Fertility Treatment Options
So we’ve taken a look at what it takes to conceive naturally. We’ve had a look at what sort of problems that can occur both in the male and the female, which impact on the chances of natural conception. And we’ve also looked at some of the tests and diagnostics that can be done to investigate a couple that is struggling to conceive.
But what happens beyond natural conception if it’s not happening within a certain timeframe? There are, of course, a number of fertility treatments available to us. We often move through fertility treatments for couples, looking at the individual problems affecting them, and then also looking at each treatment individually and its chances of success. It’s also looking at the cost and the big picture of the patient themselves in front of you. How old the patient is, how good their ovarian reserve is, and also previous history in their medical history and fertility history is really, really key to making the right decision.
For a patient who’s not releasing their eggs reliably, such as polycystic ovaries, ovulation induction by taking some simple tablets such as Clomiphene, or Letrozole, may be a very simple fix for that patient and increase their chances significantly of natural conception occurring. But if a patient, for example, has blocked tubes, natural conception is not going be an option. And IVF has actually originated from the need to bypass the fallopian tubes, to collect eggs and in a laboratory allow eggs to fertilize and create and culture embryos for transfer back into the womb. IVF has evolved over the last 40 years into a highly successful treatment, but it’s quite invasive and it’s also quite costly.
Before a patient undergoes IVF, traditionally they might have been undertaken intrauterine insemination treatment. Insemination treatment will generally involve washing and preparing sperm and then inseminating it into the. womb at the correct time of the cycle when ovulation has taken place. But the success rates of this have been surpassed by IVF over the last 10 years, and less of this is undertaken.
But in same sex, female couples, donor insemination is a key treatment that is undertaken as a first line and in fact, men who have no sperm in the ejaculate or indeed single ladies trying to conceive a baby for the first time may undertake donor insemination. So using donor sperm or indeed donor eggs may well make fertility treatment possible for people who are lacking in sperm or eggs for various reasons.
Beyond IVF, IVF allows us to create embryos, but some patients won’t return those to the their own uterus. They may be used within a surrogate, a same-sex male couple will require IVF to be taken using donor eggs, creating embryos, and replacing those embryos within a gestational carrier and a surrogate. There are huge legal implications of doing so, and of course that would need to be gone through very carefully with your fertility specialist.