Genetic testing: Genetic testing helps determine whether there’s a genetic defect causing infertility.
Treatment
Infertility treatment depends on the cause, your age, how long you have been infertile, and personal preferences.
Because infertility is a complex disorder, treatment involves significant financial, physical, psychological, and time commitments.
Although some women need just one or two therapies to restore fertility, several different types of treatment may be needed.
Treatments can either attempt to restore fertility through medication or surgery, or help you get pregnant with sophisticated techniques.
Infertility treatment
Fertility drugs regulate or stimulate ovulation. Fertility drugs are the main treatment for women who are infertile due to ovulation disorders.
Fertility drugs generally work like the natural hormones – follicle-stimulating hormone (FSH) and luteinizing hormone (LH) – to trigger ovulation.
They are also used in women who ovulate to try to stimulate a better egg or an extra egg or eggs.
Risks of fertility drugs
Using fertility drugs carries some risks, such as:
Pregnancy with multiples: Oral medications carry a fairly low risk of multiples (less than 10 percent) and mostly a risk of twins.
Your chances increase up to 30 percent with injectable medications. Injectable fertility medications also carry the major risk of triplets or more (higher-order multiple pregnancy).
Generally, the more fetuses you are carrying, the greater the risk of premature labour, low birth weight, and later developmental problems. Sometimes adjusting medications can lower the risk of multiples, if too many follicles develop.
Ovarian hyperstimulation syndrome (OHSS): Injecting fertility drugs to induce ovulation can cause OHSS, which causes swollen and painful ovaries.
Signs and symptoms usually go away without treatment and include mild abdominal pain, bloating, nausea, vomiting, and diarrhea.
If you become pregnant, however, your symptoms might last several weeks.
Rarely, it’s possible to develop a more severe form of OHSS that can also cause rapid weight gain, enlarged, painful ovaries, fluid in the abdomen, and shortness of breath.
Long-term risks of ovarian tumours: Most studies of women using fertility drugs suggest that there are few if any, long-term risks.
However, a few studies suggest that women taking fertility drugs for 12 or more months without a successful pregnancy may be at increased risk of borderline ovarian tumors later in life.
Women who have never had pregnancies have an increased risk of ovarian tumors, so it may be related to the underlying problem rather than the treatment.
Since success rates are typically higher in the first few treatment cycles, re-evaluating medication use every few months and concentrating on the treatments that have the most success appear to be appropriate.
Fertility restoration: Surgery
Several surgical procedures can correct problems or otherwise improve female fertility. However, surgical fertility treatments are rare these days due to the success of other treatments. They include:
Laparoscopic or hysteroscopic surgery: These surgeries can remove or correct abnormalities to help improve your chances of getting pregnant.
Surgery might involve correcting an abnormal uterine shape, removing endometrial polyps and some types of fibroids that misshape the uterine cavity, or removing pelvic or uterine adhesions.
Tubal surgeries: If your fallopian tubes are blocked or filled with fluid (hydrosalpinx), your doctor may recommend laparoscopic surgery to remove adhesions, dilate a tube or create a new tubal opening.
This surgery is rare, as pregnancy rates are usually better with IVF. For hydrosalpinx, removal of your tubes (salpingectomy) or blocking the tubes close to the uterus can improve your chances of pregnancy with IVF.
Reproductive assistance
The most commonly used methods of reproductive assistance include:
Intrauterine insemination (IUI): During IUI, millions of healthy sperm are placed inside the uterus close to the time of ovulation.
Assisted reproductive technology: This involves retrieving mature eggs from a woman, fertilising them with a man’s sperm in a dish in a lab, then transferring the embryos into the uterus after fertilisation.
IVF is the most effective assisted reproductive technology. An IVF cycle takes several weeks and requires frequent blood tests and daily hormone injections.