increases the quality of life. Clomiphene Citrate Clomiphene citrate, a synthetic steroid drug related to estrogen (female sex hormone), has both anti-estrogenic and estrogenic effects.

Tamoxifen
Tamoxifen, like clomiphene citrate, is an oral anti-estrogen compound that has been used to treat male infertility. But, unlike clomiphene, tamoxifen has no estrogenic activity. Tamoxifen stimulates sperm output by increasing the release of gonadotropins. Recent findings suggest that pregnancy may occur in up to one-third of couples in whom the male partner has received tamoxifen therapy.

Gonadotropins
Gonadotropins are gonad-stimulating hormones. The gonadotropins human chorionic gonadotropin (HCG), human menopausal gonadotropin (HMG), and their combinations very successfully treat men with hypogonadotropic hypogonadism (delayed sexual maturity due to sex hormone deficiency). Both HCG and HMG stimulate testosterone synthesis, which, in turn, improves sperm production and pregnancy rates.

Antibiotics
Antibiotics frequently are prescribed to eliminate infections that could impair fertility, such as infections of the urinary tract and prostate. The physician will be especially inclined to prescribe an antibiotic if leukocytes (white blood cells) are detected in the man's semen sample.

Methylprednisolone
Methylprednisolone is a corticosteroid medication that has been prescribed as a treatment for immunologic infertility. In particular, methylprednisone is used to suppress blood levels of antisperm antibodies. Methylprednisolone therapy is very controversial, since, with the high doses required (96 mg daily), it can produce many side effects that are associated with other forms of steroid therapy - that is, worsened peptic ulcer disease, skin disorders, glucose intolerance (inability to metabolize the sugar glucose) and mental disorders. Success rates are varied, but very few studies have shown much benefit.

Bromocriptine
Bromocriptine is a drug that is classified as a dopamine agonist. This means that bromocriptine acts like dopamine, a catecholamine (sympathetic nervous system chemical) that stops the release of prolactin hormone from the pituitary gland. Bromocriptine therapy is useful for men in whom impaired sperm production is due to hyperprolactinemia (high blood level of prolactin) (see also Hyperprolactinemia).

Sperm require around three months to fully mature. Once you remove the offending condition, three months are needed for a new cycle of sperm to be released. Some men see improvements in their semen analysis sooner if the offending condition is minor. Some men take longer to improve if the size and firmness of their testicles are poor.

The quality of a semen analysis is very highly dependent upon the processing technique. Method of collection, time of specimen drop-off, temperature of the specimen in the laboratory, pippeting technique and counting system can all introduce error into the results. Daily controls by the lab is very important to standardize the process of semen analysis. It is hard to compare semen analysis between two laboratories unless both labs follow the recommended processing technique.

If you need a semen analysis performed please click here. The results of your semen analysis can be used when you join the Pathways to Pregnancy program. The program offers guidance from a renowned male fertility doctor, a helpful timeline and personalized advice to help you in your efforts to conceive. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

A normal semen analysis is a pretty good indication of normal male fertility. The one aspect of semen quality which is poorly measured on semen analysis is sperm function. The morphology of the sperm approximately measures the quality of the sperm function. The morphology evaluation is the hardest test to perform correctly in the semen analysis. A normal count, motility and morphology is a good indication of normal male fertility.

If you need a semen analysis performed please click here. You can also use our Semen Analysis Calculator for a general interpretation of your analysis that will show you where you fall on the fertility scale.

The lower limit of normal sperm count is 20 million sperm per milliliter of semen. Many men with lower sperm counts have initiated pregnancies. The standard for low sperm count was derived from looking at the fertility history of thousands of men and whether they initiated a pregnancy. There was a modest break in fertility potential when the sperm count decreased below 20 million sperm per milliliter. Your semen quality has to be high enough to overcome whatever deficiencies in fertility your wife may have. Fertility potential is judged based on the deficiencies that exist within the couple. If you have had a semen analysis done, you can use our Semen Analysis Calculator for a general assessment of where you fall on the fertility scale. The results of your semen analysis can be used when you join the Pathways to Pregnancy program. The program offers guidance from a renowned male fertility doctor, a helpful timeline and personalized advice to help you in your efforts to conceive. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

Microsurgical vasectomy reversal is one of the most challenging surgical procedures performed by infertility experts. Successful vasectomy reversal is highly dependent on surgical skill, length of time since vasectomy, presence of complications at the time of vasectomy and quality of semen production at the time of reversal. While over 90% of men who have a vasectomy reversal will have sperm in the ejaculate, less than 60% of these men actually are able to initiate a pregnancy naturally. Men who were initially fertile at the time of their vasectomy can develop decreased sperm production which becomes apparent after reversal. The urologist performing the vasectomy reversal should display excellent microsurgical skills and a capability of treating all aspects of male infertility.

This question is a very common question without a strong affirmative answer. Heat does reduce sperm production. Some men's sperm production is more susceptible to heat than others'. In general, the increase heat associated with tight underwear is less than the heat seen with varicoceles, hot baths, febrile episodes or high scrotal testes. We recommend boxers because every little bit helps, but do not expect great improvement in sperm count based on underwear type alone.

If you're having difficulty conceiving, the Pathways to Pregnancy program can help you determine why you are having difficulty and what you can do to achieve conception. It can also help you communicate with your partner and coordinate with your doctor(s) to get the information and support you need. Click here to begin our free fertility survey and find out where you are on the pathway to pregnancy.

If you've just started trying to get pregnant, this is the perfect time to enter the Pathways to Pregnancy program. The Pathways are designed for couples at any point in their conception efforts.

At your stage, you need to know the basic DOs (and DON'Ts) of trying to conceive. You need to know which techniques to try first, which lifestyle changes are most effective, which diet concerns are legitimate and which are urban myths, and what you should or should not spend money on.

Early on, the Pathways to Pregnancy are an ideal companion to your efforts, because they provide the most common sense, medically proven ways to get pregnant as early as possible. And, since the Pathways to Pregnancy program is a month-to-month program, you're never tied to a long-term obligation. We're here when you need us, and no longer.

The Pathways to Pregnancy start with a free 5-minute, no-obligation survey you can begin now.