Treatments for Infertility

Approximately 6.1 million couples in the US are battling infertility. Thanks to scientific advances, there are now several treatment options which can allow these couples to become parents.

Treatments for Infertility

According to a recent survey published by the Centers for Disease Control, approximately 10% of the child bearing population is affected by infertility. Many times the cause of infertility is unknown but can be contributed equally to each sex. Of the 6.1 million couples faced with infertility, 85-90% choose conventional therapies such as medication or surgery while less than 3% opt for In Vitro Fertilization (IVF) or similar treatment.

Treatment Options

Female Infertility

Ovulation Induction: Ovulation disorders are the most common reason for infertility in women. Treatment involves the administration of drugs to induce ovulation. Examples of these drugs include Clomid, Bravelle, Gonal-F, Repronex, Follistim, and Pergonal.

Artificial Insemination: This treatment involves the injection of sperm into the female reproductive tract to facilitate fertilization.

Assisted Reproductive Technology (ART): There are several types of ART. All involve removal of the egg from the female to assist fertilization.

• In Vitro Fertilization (IVF): IVF is the least invasive of the ART procedures and is often the best choice for women with blocked fallopian tubes, couples with male factor infertility, and couples with unexplained infertility who have not been successful with less advanced treatments. As part of IVF, the female is given fertility drugs to stimulate the growth of multiple eggs. The eggs are then extracted and placed with sperm so fertilization can occur. The embryos are then placed into the female's uterus where they will hopefully implant and mature. The female is given daily injections of progesterone which helps the uterus become more hospitable to implantation. The average success rate of IVF is greater than 40%. Women who smoke or are obese often incur a lower success rate.

• Intracytoplasmic Sperm Injection (ICSI): Initially used only in cases involving severe male factor infertility, ICSI is now used in cases involving poor egg quality, limited number of eggs, advanced age, and moderate male factor infertility. This procedure is similar to IVF but differs in that an entire sperm is injected directly into the egg resulting in fertilization.

• Gamete Intrafallopian Transfer (GIFT): This procedure is similar to IVF in that the female is given fertility drugs to stimulate the growth of multiple eggs which are then extracted. The egg and sperm are then both placed directly into the fallopian tubes where, hopefully, fertilization will occur.

• Zygote Intrafallopian Transfer (ZIFT): Very similar to IVF, ZIFT involves the administration of fertility drugs and the removal of eggs. The fertilized eggs become a zygote and are not allowed to develop into an embryo. The zygotes are then placed in the fallopian tubes.

• Intrauterine Insemination (IUI): In this procedure, sperm are washed to remove extra cells and debris so the greatest concentration of mobile sperm can be obtained. The sperm are then injected directly into the woman's uterus. IUI is typically recommended for couples with no known cause of infertility.

Female Reproductive Surgery: Reproductive surgery can be used to treat female infertility caused by tubal obstruction, endometriosis, uterine fibroids, and scarring from pelvic inflammatory disease (PID),

• Laparotomy Microsurgery: This type of surgery involves the use of a microscope and is used to remove scar tissue, treat endometriosis, and repair fallopian tubes.

• Laparoscopy: Often used to remove scar tissue and endometriosis and to correct damage to the fallopian tubes, laparoscopy involves the insertion of a laparoscope through a small incision. A laparoscope is a narrow telescope-like instrument which is often inserted through the navel.

• Hysteroscopy: A hysteroscopy is often used to detect and treat fibroid tumors, endometrial polyps, intrauterine scar tissue, and other uterine problems. During this type of surgery, a fiber optic scope is inserted through the vagina and cervix into the uterine cavity.

• Falloposcopy: Tubal obstructions can often be corrected with this procedure which involves the insertion of a fiber optic scope to inspect the fallopian tubes.

Male Infertility

In 50% of cases, a couple's infertility can be contributed to the male partner. Male infertility is often due to low sperm count or poor sperm quality. There are several techniques used to collect sperm which will later be used to fertilize the egg.

• Sperm washing: This procedure increases sperm mobility by removing debris, dead cells, and seminal fluid.

• Swim-up: A modification of sperm washing, the swim-up procedure involves placing the sperm in a culture medium which they will swim up leaving seminal fluid and debris including white blood cells, dead sperm, and bacteria behind.

• Percutaneous Epididymal Sperm Aspiration (PESA): Often used in men lacking a vas deferens and those who have had a vasectomy, PESA entails the insertion of a small needle directly into the epididymis in order to remove sperm.

Male Reproductive Surgery

• Vasoepididymostomy: Used to clear obstructions in the epididymis, this procedure is the most difficult microsurgical procedure for the treatment of male infertility.

• Varicocelectomy: Varicoceles, enlargements of the veins surrounding the testicle, are the most common cause of male factor infertility. A varicocelectomy is performed to repair the varicocele and improve testicular function.

Low-Tech Options

Some studies suggest that acupuncture, consumption of herbs, and a change in diet can increase fertility. Acupuncture helps regulate body systems, normalize hormone levels, and increase blood flow which can improve the health of the reproductive system. Herbs can balance hormone levels and help improve conditions for conceiving. Before beginning consumption of any herbs, speak to someone who is knowledgeable of the subject as some herbs may have an adverse affect. Avoid processed foods and increase intake of organic foods. Females should consider eating more yams and males should consider eating more foods high in zinc. Relaxation, stress management, yoga, and meditation can also do wonders for fertility problems.

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