If you are unable to get pregnant, call your doctor right away. Your doctor will refer you to reproductive endocrinology and infertility (REI) specialist doctor. These doctors treat all kinds of infertility problems in both men and women. The specialist doctor will test both you and your partner to find out what the problem is. About 90% of the cases of infertility are medically treated with drugs or surgery.
Medical Treatment
The doctor will perform various tests to find out what caused the problem. He/she will treat you and your partner depending on the cause of infertility.
The treatment may involve:
- Medicines to treat infections and clotting disorders
- Medicines that help the growth and release of eggs from the ovaries
- Surgery to repair damage to a woman’s ovaries, fallopian tubes, or uterus. Surgery is also used to correct problems in men.
Assisted Reproductive Technology (ART)
If the medical treatment doesn’t work, the doctor may recommend one of the following methods of assisted reproductive technology to achieve pregnancy:
Intrauterine Insemination (IUI): This method of fertility treatment is also called artificial insemination. In this method, male sperm is injected into the part of the woman’s reproductive tract, such as into the uterus or fallopian tube, to facilitate fertilization. Often, IUI the along with drugs that induce a woman to ovulate.
IUI is most effective if:
- A man has a low sperm count
- A man has sperm with low mobility
- A man cannot get erections
- A man has retrograde ejaculation. This is a condition in which sperm a ejaculated into the bladder instead of the penis
- A couple has difficulty having intercourse
In Vitro Fertilization (IVF): In vitro fertilization (IVF) means joining of a woman’s egg and a man’s sperm in a laboratory dish. In vitro means outside the body. IVF involves stimulating a woman’s ovaries, removing eggs from her body, mixing them with sperm in the laboratory, and putting the embryo back into a woman’s uterus.
Intracytoplasmic Sperm Injection (ICSI): ICSI is a relatively new technique, in which a single sperm is injected directly into the center of the egg. ICSI differs from conventional IVF in that a single sperm is injected directly into an egg, instead of fertilization taking place in a dish where many sperms are placed near an egg.
This technique is useful for men whose sperm quality or quantity was previously too poor for IVF treatment. This provides a good chance of fertility treatment success.
Your fertility specialist doctor may recommend ICSI if:
- Male partner has a very low sperm count
- The male partner has other problems with sperm, such as abnormal shape or poor motility of sperm
- There was a failure of fertilization or an abnormally low fertilization rate during previous attempts at IVF
- The male partner has had a vasectomy and sperm have been collected from the testicles or epididymis
Gamete Intrafallopian Transfer (GIFT): GIFT technique is similar to IVF except that fertilization occurs inside rather than outside the body. After eggs are collected, an embryologist assesses the quality and selects three best quality eggs. The selected eggs are mixed with about a hundred thousand motile sperm. The eggs and sperm are then immediately placed in the woman’s fallopian tube.
Your fertility specialist doctor may recommend GIFT if:
- You have unexplained infertility.
- You’ve had no success with IVF.
Third Party-Assisted ART
When a couple fails to achieve pregnancy from infertility treatments or traditional ART, they can opt for third party-assisted ART methods to get pregnant.
Third-party assistance can be in the form of:
Gestational Carrier: A gestational carrier is a woman who agrees to carry the pregnancy after implanted with an embryo. The gestational carrier is implanted with an embryo that is not biologically related to her. This option is used when a woman produces healthy eggs but is unable to carry a pregnancy to term. If needed, egg or sperm donation can also be used in this situation.
Sperm Donation: A couple can opt for donated sperm if a man has a genetic disease, does not produce sperm, or produces an insufficient number of sperm. Donated sperm can be used with IUI or with IVF.
Egg Donation: Egg donation is one of the options if a woman does not produce healthy eggs that can be fertilized. An egg will be retrieved from the donor. Then the donated egg is fertilized by sperm from the male partner of the couple. The resulting embryo is then placed into the woman’s uterus.
Egg donation is usually recommended for a woman who:
- Was born without ovaries
- Has primary ovary insufficiency
- Has had surgical removal of the ovaries
- Is the carrier of known genetic diseases
- Is infertile because of poor egg quality
- Is menopausal
- Has had chemotherapy or radiation therapy
Surrogacy: Surrogacy is an agreement whereby a woman agrees to carry a pregnancy for another couple, who will become the newborn’s parents after birth. The woman who carries the pregnancy is called a surrogate. If a woman is unable to carry a pregnancy to term, she and her partner may choose a surrogate or gestational carrier. Surrogacy is an option when the female partner of the couple does not produce healthy eggs that can be fertilized.
A surrogate woman is inseminated with sperm from the male partner of the couple. The resulting child will be biologically related to the surrogate and to the male partner.
Gestational Carrier: A gestational carrier is a woman who agrees to carry the pregnancy after implanted with an embryo. The gestational carrier is implanted with an embryo that is not biologically related to her. This option is used when a woman produces healthy eggs but is unable to carry a pregnancy to term. If needed, egg or sperm donation can also be used in this situation.
Adoption
If medical treatment and assisted reproductive technology don’t work, you always have the option of adopting a child. Adopting a baby or child can be one of the most rewarding experiences in your life. You can talk with your doctor about it. You can check with your local government or an adoption social worker to find an adoption agency and know more about the laws governing adoption.