1. Getting pregnant
  2. Trouble conceiving
  3. Fertility treatments

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6 Fertility Treatment Options for Women and Men

Infertility treatment can be a long journey, but success rates are improving and procedures are safer than ever. Today, Tiffanny Jones MD from Dallas IVF lists 6 of the options that can help become parents.

1. Intrauterine insemination

Intrauterine insemination is a treatment for patients who have either unexplained infertility, meaning everything has been found to be normal from both the male and female. And we try to do that to help more sperm get to the cervix and overcome a cervical factor or a problem with the cervical mucus that we generally wouldn't pick up otherwise. 

And the other really big indicator is a mild to moderate male factor. If a male has decreased sperm counts or the motility is lower, than getting the sperm to the top of the uterus can help get more into the fallopian tubes to meet the eggs. 

Also, in same-sex couples where there is no male partner that is a preferred method to use donor sperm with intrauterine insemination because it has better success rates than putting the sperm in the vagina and the cervix.   

2. Ovulation stimulation 

It is prescribed in women who don't ovulate, and those are women with endocrine problems like hypothyroidism, hyperprolactinemia. 

So, either you can correct them or you can help them ovulate using oral medications. 

Also, women who have polycystic ovary syndrome don't ovulate because their androgens are higher. And for those people taking medications to help them ovulate, either oral or injections or a combination thereof can help them release the eggs that they aren't otherwise, which generally is quite successful for some people.  

What are the medication options for ovulation stimulation?

Generally, Clomid is used which is a medication that blocks the estrogen receptors to make the body feel like there are low levels of estrogen, which then increases the person's endogenous hormones that are released from the pituitary.

And when there are higher hormones from the pituitary, mainly FSH and LH, then either it's enough to help a follicle to grow and to ovulate or to help several follicles grow and ovulate.

Letrozole is another one. It's actually the drug of choice for women who have polycystic ovary syndrome. And that also works by blocking the enzyme that converts androgens to estrogen. So again, the body thinks that the estrogen level is low. And so, as the estrogen mainly comes from the ovary, the pituitary gland will secrete more FSH and LH to help stimulate the ovary so one or more follicles can grow.

3. In vitro fertilization (IVF)

IVF is definitely the preferred treatment for women who have tubal infertility, meaning they have both of their tubes either removed or blocked and can't be fixed. 

Since that's the only way to get an egg into the uterus you have to go straight to IVF for that.

Sometimes there's a severe male factor where the sperm has to be retrieved directly from the testicle. In those situations, we generally only get very few sperm, so it's not enough to do anything else with it except for IVF to put these sperm into the egg to create an embryo.

Women who have tried other options first and with no success, then they would go on to IVF because generally, the success rates are much higher for IVF than any of the other treatment strategies. Other people who have genetic disorders that they don't want to pass on to a child or if they're a carrier of a genetic disorder they can do IVF because embryos can be screened for that specific genetic disorder.

And then some couples want to balance their families and they want to choose the sex of the embryo and the only way to do that would be to do IVF with genetic testing.

4.IntraCytoplasmic Sperm Injection (ICSI)

ICSI is the procedure where we take the sperm and put it directly into the egg to help with fertilization.

We do that in times where we have very few sperm or there's a very severe male factor.

We also do that when we need to do testing to make sure that there's not a specific genetic disorder that the embryo carries. So, male factor, genetic diagnosis for the actual genetic syndrome. And also if someone has done IVF in the past and they did conventional insemination, which is basically putting the eggs and the sperm together in a petri dish to let them meet more naturally, if we've done that before and nothing fertilized then the next time we would need to do ICSI because sometimes there are some problems.

ICSI success story

I have not had a patient with a failed fertilization. ICSI is actually quite common.

So, there was a couple, where he had a very severe male factor. He had to go to a male infertility specialist to have his sperm taken directly from the testicle which is called a TESA.

When we got those sperm, we did the ICSI and they made lots of embryos and were able to have a pregnancy with more embryos to freeze.

That was a nice story because otherwise, they wouldn't have been able to get pregnant naturally because there were too few sperm.

5. Gestational carrier vs surrogate – what’s the difference?

A gestational carrier is someone who carries an embryo for a couple but that embryo has no genetic relation to the person carrying it.

A surrogate sometimes means that it’s the carrier's egg and her uterus, and so, typically, in some countries, that's done for same-sex couples. But we really don't do that a lot here.

Gestational carriers are needed for women who don't have a uterus or for same-sex couples that are men because there is no uterus.

Also, sometimes, despite all that we do, a couple can make great embryos and we transfer them and they don't implant, so recurrent implantation failure if you can't discover why an embryo is not implanting, sometimes the next step is to use a gestational carrier. Usually, those are people who have had pregnancies in the past and they have been successful. And then they can carry an embryo if the female partner is not capable of doing it.

6.Egg donation

Egg donation is another fertility option for women who find it hard to get pregnant. Learn more about this option in this article by Doctor Tiffanny Jones

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