Infertility Treatments

You’ve decided to get some medical help in starting your family, but what does that really mean?  There are so many therapies and options that it’s easy to get lost, or just accept the first offered therapy, without knowing all the possibilities.  Can you utilize your own sperm and/or eggs?  Do you need drug therapy?  Or artificial insemination?  Or both?

To help you make informed decisions, and ask your doctors the right questions, we’ve put together a little overview of available options in fertility therapy.  The therapies available to you depend upon the type of infertility you and/or your partner are subject to, so we’ll break it down that way.

Infertility Types and Their Treatments

• Ovulation Difficulties – Ovulation Induction:
  • In this therapy, various drugs are used to induce ovulation.  Mostly effective with women who have irregular ovulation, but also used in combination with most other methods of treatment.  Drug induced ovulation is easier to track, and therefore useful in the timing of inseminations of sperm, or placement of gametes or zygotes.
• Insemination Difficulties – Artificial Insemination
  • This treatment involves the injection of sperm into the female reproductive tract, either intracervical (ICI) or intrauterine (IUI), and may be used in combination with ovulation inducement medications.  Often used when there is anatomical difficulty in natural insemination, or in cases of low sperm count or low sperm motility.  In most cases, sperm retrieval and/or sperm preparation for insemination increases the chances of fertilization.
• Sperm Preparation
  • Preparing sperm for insemination increases the probability of conception by ensuring only the healthiest sperm are introduced.  This can be achieved using either “Sperm Washing” or the “Swim-Up Technique”.
  • In Sperm Washing, a centrifuge is used to separate healthy sperm cells from seminal fluid, chemicals, and inactive sperm cells.  It is also a good option to reduce the risk of transmission of HIV from the male to the female.
  • Swim-Up Technique is widely used, and involves placing a culture medium on top of semen in a tube.  Only the healthiest sperm will be able to “swim up” and penetrate the medium, leaving everything else behind: seminal fluid, white blood cells, bacteria, and dead sperm cells.
  • There is also the option of using a donated sperm.  This is utilized in cases where a partner’s sperm is not viable, the risk of passing on genetic disorders is too great, or when a woman wants to have a baby on her own.
    
  • The chance of becoming pregnant while having artificial insemination treatments is between 5 and 25 percent higher than otherwise.
• Fertilization Difficulties – Assisted Reproductive Technology
  • This is represents an entire arena of therapies including in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT) and intracytoplasmic sperm injection (ICSI), and many others.  All involve a different fertilization and/or insemination strategy:
  • IVF requires harvesting both eggs and sperm, conducting fertilization in the lab, and then placing the embryos into the uterus.  Success rates are about 37 percent for women under 36, gradually receding to 13 percent for women over 40.  IVF pregnancies represent 99 percent of all ART pregnancies.  Costs are around $12,400 per cycle.
  • GIFT involves placing the eggs and sperm directly into the fallopian tubes, and hoping that fertilization will occur.  At 30 percent, this method has a pretty high success rate.
  • ZIFT is a similar procedure, except that fertilization is achieved in the laboratory and the produced zygote is not allowed to mature to embryo stage.  Instead, it is placed in the fallopian tubes as a zygote and left to mature there.  Here, the success rate is about 28 percent.
  • ICSI is gaining popularity, and involves injecting a sperm directly into the egg (the other methods still count on the sperm to do its job in fertilization).  The resulting embryo is then placed in the uterus, as in IVF.  For its difficulty, and cost, its success rate hovers at about 15 to 20 percent.  The costs are about $10,000 per cycle, depending on where you live.

There are also the options of utilizing natural fertility remedies, surgical treatments where necessary, or seeking out a surrogate.