Fertility Treatments: An Overview
A quick look at fertility treatments
Fertility treatments are a variety of assisted reproductive technologies that help men, women and LGBT couples or individuals who otherwise cannot get pregnant or maintain a pregnancy to build a family.
The best infertility treatment options depend on the underlying cause(s) of fertility issues, personal choice, age and medical history.
Risks are best discussed with patients prior to beginning treatment, as the potential risk depends on what is being done. Common risks include an increased chance of multiple births (twins or more) as well as bleeding, infection and swollen ovaries due to hormone medications. However, there are also risks in doing nothing, as not conceiving can affect women and their partners as well.
What is infertility and how is it treated?
Infertility is said to exist when a couple has been unable to get or stay pregnant after one year of frequent, unprotected sex (six months if a woman is age 35 or older or has known underlying factors).
Men, women or a combination of both partners can contribute to infertility issues. Recommended treatments vary depending on the underlying cause(s) of infertility, along with personal preferences.
Related Information: Causes of Infertility Overview
Primary personal factors influencing treatment plans
- Underlying cause(s) of infertility
- How long infertility has been an issue
- The woman’s age, which affects egg quality
- Health and medical history
- Personal preferences on treatment solutions, time involved and assertiveness
Treatments for infertility
Positive Steps Fertility (PSF) knows that no two individuals or couples are alike – and no two treatment plans are either. Our first step in developing a treatment plan is talking with the individual or couple. From there, we utilize an extensive range of fertility treatment options to tailor our approach to help people build their families.
Following are the more common types of infertility treatments we provide – some for men, some for women and some applicable to both. After careful diagnosis and examination, we discuss the options with our patients based on their situation.
As a rule, we prefer to start with the simplest treatments that have a reasonably good chance of success.
These are things we see that patients can do on their own, or with a little help, to improve the chances for a successful pregnancy. This may mean stopping certain medications (particularly ones that can cause birth defects), maintaining a healthy weight, exercising regularly, limiting alcohol consumption, improving frequency or timing of sexual intercourse, and addressing other factors that may impair fertility.
Medications to improve fertility
The most common medications used to treat infertility address hormonal issues to help stimulate or increase ovulation of viable eggs in women. Fertility medications can also include drugs to improve sperm count for men.
Medications are often the first steps in fertility treatment. They can be used alone or in conjunction with inseminations, IVF and other assisted reproductive technologies.
Surgery to diagnose or treat fertility issues
Surgery such as a hysteroscopy, which is a quick procedure utilizing a hysteroscope (a small, lighted fiber optic camera) placed vaginally, allows a physician to examine a woman’s cervix and uterus. This procedure can help diagnose the cause of infertility, such as fibroids, polyps or an abnormally shaped uterus. Surgery can also repair certain causes of infertility once identified, sometimes within the same diagnostic procedure.
In some cases, other surgeries may be recommended to facilitate fertility, such as a vasectomy reversal.
Intrauterine insemination (IUI)
The procedure flushes sperm through a thin, flexible tube directly into a woman’s uterus in hopes of getting as many sperm as possible into the fallopian tubes around the time her ovary releases an egg. This positioning procedure offsets fertility issues like low sperm count, erectile dysfunction and such structural conditions as impenetrable cervical mucus. IUI can be used with donor sperm and in combination with other fertility treatments.
Assisted reproductive technologies (ART)
These are often the most common techniques to aid pregnancy because they are the most successful. ART includes any procedure where an egg and sperm are both handled by doctors to facilitate conception. These techniques can be used alone or in combination with each other or other treatments.
- In vitro fertilization (IVF) is the most common form of ART. In IVF a man’s sperm and a woman’s eggs are collected and then combined together in a lab for fertilization. Fertilized eggs (embryos) are then implanted in a woman’s uterus in the hope of a successful pregnancy. IVF is a primary treatment to work around many fertility problems, including ovulatory issues, fallopian tube blockage, male infertility factors and DNA factors that prevent the embryo from developing properly.
- Intracytoplasmic sperm injection (ICSI) can be an additional step in IVF and involves a doctor using a tiny needle to place a single sperm directly into the cytoplasm of an egg where fertilization occurs. This increases the chance of fertilizing the egg to create a healthy embryo. ICSI is often performed when the man’s sperm counts are extremely low or abnormal. If fertilization occurs, the fertilized egg (embryo) is implanted into the woman’s uterus, as in the standard IVF procedure.
- Assisted hatching is a technique that assists the implantation of the embryo into the lining of a woman’s uterus by opening the outer covering of the embryo (thus “hatching” the embryo). This is useful for women who have had previous failed attempts at embryo implantation or for women with infertility related to the uterus environment.
Egg, embryo or sperm donation
Some underlying causes of infertility cannot be corrected. In these cases, couples may still plan a family using donor eggs, embryos or sperm in conjunction with IVF.
Couples may consider using donated eggs, sperm or embryos in cases where:
- No or very few sperm or eggs are present
- Sperm or eggs are abnormal
- A man’s vasectomy reversal has failed
- Women who have had their ovaries removed or whose ovaries do not work
- For men or women who have a likely chance of passing on a genetic disease.
Some women are unable to carry a successful pregnancy, or carrying a pregnancy would put the woman’s health at risk. For these situations, or for gay male couples, a gestational carrier (a form of surrogacy) can carry the pregnancy. A gestational carrier is a woman who agrees to have another couple’s embryo, achieved through IVF, implanted in her womb for pregnancy, delivering the baby for the intended parents.
Fertility treatments for LGBT individuals or couples
Positive Steps Fertility provides assisted reproduction services to all men and women seeking help in becoming parents, including LGBT couples or individuals. LGBT patients can often succeed in building their family via fertility treatment options such as:
- Sperm, egg or embryo donation
- Gestational carrier.
Fertility treatment risks and complications
Complications due to fertility treatments depend upon the specific treatment. We discuss these risks in depth with our patients and address all their concerns. The most common concerns and risks stemming from infertility treatments include:
- Multiple births (twins, triplets or more) increase the likelihood of premature labor and delivery, as well as pregnancy concerns such as gestational diabetes. Multiple births may also cause premature birth, and preemies are at increased risk of health and developmental problems.
- Ovarian hyperstimulation syndrome (OHSS) is a swelling of the ovaries due to ovulation-inducing medication. This condition causes mild abdominal pain, bloating and nausea and in rare but severe cases, rapid weight gain and shortness of breath.
- After surgeries or invasive procedures, patients may experience bleeding, infection and pain.
Next steps: Schedule a consultation to end infertility
Positive Steps Fertility welcomes new patients and has short wait times for your first appointment. Many female patients will be candidates for our proprietary Parryscope approach, a gentle, affordable, fast and accurate female infertility test, in which we explain results in clear language in about 15 minutes.