My partner lives on the other side of the country. We are trying to get pregnant, but we have not been successful in being in the same place at the right time. Is it possible to have his sperm frozen and shipped? How do we handle defrost? What procedures would we need to arrange on each end? We are both in our late 30s, and the clock is ticking.

Debbie

This question hits a few very important issues that I want to address. The problem of conception with absent partner can easily be solved, as you suggested, by freezing sperm. I will get back to that in a moment, as I think it is important that I first touch on the issues of age, stress and lifestyle as well as the priorities you and your partner have chosen. Infertility is often the result of our stressful, hectic lifestyles and jobs that require us to be in the wrong place at the right time.

First, let's look at age. Paternal age rarely affects fertility, yet for the woman, the late 30s is a time of rapidly diminishing fertility. Ovarian reserve testing can tell you whether age has already severely diminished your ability to conceive. But even if tests indicate that egg quality has not been adversely affected by your age, you should not delay efforts to conceive if you seriously wish to have a family using your own eggs. Now is the time to set priorities. Now is the time to decide how you will feel if a less-than-wholehearted effort to conceive leaves you childless or forces you to use donor eggs at a later point.

Your partner's absence certainly makes the logistics of conception more difficult. In addition, the stress and exhaustion associated with bicoastal living arrangements can significantly affect the ability to conceive, to carry the pregnancy to term and ultimately to raise your child. Are you and your partner willing to compromise and make lifestyle changes to achieve your goal? To raise your family?

Now to the easy part. Freezing sperm is relatively simple if a qualified sperm bank is available in your community, or where your partner works. It typically costs about $100 to freeze the specimen. Each ejaculate that is processed will usually provide enough washed sperm for between two and six attempts at intrauterine insemination (IUI). After the initial sample is processed and frozen, one of the vials will be thawed and a semen analysis performed to measure the post-thaw sperm quality. Unfortunately, not all men produce sperm capable of surviving with normal motility after the freezing process.

If the post-thaw semen results are OK, you are on your way. You will monitor ovulation using a kit to test your urine for LH hormone. Once the LH surge is detected, the IUI will be carried out the next day. The cost of the insemination will likely be somewhere between $250 and $400. Many women ask if they can just the thaw the sperm and place them into the vagina. Unfortunately, this does not work. After the freezing process, the sperm's ability to swim and to fertilize an egg is diminished, so the insemination process becomes necessary to achieve a reasonably good chance of pregnancy, thereby warranting this entire effort.

Obviously, if your partner can plan to be available midcycle, that would be best. If not, the availability of a frozen sperm sample may reduce your stress about whether or not he will be available at the right time.

One additional word of caution: Please don't assume that timing is the only fertility problem. Women in their late 30s have fewer options and little room to guess wrong. You would be wise to see a fellowship-trained reproductive endocrinologist to ensure that all other factors are normal before you proceed with insemination.