Treatment Options
Treatment for fertility issues typically takes place in phases that are customized to ensure your personal needs are met. First, your doctor may recommend a basic treatment option. If basic treatments do not result in a pregnancy, assisted reproductive technology may be necessary.
Basic Treatments
Ovulation induction
If an ovulatory problem is found, hormonal therapy is recommended. During a normal cycle, the hypothalamus releases a hormone called gonadtropin-releasing hormone (GnRH) at the beginning of a follicular phase. If too little or too much is released, follicle development will not take place and ovulation will not occur. Clomiphene citrate is often prescribed for women with ovulatory dysfunction whose partners are fertile.
Superovulation
Superovulation is the use of fertility drugs to stimulate multiple follicle development. It is also called controlled ovarian hyperstimulation.
Assisted Reproductive Technology
Artificial insemination
Artificial insemination involves placing sperm directly into a woman's reproductive tract around the time of ovulation. There are many types of artificial insemination. They include intracervical insemination, where the sperm is placed into the cervix; intratubal, where the sperm is placed into the fallopian tube; and intrauterine, where sperm is placed into the uterus. Intrauterine insemination is the most common procedure.
In vitro fertilization (IVF)
In vitro fertilization is the most commonly used assisted reproductive technology procedure. It involves placing a couple's sperm and egg together in a petri dish to fertilize. A number of fertilized eggs (embryos) are placed into the woman's uterus. This procedure typically occurs in conjunction with hormonal therapy to stimulate egg development and with intracytoplasmic sperm injection in cases of male factor fertility problems.
Intracytoplasmic sperm injection (ICSI)
In intracytoplasmic sperm injection (ICSI), a single sperm is injected into an egg, bypassing the need to have the sperm swim through the reproductive track and penetrate the egg. ICSI is often a procedure that allows men with very low amounts of weak sperm, the ability to enhance fertilization.
Assisted hatching
Early embryos are surrounded by an outer coating called the zona pellucida. The zona holds the embryo together. After an embryo arrives in the uterus, the outer zona coating dissolves. This allows the embryo to "hatch" and grow larger. The embryo must hatch prior to implantation and sometimes does not happen for some women. The procedure involves using a fine needle with acid to dissolve a portion of the outer coating of the embryo. Following the procedure, the embryos are returned to culture and then placed in the patients uterus later that day.
Cryopreservation
Embryos can be preserved for future pregnancy attempts. Once they are frozen and stored, they remain viable for a long period of time. This enables some embryos to be used with assistive reproductive technologies and some stored for future use. It may also lower the cost of these procedures, because the ovarian stimulation and egg retrieval do not have to be repeated.
Advanced Care for Women
Treatment for polycystic ovary syndrome, endrometriosis and uterine fibroids
MeritCare Reproductive Medicine offers treatment options for polycycstic ovary syndrome, endometriosis and uterine fibroids.