Treating Infertility

Infertility is defined as the failure to become pregnant after one year of normal, unprotected sex. There are many causes for infertility and while some of them are not treatable, today there are a number of infertility treatments available that make it possible for infertile couples to have a baby. The ultimate goal of infertility treatment is a healthy pregnancy and the birth of a healthy baby.

Female Infertility Treatments:

• Bypass a blocked fallopian tube by collecting eggs from the ovaries for in vitro fertilization and placement of a fertilized egg in the uterus.
• Correct fallopian tube damage and structural ovarian or fallopian tube problems through tubal surgery.
• Bypass cervical problems (such as a narrow cervical opening or presence of sperm antibodies) with intrauterine insemination.
• Treat ovulation related problems with medications that stimulate production and the release of eggs. Clomiphene (Clomid, Serophene), GnRH, gonadotropins, and bromocriptine are some of the medications used for stimulating ovulation. However, treatments can vary according to the cause. For example, initial treatment of women with polycystic ovary syndrome (PCOS) often focuses on weight loss and metabolism.
• Treating the growth of uterine lining cells in other parts of the abdominal cavity (endometriosis) using laparoscopic surgery.
  In the case of inexplicable or undetectable infertility even after extensive testing, some treatment options are available. Studies have shown that stimulating multiple egg production (super-ovulation) using clomiphene increases chances of pregnancy, as does flushing sperm through the vagina and cervix into the uterus using Intra-Uterine Insemination [IUI].

Male Infertility Treatments:

• Semen without sperm can be treated by surgically taking mature or immature sperm from the testicles and using intracytoplasmic sperm injection to inject a sperm into an egg. Conception is then attempted by placing the fertilized egg in the uterus or fallopian tube.
• Low sperm counts can be treated by collecting and concentrating healthy sperm for insemination or assisted reproductive technology (ART) treatment.
• Structural problems can be treated surgically, increasing the chances of natural conception. Surgery can sometimes reverse a vasectomy, repair an enlarged vein in the scrotum (varicocele repair), or correct blockages in or absence of the vas deferens.
• Loss of sperm due to retrograde ejaculation (where the semen flows back into the bladder) can be recovered from the bladder, washed, and used for insemination.
• Sperm production problems caused by hormonal imbalances can be treated with medication or hormones that aid the hypothalamus and pituitary gland start producing normal sperm.
• If healthy sperm is not available using the above treatments, some couples may choose to use donor sperm combined with insemination or Assisted Reproductive Technology (ART). Others may opt for adoption.

Considerations While Choosing Treatment:Although the underlying causes are not yet fully clear, studies show that conceiving using ART or IUI have slightly higher incidences rates of low birth weight and birth defects.

Both super ovulation medication and assisted reproductive technology increase your risk of conceiving a multiple pregnancy. Complications of a multiple pregnancy become more likely with each additional fetus.

Infertility treatment success is influenced by many factors, including your doctor's skill and experience, and the cause or causes of your infertility.

Infertility treatment centers are not widely available in some parts of the country, especially in rural areas. You may need to travel for treatment.

You need to be aware when reviewing clinic success rates, that infertility treatment centres treating more severe infertility problems may have lower success rates. Therefore, it's possible for a clinic with a lower success rate to have greater overall expertise than clinics with higher success rates.

When reviewing treatment success rates, remember that live birth rates are always lower than ovulation and pregnancy rates. Miscarriages are common among all women and are more likely among older women and women with poorly controlled, chronic health problems.

As you evaluate your long-term options, discuss whether and under what circumstances adoption would be a reasonable alternative to infertility treatment.