Your healthcare provider will discuss the best treatment with you based on:
- How old you are
- Your overall health and medical history
- How well you can handle specific medicines, procedures, or therapies
- How long the condition is expected to last
- Your opinion or preference
Once a diagnosis is made, you can work with a fertility expert to find the best treatment. Most people with infertility are treated with conventional therapies. This includes treatment with medicine or surgical repair of reproductive abnormalities. Depending on the cause of infertility, there are many choices to offer an infertile couple.
Types of treatments for women may include:
- Intrauterine insemination. This method uses a small flexible tube called a catheter to place specially washed and prepared sperm directly into the uterus. It may be used for low sperm count or cervical mucus problems. This method is often used along with ovulation medicines.
- Ovulation medicine. These medicines help regulate the timing of ovulation. They stimulate the growth and release of mature eggs. They can also help correct hormone problems that can affect the lining of the uterus. Ovulation medicines can stimulate more than one egg to be released. This raises the chance of having twins and other multiples. Some of the common medicines include:
- Clomiphene citrate
- Human menopausal gonadotropins. Medicines with follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
- Follicle-stimulating hormone (FSH)
- Surgery. Surgery may be used to treat or repair a condition such as blocked fallopian tubes or endometriosis. This may be done using laparoscopy. In a laparoscopy, a small telescope inserted into the abdominal or pelvic cavity lets the healthcare provider see internal organs. Some methods to treat infertility can be done using instruments inserted through the laparoscope.
- Assisted reproductive technology (ART). For some couples, more extensive treatment is needed. With most forms of ART, the sperm and egg are joined in the lab. The fertilized egg is then returned to the woman's uterus where it can implant and grow. While ART procedures are often costly, many are being used with success. These include:
- In vitro fertilization (IVF). This involves removing a woman's eggs and fertilizing them in the lab with sperm. The embryo is then transferred into the woman's uterus through the cervix. Most couples transfer two embryos. More may be transferred in certain cases. IVF is the most common form of ART. It is often the treatment of choice for a woman with blocked, severely damaged, or absent fallopian tubes. IVF is also used for infertility caused by endometriosis or male factor infertility. IVF is sometimes used to treat couples with long-term unexplained infertility who have not been able to get pregnant with other treatments.
- Intracytoplasmic sperm injection (ICSI). In this procedure, a single sperm is injected directly into an egg. This method is most commonly used to help with male factor infertility problems.
- Gamete intrafallopian transfer (GIFT). This involves using a fiber-optic instrument called a laparoscope to guide the transfer of unfertilized eggs and sperm into the woman's fallopian tubes through small incisions in her abdomen. GIFT is only used in women with healthy fallopian tubes.
- Zygote intrafallopian transfer (ZIFT). This involves fertilizing a woman's eggs in the lab. Then the laparoscope guides the transfer of the fertilized eggs (zygotes) into her fallopian tubes. ZIFT is only used in women with healthy fallopian tubes.
- Donor eggs. This involves transferring an embryo from a donor to an infertile woman. The donor gives up all parental rights to any resulting children. ART using donor eggs is more common in older women. The chance of a fertilized egg implanting is related to the age of the woman who produced the egg. Egg donors are typically in their 20s or early 30s.
- Embryo cryopreservation. In this method, the embryos are frozen for transfer at a later date. This is often used when an IVF cycle produces more embryos than can be transferred at one time. The remaining embryos can be transferred in a future cycle if needed.
There is a range of treatment choices available for male factor infertility. Treatment may include:
- Assisted reproductive technologies (ART). This type of treatment may include:
- Artificial insemination. This involves placing large numbers of healthy sperm either at the opening of the cervix or directly into the woman’s uterus.
- IVF, GIFT, and other techniques. These have been used for the treatment of male infertility. As is the case with artificial insemination, IVF and similar techniques offer the chance to prepare sperm in a lab. In the lab, the eggs are exposed to the best concentration of high quality, motile sperm.
- Microsurgical fertilization (microinjection techniques, such as intracytoplasmic sperm injection, or ICSI). For this treatment, a single sperm is injected into an egg. Fertilization then takes place under the microscope.
- Medicine therapy. A few infertile men have a hormone problem that can be treated with hormone therapy. Hormone imbalances caused by a problem with the hypothalamus, the pituitary gland, and the testes directly affect the development of sperm. Medicine therapy may include gonadotrophin therapy, antibiotics, or another medicine.
- Surgery. Surgery for male infertility is done to repair anatomical problems that impede sperm production and maturation or ejaculation. Surgery to remove varicose veins in the scrotum (varicocele) can sometimes improve the quality of sperm.