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All About Infertility Treatment

Overview of Your Options for Infertility Treatment

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Updated September 15, 2013

Woman giving herself injections for infertility treatment

Infertility treatments may involve oral medications, injections, surgery, or complex procedures like IVF.

Photo: Carlos Davila / Getty Images

Your infertility treatment plan will depend on the cause or causes behind your infertility. Infertility treatment also depends on whether the problem is from the woman's side, the man's side, both sides, or remains unexplained.

The good news is that 85% to 90% of couples dealing with infertility are treated with low-tech treatments, like medication or surgery, with less than 3% being treated by Assisted Reproductive Technologies, like IVF.

Of those treated for infertility, two-thirds will go onto have a baby.

Fertility Drugs

A common cause of infertility in women, ovulation disorders account for about 25% of female factor infertility cases. The first line of treatment for most women with ovulation problems is through medication. Fertility drugs can help a woman ovulate 80% of the time.

Common fertility drugs include Clomid, Femara, and gonadotropins.

Clomid (clomiphene citrate): Probably the best well known fertility drug, Clomid is usually the first drug used in treatment. About 40% to 45% of couples using Clomid will get pregnant within six cycles of use.

More about clomid:

Femara (letrozole) and Arimidex (anastrozole): There are two medications may also be used to induce ovulation in women with ovulatory disorders. Studies have shown similar success rates as with Clomid, though research suggests a possible link between Femara and an increased risk of birth defects.

Gonadotropins, including LH, FSH, and hCG: Gonadotropins include FSH, LH, or a combination of the two. hCG (human chorionic gonadotropin) may also be used, as it mimics LH in the body. These hormonal medications are typically used when clomiphene citrate fails, or if the pituitary gland can not create LH and FSH on its own. They may also be used during IVF cycles.

Surgical Infertility Treatment

In 35% of female infertility cases, problems are found with the fallopian tubes or problems with the lining of the pelvis and abdomen. Usually, this problem is diagnosed through a test called an HSG, or hysterosalpingogram. If the HSG shows possible blockage of the tubes, the doctor may perform laparoscopic surgery to evaluate the situation, and possibly repair the problem.

Sometimes, blockage or scarring is not repairable. In this case, IVF may be recommended.

IUI - Intrauterine Insemination

Intrauterine insemination, also known as artificial insemination, is a procedure that involves placing specially washed sperm directly into the uterus. This treatment may be used in some cases of male factor infertility, if there's a problem with the woman's cervical mucus, or in cases of unexplained infertility. IUI may also be used for donor sperm.

The success rate of IUI is not very high -- with one study showing 4% of women achieving pregnancy with a non-fertility drug cycle, and 8% to 17% success for IUI cycles that use fertility drugs to produce more, high quality eggs. The advantage of IUI is the cost, which is much lower than IVF.

IVF and Assisted Reproductive Technologies

Assisted reproductive technologies (ART) refer to infertility treatments that involve the handling of eggs or embryos. This includes IVF, GIFT, and ZIFT. IVF is the most common form of ART in use today. GIFT treatments make up for less than 2% of all ART procedures, and ZIFT is used less than 1.5% of the time.

IVF (in vitro fertilization): In a typical IVF procedure, fertility drugs are used to stimulate the ovaries to produce eggs. Assuming all goes well at this stage, those eggs are then retrieved from the woman's ovaries in an out-patient procedure. Next, the eggs are placed together with sperm, in a special cocktail of nutrients, and left alone until fertilization takes place. After fertilization, one to three embryos are placed inside the woman's uterus.

GIFT: With GIFT (gamete intrafallopian transfer), the egg and sperm, or gametes, are not fertilized outside the body. Instead, they are placed together into one of the woman's fallopian tubes.

ZIFT: With ZIFT (zygote intrafallopian transfer), the zygote is placed in one of the fallopian tubes. This is usually done via laparoscopic surgery.

What's the success rate of ART?

For women under age 35, the live birth rate for each IVF cycle is 30% to 35%. For women ages 35 to 37, the rate is 25%. For women ages 38 to 40, the rate is 15% to 20%, and for women over age 40, the success rate is 6% to 10%.

ART is also sometimes performed with donor eggs and/or sperm. For women whose eggs are of lower quality, donor eggs may be the best option. The live birth rate for egg donation is between 40% to 45%, but less than 10% of couples choose to use donor eggs or sperm.

More on getting pregnant with infertility:

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Sources:

Assisted Reproductive Technologies: A Guide for Patients. American Society of Reproductive Medicine. Accessed January 29, 2008. http://asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/ART.pdf

Patient Fact Sheet: Recurrent Pregnancy Loss. American Society of Reproductive Medicine. Accessed January 29, 2008. http://asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/recurrent_preg_loss.pdf

Medications for Inducing Ovulation: A Guide for Patients. American Society of Reproductive Medicine. Accessed January 29, 2008. http://asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/ovulation_drugs.pdf

Infertility. National Library of Medicine: MedlinePlus. Accessed January 29, 2008. http://www.nlm.nih.gov/medlineplus/infertility.html

Infertility in Women. A.D.A.M. Healthcare Center. Accessed January 29, 2008. http://adam.about.net/reports/Infertility-in-women.htm

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