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Fertility Treatments

Overview: Approximately 15-percent of women are infertile. Women are considered infertile if they have been unable to get pregnant after 12 months of unprotected intercourse. The first step is to have an evaluation done by your obstetrician for causes of infertility.

 

What options are available for fertility treatment?

Your treatment options depend on the cause of infertility. Here is an overview of treatments that are offered.

  • Surgery for blocked or damaged fallopian tubes. If the fallopian tubes are severely damaged, you may need to have IVF to achieve pregnancy.
  • Correction of hormonal problems such as thyroid or prolactin hormones
  • Ovulation induction: use of drugs to promote the release of an egg. This is useful when ovulation is irregular or other causes have been ruled out.
What medications are used for ovulation induction?

The two most common medications are Clomiphene Citrate (Clomid) and Letrozole. Both of these medications can be used for 6 cycles before alternate treatment should be considered.

  • Clomiphene Citrate: stimulates hormone production to cause ovulation of one or more eggs. Approximately 40% of women will become pregnant within 6 cycles with clomiphene citrate. Side effects include hot flashes, breast tenderness, mood swings. Clomiphene citrate does increase the risk for multiple pregnancies. The risk of twins is approximately 10%. Triplets are more occur less than 1% of the time.
  • Letrozole: stimulates hormone production to cause ovulation. This usually causes release of 1 egg so the risk of twin pregnancy is < 7%. Side effects are minimal.
  • Injectable gonadotropins: These medications typically cause ovulation of many eggs. This is used for IVF or in a controlled environment for timed intercourse or artificial insemination. The risk of multiple pregnancies is much higher, up to 30% of cycles. Of those 2/3 are twins, 1/3 are triplets or more. If too many eggs are developing, your doctor may stop the cycle and encourage you to use condoms until the next month to avoid pregnancies complicated by triplets or more. Risks of gonadotropins include possibility of ovulation hyperstimulation syndrome which can cause serious medical problems and may even require hospitalization.
 
What is Intrauterine Insemination (IUI)?

Intrauterine insemination, or “artificial insemination” as it is commonly called is a procedure where healthy sperm are placed in the uterus at the time of ovulation to increase pregnancy rates. To do this, the sperm is collected, washed with special solutions and then placed into the uterus through a small tube. This procedure is used when the semen analysis shows abnormalities or to augment ovulation induction to increase pregnancy rates. We now offer IUI at our Waukesha location. Talk to your provider if you have further questions or to see if IUI is an option for you.

What is In Vitro Fertilization (IVF)?

In Vitro Fertilization is a process that is typically managed by a reproductive endocrinologist. The need for IVF depends on the reason for infertility and whether other less invasive procedures have not resulted in pregnancy.

In this procedure, women are given hormones to stimulate the production of many eggs. These eggs are then removed from the ovaries through a needle in the back of the vagina. Sedation is offered for this procedure. After the eggs are retrieved, they are fertilized with your partner’s sperm. The fertilized eggs, known as embryos, are then grown in a lab for up to 5 days. After this point, one or more embryos are placed into the uterus through the vagina. This is called an embryo transfer.

The risk of IVF includes multiple pregnancy (twins or more), ovulation hyperstimulation syndrome related to hormones given and possible increased risk of birth defects.

The cost of IVF varies on where you seek treatment but typically costs more than $10,000.

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