Infertility treatment involves caring for those who are having issues getting pregnant. The type of fertility treatment you need depends on several factors, including your age and the specific cause(s) of your fertility problems. The first step is always to try to diagnose any issues that could be the cause; that way, your treatment can be tailored to you and your partner. There is a large number of treatments out there, but here we will focus on the main types.
What type of health care professionals treat infertility?
Many people get low-level fertility help from their nurse, midwife, or regular obstetrician. However, most people who have fertility issues will seek the assistance of a specialist known as a reproductive endocrinologist (RE). An RE is someone who has completed a regular residency in obstetrics, but went on to do a fellowship of at least three years doing nothing but fertility work and surgery. Even though the RE has trained in obstetrics, they can handle some male infertility issues too. They also work with other specialists, like a urologist, depending on the male factors. Other specialists may also be brought in depending on the issues that need to be resolved.
Fertility awareness is the first step
Many couples will seek fertility help after a few months of trying to conceive and not getting pregnant. Most physicians who provide fertility treatments limit their practices to people who have been trying for at least one year or who have been trying for six months and are over the age of 35. The first step is to ensure that couples know how to figure out when they are ovulating and when to time intercourse to maximize their chances of conception. These records will be helpful in making a diagnosis later if conception does not occur without assistance.
Medications for ovulation difficulties
Clomiphene, also known as Clomid, is an oral medication that is commonly used as a first-line medication in infertility treatment. It is best used when a woman is experiencing difficulty with ovulation. This might mean that she has cycles where she doesn’t ovulate (anovulation), or has some dysfunction in the cycle of ovulation. About 80 percent of women who take clomiphene will ovulate. This medication can also be used with additional procedures, like intrauterine inseminations (IUI), but it is not used for in vitro fertilization (IVF).
There are many other medications used in the treatment of infertility. Some work to aid in the process of ovulation; others work on various hormones to assist the body through the menstrual cycle in general. There are also medications that may be taken by men for various reasons.
In intrauterine insemination (IUI) the sperm is collected outside of the body and prepared and placed inside the uterus to aid in conception. This can be helpful in a number of cases. Some reasons that your RE might suggest an IUI include:
- Blockage of the cervix
- Poor sperm quality or quantity
- Use of frozen sperm (donor or fertility preservation technique)
- Inability of the partner to maintain an erection
The success rates with IUI depend on the reason that you are experiencing infertility, your age, if you’re using other therapies as well, and other factors. You may use this therapy for multiple cycles, with or without additional medication therapies.
In vitro fertilization and other assisted reproductive technologies
In vitro fertilization (IVF) is used as an advanced measure when other fertility treatments haven’t worked or as a first-line treatment in certain causes of infertility, like when you need to use intracytoplasmic sperm injection (ICSI) to conceive using a partner’s sperm.
An IVF cycle is well timed with many medications, including some that are injectable. The first step is to take medication to help you produce eggs, which are then harvested. The eggs are retrieved and combined with the sperm (collected at the time of the egg retrieval) using a variety of techniques depending on the diagnosis. Then, the combined egg and sperm are left to grow in the lab for a few days. The best embryos are then transferred back into your uterus, and remaining embryos are frozen or donated.
IVF may also be done with donor eggs, donor sperm, or a combination. This is also something that can be done using a gestational carrier, where your embryo (using your egg) is placed into another woman’s uterus for the pregnancy. There is also the option of using gestational surrogate, which means the woman not only carries the pregnancy but donates her egg as well.
Surgery to aid in fertility
Some surgeries can help with the treatment of infertility, based on the diagnosis. For example, if you have blocked fallopian tubes, sometimes you can get a surgical repair to unblock them. A male partner may have a problem in the testicles called a varicocele, which also may be repaired by surgery. However, surgery may not be of use to everyone who is experiencing a problem with fertility.
Keep in mind…
The bottom line is that there are many types of treatments available to help those with infertility. The types of methods used will depend on your diagnosis, your age, your doctor’s preference, and your insurance or ability to pay. Many times, these methods may be combined or tried at various stages.
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Robin Elise Weiss, Ph.D., LCCE, CLC, AdvCD(DONA) is a childbirth educator, doula, founder of Childbirth.org, and the award-winning pregnancy and parenting author of “The Complete Illustrated Guide to Pregnancy” and more than 10 other books. Between her nine children, teaching childbirth classes, and attending births for more than two decades, she has built up an impressive and practical knowledge base. You can follow Robin on Twitter @RobinPregnancy, Instagram, and Facebook.