Basic Fertility Treatments

Basic fertility treatments at a glance

  • Basic fertility treatments can range from lifestyle changes patients can do on their own to fertility medications and more complex procedures, such as surgery or in vitro fertilization (IVF).
  • Basic fertility treatments can help men and women overcome many infertility conditions, increasing their chances of conceiving.
  • The general rule of thumb in fertility treatments is to begin with the least invasive options first, depending on the individual’s condition as determined by an exam and medical history.
  • Some patients will require more than one type of treatment to address their infertility conditions.

Factors in choosing basic fertility treatments

When an individual or couple receives a diagnosis of infertility, a range of options for fertility treatment is available. Many factors affect the course of treatment that a fertility doctor, a reproductive endocrinologist infertility (REI) will recommend, including the man or woman’s age, diagnosis, personal preferences and duration of infertility.

In general, a patient’s age and overall health are two of the most significant factors affecting fertility. For 25 percent of infertile couples, two or more factors contribute to their infertility, according to the American Society for Reproductive Medicine (ASRM).

A reproductive endocrinologist can help individuals and couples understand the treatment options available, and connect patients with the counseling and support that can help them through the physical, financial and emotional challenges of infertility treatment.


Basic fertility treatments for women

Fertility treatments for women in their 20s and early 30s can be particularly effective; more than half of all cases of infertility in this age range are successfully resolved through treatment. Beginning around age 35, a woman’s fertility decreases significantly, and more advanced interventions may be necessary to achieve pregnancy.

Basic treatments for infertility in women include:

Lifestyle changes

A woman can alter some lifestyle practices in order to increase her chances of getting pregnant. These can be accomplished on her own or her fertility doctor can direct her to programs that can aide in making lifestyle changes. The following are some self-controllable lifestyle choices that reduce a woman’s fertility:

  • Obesity
  • Being underweight
  • Smoking cigarettes
  • Excessive alcohol and caffeine consumption
  • Sexually transmitted diseases.

Ovulation induction

In women for whom ovulation is irregular or absent, ovulation induction may be performed. This treatment uses hormonal medications to stimulate the ovaries to release one or more mature eggs, thereby increasing the chances of pregnancy.

Ovulation inducing medications are also used to increase the number and quality of eggs a woman releases in a menstrual cycle, and/or in conjunction with other fertility treatments, such as IVF. Primary medications used to enhance ovulation include:

  • Clomiphene citrate (Clomid, Serophene)
  • Letrozole (Femara)
  • Follicle-stimulating hormone.

Intrauterine insemination (IUI)

This common type of artificial insemination involves a thin catheter tube that is used to inject prepared sperm directly into a woman’s uterus when she is ovulating. IUI is beneficial for women with a range of fertility issues or whose male partner is diagnosed with suboptimal sperm quality. It is also a treatment used by individuals or couples who require donor sperm.

Minimally invasive surgery

When structural problems exist in a woman’s reproductive anatomy, minor surgery can repair or remove physical issues, increasing a woman’s ability to conceive. Fertility specialists can remove ovarian cysts or uterine fibroids, and in some cases, repair damage to fallopian tubes. In many cases, minimally invasive laparoscopic or hysteroscopic surgeries are used, which involves smaller incisions and offers shorter recovery times.

Advanced treatment options for female infertility

IVF is the most advanced treatment for infertility. With IVF, mature eggs are retrieved from the woman and combined with sperm in a Petri dish, where an embryologist carefully monitors the progress of fertilization and identifies the highest quality embryos. After three to five days, the best embryo(s) are transferred into the woman’s uterus, where they will hopefully implant and develop into a healthy pregnancy.

In some cases, additional treatments are used together with IVF, such as intracytoplasmic sperm injection (ICSI) or assisted hatching. Some patients will opt for preimplantation genetic diagnosis (PGD) or preimplantation genetic screening (PGS) of the embryos that are created through IVF. These tests can identify embryos that have genetic defects, which greatly increase the chance of implantation failure, miscarriage and specific genetic disorders being passed on to the child.

Donor eggs may be used by women who are unable to conceive using their own eggs, but who still want to experience pregnancy and childbirth.

If health risks or issues with a woman’s uterus make carrying a pregnancy unadvisable, one advanced treatment option is to partner with a gestational carrier, which allows the intended mother’s genes to be passed on to her child that is delivered by a surrogate mother. An embryo would be created via IVF, and then placed in the gestational carrier’s uterus. She would carry and deliver the baby on behalf of the intended parent(s).


Basic fertility treatments for men

According to ASRM, in approximately 40 percent of infertile couples, the male partner is either a primary or a contributing cause of infertility. Fortunately, many effective treatments, listed below, are available for men experiencing infertility.

Lifestyle changes

A man’s overall health significantly affects his fertility. Lifestyle modifications can improve the quality and quantity of sperm, such as avoiding smoking, maintaining a healthy weight, exercising regularly and managing stress. Infertile men should also avoid excessive alcohol consumption, recreational drugs and exposure to environmental hazards.

Medication for sexual dysfunction, infection or hormonal imbalances

In some cases, medications can be used to cure infections in the man’s reproductive tract that cause infertility, such as the genital infections gonorrhea and chlamydia. Medications can also bring balance to high or low hormone levels due to problems with pituitary, adrenal, hypothalamus or thyroid glands. Men with erectile dysfunction (ED) may take medication to address that condition, sometimes in conjunction with counseling for the psychological aspects of ED.

Sperm retrieval for use with other assisted reproductive therapies

Some patients are unable to produce sperm or ejaculate properly on their own. Sperm retrieval techniques can gather the sperm directly from the man’s testes, using minimally invasive surgical procedures. This sperm can be used with other fertility treatments, such as IUI or IVF.

Surgery

Congenital abnormalities, illnesses (such as sexually transmitted diseases or mumps in adulthood), or damage to the reproductive organs can cause blockages in sperm production, maturation or ejaculation. For some men, surgical repair or correction of these blockages can be an effective treatment for infertility.

Advanced treatment options for male infertility

Due to male infertility, a couple may opt to try IVF, with ICSI (intracytoplasmic sperm injection). An embryologist performs ICSI during the IVF process in a fertility lab. The embryologist selects a single, healthy sperm and injects it directly into the egg, increasing the likelihood of fertilization for men whose sperm is limited or of low quality.

For men who cannot conceive using their own sperm due to genetic conditions, chemotherapy or other factors, donor sperm may be used to impregnate their partner, using techniques like IUI or IVF.