by Dr. Ricardo Yazigi, MD
Many couples assume that infertility treatment always leads to In Vitro Fertilization, or IVF. In reality, the most advanced fertility interventions are reserved for only a relatively small number of infertile couples, and rarely the first course of treatment.
Many Common Diagnoses Have Low Tech Fertility Treatment Options
With fertility care, most patients will begin with low tech treatment and a plan that is individualized according to the underlying cause of their disorder.
As an example, a common cause of infertility is Ovulatory Dysfunction. It affects as many as 40% of infertile women and the disorder has a spectrum ranging from erratic ovulatory cycles to complete lack of ovulation. The treatment for this common disorder is based on a medication taken by mouth for some 5 to 7 days. It is called Clomiphene Citrate. The drug stimulates the growth and maturation of eggs which culminates in the ovulatory event. In some instances the medication used is injectable. It serves the same purpose. The specialist will advise the couple on the optimal time for sexual intercourse in order to increase the chances of pregnancy. For this, a variety of means are utilized, ranging from intercourse on alternate days around the expected day of ovulation, to monitoring the progression of the cycle with vaginal ultrasounds and blood tests for a more precise timing. The vast majority of women with ovulatory dysfunction will respond to treatment and the chances of pregnancy will approach those of the standard population.
Another relatively common cause of infertility is that due to Male Factor. This means that the sperm count or motility (the number of actively moving sperm) may be decreased. It affects about 40% of infertile couples as well. Although in severe cases couples may require advanced treatments, many times it is quite possible to use less aggressive treatment, such as Intrauterine Insemination (also called Artificial Insemination). This relatively simple procedure consists of introducing the sperm inside of the uterus at the time of ovulation. The process is quick and painless. It is done in the office and the woman may resume her normal activities immediately after.
In about 10% of infertile couples, the underlying cause cannot be precisely determined with the tests that are currently available. These couples are said to have Unexplained Infertility. In these cases, the initial stages of treatment are also relatively simple and they are a combination of the two techniques explained above: Clomiphene Citrate (or an injectable medication) to induce ovulation, along with intrauterine insemination. The chances of pregnancy may be slightly lower than those of the normal population, but are still quite acceptable.
Rarely are two cases of infertility exactly the same. That’s why it’s important to undergo a consultation with a specialist and complete a comprehensive infertility evaluation before making any assumptions on the type of treatment necessary.
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