Medical ways to get pregnant

Fertility Treatments For Infertility

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Fertility Treatments
What is IVF?

What is IUI?

What fertility treatment options do I have?

If you’re struggling with infertility and need help getting pregnant, there are fertility treatments that can help increase your chances of having a baby.

What are the different types of fertility treatments?

Thanks to technology, there are lots of ways to help people with all kinds of fertility issues. The options that are best for you depend on your personal situation and what’s causing your infertility.

Sometimes only one person needs treatment, other times both partners will use a combination of treatments together.

Fertility treatments often include medications that help with hormones and ovulation, sometimes combined with minor surgical procedures. Assisted Reproductive Technology (ART) describes several kinds of procedures that can help you have a baby. ART includes procedures that make it easier for sperm to fertilize an egg, and help the egg implant in your uterine lining.

Two of the most common fertility treatments are:

intrauterine insemination (IUI)
in vitro fertilization (IVF)

Cryopreservation (aka freezing your eggs, sperm, or embryos), egg or embryo donation, and gestational carriers (aka surrogacy) are also forms of ART.

Donor sperm, donor eggs, and surrogates are often used by same-sex couples or single people who want to have a baby. You can also use sperm and/or eggs from a donor if a problem with your own sperm cells or eggs is causing infertility issues.

Talking with a doctor who specializes in pregnancy and/or infertility can help you figure out which treatments are best for you. Your family doctor or gynecologist can refer you to a fertility specialist. You may also be able to get fertility treatments, or help finding a fertility specialist in your area, from your local Planned Parenthood health center.

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Female infertility - Diagnosis and treatment

Diagnosis

Hysterosalpingography

A doctor or technician places a slender catheter inside your cervix. It releases a liquid contrast material that flows into your uterus. The dye traces the shape of your uterine cavity and fallopian tubes and makes them visible on X-ray images.

If you've been unable to conceive within a reasonable period of time, seek help from your doctor for evaluation and treatment of infertility. You and your partner should be evaluated. Your doctor will take a detailed medical history and conduct a physical exam.

Fertility tests might include:

Ovulation testing. An at-home, over-the-counter ovulation prediction kit detects the surge in luteinizing hormone (LH) that occurs before ovulation. A blood test for progesterone — a hormone produced after ovulation — can also document that you're ovulating. Other hormone levels, such as prolactin, also might be checked.
Hysterosalpingography. During hysterosalpingography (his-tur-o-sal-ping-GOG-ruh-fee), X-ray contrast is injected into your uterus and an X-ray is taken to check for problems inside the uterus. The test also shows whether the fluid passes out of the uterus and spills out of your fallopian tubes. If any problems are found, you'll likely need further evaluation.
Ovarian reserve testing. This testing helps determine the quality and quantity of eggs available for ovulation. Women at risk of a depleted egg supply — including women older than 35 — might have this series of blood and imaging tests.
Other hormone testing. Other hormone tests check levels of ovulatory hormones as well as thyroid and pituitary hormones that control reproductive processes.
Imaging tests. A pelvic ultrasound looks for uterine or fallopian tube disease. Sometimes a sonohysterogram, also called a saline infusion sonogram, or a hysteroscopy is used to see details inside the uterus that can't be seen on a regular ultrasound.

Depending on your situation, rarely your testing might include:

Laparoscopy. This minimally invasive surgery involves making a small incision beneath your navel and inserting a thin viewing device to examine your fallopian tubes, ovaries and uterus. A laparoscopy can identify endometriosis, scarring, blockages or irregularities of the fallopian tubes, and problems with the ovaries and uterus.
Genetic testing. Genetic testing helps determine whether there any changes to your genes that may be causing infertility.

Treatment

Infertility treatment depends on the cause, your age, how long you've been infertile and personal preferences. Because infertility is a complex disorder, treatment involves significant financial, physical, psychological and time commitments.

Treatments can either attempt to restore fertility through medication or surgery, or help you get pregnant with sophisticated techniques.

Medications to restore fertility

Medications that regulate or stimulate ovulation are known as fertility drugs. Fertility drugs are the main treatment for women who are infertile due to ovulation disorders.

Fertility drugs generally work like natural hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation. They're also used in women who ovulate to try to stimulate a better egg or an extra egg or eggs.

Fertility drugs include:

Clomiphene citrate. Taken by mouth, this drug stimulates ovulation by causing the pituitary gland to release more FSH and LH, which stimulate the growth of an ovarian follicle containing an egg. This is generally the first line treatment for women younger than 39 who don't have PCOS.
Gonadotropins. These injected treatments stimulate the ovary to produce multiple eggs. Gonadotropin medications include human menopausal gonadotropin or hMG (Menopur) and FSH (Gonal-F, Follistim AQ, Bravelle).

Another gonadotropin, human chorionic gonadotropin (Ovidrel, Pregnyl), is used to mature the eggs and trigger their release at the time of ovulation. Concerns exist that there's a higher risk of conceiving multiples and having a premature delivery with gonadotropin use.
Metformin. This drug is used when insulin resistance is a known or suspected cause of infertility, usually in women with a diagnosis of PCOS. Metformin (Fortamet) helps improve insulin resistance, which can improve the likelihood of ovulation.
Letrozole. Letrozole (Femara) belongs to a class of drugs known as aromatase inhibitors and works in a similar fashion to clomiphene. Letrozole is usually used for woman younger than 39 who have PCOS.
Bromocriptine. Bromocriptine (Cycloset, Parlodel), a dopamine agonist, might be used when ovulation problems are caused by excess production of prolactin (hyperprolactinemia) by the pituitary gland.

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%) and mostly a risk of twins. Your chances increase up to 30% with injectable medications. Injectable fertility medications also carry the major risk of triplets or more.

Generally, the more fetuses you're carrying, the greater the risk of premature labor, low birth weight and later developmental problems. Sometimes, if too many follicles develop, adjusting medications can lower the risk of multiples.
Ovarian hyperstimulation syndrome (OHSS). Injecting fertility drugs to induce ovulation can cause OHSS, which is rare. Signs and symptoms, which include swollen and painful ovaries, usually go away without treatment, and include mild abdominal pain, bloating, nausea, vomiting and diarrhea.

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 tumors. 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 might be at increased risk of borderline ovarian tumors later in life.

Women who never have pregnancies have an increased risk of ovarian tumors, so it might be related to the underlying problem rather than the treatment. Since success rates are typically higher in the first few treatment cycles, reevaluating medication use every few months and concentrating on the treatments that have the most success appear to be appropriate.

Surgery to restore fertility

Several surgical procedures can correct problems or otherwise improve female fertility. However, surgical treatments for fertility are rare these days due to the success of other treatments. They include:

Laparoscopic or hysteroscopic surgery. Surgery might involve correcting problems with the uterine anatomy, 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, your doctor might 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 in vitro fertilization (IVF). For this surgery, removal of your tubes 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 around the time of ovulation.
Assisted reproductive technology. This involves retrieving mature eggs, fertilizing them with sperm in a dish in a lab, then transferring the embryos into the uterus after fertilization. IVF is the most effective assisted reproductive technology. An IVF cycle takes several weeks and requires frequent blood tests and daily hormone injections.

More Information

In vitro fertilization (IVF)

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Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Coping and support

Dealing with infertility can be physically and emotionally exhausting. To cope with the ups and downs of infertility testing and treatment, consider these strategies:

Learn all you can. Ask your doctor to explain the steps for your therapy to help you and your partner prepare. Understanding the process might help reduce your anxiety.
Seek support. Although infertility can be a deeply personal issue, reach out to your partner, close family members or friends, or a professional for support. Many online support groups allow you to discuss issues related to infertility without identifying yourself.
Exercise and eat a healthy diet. Keeping up a moderate exercise routine and eating healthy foods can improve your outlook and keep you focused on living your life despite fertility problems.
Consider other options. Determine alternatives — adoption, donor sperm or egg, or even having no children — as early as possible in the infertility treatment process. This can reduce anxiety during treatments and disappointment if conception doesn't occur.

Preparing for your appointment

For an infertility evaluation, you'll likely see a doctor who specializes in treating disorders that prevent couples from conceiving (reproductive endocrinologist). Your doctor will likely want to evaluate both you and your partner.

What you can do

To prepare for your appointment:

Chart menstrual cycles and associated symptoms for a few months. On a calendar or an electronic device, record when your period starts and stops and how your cervical mucus looks. Make note of days when you and your partner have sex.
Make a list of all medications, vitamins, herbs or other supplements you take. Include the doses and how often you take them.
Bring previous medical records. Your doctor will want to know what tests you've had and what treatments you've tried.
Bring a notebook or electronic device with you. You may receive a lot of information at your visit, and it can be difficult to remember everything.
Think about what questions you'll ask. List the most important questions first to be sure that they get answered.

Some basic questions to ask include:

When and how often should we have sex if we hope to conceive?
Are there lifestyle changes we can make to improve the chances of getting pregnant?
Do you recommend testing? If so, what kind?
Are medications available that might improve the ability to conceive?
What side effects can the medications cause?
Would you explain our treatment options in detail?
What treatment do you recommend in our situation?
What's your success rate for assisting couples in achieving pregnancy?
Do you have brochures or other printed materials we can have?
What websites do you recommend?

Don't hesitate to ask other questions you have.

What to expect from your doctor

Some potential questions your doctor or other health care provider might ask include:

How long have you been trying to become pregnant?
How often do you have sex?
Have you ever been pregnant? If so, what was the outcome of that pregnancy?
Have you had pelvic or abdominal surgeries?
Have you been treated for gynecological conditions?
At what age did you start having periods?
On average, how many days pass between the beginning of one menstrual cycle and the beginning of your next menstrual cycle?
Do you have premenstrual symptoms, such as breast tenderness, abdominal bloating or cramping?

By Mayo Clinic Staff

Associated Procedures

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12 ways / “I want a child”

#6(25) 2010

Nona Hovsepyan, Consultant Physician, Independent Laboratory INVITRO

Only 25% of couples manage to conceive a child in the first month of unprotected sexual activity. How to become one of the lucky ones?

1. Review your diet

No weight loss programs: eating low-calorie foods negatively affects fertility hormones. Part of estrogen (female sex hormones) is synthesized not only in the ovaries, but also in adipose tissue. Less fat means less estrogen. Try to eat more vegetables, fruits, and fiber-rich foods (wholemeal bread, rice, and pasta). Folic acid, essential for both conception and pregnancy, can be found in leafy green vegetables such as kale, broccoli, or spinach. Proteins and iron, which affect the general condition of the ovaries and the mechanism of ovulation, are found in large quantities in legumes. A source of calcium that a baby will definitely need is dairy products. And in order for the body to receive omega-3 fatty acids, which provide blood flow to the uterus, it is recommended to include salmon in the diet. Vegetable fats are useful - "suppliers" of vitamin E, which, by the way, should be taken at least three months before the planned conception. It is better to refuse sweets: an increase in blood sugar provokes an excessive release of adrenaline, a hormone that “attacks” progesterone, which is useful for conception.

2. Stop smoking

Trite, but effective. In men, nicotine reduces spermatogenesis, that is, it delays the formation of spermatozoa and impairs their mobility, and in women it reduces the level of estradiol, the most active sex hormone. According to a study published by the British Medical Association, smoking even one of the couple reduces the chances of getting pregnant by 10-40%. In addition, this habit reduces sexual desire and causes a lack of orgasm. So give up cigarettes yourself and try to avoid secondhand smoke in public places.

3. Check first aid kit

During ovulation, do not take anti-inflammatory drugs and analgesics: they negatively affect the hormonal balance. Decongestants and antihistamines can cause vaginal dryness and thickening of cervical mucus, making it difficult for sperm to move.

Taking antibiotics provokes a violation of the bacterial flora in the vagina: you have to wait 1-2 cycles with conception. After the end of any drug therapy, it is worth leaving attempts to get pregnant for a month, since the removal of drugs from the body lasts several weeks. Important: this does not apply to vitamins, in the period of preparation for pregnancy they will be very useful!

4. Track your ovulation

It is more customary, of course, to start a calendar and count the 14-16th day from the beginning of menstruation. But it is better and more reliable to use special tests: ovulation can occur on other days of the menstrual cycle, especially if it is irregular. Do not forget about the well-known method for determining ovulation - measuring basal temperature. To determine the nature of ovulation, you need to carry out this procedure for 3-5 menstrual cycles.

5. Maintain the rhythm

Abstaining from sex for more than seven days may reduce male fertility. This has been proven by scientists. At this time, the amount of sperm increases, but not its quality. However, in men who have an intense sex life, the quality of sperm also suffers - it simply does not have time to be produced. The optimal mode is sex 3-4 times a week.

6. Maintain posture

The most favorable posture depends on how the woman is "arranged". If the uterus is in the middle position or tilted forward from the small pelvis, there are no restrictions. And with the uterus tilted back (retroversial position), spermatozoa may have difficulties. In some cases, doctors recommend lying on your stomach, in others, lifting your hips up. When sperm enters the vagina, only diseases of the cervix can interfere with sperm. The flow of part of the "extra" sperm after sexual intercourse is completely natural.

7. Call your parents...

...to learn about possible genetic and hereditary diseases in the family. Regardless of the information received, it is worth going to a consultation with a geneticist. The specialist is able to detect hidden problems that can have a negative impact on conception, pregnancy or the health of the unborn baby. Children with congenital defects can also be born to completely healthy parents due to disorders in the germ cells.

8. Manage physical activity

Any kind of aerobic activity - dancing, cycling, swimming, even walking - makes the heart and lungs work harder, and oxygen-rich blood is carried throughout the body, including the reproductive system. Doctors advise to pay attention to strengthening the back and abdominals, but physical activity should not be intense. A couple of months before the intended conception, it is better to slow down the pace. Active training causes a protective reaction of the body: it is not up to pregnancy, all efforts are directed to the development of muscles, the excessive tension of which leads to a reflex change in the contractile activity of the fallopian tubes and uterus. This may interfere with fertilization.

9. Visit doctors

It is necessary to check for the presence of various chronic infections: toxoplasmosis, chlamydia, cytomegalovirus, herpes. Before conception, you need to cure these diseases and undergo a rehabilitation course. During pregnancy, due to a physiological decrease in immunity, all “hidden” diseases can appear. Go to the dentist: gingivitis and periodontitis (inflammation of the gums) interfere with the normal functioning of sex hormones. Underweight or overweight in women: both lead to irregular cycles and disruption of ovulation. It does not hurt to check at the clinic whether all routine vaccinations have been made: it is more than undesirable to get measles or rubella during pregnancy.

10. Be careful with "chemistry"

Certain chemicals found in household products can cause hormonal imbalances. If the substance smells strongly, you need to wear a mask when cleaning. It is better to prefer liquid cleaners to aerosols. Do not remove stains on clothes at home: take things to dry cleaning.

11. Do not overheat partner

The optimal temperature for sperm maturation is about 2 degrees below the general body temperature of a man. To ensure this temperature in the groin area, underwear should be made from natural materials and have a free form. Wearing tight pants, synthetic underwear, hot baths, saunas, heated car seats can interfere with fertility.

12. Learn to relax

Even in the most busy schedule, you need to find time to relax. Any pastime in the company of a loved one is a long-tested means of restoring peace of mind. You can do interesting things, go to the cinema or theater, spend time in nature. This will strengthen relationships, bring spouses closer, and relieve the stress that accompanies trying to conceive a child.

How can you speed up the onset of conception?

Despite the fact that conception is a rather complicated process, it is relatively easy for many couples. Approximately 85% of women become pregnant within a year of stopping the use of contraceptives. However, it also happens that, despite all the efforts of the spouses, conception does not occur. If you are facing such problems, our IVF center can help you.

Every woman may have her own reasons why she wants to become a mother as soon as possible. For those who wish to accelerate the onset of pregnancy, doctors recommend:

Pass a medical examination to exclude the presence of any diseases and pathologies.
Learn to determine the onset of ovulation. This can be helped by special tests that can be bought at a pharmacy, as well as keeping a graph of basal temperature.
Normalize power mode. It is necessary to give preference to natural products, saturated with vitamins and nutrients.
Try to avoid stress and overwork.
Get rid of bad habits such as smoking and drinking alcohol.
Be sure to have sex 1-3 days before and during ovulation.

For men, doctors recommend leading a healthy lifestyle, avoiding baths and saunas, as well as wearing tight underwear. Do not carry a mobile phone in a trouser pocket, as electromagnetic radiation can adversely affect sexual function. If you want to become a father as soon as possible, you should avoid taking medications, especially painkillers, antihistamines and antibiotics, as they negatively affect spermatogenesis, but we recommend that you consult with your doctor before stopping drugs or starting them.

Both spouses are encouraged to control their weight. In women, body weight directly affects ovulation and the ability to conceive, since certain hormones are produced in adipose tissue. Obesity in men leads to impaired spermatogenesis.

If you need to lose weight, you should avoid strict diets, as they reduce the intake of vitamins and nutrients in the body, and this negatively affects the ability to conceive. It would be much more expedient to normalize your diet, include in the diet as many fresh vegetables and fruits as possible. Men are advised to consume nuts, meat, grains and seafood as they improve spermatogenesis. To develop an individual diet, you can always visit a dietitian.

Mothers and grandmothers often give young women advice on how to get pregnant as soon as possible. Thus, folk signs are formed, which are passed down from generation to generation. If you want, you can test their effect on yourself: it will not make you worse in any case. For example, some women claim that wearing pearl jewelry helped them get pregnant quickly. Agate stone also has the property to accelerate the onset of conception.

Representatives of the older generation often argue that in order to quickly get pregnant, you need to grow geraniums or ficus at home. There are also signs according to which, in order to speed up conception, you need to stroke the belly of a pregnant woman, sit on a chair after her and take a picture with her. Many girls also claim that they managed to see the desired two stripes on a pregnancy test only after they stopped worrying about conception and let the situation take its course.