Infertility Treatment Options

What is fertility treatment?

If you’ve been trying to conceive for longer than a year, there are a number of tests your healthcare provider (HCP) may recommend:

• Ovulation testing – helps determine the time in your cycle when you’re most likely to get pregnant
• Hysterosalpingography – an X-ray procedure to see if the fallopian tubes are open and to see the inside of your uterus to detect any abnormalities
• Ovarian reserve testing – testing to determine how many eggs you have left
• Hormone testing – testing to determine the levels of hormones that are necessary to become pregnant in your blood
• Pelvic ultrasound or sonohysterogram – medical imaging used to look inside the organs or structures in the pelvis or in the uterus
• Laparoscopy – a minimally invasive surgical procedure to directly look at your pelvic organs
• Genetic testing – testing to evaluate your DNA to see if there are any issues that can increase the risk of miscarriage or pregnancy complications

The cause of infertility, as well as age, overall health and personal preferences can determine the type of treatment your HCP recommends. It’s important to note that many women will need multiple treatments and may need a combination of procedures and medications. The medical options for women dealing with infertility include:

Fertility drugs

Fertility medications are often prescribed for women who have irregular or absent periods to help regulate or induce ovulation. The more common drugs include:

• Clomiphene citrate: An oral medication that stimulates ovulation. It’s usually the first treatment for women who don’t have polycystic ovary syndrome (PCOS).
• Letrozole: An oral medication that works by reducing estrogen levels in order to stimulate ovulation and may be used for women with PCOS.
• Gonadotropins: These medications are used, usually with IVF, to stimulate the ovary to produce multiple eggs or to mature the eggs before they’re released.
• Metformin: Women with PCOS may have insulin resistance, which can be a cause of infertility. Metformin can improve insulin resistance and may improve ovulation.

Fertility surgery

For women with uterine problems, surgery can help remove certain infertility-causing issues such as uterine polyps or noncancerous fibroids.

Intrauterine insemination (IUI)

IUI is a type of reproductive assistance where sperm is placed directly in the uterus around the time of ovulation. The procedure is quick — it takes about a minute — but there’s some preparation required, including keeping track of ovulation. Women with certain health conditions such as endometriosis and infertility with no known cause may be candidates for IUI.

Reproductive assistance

The main types of reproductive assistance are assisted reproductive technology (ART) and in vitro fertilization (IVF).

ART treatment options include egg or sperm donation. This is when eggs, sperm or embryos from someone other than the intended parent(s) are needed to have a child. Some people may choose this option because of medical issues. LGBTQ couples and single people may also choose this treatment.

In IVF treatment, mature eggs are retrieved and then fertilized with sperm in a laboratory. Once fertilized, the embryos are transferred into the uterus.

Assisted hatching is a procedure often used with IVF. Once an embryo has been created through IVF, it’s surrounded by a hard outer layer of cells. Assisted hatching creates a small crack in the outer layer to increase the chances of the embryo implanting in the uterus. Women who have previously been unable to conceive through IVF may want to consider assisted hatching.