If you've been struggling to get pregnant naturally, and an OB-GYN or specialist—through tests—has diagnosed you with a condition that impacts fertility, all is not lost. You can still totally have a child that shares your DNA.
While every individual case may differ in its course of treatment, Aaron K. Styer, M.D., reproductive endocrinologist and co-medical director of CCRM Boston, describes some of the most common infertility treatments:
Natural Cycle Monitoring
“Some patients do not become pregnant because of difficulties related to ovulation timing,” explains Dr. Styer. “In this case, patients will be monitored to determine when ovulation occurs so that intercourse or Intrauterine Insemination (more on that below) can be timed.” Monitoring typically involves a blood test and a transvaginal ultrasound to see how follicles are progressing, but fertility medications are not used for natural cycle treatments.
If you’re not successfully ovulating on your own, there’s a first-line treatment for that: ovulation induction. Dr. Styer explains that this common treatment involves the stimulation of a woman’s ovaries through medications (you may have heard of Clomid, for example), some of which are oral, some of which are injected at home using a very thin needle. Ovulation induction is frequently used in combination with Intrauterine Insemination (IUI).
Intrauterine Insemination (IUI) is the placing of washed sperm—sperm that has been separated from semen and includes only the best, most viable swimmers—into the women’s uterus when she is ovulating via a thin catheter passed through the cervix. IUI is especially useful when sperm has had difficulty reaching an egg and is frequently used for the treatment of mild to moderate male factor problems, such as poor sperm function.
Minimally Invasive Surgery (Laparoscopy or Hysteroscopy)
During laparoscopy, a number of small (read: one-half-inch or less) cuts are made into the abdomen. A thin, flexible tube is then inserted into the cuts, and a camera and the surgical tools placed in that. Laparoscopy is performed to examine the abdominal wall or the female pelvic organs and diagnose problems such as cysts, adhesions, fibroids, endometriosis, or infections that might be impacting ovulation or implantation. During hysteroscopy, meanwhile, a thin camera is inserted into the vagina and moved gently to the cervix and then into the uterus to inspect the inside of the uterus for fibroids, polyps, scarring, or an abnormal shape that could impede ovulation or implantation. During this procedure a small tissue sample may be taken for a biopsy.
In Vitro Fertilization
“IVF is the most successful method of fertility treatment utilized today,” says Dr. Styer. It includes stimulation of the ovaries through injectable fertility medications given over the course of seven to 12 days to produce multiple eggs at one time. Several appointments for blood tests and transvaginal ultrasounds may be required. Following that, the eggs are removed from the ovary (called egg retrieval), fertilized in a laboratory, and the resulting embryos are subsequently placed into the uterus (called embryo transfer), usually five days after fertilization.
Despite its relative success, IVF may or may not result in a viable embryo, and even a viable embryo may or may not implant because of a number of factors—which is why some women find themselves undergoing multiple IVF cycles to achieve pregnancy. “The chance of pregnancy from IVF depends primarily on the age of the woman, the cause of infertility, and factors related to the quality of the IVF laboratory,” Dr. Styer emphasizes.
Still have questions about getting pregnant? Check out our fertility FAQ here.
Editors’ note: We use the terms “woman” and “female” in this article to refer to people with internal reproductive organs; however we understand that not everyone with internal reproductive organs identifies as a woman or a female. We use the terms “man” and “male” to refer to people with external reproductive organs; however we understand that not everyone with external reproductive organs identifies as a man or a male.