Both Jamie Kale of Shenango Township, Lawrence County, and Lisa Ramirez of Meadville had trouble getting pregnant until they saw Dr. Michael Abdul-Malak, obstetrician-gynecologist and director of women's clinical studies with Magee Women's Hospital in Pittsburgh.

Now Mrs. Kale and her husband, Rick, are the parents of a nearly two-month old baby, and Mrs. Ramirez is expecting her first child in October.

Both Mrs. Kale and Mrs. Ramirez underwent artificial insemination, a procedure available at Malak's office in the UPMC Horizon Womancare Center in Hermitage and through the Primary Health Network.

Malak, one of the few doctors in this area who offers artificial insemination, has been doing the procedure for three years.

"We owe him a lot," Kale said of Malak.

"I just love him," Mrs. Kale added. "He's so sweet. You never see him rushed or anything."

In artificial insemination, a doctor injects sperm into a woman's body to shorten the distance between the egg and the sperm, increasing the likelihood of pregnancy.

The procedure is performed on women who have difficulty conceiving for various reasons, including hostile cervical mucus, absence of ovulation, polycystic ovary disease, endometriosis, low sperm count in the man or unexplained infertility.

Age is another factor in women who have trouble getting pregnant. Fertility starts to drop after age 35, when ovarian reserves begin to get depleted. Even if an older woman gets pregnant, the risk of miscarriage increases with age, Malak said.

In some cases, a woman can't conceive because her fallopian tubes are blocked or closed. Malak refers these patients to Pittsburgh for in-vitro fertilization, a process in which the egg is fertilized outside the body, then placed in a woman's uterus.

Malak said in cases of couples who have difficulty conceiving, 35 percent of the time the woman has the problem, and 35 percent of the time the man has the problem. In the other 30 percent, both have a problem.

About 15 percent of couples have unexplained infertility. Malak said these couples are the best candidates for ovulation induction and artificial insemination.

Malak tries ovulation inducing drugs as the first step in the process. He also tests the cervical mucus to see if it's hostile.

"Usually we start with that, and if they don't get pregnant, we add insemination," Malak said. "It increases their chances of getting pregnant."

If a woman does not conceive with the ovulation induction drugs, or has hostile cervical mucus, Malak then tries artificial insemination.

"In all of the cases I've worked with there's a good chance of response," Malak said.

The Kales had tried for about three years to conceive before seeking out Malak. They started coming to his office last September.

"Actually, I got lucky," said Mrs. Kale, a telemetry nurse at UPMC Horizon, Greenville. "The doctor I had left town. He just gave me the names of doctors and I picked Dr. Malak."

Mrs. Kale had been on Clomid, a fertility drug, before receiving two ovulation-induction shots. When she had her first insemination, she had not ovulated yet.

"I came back in the next day, on a Saturday, his day off," Mrs. Kale said. "That was wonderful."

Mrs. Kale got pregnant on Sept. 29, 2001. Her baby was born in June.

"We took three pregnancy tests at home and then did one here just to be sure," she said.

Mrs. Ramirez, who grew up in the Greenville area, learned of Malak through a newspaper advertisement. She had a miscarriage in 1999 for "no apparent reason," then had another miscarriage in spring 2001.

Her doctor recommended she try to get pregnant for the third time but, "I didn't want to wait," she said.

Mrs. Ramirez first saw Malak in October 2001.

"He sat down and discussed my past, what I had gone through, worked through blood tests, studies, the usual work-up," she said. "Everything seemed to be fine. He couldn't find anything abnormal."

Mrs. Ramirez took Clomid and was artificially inseminated to "speed along the process," she said.

"We started that in December ... it didn't take the first time," she said.

She tried again a month later, and it worked. She became pregnant on Jan. 17, and her baby is due Oct. 10.

"He's a great doctor," Mrs. Ramirez said of Malak. "I'm sure he helps a lot of people. He has a good reputation."