Let's make things simple for you, and give you an overview of the kinds of treatments available, costs involved and medicines.
Fertility treatments are of three major types:
1. Fertility drugs – Medicines are given, either orally or by injections, to help with ovulation.
2. Surgery – Required when the cause of infertility requires surgical intervention.
3. Assisted conception – where doctors help with the fertilization of the egg and/or implantation in the uterus.
Depending upon the type of infertility, these methods might be used in combination by your doctor.
Medicines that help improve infertility:
These are mainly to help stimulate ovulation.
• Clomiphene is a medicine taken orally, that helps make more of the hormones that cause the eggs to mature. It induces the ovaries to release eggs. Studies say that the results with clomiphene are quite good, but there might be a small chance of multiple births (twins/triplets).
• Medicines that contain gonadotrophins are injected into the blood. They stimulate eggs to grow in ovaries. The chance of multiple pregnancy could be greater here, than with clomiphene.
• Metformin is used to treat PCOS (Polycystic Ovarian Syndrome) which is a hormone imbalance problem.
• If the woman has abnormally high levels of the hormone prolactin, it can impede ovulation. To treat this, Bromocriptine and Cabergoline are given in the form of oral pills.
Please contact your doctor to know which may be most suitable for your particular condition.
• Blocked or damaged fallopian tubes – In some women, the fallopian tube might be damaged by pelvic inflammatory disease or it could be scarred by an infection or from a previous disease. Or the tube could be damaged by a previous surgery for an ectopic pregnancy. Keyhole surgery can set these problems right by removing blocks and repairing tubes.
• Endometriosis – This is a condition where endometrial tissue (the tissue that lines the uterus) appears outside the uterine cavity. Laparoscopic surgery for this is known to have high success rates in treating infertility. Statistics show that if endometriosis was the cause for infertility, the chances of conceiving might even double after this surgery.
• PCOS (Polycystic Ovarian Syndrome) – Keyhole surgery is performed to remove some of the cysts that have developed on the ovaries. This is usually done only if all other treatments for PCOS have failed to work.
• IVF – In-vitro fertilization (Literally, fertilization in glass) - In this process, fertility medicines are given to the woman to induce her ovaries to make more eggs than usual. These eggs are harvested, and placed in a petri dish. Sperms from her partner are introduced into the dish, and the dish is placed in a favourable environment, to let the sperms fertilize the eggs. If embryos are formed, they are placed in the woman's uterus, and are allowed to be implanted. Extra embryos can be frozen for later use in case the first set of embryos don't implant and grow. According to research, the success rate for IVF is very encouraging, particularly in women who are less than 35 years old.
• ICSI (pronounced Ick-see) – Intracytoplasmic sperm injection - In this method, a single sperm is injected into the outer part of the egg (the cytoplasm). This egg is then placed inside the uterus. This method is used when the sperm finds it difficult to penetrate the outer part of the egg to fertilize it. It is also used when the sperm count of the male is low, as only one sperm is required.
• Intrauterine insemination (IUI) – Healthy sperm is placed directly in the uterus during the time the woman ovulates.
The other options include using a donor egg/sperm/embryo, or else, placing the fertilized egg in a surrogate mother's womb, where it grows to full term.
Complications and Risks of fertility treatments
• Multiple pregnancies – Twins, and sometimes triplets are very common in women who have undergone fertility treatments. This is because the ovaries have been induced to produce more number of eggs, and many eggs might be released at one time, resulting in fertilization of all of them. You cannot really call this a risk or a complication, because it is a joy for most parents. But it cannot be denied that the risks associated with the pregnancy and delivery are higher.
• Ectopic pregnancy – Especially if the reason for infertility is due to a problem in the fallopian tubes, fertility treatment might increase chances of an ectopic pregnancy.
• OHSS – Ovarian hyperstimulation syndrome – Caused by the use of fertility drugs to induce ovulation. The ovaries can become overstimulated, and swell due to cysts that form on them. It can be painful, and be accompanied by nausea. This is easily treatable, though.
• Bleeding/infection – Though the risk is small, there is a chance of infection or bleeding in case of assisted reproductive techniques.
• Stress – Fertility treatments are often long-drawn out, and invasive. It costs time, energy, is expensive, and if results are not immediately apparent, it can be quite depressing. This can lead to stress and cause trouble between the couple. It helps to keep all communication lines open between the partners, and the doctors.
ALWAYS consult with your doctor about what is the right treatment for you. Thankfully, most fertility treatments are well-developed, and fertility clinics are kind and welcoming. Hopefully, things should work out quickly for you!