If you've been struggling to get pregnant, you're not alone. As much as 12% of American women of childbearing age struggle with infertility issues. In the United States, 7% of couples who are married have reported that they were not successful after 12 months of trying to get pregnant — doctors define this as infertility. Fortunately, the medical field has made great strides in providing infertility treatments for couples who want to start or grow their family.
In order for a woman to get pregnant, she must release a healthy egg from her ovaries (ovulation), which must be able to travel through the fallopian tubes without impediment. This egg must be fertilized by her partner's sperm and be implanted into the uterus. While this process may seem simple, there are many problems and complications that can affect even one step, causing infertility. For women, the problem is most often due to ovulation — they're either not ovulating, or ovulating irregularly due to health factors, illness or hormonal imbalance. The problem may occur in the fallopian tubes due to damage by congenital defect, illness or sexually transmitted disease. If the infertility problem lies with the man, he may have problems with the quantity or the quality of his sperm.
Your infertility problem may range from a simple explanation due to lifestyle choices such as obesity, drinking, smoking and stress to more complicated medical problem. In some cases, you may be able to avoid infertility treatments altogether by following a doctor's advice in getting healthier, and thus, improving your fertility.
Once your doctor has gone through the battery of tests to determine the fertility issue you are experiencing, he or she may start infertility treatment using the drug clomiphene which may also be known by the brand names, Serophene, Milophene, and Clomid. This is often used when ovulation is the primary reason for infertility. Taken in pill form, clomiphene helps to stimulate the ovaries to release an egg. If this is the only problem, fertilization may take place naturally, once the woman begins to ovulate normally. This infertility treatment is inexpensive and is often the first step in treating infertility. It does have some side effects, such as weight gain, nausea and bloating, and carries a higher risk of multiples, as more than one egg may be released at a time.
Ovulation may not be occurring due to polycystic ovary syndrome (PCOS). If this is the case, the doctor may prescribe clomiphene along with metformin to stimulate ovulation.
If clomiphene does not work, your doctor may decide to prescribe injected hormones, which requires a lot more dedication, time and tolerance to side effects. You will have to have shots every day, beginning at the start of your menstrual cycle. As with clomiphene, you may experience nausea, bloating and in addition, ovarian cysts. One risk is the increased chance of multiples.
A woman's fallopian tubes may be scarred or damaged, making it difficult or impossible for the egg to travel through it. Tubal surgery may be utilized as an infertility treatment, and it does have a 20-60% success rate, resulting in an eventual pregnancy. When fallopian tubes are damaged due to endometriosis, your doctor may be able to laparoscopically remove the growth(s) of endometrial tissue from the tubes. Unfortunately, if there is extensive blockage, the fallopian tubes may not be repairable, and the couple must resort to more complicated infertility treatments.
When the fertility problem lies with the man, artificial insemination may be useful if there is a problem with sperm count or ejaculation. In rare cases, retrograde ejaculation causes the sperm to be expelled into the bladder than out through the penis. This wayward sperm can be removed from the bladder and used. In cases of low sperm count, several collections of sperm may be concentrated to create a denser batch of sperm which may then be inseminated into the woman. In some cases, a man may need hormone treatments to counteract a hormonal imbalance to kick start sperm production. If the quality of the sperm is an issue, then couples may have to resort to using donated sperm.
If the above infertility treatments are not successful, your doctor may turn to the array of infertility treatments available as part of Assisted Reproductive Technology (ART), which has been in use since 1981. This includes artificial insemination, where sperm is artificially introduced into the uterus in the hopes of fertilization. Intracytoplasmic sperm injection (ICSI) is a procedure where a doctor injects sperm directly into an egg, then if the egg is fertilized, into the uterus. One of the most popular and successful infertility treatments is in vitro fertilization (IVF), where eggs are harvested from the ovaries then fertilized by sperm artificially. Fertilized eggs are then implanted into the uterus in the hopes that they'll "take."
IVF is a costly, time consuming and labor intensive undertaking. It requires numerous blood tests, hormone injects every day as well as an extreme emotional investment. For one in three women, the painful injections, weight gain and nausea is worth it when they get pregnant. It does however, carry an increased risk of multiples as several embryos are implanted at one time, all of which can result in a baby. Within IVF, there are several options. Couples may use any combination of their own eggs and sperm, or those of donors. Donated embryos are even available for couples who cannot use their own.
Couples struggling with infertility have more options than ever, so it is important to do your homework: research your condition, choose a competent doctor and don't give up the fight — it will be worth it in the end!