If you're experiencing infertility, you might worry that there's nothing you can do. You might feel hopeless, as if your dreams of becoming a parent are crumbling to dust. There's no need to jump to conclusions, however. A lot of infertility cases can be treated; even if they can't, there are other ways you can become a parent!
Key Points
- It's important to visit a doctor to get a proper fertility test done on both you and your partner. This will help guide your doctor to the right treatments.
- Drugs, surgery, and assisted reproductive technology are all ways that doctors can help treat your infertility.
- Even if your infertility is determined to be untreatable, there are still other ways to become a parent.
First Step: Getting a Fertility Test
The first step to treat infertility is to see a doctor for a fertility evaluation. He or she will test both the woman and the man, to find out where the problem is. The tests for the man can include:
- An x-ray to look at his reproductive organs
- A mucus penetrance test
- A hamster-egg penetrance assay. This will look to see if his sperm can go through hamster egg cells, somewhat showing their ability to fertilize human eggs.
Testing for the woman first looks at whether she is ovulating each month. This can be done by having her chart changes in her morning body temperature, by using an FDA-approved home ovulation test kit (which she can buy at a drug store), or by looking at her cervical mucus, which changes throughout her menstrual cycle.
Ovulation also can be checked in her doctor's office with an ultrasound test of the ovaries, or simple blood tests that check hormone levels, like the follicle-stimulating hormone (FSH) test.
FSH is produced by the pituitary gland. In women, it helps control the menstrual cycle and the production of eggs by the ovaries. The amount of FSH varies throughout the menstrual cycle and is highest just before an egg is released. The amounts of FSH and other hormones, such as luteinizing hormone, estrogen, and progesterone, are measured in both a man and a woman to determine why the couple cannot achieve pregnancy.
If the woman is ovulating, more testing will need to be done. These tests can include:
- An hysterosalpingogram (an x-ray to check if the fallopian tubes are open and to show the shape of the uterus)
- A laparoscopy (an exam of the tubes and other female organs for disease)
- An endometrial biopsy (an exam of a small shred of the uterine lining to see if monthly changes in it are normal)
Other tests can be done to show whether the sperm and mucus are interacting in the right way, or if the man or woman is forming antibodies that are attacking the sperm and stopping them from getting to the egg.
Infertility Treatment – Drugs and Surgery
Different treatments for infertility are recommended depending on what the problem is. About 90 percent of cases are treated with drugs or surgery. Various fertility drugs may be used for women with ovulation problems. It is important to talk with your doctor about the drug to be used.
You should understand the drug's benefits and side effects. Depending on the type of fertility drug and the dosage of the drug used, multiple births (such as twins) can occur in some women.
If needed, surgery can be done to repair damage to a woman's ovaries, fallopian tubes, or uterus. Sometimes a man's infertility problems can be corrected by surgery.
Infertility Treatment – Assisted Reproductive Technology (ART)
Assisted reproductive technology (ART) uses special methods to help infertile couples, and involves handling both the woman's eggs and the man's sperm. Success rates vary and depend on many factors. But ART has made it possible for many couples to have children that otherwise would not have been able to.
ART can be expensive and time-consuming. Many health insurance companies do not provide coverage for infertility or provide only limited coverage. Check your health insurance contract carefully to learn about what is covered. In addition, check your state's laws to see what they say about infertility coverage.
In vitro fertilization (IVF) is a type of ART that is often used when a woman's fallopian tubes are blocked or when a man has low sperm counts. A drug is used to stimulate the ovaries to produce multiple eggs. Once mature, the eggs are removed and placed in a culture dish with the man's sperm for fertilization.
After about 40 hours, the eggs are examined to see if they have become fertilized by the sperm and are dividing into cells. These fertilized eggs (embryos) are then placed in the woman's uterus, thus bypassing the fallopian tubes.
Gamete intrafallopian transfer (GIFT) is similar to IVF, but used when the woman has at least one normal fallopian tube. Three to five eggs are placed in the fallopian tube, along with the man's sperm, for fertilization inside the woman's body. Zygote intrafallopian transfer (ZIFT), also called tubal embryo transfer, combines IVF and GIFT. The eggs retrieved from the woman's ovaries are fertilized in the lab and placed in the fallopian tubes rather than the uterus.
Donation and Surrogacy
ART sometimes involves the use of donor eggs (eggs from another woman) or previously frozen embryos. Donor eggs may be used if a woman has impaired ovaries or has a genetic disease that could be passed on to her baby.
If a woman does not have any eggs, or her eggs are not of a good enough quality to produce a pregnancy, she and her partner might want to consider surrogacy. A surrogate is a woman who agrees to become pregnant using the man's sperm and her own egg. The child will be genetically related to the surrogate and the male partner, but the surrogate will give the baby to the couple at birth.
A gestational carrier might be an option for women who do not have a uterus, from having had a hysterectomy, but still have their ovaries, or for women who shouldn't become pregnant because of a serious health problem. In this case, the woman's eggs are fertilized by the man's sperm and the embryo is placed inside the carrier's uterus. In this case, the carrier will not be related to the baby, and will give the baby to the parents at birth.
Infertility Treatment – Take Care of You
If you've been having problems getting pregnant, you know how frustrating it can feel. Not being able to get pregnant can be one of the most stressful experiences a couple goes through.
Both counseling and support groups can help you and your partner talk about your feelings, and to help you meet other couples like you in the same situation. You will learn that anger, grief, blame, guilt, and depression are all normal. Couples do survive infertility, and can become closer and stronger in the process.
Ask your doctor for the names of counselors or therapists with an interest in fertility. It may be beneficial for both you and your partner to go through therapy together, since this experience is likely affecting both of you. There's no shame in needing some counseling for these issues. You may also want to search for an infertility support group, so that you can connect with couples having similar experiences.
Conclusion
Now you know all about how infertility is tested for and treated. The process can be lengthy and expensive, depending on what state you live in and what procedures you need. There's no reason to give up hope when struggling with infertility. As we covered in this article, even if you can't get pregnant the traditional way, there are still other ways to become a parent. Many couples experience these issues, so know that you aren't alone.
None of the information provided in this article should be taken as medical advice. If you have any concerns or questions about your health, please seek the advice of a qualified medical professional.
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