Understanding the Treatment Options for Infertility
Once you’ve been diagnosed with a specific type of infertility, the options that are open to you can be quite confusing. Of course, one of the best guides that you have is your fertility doctor, who can determine which options may be right for you. However, being armed with a bit of information beforehand will give you a leg up in these discussions.
One of the first things to consider is fertility drugs. Two of the most common are clomiphene (one brand name is Clomid) and gonadotropins. These products act on the woman's reproductive hormones and will trigger the production of one or more of eggs per ovulation cycle. Most women find that they need to use them for three to six months before they conceive or before trying a different kind of treatment.
There are some side effects to fertility drugs that you should know about – namely that clomiphene can cause headaches, some visual symptoms, hot flashes, cramping, bloating, and what is euphemistically called “personal” dryness. Gonadotropins, on the other hand, can cause soreness, bloating, and rashes. You should also know that both drugs will increase the odds of having higher order multiples if you do become pregnant.
Typically, the success rate of fertility drugs falls between 20 to 60 percent of patients becoming pregnant, but these figures often come from the combined use of fertility drugs with artificial insemination.
Artificial insemination, also known as AI, is when a concentrated dose of sperm (from either your partner or from a donor) is injected directly into your cervix or uterus with a catheter. When the sperm sample is delivered directly into the uterus, the process is called IUI for intra-uterine insemination. The biggest side effect here is some cramping a day or so after the procedure. As mentioned earlier, this procedure is often used in conjunction with the fertility drugs, and there’s a conception rate of between 5 and 25 percent associated with this process.
Depending on the specific diagnosis of the infertility, surgery may be an option for you. Surgery is often used in the case of genetic defects or blocked or malformed fallopian tubes, or perhaps to remove endometriosis, fibroids, or some types of ovarian cysts. Success rates vary depending on the kind and nature of the surgery. For example, about 40 to 60 percent of women who have surgery for endometriosis or scar tissue are able to conceive. Conversely, anywhere from 10 and 90 percent of women who have surgery on their fallopian tubes conceive, depending on the exact problem causing the infertility.
With IVF – or in-vitro fertilization – eggs are surgically removed from your ovaries and fertilized with sperm (from a donor or from your partner) in the laboratory. The resulting embryos are then implanted in your uterus. Again, you’ll probably need to take fertility drugs before the procedure, which will increase your risk of having multiples. In addition, there’s a success rate of between 28 and 35 percent for women using this procedure.
There is another, lesser-known procedure that has some similarities to IVF, called gamete intra-fallopian transfer, or GIFT. In it, your eggs are mixed with sperm in a lab, and the mixture is surgically injected directly into your fallopian tubes so that fertilization occurs inside your body. It’s important to note that this procedure has a longer recovery time than IVF, and again, fertility drugs will be taken before the procedure, with all their associated risks. Typically, GIFT has a success rate of about 25 to 30 percent.
There’s one other infertility treatment that takes place primarily in the lab – intracytoplastic sperm injection, or ICSI. In this procedure a single sperm is injected directly into a single egg, an embryo results, and that embryo is then implanted into the uterus. The big difference here is that the semen is drawn directly from the donor with a microscopic needle or through a surgical biopsy of the testicles. There’s a success rate of around 35 percent for this process.
There are, as you can see, a variety of treatment options for infertility. Which treatment option is best for you is a decision to be made by you and your partner together with your physician.