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Anyone who has ever had trouble getting pregnant knows that fertility struggles can be overwhelming and heartbreaking. Luckily there are tons of ffertility treatments out there who can help — but first doctors need to get to the bottom of the matter.
Although there are times when doctors cannot figure out exactly what is going on, they are often able to diagnose the problem – and this is because fertility issues are very common. “Infertility is a medical condition in which the ability to conceive and give birth to a child is limited or impaired in some way. Patients who struggle with infertility often feel alone, but infertility is actually very common. , which is an estimated one in seven couples, ”explains Dr. Elliott Richards, MD Director of Reproductive Endocrinology and Infertility Research, Cleveland Clinic. “While not all of these people seek treatment, the CDC reports that 12% of all women of childbearing age use some form of fertility service.”
Dr Richards says fertility treatments address the underlying cause of infertility, so certain fertility treatments may not work for some patients. If you are considering talking to your doctor about fertility treatments and want to understand what options are available, here is everything you need to know.
Are fertility treatments right for you?
Infertility is often defined as the inability to conceive after 12 months despite regular intercourse and regular menstrual cycles, or six months if the woman is 35 or older, explains Dr. Richards. “While this is a good general rule, this definition does not apply to many patients, such as single individuals who want to be a parent, many transgender individuals, patients in same-sex relationships, or patients with recurrent miscarriages,” he says. “In addition, fertility treatments can be used by patients who do not want to become pregnant yet, but want to preserve their fertility for personal or medical reasons.”
Dr. Richards adds that the best way to determine if you need fertility treatments is to talk to your gynecologist or a reproductive endocrinologist first. For men, there are urologists trained in male fertility who can also help.
There are a variety of fertility treatments that can help with pregnancy, so here is a look at the different types of treatments that can help you expand your family.
1. Medications to cause ovulation
Dr Richards says for a woman without regular menstrual cycles and ovulations, there are oral and injectable medications to help cause ovulation. “The most common two are clomiphene citrate (Clomid) and letrozole (Femara),” he says. Both of these medications help stimulate the ovaries to correct irregular ovulation and suppress estrogen production. There are also hormone shots called gonadotropins that will stimulate ovulation directly. Metformin is also used if your irregular ovulation is caused by polycystic ovary syndrome (PCOS). It is commonly used to treat diabetes, but it also works to sensitize insulin levels to ensure regular ovulation.
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2. Medication to improve egg or sperm quality
“There are supplements that can improve egg and sperm quality, but typically they are not enough on their own and are done in combination with another treatment,” says Dr. Richards.
3. Surgery to reverse a previous tubal ligation
All hope is not lost for women who previously tied their tubes and now want a child. Dr. Richards says talk to your doctor to find out if you are a candidate for surgery to reconnect the tubes.
4. Surgery to repair a blocked tube
Sometimes surgical measures will have to be taken to repair part of the reproductive system. “Tubes can be damaged by pelvic infections and inflammatory conditions such as endometriosis. In some cases, the clogged fallopian tubes can be surgically repaired, depending on the location and extent of the damage and the condition of the tube, ”explains Dr Richards.
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5. Surgery to remove a uterine polyp, fibroid, adhesion or septum
“If the uterine cavity, which is the inside of the uterus where the embryo implants and the fetus grows, is damaged or distorted, fertility can be affected. Special hysteroscopic procedures can be performed where a small extent is placed through the cervix to guide small instruments to remove lesions and restore the normal cavity, ”says Dr. Richards. Skin incisions are not done, so it is the least invasive.
6. Surgery to remove endometriosis
Endometriosis is a painful disorder where the tissue that normally occupies the inside of your uterus grows outside the uterus and attaches itself to nearby organs. “Endometriosis is an inflammatory condition that affects 10% of reproductive women and is a common cause of unexplained infertility. “Surgery can be performed to diagnose and treat endometriosis lesions, which can improve fertility in some patients,” says Dr. Richards.
7. Surgery to transplant a uterus
No, this is not just a storyline for the program Grays Anatomy, you may actually have a uterine transplant. “For women without a functional uterus, a uterus can be temporarily transplanted into their body so that they can carry children. Although it is not yet available for men or transgender women, many predict that this treatment will one day be available for this population, ”said Dr. Richards said.
8. Intrauterine insemination (IUI)
It is a simple office procedure where the male sperm is washed and prepared, then a small catheter is inserted through the woman’s cervix to inject the sperm directly into the uterine cavity. The goal of this treatment is to improve the chances of conception by increasing the number of healthy sperm that reach the fallopian tubes when the woman is most fertile. This procedure may be right for couples dealing with low sperm counts or poor sperm motility, same-sex couples or couples using a surrogate, or single women who want to have a child on their own.
9. In vitro fertilization (IVF)
“In this complex procedure, the ovaries are stimulated with medication for several days and eggs are extracted and fertilized in a specialized laboratory. The resulting embryos are either transferred to the uterus or frozen for future use, ”says Dr. Richards. IVF has several stages and cycles, and you will start taking hormone injections that can have some unpleasant side effects.
IVF can be a good choice for those dealing with severe fallopian tube blockages, ovulation problems, reduced ovarian reserve, poor egg quality, PCOS, endometriosis or sperm deficiency. “IVF is able to treat many male fertility problems, such as low sperm counts or abnormally shaped sperm. For men with extremely low sperm counts, special sperm extraction procedures can be done with IVF. For some men, there may be medication and surgery to improve sperm counts without extracting sperm, ”adds dr. Richards by.
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10. Egg freezer
It is a process in which medication is used to stimulate a woman’s ovaries to produce multiple adult eggs. Dr Richards says the procedure is similar to IVF, except that the eggs are immediately frozen and stored for future use. Once you are ready to get pregnant, the eggs are thawed and fertilized with your partner’s or donor’s sperm and implanted in the uterus using the IVF procedure. A simple blood test to determine your levels of anti-mullerian hormone will indicate how many eggs you have left in your ovaries to help you decide if this is the best option.
A surrogate carries a child for another woman or couple of the same sex. The parents undergo IVF and the embryo is implanted in the surrogate’s uterus. Both parents have a genetic link with the baby, but the surrogate does not. “Many patients use egg and / or sperm donors in IUI or IVF procedures above, or they may use a pregnancy surrogate to carry their genetic offspring,” says Dr. Richards. Surrogate costs can often skyrocket to more than $ 100,000, depending on fertility costs, the surrogate’s medical costs, legal costs, and any other associated costs.
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