According to the National Institute of Health, one in eight couples has difficulty getting pregnant or staying pregnant. This can cause emotional distress, relationship tension, and health irregularities. But there’s hope! Thanks to modern medicine, infertility is not always the end of a woman’s reproductive journey. There are more effective and safe infertility treatment options than ever, from medication to surgical procedures to assisted reproductive technology.
If you’ve been trying to conceive for over a year, or you have not been able to carry a baby full term, fertility treatment may be right for you. There could be many reasons you are unable to conceive or carry full term, but the most common is usually age. Other reasons may involve needed lifestyle changes such as quitting smoking or excessive alcohol consumption. And sometimes, a woman or man’s body may just not have the right balance of hormones or overall health that is needed.
Whatever your reason may be for seeking fertility treatment, it’s important to know what your options are and to talk through them with your provider. The first step toward answers and a solution will be to get a fertility evaluation. Through this diagnostic testing, your provider can build out a personalized treatment plan that’s right for you and your partner. Let’s take a look at the types of treatment they may prescribe.
If your infertility is caused by a hormonal imbalance, there are fertility medications that may be prescribed by your provider. Sometimes they work on their own, but many times they are combined with another fertility treatment method, such as intrauterine insemination.
There are two types of insemination that are commonly prescribed by providers to treat infertility in couples dealing with low sperm counts or poor sperm motility- Intrauterine insemination and artificial insemination. These may also be the suggested method for same-sex couples, couples using surrogates, or single women who desire to be mothers. These methods are typically less effective for women over the age of 40, women with fallopian tube blockages, women with a history of pelvic infections, women with endometriosis, and men with significant infertility issues.
Intrauterine Insemination (IUI)
This fertility treatment is a type of artificial insemination where the sperm has been washed and a concentrated amount of them are placed directly in a woman’s uterus around the time her ovary releases eggs to be fertilized. The goal of this method is to increase the chances that sperm can reach the eggs and fertilize.
Success rate: 5-20%
Artificial Insemination (AI)
Artificial insemination is a type of fertility treatment where sperm (whether from a partner or a donor) is placed inside a woman’s reproductive tract during ovulation. If a woman is ovulating normally, artificial insemination can happen without any fertility medication. If she isn’t ovulating normally, fertility medication may be prescribed to increase the chances of pregnancy.
Success rate: 40% of women under the age of 40 typically get pregnant within six tries.
In Vitro Fertilization (IVF)
In vitro fertilization is considered to be the most effective fertility treatment available and uses assisted reproductive technology. In this process, the woman’s eggs are removed from her ovaries through an outpatient procedure under anesthesia and then are fertilized with sperm in a lab. Once fertilized, the embryos are allowed to develop in the lab for 5-6 days, and then they are transferred back to the woman’s uterus for her to carry to term.
IVF is usually recommended if AI or IUI haven’t been successful, or if they weren’t an option due to other health reasons. IVF can be a lengthy and emotionally challenging process, which is why it typically isn’t the first thing your provider may prescribe.
Success depends on a lot of factors, with age being the biggest. For a woman under 35, IVF could have as high as a 50% success rate. For women 35-37, the success rate is around 38%. For women 38-40, the success rate is around 24%. For women 41-42, the success rate is around 12%, and for women over 42, the success rate is around 4%.
Possible risks and downsides include:
- Unpleasant side effects of the hormone shots that are required before the eggs are harvested
- Implanting more than one fertilized egg can increase the likelihood of twins or multiples, increasing the chance of complications
- The procedure itself is invasive
There is a type of alternative that skips the hormone injection phase called “natural cycle IVF”. Your provider will monitor your natural cycle and retrieve a single egg when you’re ready to ovulate. Your egg is then fertilized in a lab and transferred to your uterus. The success rates for natural cycle IVF are around 20-25%.
If a woman doesn’t have viable ovaries or eggs, she can receive a donor egg from a fertile woman. This egg is fertilized with the sperm of their partner or a sperm donor and then it is implanted into the woman’s uterus, similarly to IVF. The woman will be listed as the birth mother on record; however, she won’t be related to the baby biologically.
This fertility method is usually prescribed if traditional IVF hasn’t worked, or if a woman has a low egg count or poor egg quality. It has also been the method chosen by individuals or couples who have genetic disorders or serious conditions that they wouldn’t want to be passed on to their child.
This method is up to 55% successful when fresh donor eggs are used and up to 40% successful when frozen donor eggs are used.
As with traditional IVF, this method can be a lengthy process and run the risk of multiples and related complications.
Surrogacy involves a woman (the surrogate) carrying a child for another woman or for a same-sex couple. The parents will undergo IVF and the embryo is implanted in the surrogate’s uterus, where she will then carry it to term. Both parents will typically have a genetic tie to the baby, but the surrogate will not.
This method is typically a good option for parents that desire a biological child but aren’t able to or would rather not be pregnant.
The success rate for surrogacy is around 50% if the egg comes from a woman under the age of 35 but quickly drops to less than 10% if the donor is over the age of 42.
Surrogacy can be a very intensely emotional process that can last a couple of years. It also comes with many legal aspects to consider. A detailed contract is always recommended to handle issues that may arise. Surrogacy is also not legal in every state, but your provider will let you know if that is an option for you in your state.
Freezing eggs is a popular choice among women who know they want to reproduce at some point but also know that they don’t want to for many years. Women between the age of 20 and 30 have the highest chance of success at retrieving, freezing, and storing their healthy eggs.
This is a good option for women with a family history of early menopause or lengthy perimenopause, endometriosis, ovarian cysts, or women undergoing cancer treatment.
Surgery is typically only recommended if a woman has certain conditions, such as:
- A laparoscopy to treat endometriosis
- A reversal of tubal ligation (tied tubes)
- A hysteroscopy to treat fibroids, uterine septum, or adhesions
- A myomectomy to remove uterine fibroids
Your provider will inform you if they believe surgery is your best option.
Which Fertility Treatment is Right For You?
Every woman and every couple is different, which means the fertility treatment you could be prescribed could vastly differ from another woman or couple. The best way to determine which course of fertility treatment is right for you is to talk with your provider. They’ll be able to sit down with you and talk through everything that factors in and then provides you with a plan of action. Schedule an appointment today to talk with one of our providers near you!