How is Infertility Treated?
There are now more answers and treatment options to both men and women who are trying to conceive a child.
- Hormonal treatments-There are a variety of medications used to treat infertility. It is important to understand the medications and what their purpose is and to speak with your physician about the medications that will be used in your specific treatment plan.
- According to ASRM, 85-90% of infertility cases are treated with drug therapy or surgical procedures. Fewer than 3% need advanced reproductive technologies like in vitro fertilization (IVF).
- Clomiphene citrate (Clomid®*) an oral medication that causes ovulation by acting on the pituitary gland
- Human menopausal gonadotropinor hMG (Repronex®*; Pergonal ®*) are injectable medicine that acts directly on the ovaries to stimulate ovulation.
- Follicle-stimulating hormone or FSH (Gonal-F®*; Follistim®*) are typically injectable medicines that work much like hMG. It causes the ovaries to begin the process of ovulation.
- Gonadotropin-releasing hormone (Gn-RH) are medicines often used for women who don’t ovulate regularly each month. Women who ovulate before the egg is ready can also use these medicines. Gn-RH analogs act on the pituitary gland to change when the body ovulates. These medicines are usually injected or given with a nasal spray.
- Metformin (Glucophage®*) is a medicine doctors use for women who have insulin resistance and/or PCOS . This drug helps lower the high levels of male hormones in women with these conditions. This helps the body to ovulate. Sometimes clomiphene citrate or FSH is combined with metformin. This medicine is usually taken by mouth.
- Bromocriptine (Parlodel®*) is a medicine used for women with ovulation problems because of high levels of prolactin. Prolactin is a hormone that causes milk production.
- Many fertility drugs increase a woman’s chance of having twins, triplets, or other multiples.
- Ovulation induction
- Intrauterine insemination (IUI)-washed and concentrated sperm are placed directly into the uterus of a woman around the time of ovulation. In some cases, an IUI is done in conjunction with hormone medication.
- In vitro fertilization (IVF)-a mature egg is removed from a woman and then joined with a sperm cell from a man in a test tube (in vitro). The fertilized egg or eggs (embryos) are then implanted into the uterus. For an IVF procedure, donor eggs, sperm or embryos may be used. The embryos can also be implanted in a gestational carrier with no genetic connection to the embryo.
- ICSI-involves injecting a single sperm directly into an egg in order to fertilize it. The fertilized egg is then transferred into the woman’s womb. This is used in circumstances where the men has the most severest degrees of infertility or after several failed IVF attempts.
- Surrogacy-is a woman who agrees to become pregnant using the man’s sperm and her own egg. This is done via artificial insemination. The child will be genetically related to the surrogate and the male partner. This can also include a gestational carrier who has no relation to the embryo. Council for Responsible Genetics says there are no surrogacy statistics however estimates say between 2004-2008, 5000 children were born via surrogacy. Other estimates say on average 9 children are born to surrogates in every state each year.
- Egg/sperm donation
- Embryo donation.
- Foster Care-According to the Congressional Coalition on Adoption Institute, there are In the U.S. 400,540 children are living without permanent families in the foster care system. 115,000 of these children are eligible for adoption, but nearly 40% of these children will wait over three years in foster care before being adopted.
- Adoption- a process whereby a person assumes the parenting for another and, in so doing, permanently transfers all rights and responsibilities from the biological parent or parents.
Many times these treatments are combined. Doctors recommend specific treatments for infertility based on
- The factors contributing to the infertility.
- The duration of the infertility.
- The age of the female.
- The couple’s treatment preference after counseling about success rates, risks, and benefits of each treatment option.
According to the CDC’s 2011 Preliminary Assisted Reproductive Technology (ART) Success Rates, the average percentage of fresh, nondonor ART cycles that led to a live birth were—
- 40% in women younger than 35 years of age.
- 32% in women aged 35–37 years.
- 22% in women aged 38–40 years.
- 12% in women aged 41–42 years.
- 5% in women aged 43–44 years.
- 1% in women aged 44 years and older.
Success rates vary and depend on many factors, including the clinic performing the procedure, the infertility diagnosis, and the age of the woman undergoing the procedure. This last factor—the woman’s age—is especially important.
ART can be expensive and time-consuming, but it has allowed many couples to have children that otherwise would not have been conceived. The most common complication of ART is a multiple fetus pregnancy. This is a problem that can be prevented or minimized by limiting the number of embryos that are transferred back to the uterus.
Success rates vary and depend on many factors. Some things that affect the success rate of ART include:
- Age of the partners
- Reason for infertility
- Type of ART
- If the egg is fresh or frozen
- If the embryo is fresh or frozen
Infertility in Women
Infertility in Men