What infertility treatments are available?

 

What infertility treatments are available?

Treatments for infertility can range from medications to embryo implantation through assisted reproductive technology (ART). There are treatments that are specifically for men or for women and some that involve both partners.

Fertility Treatments for Females

Once a woman is diagnosed with infertility, the overall likelihood for successful treatment is 50%.

Whether a treatment is successful depends on:

  • The underlying cause of the problem
  • The woman's age
  • Her history of previous pregnancies
  • How long she has had infertility issues
  • The presence or absence of male factor infertility

Fertility treatments are most likely to benefit women whose infertility is due to problems with ovulation. Treatment with medications is least likely to benefit infertility caused by damage to the fallopian tubes or severe endometriosis, although In Vitro Fertilization can help women with these conditions to conceive.



Medication 

Treatments for Female infertility: The most common medications used to treat infertility .

  1. Clomiphene or Clomiphene Citrate
  2. Letrozole
  3. Gonadotropins or Human Chorionic Gonadotropin (hCG)
  4. Bromocriptine or Cabergoline

1.     Clomiphene or Clomiphene Citrate is a medication patient take by mouth (orally). It causes the body to make more of the hormones that cause the eggs to mature in the ovaries.

2.     Letrozole is an oral pill that decreases the amount of estrogen a woman makes, stimulating her ovaries to release eggs.

3.     Gonadotropins and Human Chorionic Gonadotropin (hCG): Gonadotropins such as follicle-stimulating hormone (FSH) are hormones that are injected in a woman to directly stimulate eggs to grow in the ovaries, leading to ovulation. Doctors normally prescribe gonadotropins when a woman does not respond to clomiphene or to stimulate follicle growth for assisted reproductive technology (ART).

4.     Bromocriptine or Cabergoline: Bromocriptine and cabergoline are pills taken orally to treat abnormally high levels of the hormone prolactin, which can interfere with ovulation. Pituitary growths; certain medications, including antidepressants; kidney disease; and thyroid disease can cause high levels of prolactin.

·         Bromocriptine or cabergoline allow 90% of women to have normal prolactin levels.

·         Once prolactin levels become normal, 85% of women using bromocriptine or cabergoline ovulate.

Surgical Treatment for Female Infertility: If disease of the fallopian tubes is the cause of infertility, surgery can be used to repair the tubes or remove blockages in the tubes. Success rates of these types of surgery, however, are low.

Assisted Reproductive Technology (ART): ART refers to treatments and procedures that aim to achieve pregnancy. These complex procedures may be an option for people who have already gone through various infertility treatment options but who still have not achieved pregnancy.

Some ART options include the following.

Intrauterine Insemination (IUI): Intrauterine insemination is the placement of a man's sperm into a woman's uterus using a long, narrow tube similar to a thin straw.

  • IUI can be used in combination with medications that stimulate ovulation. This combination can increase the chance of pregnancy in some cases.



 

In Vitro Fertilization: During IVF, eggs and sperm from the couple are incubated together in a laboratory to produce an embryo. A health care provider then places the embryo into the woman's uterus, where it may implant and result in a successful pregnancy.

The steps of IVF are:

Superovulation

This is process, also known as ovarian stimulation, ovulation induction, or stimulation of egg maturation.

Egg Retrieval

This is the process used to remove the eggs from the ovaries so they can be fertilized.

Fertilization

A man provides a semen sample. If the sperm are healthy, they are centrifuged to concentrate them and reduce the volume, placed in a dish with the egg, and left overnight in an incubator. Fertilization usually occurs on its own. However, sometimes sperm are not able to fertilize the egg on their own. When this is the case, a single sperm is injected into an egg using a needle. This process is called intracytoplasmic sperm injection (ICSI).




Embryo Transfer

This procedure is normally painless, but some women may experience cramping. A health care provider inserts a long, thin tube through the vagina and into the uterus and injects the embryo into the uterus.

Treatments for Diseases That Cause Infertility

Specific treatments for diseases that sometimes cause infertility can sometimes also improve fertility. Treatments for other diseases, such as thyroid disorders, may also improve fertility in women who have them.

·         Treatments for Polycystic Ovary Syndrome (PCOS)

·         Treatments for Endometriosis

·         Treatments for Primary Ovarian Insufficiency (POI)

Treatments for Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome, or PCOS, is a set of symptoms related to a hormonal imbalance that can affect women and girls of reproductive age. PCOS may cause menstrual cycle changes, skin changes such as increased facial and body hair and acne, cysts in the ovaries, and infertility. Often, women with PCOS have problems with their metabolism also.

Treatments for infertility in women with PCOS include:

  • Weight loss
  • Medication to promote ovulation. Clomiphene
  • Insulin-sensitizing medication. metformin
  • A combination of clomiphene and metformin.
  • Hormone therapy. Gonadotropins and hCG
  • Fertility treatments. ART, such as IVF.
  • Surgery. Ovarian drilling is a surgical treatment that can stimulate ovulation in women with PCOS.

 Treatments for Endometriosis

Endometriosis is a disease in which tissue similar to the lining of the uterus grows in other places in the body.

Treatments for the infertility that can occur with endometriosis include.

  • Surgery to remove the patches of tissue caused by endometriosis can improve a woman's chances of getting pregnant.
  • A.R.T.

Treatments for Primary Ovarian Insufficiency (POI)

There are currently no treatments that increase fertility among women with POI.

Treatments for male infertility include

  • Surgery
  • Treating infections
  • Treatments for sexual intercourse problems
  • Hormone treatments and medications
  • Assisted reproductive technology (ART)

Obesity

Obesity is a medical condition in which excess body fat has accumulated to an extent that it may have a negative effect on health. People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a person's weight by the square of the person's height, is over 30 kg/m2; the range 25–30 kg/m2 is defined as overweight. Obesity increases the likelihood of various diseases and conditions, particularly

·         Polycystic ovarian syndrome

·         Menstrual disorders

·         Infertility

·         Complications during pregnancy

·         Birth defects

·         Intrauterine fetal death

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