Infertility affects millions worldwide, but it doesn’t have to be the end of the road. Thanks to advances in reproductive medicine, several options are available to help couples overcome infertility and achieve their dream of having a baby.
This comprehensive guide provides an overview of fertility treatment options, beginning with the basics.
In the following chapters, we’ll explore the most common causes of infertility, fertility treatment options, their success rates, and more so you can make informed decisions and feel empowered on your journey to parenthood.
Natural Conception: How Pregnancy Happens
Believe it or not, getting pregnant isn’t as simple as having unprotected sex; it involves a series of complex events that must occur at the right time, starting with ovulation.
Ovulation
Ovulation is the release of an egg (ovum) from the ovary and into the fallopian tube. This typically occurs once a month, approximately 13 to 15 days into the menstrual cycle, but can vary from person to person.
Ovulation is a complicated process regulated by hormones. Various factors, including a person’s stress levels, sleep hygiene, weight, age, certain medical conditions (e.g., polycystic ovary syndrome or PCOS, endometriosis, thyroid disorders, etc.), and lifestyle choices (such as smoking or alcohol consumption, can affect ovulation. Even short-term factors, like seasonal changes, traveling across time zones, or changes in routine, can impact ovulation.
The Ovulation Process
Before ovulation, the pituitary gland releases small, continuous bursts of follicle-stimulating hormone (FSH), which stimulate the ovaries to develop follicles — fluid-filled sacs that house the eggs.
The body then selects one dominant follicle to mature while the others shrink and disappear. As the dominant follicle grows, it releases estrogen, thickening the endometrium (uterine lining) and preparing it for a potential pregnancy.
This estrogen surge signals the brain to produce luteinizing hormone (LH), which triggers ovulation. This rise in LH also causes the resumption of meiosis, or the process that makes the egg released from the follicle genetically mature and competent so that it can later be fertilized by sperm.
Ovulation causes the mature follicle to release the egg, which is swept up by the fimbriae (tiny hair-like structures on the end of the fallopian tubes) and into one fallopian tube, where it will either be fertilized by sperm or disintegrate if not fertilized within 24 hours.
During this process, the egg goes through cellular changes to prepare for fertilization and uterine implantation.
Following the egg’s release, the remaining follicle transforms into a temporary endocrine gland called the corpus luteum, which secretes progesterone and estrogen to support the uterine lining and prepare it for the implantation of a fertilized egg.
If a pregnancy does not occur, the corpus luteum will dissolve (become a corpus albicans), progesterone levels will drop, and the body will shed its uterine lining, resulting in menstruation. If a pregnancy occurs, the hormone hCG supports the corpus luteum to continue to make estrogen, progesterone, and other factors until the placenta takes over at approximately 9-11 weeks.
The Importance of Ovulation
Ovulation is a crucial step in the menstrual cycle and fertility. While not ovulating occasionally isn’t a cause for concern, not ovulating for four or more months of the year or stopping ovulation altogether (anovulation) can lead to serious health issues. This is because ovulation provides necessary hormone signals for establishing pregnancy and preventing abnormal uterine lining growth that can lead to cancer. The lack of ovulation can also indicate other health problems like thyroid disease or hypothalamic and pituitary disorders (like hyperprolactinemia); these specific health problems can have significant downstream effects on bone density levels, heart health, and cognitive function.
To get a better idea of your ovulation patterns, you can:
- Track your menstrual cycle either via a period-tracking app or by keeping a menstrual calendar
- Monitor your basal body temperature (BBT), which slightly increases right after ovulation
- Observe changes in cervical mucus
- Use an ovulation predictor kit (OPK) to detect changes in hormones
- Ask a healthcare professional to check your hormone levels
Fertilization
Fertilization is when a sperm penetrates and fertilizes an egg in the fallopian tube. Before a sperm can fertilize an egg, it undergoes capacitation and the acrosome reaction. Capacitation is a process that enhances the sperm’s motility and allows for the sperm to attach to the “shell” (zona pellucida) of the egg. At the same time, the acrosome reaction releases enzymes that help the sperm penetrate the egg’s outer layer.
After ejaculation, sperm can survive in the female reproductive tract for up to five days. This means fertilization can happen up to six days after unprotected sex. Although pregnancies have been achieved when unprotected sex occurs between 6 days before and up to 3 days after ovulation, most pregnancies occur when intercourse is within the 3-day interval before ovulation. However, despite the release of millions of sperm during ejaculation, only one sperm can fertilize an egg.
When a sperm finds and penetrates an egg, the two cells fuse. This fusion allows the sperm’s genetic material to enter the egg. The sperm and egg then trigger events that activate the egg, including releasing calcium ions and forming a fertilization cone. Finally, the sperm and egg nuclei fuse in a syngamy process, forming an early embryo called a zygote.
Implantation
After fertilization, the zygote travels toward the uterus, eventually implanting and growing into a fetus.
During its journey — which could take three to five days — the zygote undergoes cell division (dividing into two cells, four cells, and more) and forms a ball of cells called a blastocyst.
When the blastocyst reaches the uterus, cross-talk between the blastocyst and uterus allows the blastocyst first to get close to the lining (“apposition”), attach and adhere to the lining, and finally invade the lining. This entire, complex process is called implantation. While most implantations are successful, there are instances when implantation fails, resulting in a chemical pregnancy or early miscarriage.
Causes of Infertility: Issues That Prevent Pregnancy
Infertility isn’t a one-size-fits-all issue, as various factors can hinder pregnancy. Understanding the underlying causes of infertility can help individuals and couples navigate their fertility journey and the path to parenthood.
This section explores the most common issues that prevent pregnancy. By gaining insight into these causes, individuals can work with their healthcare professionals to explore possible treatment options and improve their chances of conceiving. Unfortunately, up to 30% of couples will be diagnosed with “unexplained” infertility after a thorough infertility workup. Despite not knowing the exact cause, many treatment options are successful in helping these individuals achieve pregnancy.
Premature Ovarian Insufficiency (POI)
Premature Ovarian Insufficiency (POI) is a condition that affects women under 40, with a prevalence of approximately 1% in this population. It’s a heterogeneous disorder, meaning it can vary in its presentation and causes.
POI occurs when the ovaries stop functioning correctly, resulting in reduced fertility or infertility. Common symptoms of POI include irregular or skipped menstrual cycles, hot flashes, vaginal dryness, night sweats, irritability, and decreased sexual desire.
There are several causes of POI, including autoimmunity, exposure to toxins or certain medications, chemotherapy and pelvic radiation for cancer treatment, and genetic defects. Chromosome abnormalities, such as Turner syndrome, can also cause POF.
Aside from infertility, POI can lead to other health issues, including osteoporosis, depression or anxiety, and heart disease.
Polycystic Ovarian Syndrome (PCOS)
also known as polycystic ovary syndrome, is a common hormonal disorder that affects approximately 10 million people worldwide.
PCOS is a leading cause of infertility, impacting about one in 10 women of reproductive age. It occurs due to an imbalance of hormones in the body, specifically androgens, insulin, and progesterone. This hormonal imbalance disrupts the normal ovulation process, leading to difficulties in releasing eggs.
Common symptoms of PCOS include irregular menstrual periods (usually eight or less per year), excessive male-pattern facial and body hair growth, acne, weight gain, and the development of skin tags. Individuals with PCOS are also at risk for cardiovascular disease, high blood pressure, high cholesterol, impaired glucose tolerance and type 2 diabetes, obstructive sleep apnea, uterine cancer, and mood disorders like depression and anxiety.
During pregnancy, PCOS can contribute to complications such as miscarriage, gestational diabetes, and preeclampsia (a severe blood pressure condition). However, with proper management and treatment, many individuals with PCOS can achieve conception and have a healthy pregnancy.
Endometriosis
Endometriosis is a chronic inflammatory condition in which endometrial-like tissue grows outside the uterus, causing inflammation, scar tissue, pain, and, in some cases, infertility.
Despite affecting an estimated 200 million people worldwide, endometriosis is often misdiagnosed and overlooked for years, leading to delayed treatment and increased complications.
Symptoms of endometriosis include painful periods, pelvic pain outside of menstruation, pain during intercourse, sciatic pain, bowel or bladder issues, and infertility.
While there’s no definitive cure for endometriosis, various treatment options are available to manage symptoms and improve quality of life. The gold standard treatment is laparoscopic excision surgery, which involves removing or excising the affected tissue. However, hormone treatment can improve symptoms for many individuals to allow attempts for conception with or without the help of fertility treatment.
The most important thing a person with endometriosis can do is find an educated and experienced surgeon with a thorough understanding of the condition to ensure proper diagnosis, treatment, and management.
Note: It’s a common misconception that a hysterectomy (removal of the uterus) will cure endometriosis. If a healthcare professional suggests a hysterectomy as a treatment option for endometriosis, seeking a second opinion is advisable, especially if family-building goals have not yet been achieved.
Male Factor Infertility
Male factor infertility accounts for 40 to 50% of infertility cases. It refers to fertility issues related to the male reproductive system.
Symptoms of male factor infertility may not be readily apparent, but some indicators include low sperm count, abnormal sperm morphology (shape), poor sperm motility (movement), erectile dysfunction, and ejaculation disorders.
People who suspect they have male-factor infertility should undergo a thorough evaluation and diagnostic tests to understand the underlying cause and explore suitable treatment options. These assessments can help identify factors such as hormonal imbalances, genetic abnormalities, structural abnormalities, infections, or lifestyle factors that may contribute to male infertility.
The outlook for male factor infertility depends on various factors, including the specific cause, the severity of the condition, and the individual’s overall health. The good news is that advancements in reproductive medicine have led to a wide range of treatment options for addressing male factor infertility. These treatments aim to improve fertility outcomes and increase the chances of conception.
Tubal Disease
Tubal disease affects the fallopian tubes, which are essential for fertility, by facilitating the movement of eggs from the ovaries to the uterus. When the fallopian tubes are affected by disease or damage, it can lead to fertility issues and increase the risk of infertility.
Symptoms of tubal disease can vary depending on the underlying cause but may include pelvic pain, abnormal bleeding, unusual vaginal discharge, and infertility. It’s important to note that tubal disease may not always cause noticeable symptoms, and some individuals may only become aware of it after experiencing difficulties in conceiving.
Sometimes, a fertilized egg may implant in the fallopian tube, leading to an ectopic pregnancy, a medical emergency.
Several factors can contribute to tubal disease, including sexually transmitted infections, pelvic inflammatory disease (PID), endometriosis, previous surgeries involving the reproductive organs or other pelvic surgeries, and congenital abnormalities of the fallopian tubes, such as structural malformations or blockages present from birth.
Treatment may involve surgical interventions to repair or remove damaged portions of the fallopian tubes or assisted reproductive techniques like in vitro fertilization (IVF), which bypasses the fallopian tubes.
By addressing tubal disease and receiving the necessary care, individuals can improve their prospects of conception and fulfill their desire to have a child.
Recurrent Pregnancy Loss
The American College of Obstetricians and Gynecologists (ACOG) defines recurrent pregnancy loss as two or more consecutive miscarriages, and the American Society for Reproductive Medicine defines recurrent pregnancy loss as the spontaneous loss of two or more pregnancies (does not have to be consecutive). It’s a profoundly challenging and heartbreaking experience for individuals and couples hoping to start or expand their families.
Symptoms of recurrent pregnancy loss may include vaginal bleeding and cramping, similar to those experienced in a regular miscarriage. The repeated loss of pregnancies can have a profound emotional impact, necessitating additional support and counseling to cope with the grief and navigate the journey toward future pregnancies.
Genetic factors, such as chromosomal abnormalities in either parent or the developing fetus, hormonal imbalances, reproductive system infections, anatomical abnormalities in the uterus or cervix, autoimmune disorders, sperm factors, and lifestyle factors like smoking, alcohol consumption, or advanced maternal age can all contribute to recurrent pregnancy loss.
Accurate diagnosis of the underlying factors responsible for recurrent pregnancy loss is crucial for effective management and reducing the risk of future miscarriages. This often entails a comprehensive evaluation that includes a thorough medical history review, genetic testing, hormonal assessments, imaging studies, sperm DNA fragmentation testing, and uterine evaluations to identify potential abnormalities or contributing factors.
In addition to medical interventions, supportive care is essential for individuals and couples experiencing recurrent pregnancy loss. Seeking emotional support and counseling from mental health professionals, connecting with support groups of individuals who have gone through similar experiences, and working closely with healthcare providers specializing in fertility can provide guidance, empathy, and valuable resources to navigate this journey’s emotional and physical aspects.
Unexplained Infertility
Despite comprehensive medical evaluation, unexplained infertility cannot be attributed to a specific cause. It can be a frustrating and challenging experience for individuals and couples seeking answers and hoping to conceive.
Doctors will only diagnose unexplained infertility after both partners undergo a thorough medical evaluation, including assessments of reproductive health, hormonal levels, uterus and fallopian tube anatomy, semen analysis, and any potential fertility-related factors. When no apparent issues or abnormalities are found, unexplained infertility is diagnosed.
Approximately 30% of couples who present for fertility evaluation are diagnosed with unexplained infertility, adding to the complexity and uncertainty of the fertility journey. The lack of a clear explanation can be emotionally distressing and may leave individuals and couples feeling discouraged or uncertain about their chances of conception.
Assisted reproductive technologies such as IVF and ovulation induction with intrauterine insemination (IUI) are commonly recommended for individuals and couples with unexplained infertility. These treatments aim to bypass or support natural conception processes and can provide hope and opportunities for a successful pregnancy.
Exploring the various causes of infertility reminds us of the complexity of the journey to parenthood. The following section covers diagnostic tools and techniques available to uncover underlying factors and guide individuals and couples toward effective fertility solutions.
Infertility Testing Methods
Each of the following infertility testing methods uniquely identifies potential factors contributing to infertility and helps paint a more precise and comprehensive picture of an individual’s or couple’s reproductive health.
Blood Testing
Standard blood tests used in infertility testing include:
- Hormone testing: Hormone testing helps assess levels of key hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, testosterone, thyroid-stimulating hormone (TSH), and prolactin. Abnormal hormone levels can indicate ovarian dysfunction, PCOS, or pituitary and thyroid disorders.
- Infectious disease testing: Sexually transmitted infections (STIs) can affect fertility. Blood tests can check for infections such as syphilis, gonorrhea, chlamydia, and HIV.
- Genetic testing: Genetic testing can help identify chromosomal abnormalities, such as a balanced translocation or gene mutations related to reproductive health.
- Thyroid function: Blood tests assess thyroid function by measuring thyroid-stimulating hormone (TSH) and thyroid hormone levels (T3 and T4). Proper thyroid function is essential for optimal fertility.
Ultrasound
Ultrasounds utilize sound waves to create images of the reproductive organs and structures within the body. These images can help healthcare professionals identify uterus abnormalities, fallopian tubes, and ovaries.
A pelvic ultrasound is a safe and non-invasive technique that allows for the quick visualization of these organs. During a pelvic ultrasound, the healthcare provider can identify any abnormalities such as cysts, fibroids, polyps, or structural issues that may contribute to infertility.
In addition to a pelvic ultrasound, a transvaginal ultrasound may be utilized for more detailed imaging. This type of ultrasound involves the insertion of a tiny probe into the vaginal canal, providing a closer and clearer view of the reproductive organs. Transvaginal ultrasound is especially useful in assessing the ovaries, detecting ovarian cysts, and monitoring follicle development during fertility treatments.
Genetic Testing
Genetic testing is valuable for identifying genetic factors that may impact fertility. It involves the analysis of an individual’s genetic material, such as DNA or chromosomes, to detect any abnormalities or mutations that could contribute to infertility.
Examples of genetic testing used in infertility include:
- Karyotype testing: Karyotype testing examines the structure and number of chromosomes in an individual’s cells to identify chromosomal abnormalities, such as aneuploidy (an abnormal number of chromosomes) or structural rearrangements. These abnormalities can disrupt normal reproductive processes and increase the risk of miscarriages or fertility problems.
- Genetic carrier screening: The American College of Obstetricians and Gynecologists recommends genetic carrier screening for all individuals attempting pregnancy. This test assesses whether an individual carries gene mutations associated with certain genetic conditions. While carriers themselves may not have the condition, if both partners are carriers for the same genetic disorder, there’s an increased risk of passing the condition to their offspring. Genetic carrier screening can help individuals make informed decisions regarding family planning and explore options like preimplantation genetic testing (PGT) to reduce the risk of passing on genetic conditions.
- Single-gene testing: This type of genetic testing focuses on specific genes associated with reproductive health. It can identify mutations or variations in genes that play a role in hormone regulation, ovarian function, or sperm production.
Genetic counseling is often recommended alongside genetic testing to provide guidance, support, and interpretation of test results to ensure individuals understand their reproductive health.
Hysterosalpingogram (HSG)
A hysterosalpingogram (HSG) is a quick diagnostic procedure that uses X-rays to evaluate the uterine cavity and fallopian tubes.
During the HSG, a specialist injects a contrast dye into the uterus through the cervix. X-ray imaging is then used to visualize the movement of the dye as it fills the uterine cavity and flows through the fallopian tubes. This allows healthcare professionals to identify abnormalities or blockages that may impact fertility.
The HSG procedure can help detect uterine fibroids, polyps, adhesions, abnormal tubal anatomy, or blockages. These issues can decrease the success of getting pregnant on your own or with infertility treatment and sometimes increase the risk of ectopic pregnancy.
Saline Sonogram
A saline sonogram, sonohysterography, or saline ultrasound is a diagnostic procedure used to evaluate the uterine cavity and detect any abnormalities that may contribute to infertility.
During a saline sonogram, a specialist injects a small amount of sterile salt water solution (saline) into the uterine cavity through a thin catheter. This expands the uterine walls and provides more precise imaging during the ultrasound. An ultrasound probe is inserted into the vagina to visualize the uterine lining and assess its structure.
A saline sonogram can identify uterine polyps, fibroids, adhesions, or other abnormalities that may not be visible on a traditional ultrasound.
Common Treatment Options for Infertility
There are various treatment options available for individuals and couples struggling with infertility. This section explores the most common treatment options, including assisted reproductive technologies, hormonal therapies, and surgical interventions.
In Vitro Fertilization (IVF)
In vitro fertilization (IVF) is an advanced assisted reproductive technology that involves fertilizing eggs and sperm outside the body in a laboratory dish.
IVF is often recommended for individuals or couples unable to conceive through simpler treatments like medication and IUI.
The IVF process usually begins with ovarian stimulation through fertility medications. These medications stimulate the ovaries to produce multiple eggs. These medications are similar to the hormones your brain makes when it normally stimulates the growth of one egg each month. These eggs are then retrieved from the ovaries through a minimally invasive procedure known as follicular aspiration.
After the eggs are collected, they’re fertilized with sperm from a partner or donor sperm. This can be done through traditional IVF, where the sperm is added to the eggs in a dish, or through intracytoplasmic sperm injection (ICSI), where a single sperm is injected into each egg.
Once the eggs are fertilized, the resulting embryos are monitored and cultured in the lab for a few days before being transferred into the uterus. Only the healthiest and most viable embryos are selected for transfer.
The embryo transfer procedure is a simple and relatively painless process where the selected embryos are carefully placed into the uterus using a thin catheter.
Following the embryo transfer, the individual or couple undergoes a waiting period to determine if the embryo implantation is successful and leads to pregnancy. In some cases, additional embryos can be cryopreserved (frozen) for future use.
IVF has the potential to help individuals and couples overcome various infertility challenges, including issues with egg quality, sperm quality, tubal factors, endometriosis, and unexplained infertility.
That said, it’s important to note that IVF is a complex and highly individualized process that requires careful evaluation, personalized treatment plans, and ongoing support from a team of fertility specialists.
IVF success rates can vary depending on factors such as age, overall health, and the underlying cause of infertility.
Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic sperm injection (ICSI) is a specialized technique used with IVF to address male factor infertility. It involves injecting a single sperm directly into an egg to facilitate fertilization.
ICSI particularly benefits couples facing challenges related to sperm quality, quantity, DNA fragmentation, or motility (movement).
The ICSI procedure begins with retrieving eggs from the ovaries, similar to the IVF process. The eggs are then carefully held in place using a specialized holding pipette, while a microneedle is used to immobilize a single sperm. The microneedle is carefully inserted through the egg’s outer membrane (called the zona pellucida), and the sperm is injected into the egg’s cytoplasm.
Following the injection, the eggs are incubated and monitored in the laboratory to observe fertilization and early embryo development. The resulting embryos are evaluated, and the healthiest and most viable embryos are selected for transfer into the uterus.
Preimplantation genetic testing (PGT) can help identify potential genetic concerns and ensure the healthiest embryos are selected for transfer.
By incorporating ICSI into the IVF process, individuals and couples facing male-factor infertility can increase their chances of successful fertilization and ultimately achieve their dream of starting or expanding their family.
Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) is a simpler and less invasive fertility treatment option than IVF and ICSI. It involves placing washed and concentrated sperm directly into the uterus during a woman’s fertile window to increase the chances of conception.
The IUI procedure takes 15 to 20 minutes and can be performed in a doctor’s office or fertility clinic. Before the procedure can occur, couples may be asked to undergo a series of fertility tests to determine if IUI is the best choice.
Additionally, the sperm sample (from the male partner) must be washed and prepared in a lab before it’s transferred into the uterus. Couples using donor sperm will not need to provide a sperm sample as the clinic will already have it available and prepared.
During the procedure, the doctor uses a speculum to visualize the cervix and inserts a small, flexible catheter through the cervix and into the uterine cavity. This catheter is used to deposit the sperm sample directly into the uterus.
IUI is the first-line treatment for unexplained infertility in individuals 35 and younger. It’s also a good option for couples unable to have vaginal sex due to a physical disability or erectile dysfunction. Individuals with endometriosis or PCOS may also benefit from IUI.
Ovulation Induction Treatment
Ovulation induction treatment (OI) is a fertility treatment option that stimulates the ovaries to produce one or more eggs in a cycle. It’s commonly recommended for individuals who experience difficulties with ovulation or irregular menstrual cycles.
OI involves using medications, either in oral or injectable form, to regulate hormone levels and promote the growth of follicles in the ovaries.
One commonly used medication for OI is clomiphene citrate (Clomid). Taken orally, clomiphene citrate blocks the negative feedback mechanism of estrogen on the hypothalamus, leading to increased production of follicle-stimulating hormone (FSH). This stimulates the growth and development of follicles, enhancing the chances of ovulation.
Letrozole, an aromatase inhibitor, is another medication option for OI. Like clomiphene citrate, letrozole increases FSH levels, promoting follicle development and ovulation. It is often prescribed for individuals who do not respond well to clomiphene citrate or have specific medical conditions.
A doctor monitors the patient’s response throughout the OI treatment using ultrasound scans and hormonal assessments. These monitoring sessions help track the development of follicles and determine the optimal timing for triggering ovulation.
Sometimes, the doctor may administer human chorionic gonadotropin (hCG), a medication that triggers ovulation. By inducing the release of mature eggs from the follicles, hCG further enhances the chances of successful conception.
Timed intercourse is often recommended during OI treatment to maximize the chances of fertilization. The doctor may also recommend other assisted reproductive techniques, such as IUI, to increase the likelihood of successful conception.
Frozen Embryo Transfer
Frozen embryo transfer (FET) is a technique used in assisted reproductive technology (ART) to maximize the chances of achieving pregnancy. It involves transferring previously frozen embryos into the uterus following an initial IVF cycle.
During the IVF cycle, the ovaries are stimulated to produce multiple eggs, which are then retrieved and fertilized in a laboratory. Any excess high-quality embryos not transferred during the fresh cycle are cryopreserved using a rapid freezing technique called vitrification.
When the time is suitable for the FET, the cryopreserved embryos are thawed and carefully transferred into the uterus using a thin catheter under ultrasound imaging guidance.
Hormonal medications may be prescribed to prepare the uterine lining and create a welcoming environment for embryo implantation.
FET is a relatively simple and minimally invasive outpatient procedure. It typically involves a few straightforward steps, and most patients experience little to no downtime, allowing them to resume their regular activities without significant interruption.
Single Embryo Transfer
Single embryo transfer (SET) is a procedure in which only one carefully selected embryo is transferred during an IVF or frozen embryo transfer (FET) cycle. This reduces the likelihood of multiple pregnancies and other risks associated with carrying multiples, such as preterm birth and low birth weight.
Third-Party Reproduction
Third-party reproduction refers to using donated eggs or sperm, a surrogate uterus, or both to achieve pregnancy. It provides an alternative path to parenthood for individuals or couples who cannot conceive or carry a pregnancy on their own.
Third-party reproduction options include:
- Egg donation: When a woman cannot produce viable eggs, donated eggs can be used during the in vitro fertilization (IVF) process. This can be due to factors such as diminished ovarian reserve, genetic disorders, or previous unsuccessful attempts at IVF.
- Sperm donation: Sperm donation is an option for single women, same-sex couples, or heterosexual couples facing male-factor infertility. Donor sperm can be used in various fertility treatments, including IVF or intrauterine insemination (IUI).
- Gestational Surrogacy: Gestational surrogacy involves an arrangement where a surrogate, also known as a gestational carrier, carries and delivers a baby for another couple or individual who cannot carry the pregnancy themselves. The embryo transferred to the surrogate can be created using the intended parents’ or donors’ gametes.
Third-party reproduction provides hope and opportunity for individuals and couples to build a family and fulfill their dream of parenthood. That said, it’s important to note that these arrangements can be complex and often require a lot of planning and consideration, both legally and emotionally.
Reproductive Surgery
Reproductive surgery encompasses a range of surgical procedures designed to treat reproductive conditions that may contribute to infertility or hinder successful pregnancy outcomes.
Examples of reproductive surgery include:
Laparoscopy
During laparoscopy, surgeons make small incisions in the abdomen, fill the abdomen with air, and insert a slender instrument called a laparoscope. This technique allows the surgeon to visually examine the patient’s pelvic organs and diagnose conditions such as endometriosis, ovarian cysts, pelvic adhesions, and tubal blockages with minimum pain and healing time.
Hysteroscopy
Surgeons perform hysteroscopy by inserting a slender, illuminated instrument called a hysteroscope through the vagina and cervix. This procedure gives specialists a closer look at a patient’s cervix and uterus to diagnose and treat intrauterine abnormalities. During hysteroscopy, polyps, fibroids, scar tissue, and other structural irregularities that can affect fertility or contribute to recurrent miscarriages can be detected and removed.
Myomectomy
Surgeons conduct myomectomies to remove uterine fibroids, which are benign growths that can impede fertility and cause symptoms like heavy menstrual bleeding or pelvic pain. Depending on the fibroids’ size, number, and location, myomectomy can be performed using different approaches, including open surgery, laparoscopy, or hysteroscopy.
How to Naturally Increase Fertility
While medical intervention is valuable in addressing reproductive issues, there are lifestyle adjustments that individuals or couples can make to increase their chances of conceiving naturally.
This section covers natural methods for boosting fertility.
Fertility Diet
Prepping our bodies for pregnancy often begins with the food we eat. While no specific “fertility diet” guarantees conception, certain food choices may help support reproductive health and increase the chances of getting pregnant.
A fertility diet typically includes the following:
- Nutrient-rich foods: Fruits, vegetables, whole grains, lean proteins, and healthy fats provide essential vitamins, minerals, antioxidants, and phytochemicals that support reproductive function.
- Adequate hydration: Water helps maintain optimal bodily functions and promotes healthy cervical mucus production.
- Healthy fats: Avocados, nuts, seeds, and olive oil aid in hormone production and balance, which are crucial for fertility.
- Plant-based proteins: Plant-based protein sources like beans, lentils, tofu, and quinoa provide essential nutrients and can benefit fertility.
- Limit processed foods and sugar: Processed foods, sugary snacks, and beverages can negatively impact fertility. Opt for whole, unprocessed foods whenever possible.
It’s important to consult with a doctor or fertility specialist before making significant dietary changes.
Fertility Supplements
While a balanced diet should be the primary source of essential nutrients for reproductive health, some individuals may consider taking fertility supplements as a complementary measure to support their fertility journey.
Fertility supplements should not replace a healthy diet but can be used in consultation with a healthcare professional.
Examples of fertility supplements include:
- Folic acid
- Vitamin C
- Coenzyme Q10 (CoQ10)
- DHEA
It’s worth noting that there’s limited scientific evidence supporting the effectiveness of fertility supplements.
Additionally, fertility supplements may have potential side effects or interact with other medications. Proceeding cautiously and following the recommended guidelines is essential to ensure safety and effectiveness.
The Importance of Exercise
Regular physical activity and exercise are essential for overall health and well-being and can also play a significant role in fertility. Studies show that moderate, regular physical activity can improve the chances of conception and positively affect reproductive function.
Here are some of the ways that exercise can help improve fertility:
- Hormonal balance: Exercise helps regulate hormonal levels in the body, including those involved in reproduction. Achieving a healthy hormonal balance, particularly with estrogen and progesterone, is vital for optimal reproductive function. By promoting hormonal equilibrium, exercise supports regular ovulation and menstrual cycles, increasing the chances of conception.
- Improved circulation: Physical activity improves blood flow and circulation throughout the body, including the reproductive organs. This increased blood flow ensures that the ovaries and uterus receive essential nutrients and oxygen. Furthermore, exercise helps release toxins and waste products, creating a healthier environment for eggs and embryos.
- Stress management: Exercise is a natural stress reliever and mood enhancer. It stimulates the release of endorphins, also known as “feel-good” hormones, which can alleviate stress, anxiety, and depression. High levels of stress can disrupt hormonal balance and negatively impact ovulation.
- Improved egg quality: Research suggests regular physical activity is associated with improved egg quality. Women who engage in exercise routines tend to have higher-quality eggs, which have a greater likelihood of successful fertilization and implantation.
Finding a balance is key when it comes to exercise and fertility. While moderate activity can be beneficial, excessive or intense exercise can have the opposite effect. Consulting with a healthcare professional or fertility specialist can help determine the appropriate exercise regimen based on individual needs and health conditions.
The Importance of Mental Health
Physical fitness isn’t the only factor contributing to overall health and well-being. This is especially true for individuals and couples going through the fertility process, which can be emotionally and mentally taxing.
Here are some of the reasons why mental health is equally important during fertility:
- Emotional well-being: Fertility treatments can be stressful and emotionally exhausting. It’s important to prioritize mental well-being and find healthy ways to cope with these emotions. Taking care of one’s mental health can lead to a more positive mindset, better stress management, and improved overall emotional well-being during the fertility journey.
- Impact on relationships: Fertility struggles can strain relationships with partners, family, and friends. Nurturing open communication, understanding, and support can help alleviate these tensions and create a stronger foundation for platonic and romantic relationships.
- Increased resilience: Fertility treatments may involve setbacks and disappointments along the way. Building resilience and developing healthy coping strategies are essential. Taking time to process emotions, seeking professional help, and accessing support networks can help individuals and couples navigate setbacks and maintain a positive outlook on their fertility journey.
Seeking support from mental health professionals, counselors, or fertility support groups can be beneficial in addressing emotional challenges and enhancing mental well-being throughout the fertility journey.
Here are some tips for prioritizing mental health during the fertility journey:
- Talk to someone: Engaging in open conversations about feelings and emotions with a trusted friend, family member, or therapist can provide support, facilitate the processing of emotions, and reduce feelings of isolation.
- Practice relaxation techniques: Incorporating relaxation techniques such as yoga, meditation, and deep breathing exercises into daily routines can help alleviate stress and anxiety and promote a sense of calm and well-being.
- Prioritize sleep: Getting enough sleep is essential for maintaining physical and mental well-being. Striving for seven to eight hours of quality sleep each night can enhance overall mental health.
- Set realistic expectations: Fertility treatments may not always lead to immediate success, and it’s normal for the process to take time. Setting realistic goals can help manage emotional expectations and reduce stress.
- Seek professional help: If coping with the emotional challenges of fertility becomes overwhelming, seeking assistance from mental health professionals or participating in fertility support groups can provide valuable guidance and support. Remember, seeking professional help is a sign of strength and self-care.
Diagnosing Fertility Issues & Getting Help
If you’re struggling to conceive and suspect you may be experiencing fertility issues, the first step is to schedule an appointment with a fertility specialist.
Here’s what to expect during the diagnosis and treatment process:
- Medical history: The initial consultation will involve a thorough medical history, including pre-existing medical conditions, previous surgeries, medications, and reproductive health history for both partners.
- Physical exams and testing: Physical examinations are conducted to assess reproductive health. This may involve pelvic examinations, assessing the uterus, ovaries, and fallopian tubes for women. Men may undergo semen analysis to evaluate sperm count, motility (movement), and morphology (shape).
- Hormonal testing: Blood tests may be performed to evaluate hormone levels, such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and thyroid function.
- Diagnostic imaging: Imaging techniques such as ultrasound, hysterosalpingography (HSG), or sonohysterography may be used to evaluate the reproductive organs’ structure and identify abnormalities.
- Genetic testing: Genetic testing may be recommended to identify any inherited genetic disorders or chromosomal abnormalities that could impact fertility or the future child’s health.
The Benefits of Visiting a Fertility Clinic
Individuals and couples facing infertility may sometimes feel overwhelmed, lost, or hopeless. Visiting a fertility clinic is one way to regain control and take proactive steps toward achieving a healthy pregnancy.
Benefits of visiting a fertility clinic include access to specialized diagnostic testing and treatment options, an individualized approach to care, and the support of a team of experts dedicated to helping patients navigate the challenges of infertility.
A Word From RMA Network
RMA Network is dedicated to providing comprehensive fertility care and helping individuals and couples on their journey to parenthood. With our team of experienced fertility specialists, advanced technologies, and patient-centered approach, we’re committed to offering personalized care tailored to each patient’s unique needs.
Our mission is to provide compassionate support, access to cutting-edge treatments, and guidance throughout the fertility process. Whether you’re seeking fertility evaluations, diagnostics, or advanced reproductive therapies, we are here to support you every step of the way.
Contact RMA Network to schedule a consultation and take the first step towards building your family.
*Disclaimer: Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to the sex assigned at birth.
