After a year of trying to get pregnant, Jackie sought help from her obstetrician, who prescribed hormone pills. She felt like she had bad PMS every day, not to mention hot flashes, bloating, and extreme mood swings.

After a few unsuccessful, painful months, Jackie switched obstetricians and both she and her husband underwent fertility testing. Male infertility was ruled out, and her second doctor found multiple cysts on Jackie's ovaries. She was referred to a fertility specialist—a reproductive endocrinologist (RE)—and began cycles of fertility shots, daily monitoring, and artificial insemination.

Relationship Stress

"It breaks your heart," says Jackie, an emergency room nurse from Cincinnati. "You don't think you'll ever have kids, then you go through these treatments that totally mess your hormones up. You gain weight, you feel bad, and then you still don't get pregnant."

The devastation Jackie felt each time she started her period, along with the hormone-induced mood changes, took a toll on her marriage. "I can't say we were actually going to get divorced," says her husband Eric. "But we weren't getting along very well."

"If we had stopped trying, our marriage would have been in really big trouble," adds Jackie. "I would have always felt inadequate."

Artificial Insemination

Conception, which finally happened after a successful artificial insemination, was not the magic cure Jackie hoped for. She developed diabetes and had to take four insulin shots a day. Her blood pressure rose dangerously high. She was hospitalized and put on bed rest for the last 12 weeks of her pregnancy, which ended early with a Cesarean section.

Two years later, the nightmare had faded enough so that Jackie underwent fertility shots and artificial insemination once again. When the techniques did not work after three months, her RE recommended in vitro fertilization (IVF). Though Jackie did not rule out this expensive option, she wanted a second opinion.

Polycystic Ovary Syndrome

The next RE saw the ring of cysts around Jackie's ovaries and diagnosed her with polycystic ovary syndrome (PCOS), a condition that has been associated with high blood pressure, type 2 diabetes, and metabolic syndrome.

At the recommendation of her RE, Jackie tried fertility shots again, coupled with a technique to thicken the lining of her uterus to increase her chances of conceiving. Jackie became pregnant after the first try, then miscarried.

Medication for PCOS

After stopping fertility treatment for a time, Jackie decided to work with Dr. Charles Glueck, who had experience treating PCOS patients with metformin, a diabetes drug. The first month Jackie took the drug, she ovulated and became pregnant. Jackie continued to take metformin throughout the pregnancy and gave birth to a healthy baby girl.

Deciding to Seek Help

Like millions of couples each year, Jackie learned how emotionally and financially draining infertility can be. Steven Nakajima, MD, an RE at the University of Louisville, says that couples should not necessarily wait a full year before consulting a specialist. Those who should seek early fertility help include women who:

• Are 35 years of age or older
• Are smokers or heavy drinkers
• Have had previous reproductive surgery
• Have a history of sexually transmitted disease
• Have irregular menstrual cycles

If you are concerned about your fertility, make an appointment with a specialist who has extensive experience in the field. A range of tests can be done to evaluate your reproductive health and help you to better understand your condition. As Jackie discovered, sometimes second and even third opinions may be needed to discover the right treatment option for you.