Word to pdf loses pictures and annotations

I am converting Word2003 and Word2010 docs to pdf. I am having a problem. Many pictures, shapes, textboxes and annotations are being lost during the conversions.
I have tried the save as pdf function in Word, print to PDF using Adobe Acrobat 9Pro, and Cutewriter Pdf.
The problems are not consistent with any of the three methods. The only thing consistent is that I do not get an accurate pdf.

Is anyone else having this problem?
Is there a cure?

Thanks,
Scott