What are My Available Options for Fertility Treatments

Fertility Drugs

The two most commonly used fertility drugs are Clomiphene and Gonadotropins. They regulate reproductive hormones and trigger the release of one or more eggs in each ovulation cycle. Women use them for about three to six months before either conceiving or trying a different method of treatment.
80% of women who use clomiphene ovulate in the first three months of treatment. Of them, between 30% to 40% will conceive by their third treatment cycle. The pregnancy rate for gonadotropins with timed intercourse is about 15% per cycle.

Surgery

Often times infertility is caused by issues that can be reversed with surgery. Things like genetic defects, blocked fallopian tubes, fibroids, excess of tissue from endometriosis, and PCOS (polycystic ovarian syndrome) are most often treated with surgery. The two surgical procedures commonly used to treat gynecological problems are laparoscopy (which uses thin instruments and a lighted camera inserted through several small incisions in the abdomen) and laparotomy (which is done through a larger abdominal incision). Women with mild cases of endometriosis have about a 40% chance of getting pregnant by 9 - 9 months after laparoscopic treatment. Between 20% and 60% of women whose fallopian tubes are opened do conceive. Women with PCOS who have ovarian drilling surgery have a 50 percent chance of getting pregnant within one year.

Intrauterine insemination (IUI)

IUI involves depositing a concentrated amount of sperm from your partner or a donor directly into your uterus, using a catheter that passes through the cervix. The pregnancy rate is 7% - 16% per stimulated IUI cycle in couples with unexplained infertility.

In vitro Fertilization (IVF)

For in vitro fertilization (IVF), eggs are removed from your ovaries and then combined in a laboratory with sperm from your partner or a donor. If fertilization is successful, the resulting embryo or embryos are transferred to your uterus. IVF cycles that lead to a live birth are predominantly affected by age: 40% for women age 34 and under, 31% for women age 35 to 37, 21% for women age 38 to 40, 11% for women age 41 to 42 and 5% for women age 43 and over.

Intracytoplasmic sperm injection (ICSI)

ICSI is often added to an IVF treatment to overcome male fertility problems or to help the fertilization process along when it might be a challenge. During ICSI, a single sperm is injected into a single egg and the resulting embryo is transferred to your uterus. ICSI successfully fertilizes 50% to 80% of eggs. After fertilization, your chance of having a baby is the same as that of couples who used IVF without ICSI

Donor Eggs and Embryos

Using IVF techniques, an egg donated by another woman is mixed with your partner's sperm and transferred to your uterus. If you use a donor embryo, you take medications to prepare your uterine lining for pregnancy before the embryo or embryos are transferred to your uterus. Success rates are as follows: 50% using fresh donor eggs, 38% using frozen embryo from a previous donor egg cycle, 43% using embryos created from frozen donor eggs and 37% using frozen donor embryos. Choosing the egg (or embryo) donor can be a long process and some people report feeling a sense of loss at having a baby who is not genetically theirs.

Gestational Surrogacy

A gestational carrier (woman) carries your embryo, or a donor's embryo to term and then signs away all her parental rights. This option can become tricky because of the legal issues being complex and emotionally draining. It requires a considerable amount of money, time, and patience to succeed. You may also feel like you don't have control over the pregnancy with things like health and nutrition. This option can also be costly with about $35,000 being paid to the gestational carrier. More money goes to your carrier's expenses and insurance costs as well as the cost of IVF treatment and legal, administrative, and counseling fees set by lawyers and the agency.

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Michael Hickey