Let’s get right to it: no, not every patient needs In Vitro Fertilization (IVF).
Infertility, like many other medical diagnoses, sits on a continuum – there are mild cases of infertility, moderate cases of infertility, and severe cases of infertility. For women struggling to get pregnant, however, adjectives are not important – any kind of infertility is heartbreaking and prevents a woman from becoming pregnant.
If you’ve been trying without success and think it’s time to see a doctor, you might be wondering what type of fertility treatments there are and if all roads lead to IVF.
Here’s the truth – IVF is the most effective fertility treatment today, meaning it has the highest success rates, but it is not the only one. There are several other treatment paths for women to take.
This blog is part of Fertility FAQ, a series where RMA doctors answer your most pressing questions about treatment.
Today’s RMA physician expert is board-certified reproductive endocrinologist Dr. Ndeye Aicha Gueye.
Ovulation Monitoring
The simplest of these is natural ovulation monitoring, which is not a treatment but does require going to a fertility clinic for help.
It is when a doctor draws your blood and performs a vaginal ultrasound to see how close you are to ovulating, and instructs you to have sex at the optimal time.
This nudge is helpful for couples that may not have infertility, but are not conceiving because they are having sex at the wrong times.
Ovulation Induction
The next path is ovulation induction, which is when you take oral medication, such as Clomid, to help you ovulate.
The vaginal ultrasound you will get will alert doctors as to when you will ovulate, and you’ll have sex at that time.
This can be an effective treatment path for women who have irregular cycles or Polycystic Ovarian Syndrome (PCOS), a hormonal condition that disrupts ovulation.
Clomid is a very well-known and popular fertility medication and has helped many women conceive.
Intrauterine Insemination (IUI)
Moving up the treatment ladder is Intrauterine Insemination (IUI), which is helpful for men with mild sperm issues, such as motility.
During an IUI, the man’s semen will be ‘washed’ to isolate the swimming sperm, and then injected, using a simple catheter, into a woman’s uterus at the time of ovulation.
IUI is considered the first line of treatment for most cases of infertility and is successful for many couples with mild infertility.
In Vitro Fertilization (IVF)
The next and final fertility treatment is IVF, which, as mentioned earlier, has the highest pregnancy success rates, and is the most advanced of all treatments.
Women with PCOS, Diminished Ovarian Reserve (DOR), endometriosis, and severe male factor infertility, such as low sperm count and motility, are all good candidates for IVF.
While IVF is technologically and medically advanced, the treatment itself is not complex. It is simply the act of joining sperm and egg outside of the body to create an embryo that is then transferred into a woman’s uterus in hopes of achieving pregnancy.
During IVF, a woman takes ovary-stimulating medication to grow the eggs in her ovaries.
About 10-12 days later, she undergoes a short egg retrieval procedure to have the eggs removed, and immediately afterward, her mature eggs will be paired with her partner’s sperm to make embryos.
Once the embryos are mature enough, they will be biopsied for their chromosomal makeup using Preimplantation Genetic Diagnosis (PGD) and frozen.
Several weeks later, doctors will transfer one chromosomally normal embryo into the woman’s uterus using a catheter, and about 10 days later, draw her blood to check for a positive pregnancy.
So what’s the takeaway? There is no one-size-fits-all solution for infertility, and not everyone needs IVF. Just make sure that you and your doctor decide together which treatment path is right for you.
